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Nurses' discourse in contraceptive prescribing: an analysis using Foucault's 'procedures of exclusion'

Hayter, Mark


Mark Hayter


Aim.  This paper is a report of an analysis of the discourse about contraceptive efficacy and side effects used by nurses when prescribing contraception.

Background.  All women seeking contraception should be informed of the efficacy and potential adverse effects of the particular method they are considering. This information facilitates an informed choice. Women also require this information in order to monitor for any side effects. Paradoxically, side effects are also a key factor in reducing adherence with contraceptive regimens. However, there is no literature that explores specifically how this issue is addressed in clinical consultations, or places these practices in a theoretical context.

Method.  Forty‐nine consultations between nurses and women in sexual health clinics were audio‐recorded during 2002. Data were subject to a discourse analysis using Foucault's ‘procedures of exclusion’ to explore the discursive construction of contraceptive efficacy and side effects

Findings.  The nurses employed specific discursive strategies when discussing contraception. When addressing efficacy, discourse centred on medico‐statistical facts, but side effects were described in lay terms that minimized their severity. Nurses contextualized contraceptive side effects within potential problems that women might experience in pregnancy, and also attempted to ‘normalize’ contraceptive‐related problems.

Conclusion.  Discourse and its deployment play a key role in practitioner–client relationships that sexual health nurses need to become more aware of how they discuss clinical issues about contraception with women. Clinical data on contraceptive side‐effects are present in the literature, and it is important that sexual health nurses use this to help women make truly informed decisions.


Hayter, M. (2007). Nurses' discourse in contraceptive prescribing: an analysis using Foucault's 'procedures of exclusion'. Journal of advanced nursing, 58(4), 358-367.

Journal Article Type Article
Acceptance Date Jan 4, 2007
Online Publication Date Apr 17, 2007
Publication Date 2007-05
Journal Journal of Advanced Nursing
Print ISSN 0309-2402
Electronic ISSN 1365-2648
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 58
Issue 4
Pages 358-367
Keywords Contraception; Discourse analysis; Family planning; Foucault; Nursing; Prescribing; Sexual health
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