Abstract
Maternity care in Ireland has been described as a ‘testament to the strength and influence of the medical profession' (Mc Kee 1986: 192). A review of maternity and gynaecology services in the Dublin area in 2004 revealed that ‘no participant…thought that the maternity services were women centred at the time' (Women's Health Council, 2007, Review of the gynaecology and maternity services in the greater Dublin area). Meanwhile, current Department of Heath policy aims to deliver ‘woman centred' maternity care as a means to ensuring the well being of Irish women (Department of Justice, Equality and Law Reform 2007, National women’s strategy 2007–2016. Dublin: Stationery Office). This paper deploys Frame Analysis in order to show how maternity policy is articulated in the face-to-face interaction of a midwives' ante-natal clinic. Drawing on the interactive notion of frames and knowledge schemas (Goffman 1967, Interaction ritual: Essays on face to face behaviour. New York: Pantheon; 1981, Tannen and Wallat 1993), the analysis shows how current maternity policy is articulated linguistically in the context of a midwives' ante-natal clinic. Several frames are intertwined in the talk: examination frame, reporting frame, socio-relational frame. The frames can be identified with reference to question- answer- comment/next question exchange structures, and a conversational register. Frame switches are accomplished by both the women and the midwives. The medical model of pregnancy and birth prevails in the interactions. The analysis also shows how women attempt to articulate their perspectives on pregnancy and birth through the alignments they take up in the talk that occurs and through their ability to frame switch gracefully.Resistance to current policy occurs occasionally and fleetingly, instigated by women's introduction of a birth plan or by recommendations of the midwife. Resistance is a delicate undertaking and ultimately the medical perspective that prevails in the face-to-face interaction while alternative perspectives are heard as whispers that are easily silenced. Close analysis of how policy is enacted and resisted in face-to-face interaction in this health care context is important for enabling change to take place.
Similar content being viewed by others
References
Bateson, G. (1978). Steps to an ecology of mind. UK: Paladin.
Cuidiú Irish Childbirth Trust. (2008). Consumer guide. http://www.cuidiu-ict.i.e/frulcrum.html?ep=13&ad=23&to=0 Accessed 31 October 2008.
Department of Health and Children. (1997). Report of the maternity and infant care scheme review group. Dublin: The Stationery Office.
Department of Justice, Equality, Law Reform. (2007). National women’s strategy 2007–2016. Dublin: Stationery Office.
Devane, D., Murphy-Lawless, J., & Begley, C. (2005). Childbirth policies and practices in Ireland and the journey toward midwifery-led care. Midwifery, 23, 92–101.
ESRI and Department of Health, Children. (2005). Report on perinatal statistics for 2001. Dublin: HIPE and NPRS Unit, ESRI.
Fisher, S., & Groce, S. (1990). Accounting practices in medical interviews. Language in Society, 19, 225–250.
Gilson, L., & Raphaely, N. (2008). The terrain of health policy analysis in low and middle income countries: a review of published literature 1994–2007. Health Policy and Planning, 23, 294–307.
Goffman, E. (1967). Interaction ritual: Essays on face to face behaviour. New York: Pantheon.
Goffman, E. (1986). An essay on the organisation of experience. Boston: North-eastern University Press.
Harper, C., Platt, E., Naranjo, C., & Boynton, S. (2007). Marching in unison: Florida ESL teachers and no child left behind. TESOL Quarterly, 41(3), 642–651.
Heritage, J., & Robinson, J. (2006). Accounting for the visit: Giving reasons for seeking medical care. In J. Heritage & D. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 48–85). UK: CUP.
Hornberger, H., & Cassells-Johnson, D. (2007). Slicing the onion ethnographically: Layers and spaces in multilingual language education policy and practice. TESOL Quarterly, 41(3), 509–532.
Hutchby, I. (1999). Frame attunement and footing in the organization of talk radio openings. Journal of Sociolinguistics, 3(1), 41–63.
Kennedy, P., & Murphy-Lawless, J. (1998). Risk and safety in childbirth: Who should decide? In P. Kennedy & J. Murphy-Lawless (Eds.), Returning birth to women: Challenging policies and practices (pp. 2–9). Dublin: Centre for Women’s Studies T.C.D. and W.E.R.R.C. U.C.D.
Martinez, G. (2008). Language-in-healthcare policy, interaction patterns and unequal care on the U.S.-Mexico border. Language Policy, 7, 345–363.
Millar, S. (2009). School of nursing and midwifery. Dublin: Trinity College. Personal communication.
Murphy-Lawless, J. (1987). Women and childbirth: Male medical discourse and the invention of female incompetence. Ph.D. Thesis, T.C.D.
Murphy-Lawless, J. (1998). Reading birth and death: A history of obstetric thinking. Cork: Cork University Press.
Omoniyi, T. (2007). Alternative contexts of language policy and planning in sub-Saharan Africa. TESOL Quarterly, 41(3), 533–549.
Parmar, F. (2007). Transforming language policies to make more room: Reflections from a principal of a college Ahmedabad, Gujarat, India. TESOL Quarterly, 41(3), 557–561.
Ramanathan, V., & Morgan, B. (2007). TESOL and policy enactments: Perspectives from practice. TESOL Quarterly, 41(3), 447–463.
Ricento, T. (2006a). Theoretical perspectives in language policy: An overview. In T. Ricento (Ed.), An introduction to language policy: Theory and method (pp. 3–9). London: Blackwell.
Ricento, T. (2006b). Language policy: Theory and practice: An introduction. In T. Ricento (Ed.), An introduction to language policy: Theory and method (pp. 10–23). London: Blackwell.
Ricento, T., & Hornberger, H. (1996). Unpeeling the onion: language planning and policy and the ELT professional. TESOL Quarterly, 30(3), 401–427.
Robinson, J. (2006). Soliciting patients’ presenting concerns. In J. Heritage & D. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 22–47). UK: CUP.
Romero-Little, M. E., McCarty, T. L., Warhol, L., & Zepeda, O. (2007). Language policies in practice: preliminary findings from a large scale national study of Native American language shift. TESOL Quarterly., 41(3), 607–618.
Shohamy, E. (2006). Language policy: Hidden agendas and new approaches. London: Routledge.
Tannen, D. (1993). Introduction. In D. Tannen (Ed.), Framing in discourse (pp. 1–13). Oxford: OUP.
Wang, J. (2006). Questions and the exercise of power. Discourse and Society, 17(4), 529–548.
Wodak, R. (2006). Linguistic analyses in language policies. In T. Ricento (Ed.), An introduction to language policy: Theory and method (pp. 170–193). London: Blackwell.
Women’s Health Council. (2007). Review of the gynaecology and maternity services in the greater Dublin area. Dublin: WHC.
Wren, M. A. (2003). Unhealthy state: Anatomy of a sick society. Dublin: New Island.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
O’Malley, MP. ‘So either you have a foetal monitor or you have your waters broken, basically is it?’: Articulating maternity care policy at a midwives’ ante-natal clinic. Lang Policy 9, 87–96 (2010). https://doi.org/10.1007/s10993-009-9152-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10993-009-9152-9