Self-Initiated Problem Presentation in Prenatal Checkups: Its Placement and Construction

Abstract

Unlike primary care acute visits, which are occasioned by a matter of concern to the patient, regular prenatal checkups provide no structural positions for presenting problems that they wish to discuss. I find that there does nevertheless seem to be a systematic sequential position (namely, where an incipient activity is in progress) at which pregnant women can and do raise their concerns. I examine the defensive and evidence-sensitive nature of the construction of the problem presentations initiated at this position. I thereby demonstrate the mutual dependence between the position and construction of problem presentations. The position and construction of presentations are consequential to the way in which health-care professionals respond to them; they may engender a cycle where the pregnant woman (re)attempts to legitimize her original problem presentation and the health-care professional (re)attempts to confirm her or his no-problem response. In conclusion, I discuss some implications of the present study for the study of medical interaction in particular and the study of human interaction in general.