Asking About Violence in Antenatal Care: How Wording and Timing Shape Response Opportunities

Routine enquiries about violence in antenatal care are recommended in many countries, yet little is known about how such questions are designed in practice and how different ways of asking may shape pregnant women's opportunities to respond. This study examines how midwives ask about violence in Norwegian antenatal care consultations. These data comprise 35 video- and audio-recorded first and second antenatal consultations with eight midwives, of which 20 included routine enquiries about violence. Using conversation analysis, we identified four recurring question formats: bare category questions, post-answer specifications, within-question specifications and concrete-act questions. Bare category questions treated violence as a self-evident gloss and commonly occasioned minimal, sequence-closing denials. Post-answer specifications introduced clarification only after an initial denial, thereby reinforcing the answer rather than reopening the enquiry. Within-question specifications progressively unpacked the category of violence before a response was required, making narrative or transformative responses relevant next actions. Concrete-act questions avoided category labels altogether and instead invited responses to specific behaviors, supporting uptake based on lived experiences. Taken together, the findings show that routine violence enquiry cannot be understood as a uniform yes/no screening item: rather, whether, how, and when "violence" is specified or described through word selection may influence what types of responses become relevant. The study contributes to health-communication research by demonstrating how guideline-recommended questioning is accomplished turn by turn and discusses implications for communication training and policy implementation in antenatal care.