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

BACKGROUND National sexual health frameworks in the UK advise that women in maternity units who are at risk of unintended pregnancy should receive contraceptive advice and supplies of the most effective long-acting reversible methods of contraception (LARC). In the UK, midwives currently deliver contraceptive advice to women following childbirth. There is a lack of information on how midwives currently view their role as provider of contraceptive advice and how they would feel about expanding this to include provision of LARC. OBJECTIVE To explore midwives' experiences and views of giving postpartum contraceptive advice and of possible expansion of role to include provision of LARC. 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.