Exploring the relationship between communication, experience and outcome for Black pregnant women receiving midwifery antenatal care: a conversation analytic study.
The relationship between communication, experience and outcome for Black women receiving midwifery antenatal care
The research design will combine a detailed analysis of the language used in antenatal appointments between Black pregnant women and white midwives, with a complementary analysis of the pregnant women participants’ subjective experiences of this communication and their satisfaction with any decisions made during the appointment. Data collection 1 – Observational data The research team aim to video or audio record 20-30 antenatal appointments between Black pregnant women and white midwives collecting observational data for conversation analysis. Audio-visual recording is preferable to capture non-verbal communication, which is known to be a commonly used channel for affective behaviours or displaying emotion. However, pregnant women who do not wish to consent to audio-visual recording could consent to audio-only recording as an alternative. Midwives will not have the option to consent to audio-only recordings, as this would preclude any pregnant women participants in their care from selecting to be video-recorded Data collection 2 – Short questionnaire Immediately post appointment, pregnant women participants will be asked to complete a short (maximum 15-question) Likert scale questionnaire probing their experience of communication, wider experience, assessment of outcomes, and assessment of the salience of the race of either midwife or pregnant woman during the appointment. Completing this is expected to take between 2 and 8 minutes. Data collection 3 – Semi-structured qualitative interviews After a period of a minimum of 24 hours following the appointment, pregnant women participants who have consented will take part in a qualitative interview. This will allow for a period of reflection and may uncover different subjective truths to those captured in the contemporaneous data. The interviews will probe the same subject areas as the short questionnaire but be semi-structured to allow space for participants to explore their independent thoughts and observati
This research has two distinct participant groups with two different inclusion criteria. Pregnant people participants: 1. Black pregnant women or birthing people receiving antenatal care at a participating site with a participating midwife 2. Black identity will be determined by self-identification as any of the following racially characterised ethnicities on their NHS ethnicity data, as indicated on their consent form: Black or Black British - African, Black, or Black British - Caribbean, Black or Black British – Any other Black background, Mixed - White and Black Caribbean, Mixed – White and Black African 3. Attending a routine antenatal appointment from the booking appointment to the 40-week appointment Midwife participants: 1. White midwives delivering antenatal care at a participating site 2. White identity will be determined by self-identification as White - British, White - Irish or White – any other White background, as indicated on their consent form
Pregnant people participants: 1. Pregnant women or birthing people who do not meet all the inclusion criteria, e.g., pregnant people with other racially characterised ethnicities 2. Pregnant people who require a formal or informal interpreter during their appointment 3. Pregnant people with impaired capacity to consent, who require support to access antenatal care or make decisions about their care 4. Pregnant people under the age of 18 years 5. Pregnant people attending a non-routine or 41- or 42-week appointment Midwife participants: Participants who do not meet the inclusion criteria