Contesting and Deploying Uncertainty: Negotiations of Contraceptive Use in the Clinical Encounter

• In Event: 243 - Regular Session. Health Care and Care Delivery

Abstract

Hormonal contraception has been celebrated as one of the most important technological inventions of the 20th century. Despite improvements in contraceptive technology, however, science cannot eradicate the uncertainty inherent in predicting women’s experiences with side effects. In this study, we draw on a unique dataset of 102 audio recordings of contraceptive counseling visits to understand how clinicians navigate uncertainty as a social process. We show that clinicians deal with the unknown when discussing concerns about highly effective birth control by contesting and deploying uncertain information. When counseling women on choosing a method, clinicians contest uncertainty by describing the low risk of experiencing serious side effects as negligible and controllable, deploy uncertainty by suggesting that women will more likely experience common positive side effects than common negative side effects, and gain control by negotiating the content of uncertain information. Our results demonstrate the importance of establishing conceptual frameworks for examining uncertainty as a social process, highlighting the need to consider how medical uncertainty is translated, instantiated, and constructed during interaction—both in theory and in practice.

Authors

• Krystale Littlejohn, Occidental College

• Katrina E. Kimport, University of California, San Francisco