An observation of midwives’ health behaviour change language
Research type
Research Study
Full title
An observational study of the language used by midwives in health behaviour change interactions within the antenatal booking appointment.
IRAS ID
336985
Contact name
Hannah Talbot
Contact email
Sponsor organisation
University of Manchester
ISRCTN Number
ISRCTN89652750
Clinicaltrials.gov Identifier
ISRCTN Registry, ISRCTN89652750
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
In pregnancy, women often engage in poor health behaviours, such as smoking, alcohol consumption, poor diet, lack of physical activity and non-adherence to vaccination, which contribute to adverse pregnancy outcomes. Pregnancy has been identified as a Teachable Moment, as it is a life event that presents an opportunity for health behaviour change. As the primary maternity care provider for most women, midwives are in an optimal position to support women with this behaviour change. However, midwives find these conversations challenging and de-prioritise them in clinical practice. The success of behaviour change conversations is impacted by the health professional’s communication and more specifically, the language that they use. Evidence has shown that language is powerful within midwife-woman interactions, however, research has not yet explored the language used by midwives when discussing health behaviours. Therefore, the current research aims to explore the language used by midwives in health behaviour change discussions. Participants of the study will be midwives and pregnant women in the antenatal booking appointment in hospital and community antenatal clinics. The appointment, which typically lasts one hour, will be observed and audio-recorded. The data on midwives’ language will be analysed using qualitative methods and it is hoped that areas to target for improvement can be identified and an intervention developed.
Summary of results
Results: Health behaviour change was routinely discussed in the booking appointment, but to varying extents. BECCI scores indicated that behaviour change counselling was conducted “To some extent”. Qualitative content analysis of midwives’ communication behaviours revealed that midwives were skilful behaviour change communicators, able to knowledgably provide information, individualise support and navigate sensitive topics.
However, some of their communication behaviours suggested that pregnancy health behaviour taboos persist, specifically relating to typically stigmatised behaviours, such as; weight management, alcohol and substance use, mental health and partners’ smoking. With these behaviours, midwives often acknowledged the delicate nature of the topic, focused on risk avoidance in favour of health promotion and overlooked women’s disclosures.
Conclusion: Health behaviour change is routinely and skilfully discussed in the antenatal booking appointment. However, there are opportunities to improve midwives’ communication when discussing certain health behaviours, so that midwives may continue to positively improve the health of women and their families.
Practice implications: Educational interventions underpinned by psychological theory may be an effective way to support midwives to communicate about stigmatised health behaviours without assumptions, with a focus on positive health promotion and capitalising on women-initiated conversations where motivation may be high.REC name
London - Bromley Research Ethics Committee
REC reference
24/LO/0693
Date of REC Opinion
24 Oct 2024
REC opinion
Further Information Favourable Opinion