Risk and decision-making: Communication between health professionals and pregnant women at risk of preeclampsia in Catalonia

Mariana Campos Lichtsztejn, Anna Molas Closas and Joan Pujol-Tarrés

Social Science & Medicine, 2025, vol. 367, issue C

Abstract: The biomedical model of attention focuses on preventive risk assessment to mitigate the apparition of future diseases. In the event of a pregnancy classified “at risk” of preeclampsia, screening undertaken in first-term ultrasound controls determines which patients receive preventive treatment. This article examines women's narratives on the communication dynamics with health professionals by drawing on an eight-month ethnographic fieldwork, between 2022 and 2023, in a Barcelona hospital's obstetrics department and 24 semi-structured interviews with women in the postpartum period. The participants of this study had been classified at high risk of developing preeclampsia, which is determined through a screening undertaken during the first trimester of pregnancy, or had a diagnosis of preeclampsia. The results suggest that risk classification significantly impacts the decision-making process and the technical parameters. As we contend, participants experienced difficulties receiving quality information and communicating with professionals, making shared decision-making challenging. As we conclude, doctor-patient dialogue and shared decisions are increasingly replaced by institutional protocols where patients feel their knowledge and experiences have little room.

Keywords: Pregnancy; Risk; Preeclampsia; Decision-making; And female reproductive health (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.117786

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