Laughter as a 'serious business': Clients' laughter in prenatal screening for Down's syndrome

Abstract

In this chapter we build on our previous research on laughter as an interactional resource that is regularly employed by healthcare professionals (Zayts and Schnurr, 2011) and examine instances of patient-initiated laughter. There is a substantial body of research on patient laughter (e.g. West, 1984, Aleswärd, 1989; Haakana, 2001) that has shown that in healthcare contexts it is typically patients who laugh and that their laughter performs various interactional functions. These studies, however, have been conducted among native English-speaking patients and laughter as a non-verbal interactional resource employed by non-native speaking patients has not yet received systematic attention in the literature. The data that we examine in this chapter comes from a large scale project on prenatal screening for Down’s syndrome. In Hong Kong where we collected these data, pregnant women are referred for prenatal screening as part of their routine prenatal care. Our corpus includes 75 audio- and video-recorded interactions with women from over 20 countries. The healthcare professionals are Hong Kong Chinese, and the consultations are conducted in English. Using an interactional sociolinguistic approach we examine sequences of patient-initiated laughter and discuss the various functions that laughter performs in these interactional contexts. In particular, we show that laughter contextualizes “specific constraints and delicate issues” (Haakana, 2001) that the patients are dealing with in the specific context of prenatal screening, including the women’s psychosocial concerns and constrained socioeconomic circumstances that may prevent them from having a child with Down’s syndrome. In the context where termination of pregnancy is the only ‘medical intervention’ available to these women, laughter allows the participants to engage in negotiating and resolving these delicate issues in spite of their sometimes limited language proficiency.