Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
Present address: School of Health & Social Care, London South Bank University, London, UK.
BMC Pregnancy Childbirth. 2021 Jun 2;21(1):411. doi: 10.1186/s12884-021-03895-2.
Provision of contraception to women in the immediate postnatal period has been endorsed by professional bodies, to reduce the incidence of short inter-pregnancy intervals. This study examined the views of postnatal women and practising midwives regarding provision of contraceptive advice and contraceptive methods by midwives, in a region of the United Kingdom.
A mixed-method approach using qualitative interviews with midwives, and a postnatal survey followed by qualitative interviews with postnatal women, in five hospitals in the East of England. Twenty-one practising midwives and ten women were interviewed. Two hundred and twenty-seven women returned a survey. Survey data was analysed descriptively, augmented by Student's t-tests and Chi-squared tests to examine associations within the data. Interviews were recorded, transcribed and analysed guided by the phases of thematic analysis.
Midwives and women supported the concept of increased midwifery provision of contraceptive advice, and provision of contraceptive methods in the postnatal period. Convenience and an established trusting relationship were reasons for preferring midwifery provision over visiting a doctor for contraception. The best time for detailed discussion was reported to be antenatal and community visits. The Progesterone-only-pill (POP) was the method, in which women indicated most interest postnatally. Concerns for midwives included the need for increased education on contraceptive methods and training in supplying these. Structural barriers to such provision were time pressures, low prioritisation of contraceptive training and disputes over funding.
Women reported interest in midwives supplying contraceptive methods and expressed the view that this would be convenient and highly acceptable. Midwives are supportive of the concept of providing enhanced contraceptive advice and methods to women in their care, and believe that it would be advantageous for women. Institutional support is required to overcome structural barriers such as poor access to continuous professional development, and to allow contraceptive provision to be fully recognised as integral to the midwifery role, rather than a marginalised addition.
专业机构支持在产后立即为妇女提供避孕措施，以减少短妊娠间隔的发生率。本研究调查了英国东部地区的产后妇女和执业助产士对助产士提供避孕咨询和避孕方法的看法。
采用混合方法，对东英格兰五家医院的助产士进行定性访谈，并对产后妇女进行产后调查，随后进行定性访谈。共访谈了 21 名执业助产士和 10 名妇女。有 227 名妇女回复了调查。对调查数据进行了描述性分析，并通过学生 t 检验和卡方检验对数据进行了关联分析。访谈记录、转录和分析均遵循主题分析的阶段进行。
助产士和妇女支持增加助产士提供避孕咨询和在产后期间提供避孕方法的概念。方便和已建立的信任关系是选择由助产士提供避孕服务而不是去看医生的原因。报告称，详细讨论的最佳时间是产前和社区访问。产后妇女最感兴趣的方法是孕激素仅避孕药（POP）。助产士关注的问题包括需要增加避孕方法的教育和培训，并提供这些方法。提供这种服务的结构障碍包括时间压力、避孕培训的优先级低以及对资金的争议。
妇女报告说对助产士提供避孕方法感兴趣，并表示这将是方便和高度可接受的。助产士支持为她们护理的妇女提供增强的避孕咨询和方法的概念，并认为这对妇女有利。需要机构支持来克服结构性障碍，例如难以获得持续的专业发展，以及允许避孕服务被充分认可为助产士角色的一个组成部分，而不是边缘化的附加服务。
