Paper short abstract:

How do healthcare professionals navigate the logics of specialization and care in antenatal care? Through ethnographic fieldwork at an outpatient clinic, we explore ethical negotiations as health providers are caught between logics.

Paper long abstract:

This paper examines how healthcare professionals in the Danish antenatal care system navigate the interplay between the logics of specialization and care. These logics present distinct opportunities and challenges in caring for pregnant persons with diabetes, who have been categorized as socially vulnerable. While specialization enhances precision in medical practice, it often fragments care, creating gaps that patients and care providers must navigate. Conversely, normative ideals of "care," emphasizing holistic, patient-centered approaches, may generate ethical dilemmas and tensions within specialized frameworks.

Based on ethnographic fieldwork in an outpatient clinic for pregnant persons with diabetes, we analyze how healthcare professionals act as navigators and negotiators of these logics. We highlight their dual responsibility: delivering specialized care while addressing patients' broader, holistic needs that often fall outside rigid protocols. Our analysis shows how professionals, often isolated within their specializations, reconcile these competing logics through ethical decision-making and relational care, bridging gaps left by specialization. Although designed for precision, the organizational environment often undercuts integrated care, leaving providers with conflicting obligations.

This study highlights how navigating the interplay between specialization and care is essential for addressing systemic gaps, offering insights into improving equitable and integrated care in complex healthcare systems.