Interprofessional and intersectoral collaboration in the care of vulnerable pregnant women: An interpretive study

ABSTRACT

‘Vulnerable’ is a term often used for pregnant women in need of extended antenatal care, although the term is not well defined. This study focuses on healthcare professionals’ interpretations and understanding of vulnerability in pregnancy, including their own role, to understand the practices of interprofessional and intersectoral collaboration in antenatal care for vulnerable pregnant women. Intrepretive Description informed the methodology of the study and the theoretical framework was inspired by Symbolic Interactionism. It was found that definitions of vulnerability in pregnancy are fluid, being based on the healthcare professional’s individual assessment of the pregnant woman´s personal resources, personal characteristics and psychological factors, and that these definitions also depend on the healthcare professional’s role in relation to the pregnant woman. The different interprofessional teams’ identification of what constitutes vulnerability in a pregnant woman was complex and relied on different components. Interprofessional collaboration was influenced by the relationships between professionals and sectors involved in antenatal care for pregnant women and was thereby influenced by the settings and structures in place for interprofessional and intersectoral collaboration. Insight into the healthcare professionals’ perspectives of vulnerability in pregnancy can help develop and improve the interprofessional and intersectoral collaboration in antenatal care of vulnerable pregnant women and their unborn babies.

KEYWORDS:

• Vulnerability
• pregnancy
• antenatal care
• collaboration
• identity

KEYWORDS:

• Vulnerability
• pregnancy
• antenatal care
• collaboration
• identity

Declaration of interest

The authors report no conflicts of interests. The authors alone are responsible for the content and writing of this article.

Notes

1. In Denmark, midwives have a bachelor degree, which is separate from that of other healthcare professionals.

2. In this study, the nurses were included in the interprofessional teams because of the role as providing care for vulnerable women at the maternity unit.

3. In Denmark, a General Practitioner is a doctor working in general practice in the community. Everyone in Denmark has an assigned GP and every pregnant woman has at least two scheduled consultations with the GP during pregnancy. The GP has a responsibility to inform the hospital if they have any concerns for the pregnant woman and her unborn child.

4. In Denmark, a health visitor is a nurse, who has a specialist education with a focus on carrying health promotion and disease prevention tasks in relation to children, adolescents and their families. The health visitor is employed by the municipality.

Additional information

Notes on contributors

Karina Klode

Karina Klode is nurse and Master of Health Science. She is working in Psychiatry, Region Zealand, Denmark and have an interest in vulnerable populations.

Agnes Ringer

Agnes Ringer is a clinical psychologist and researcher at the Centre for Health Promotion Research at Roskilde University, Denmark. Her research interests include discourses surrounding mental health, institutional and professional identities in mental health as well ethnographic research methods.

Bibi Hølge-Hazelton

Bibi Hølge-Hazelton is professor of nursing at University of Southern Denmark and Zealand University Hospital, Denmark. Currently she is in charge of a Capacity Building research program and a research program concerning recruitment and retention of nurses.