Berglundh Sofia, Abunnaja Khadija, Herzig van Wees Sibylle, Larsson Elin C, Kilander Helena
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Reprod Health. 2025 Jul 12;22(1):128. doi: 10.1186/s12978-025-02074-2.
Immigrant women living in Europe report lower use of contraceptives compared to native born women. The postpartum period is a key opportunity to provide high quality contraceptive counselling to support birth spacing, but little is known on how the counselling could be adapted to meet the needs and preferences of immigrant women. Approximately a third of all women giving birth in Sweden have an immigrant background, whereof Arabic speaking women constitutes one of the largest groups. Hence, the aim of this study was to explore Arabic speaking women's perspectives of contraceptive counselling postpartum. METHOD: Five focus group discussions (FGDs) were conducted with 23 Arabic speaking women. The FGDs were conducted in Arabic and translated to English. Data was analysed using reflexive thematic analysis.
Four main themes were created: 1) Adapting to new circumstances influence reproductive intentions:raising children in a new setting was described as a double burden and birth spacing was seen as essential for the family's wellbeing. 2) Reproductive decision-making - the women's choice but partner's support is important: inviting the partner to the contraceptive counselling was thought to enhance both his knowledge of contraceptives and his understanding of the woman's entire life situation postpartum. 3) Conflicting information about contraceptives creates hesitancy: navigating opposing information on contraceptives from the woman's home country and midwives in Sweden was confusing and fears of negative side effects from contraceptives were deep-rooted. 4) Trust and mistrust in antenatal and postpartum contraceptive services: trust included experience of emotional support and an open-minded attitude from the midwife. Mistrust involved scarce support in handling side effects, limited decision support and a feeling of breached privacy.
To provide person-centred and equitable contraceptive counselling postpartum, health care services need to shift attention from individual barriers to how the counselling can be improved. Key elements include integrating the concept of birth spacing in the postpartum contraceptive counselling, ensuring accessible follow-up services and to provide comprehensive information in the native language to support informed choices. An open-minded engagement with patients is also central to provide contraceptive counselling that is inclusive for all women.
与本土出生的女性相比，居住在欧洲的移民女性使用避孕药具的比例较低。产后时期是提供高质量避孕咨询以支持生育间隔的关键时机，但对于如何调整咨询以满足移民女性的需求和偏好却知之甚少。在瑞典分娩的所有女性中，约有三分之一有移民背景，其中说阿拉伯语的女性是最大群体之一。因此，本研究的目的是探讨说阿拉伯语的女性对产后避孕咨询的看法。
与23名说阿拉伯语的女性进行了五次焦点小组讨论（FGD）。焦点小组讨论用阿拉伯语进行，并翻译成英语。使用反思性主题分析法对数据进行分析。
形成了四个主要主题：1）适应新环境影响生育意愿：在新环境中抚养孩子被描述为双重负担，生育间隔被视为家庭幸福的关键。2）生殖决策——女性的选择，但伴侣的支持很重要：邀请伴侣参加避孕咨询被认为既能增加他对避孕药具的了解，也能增进他对女性产后整体生活状况的理解。3）关于避孕药具的相互矛盾的信息导致犹豫不决：在来自女性祖国和瑞典助产士关于避孕药具的相反信息中做出选择令人困惑，对避孕药具负面副作用的恐惧根深蒂固。4）对产前和产后避孕服务的信任与不信任：信任包括助产士给予情感支持和开放态度的体验。不信任包括在处理副作用方面缺乏支持、决策支持有限以及隐私被侵犯的感觉。
为了提供以人为本且公平的产后避孕咨询，医疗保健服务需要将注意力从个体障碍转移到如何改进咨询上。关键要素包括在产后避孕咨询中纳入生育间隔的概念，确保可获得后续服务，并以母语提供全面信息以支持明智的选择。对患者保持开放的态度对于提供对所有女性都具有包容性的避孕咨询也至关重要。
