Between Biomedical Orders and Muslim Faith Discourse: Midwives’ Scale-Shifting Practices in Kano-Nigeria Labour-Room Interactions

Research in maternity communication has largely overlooked how Muslim-faith discourse shapes midwifery interactions in northern Nigeria. To address this gap, we collected audio recordings of naturally occurring interactions in a Kano labour ward and used Blommaert's Sociolinguistic Scale Theory with Kretzschmar's Dynamic System Theory with conversation analysis to analyse how midwives negotiate authority, manage patient anxiety, and foster resilience by invoking Islamic faith alongside medical instructions. Our findings revealed that midwives fluidly interweave biomedical instructions and Islamic supplications into a unified process of care, thereby modulating their talk (scale-shifting) at each contraction. We showed, for example, that a midwife may punctuate a medical directive with a brief prayer or reassurance before resuming her instructions, carefully timing turns, silences, repairs and supplications to manage fear and sustain cooperation. In this way, labour-ward talk becomes an adaptive, multi-layered communication in which clinical, emotional and spiritual forces are continuously renegotiated. We thus treated sociolinguistic scale as an observable dynamic process and framed intrapartum communication as a complex dynamic system. In practice, we suggested that midwifery training should explicitly recognise the therapeutic role of religiously situated speech alongside clinical expertise (a context-sensitive model of care) which would make childbirth safer and more emotionally bearable.