J Fam Plann Reprod Health Care 2014 Feb 5. doi: 10.1136/jfprhc-2013-100770

Midwives experiences and views of giving postpartum contraceptive advice and providing long-acting reversible contraception: a qualitative study

McCance K and Cameron S

Abstract

Objective To explore midwives' experiences and views of giving postpartum contraceptive advice and of possible expansion of role to include provision of LARC [long-acting reversible contraception].

Methods: Semi-structured, audio-recorded interviews were carried out with 12 midwives involved in the postpartum care of women in Edinburgh, Scotland, UK. Interviews were transcribed verbatim and analysed using thematic analysis.

Results: Midwives confirmed that they all routinely give contraceptive advice, but that this was mostly cursory. They viewed this part of their job as of lesser importance and one that they felt inadequately trained for. Many barriers to discussing contraception were identified including lack of time and privacy, or mothers being preoccupied with concerns about their baby. Midwives expressed concern about taking on a greater role in giving contraceptive advice or providing LARC, given their current heavy workload.

Conclusions: Midwives require ongoing training and support to be effective in their current role as provider of contraceptive advice. Better links between midwifery and specialist sexual and reproductive health services should therefore be encouraged, particularly if a midwife's role is expanded to include provision of contraception such as LARC.

Comment: When it comes to long-acting reversible contraception, midwives are able to provide this; however, they must be regularly trained and receive feedback and follow-up from a specialized clinician. (Hans Vemer)