Research Article| Volume 35, ISSUE 4, P360-366, July 2022

Sexual and reproductive health education: Midwives’ confidence and practices

Published:September 15, 2021DOI:



      There is limited evidence regarding midwives’ confidence and practices in providing sexual and reproductive health care in Australia.


      Midwives provide important public health education to women regarding sexual and reproductive health care.


      The aim of this study was to explore midwives’ confidence and practices around providing education to women on three key areas of sexual and reproductive health: contraception and family planning; sexual activity; and sexual health.


      A cross-sectional exploratory study was conducted with responses from n = 164 midwives (43.1% response rate) working in a public tertiary maternity hospital in Western Australia. The survey included items measuring confidence; method and frequency of practice. Open-ended questions captured qualitative data. Data analysis was conducted using descriptive statistics for quantitative data and content analysis for qualitative data.


      There was a significant association between age, years of clinical experience (p = 0.001) and work setting (p = 0.032) on the confidence to provide education on sexual activity. Most (92.1%) midwives indicated that they wanted further education. Lack of time, knowledge and language barriers were key factors preventing education.


      Midwives’ provision of education to women is essential for improving health literacy and health outcomes. Results reveal the necessity to include sexual and reproductive health education in entry to registration courses and the importance of continuing professional development.


      Evidence of midwives’ confidence and current practices in the provision of sexual and reproductive health care offers utility for leaders and educators in midwifery to prepare and equip midwives to fulfil this important public health role.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • WHO
        Respectful Maternity Care: The Universal Rights of Childbearing Women.
        The White Ribbon Alliance, World Health Organization, Washington, DC2018
        • COAG
        Council CoAGH Woman-Centred Care: Strategic Directions for Australian Maternity Services. Department of Health, Canberra2019
        • ICM
        Essential Competencies for Midwifery Practice. International Confederation of Midwives.
        International Confederation of Midwives, Geneva2019
        • Health Do
        Health Do Clinical Practice Guidelines: Pregnancy Care. Department of Health Canberra: Australian Government, 2020
        • NMBA
        Midwife Standards for Practice.
        Nursing and Midwifery Board of Australia, 2018
        • UNFPA
        State of the World’s Midwifery 2021.
        United Nations Population Fund, Geneva2021
        • WHO
        Sexual and reproductive health literacy and the SDGs.
        9th Global Conference on Health Promotion. World Health Organization, Shanghai2016
        • Baptiste D.
        • Kapungu C.
        • Khare M.H.
        • Lewis Y.
        • Barlow-Mosha L.
        Integrating women’s human rights into global health research: an action framework.
        J. Womens Health. 2010; 19: 2091-2099
        • WHO
        Strengthening Quality Midwifery Education for Universal Health Coverage 2030: Framework for Action.
        World Health Organization, Geneva2019
        • Kilfoyle K.A.
        • Vitko M.
        • O’Conor R.
        • Bailey S.C.
        Health literacy and women’s reproductive health: a systematic review.
        J. Womens Health. 2016; 25: 1237-1255
        • Hanley G.E.
        • Hutcheon J.A.
        • Kinniburgh B.A.
        • Lee L.
        Interpregnancy interval and adverse pregnancy outcomes: an analysis of successive pregnancies.
        Obstet. Gynecol. 2017; 129: 408-415
        • McKinney D.
        • House M.
        • Chen A.
        • Muglia L.
        • Defranco E.
        The influence of interpregnancy interval on infant mortality.
        Am. J. Obstet. Gynecol. 2017; 216: 316.e1-316.e9
        • McDonald E.
        • Woolhouse H.
        • Brown S.J.
        Sexual pleasure and emotional satisfaction in the first 18 months after childbirth.
        Midwifery. 2017; 55: 60-66
        • Bender S.S.
        • Sveinsdóttir E.
        • Fridfinnsdóttir H.
        “You stop thinking about yourself as a woman”. An interpretive phenomenological study of the meaning of sexuality for Icelandic women during pregnancy and after birth.
        Midwifery. 2018; 62: 14-19
        • Botfield J.R.
        • Tulloch M.
        • Contziu H.
        • Phipps H.
        • Bateson D.
        • Wright S.M.
        • et al.
        Contraception provision in the postpartum period: knowledge, views and practices of midwives.
        Women Birth. 2020; 34: e1-e6
        • ANMAC
        Midwife Accreditation Standards and Essential Evidence.
        ANMAC: Australian Nursing and Midwifery Accreditation Council, Canberra2021
        • Kesmodel U.S.
        Cross‐sectional studies – what are they good for?.
        Acta Obstet. Gynecol. Scand. 2018; 97: 388-393
        • Vaismoradi M.
        • Turunen H.
        • Bondas T.
        Content analysis and thematic analysis: implications for conducting a qualitative descriptive study.
        Nurs Health Sci. 2013; 15: 398-405
        • ten Hoope-Bender P.M.B.A.
        • de Bernis L.M.D.
        • Campbell J.M.P.H.
        • Downe S.P.
        • Fauveau V.P.
        • Fogstad H.M.H.A.
        • et al.
        Improvement of maternal and newborn health through midwifery.
        Lancet. 2014; 384: 1226-1235
        • Byers-Heinlein A.
        • McCallum A.
        • Byers E.S.
        • Pukall C.
        Sexual health-related training of Canadian midwives and its association with practice outcome.
        Women Birth. 2020; 33: e199-e207
        • Henriksen L.
        • Garnweidner-Holme L.M.
        • Thorsteinsen K.K.
        • Lukasse M.
        ‘It is a difficult topic’ – a qualitative study of midwives’ experiences with routine antenatal enquiry for intimate partner violence.
        BMC Pregnancy Childbirth. 2017; 17
        • Mengesha Z.B.
        • Perz J.
        • Dune T.
        • Ussher J.
        Talking about sexual and reproductive health through interpreters: the experiences of health care professionals consulting refugee and migrant women.
        Sex. Reprod. Healthc. 2018; 16: 199-205
        • Mengesha Z.B.
        • Dune T.
        • Perz J.
        Culturally and linguistically diverse women’s views and experiences of accessing sexual and reproductive health care in Australia: a systematic review.
        Sex. Health. 2016; 13: 299
        • Höglund B.
        • Larsson M.
        Midwives’ work and attitudes towards contraceptive counselling and contraception among women with intellectual disability: focus group interviews in Sweden.
        Eur. J. Contracept. Reprod. Health Care. 2019; 24: 39-44
        • Warenius L.U.
        • Faxelid E.A.
        • Chishimba P.N.
        • Musandu J.O.
        • Ong’Any A.A.
        • Nissen E.B.M.
        Nurse-midwives’ attitudes towards adolescent sexual and reproductive health needs in Kenya and Zambia.
        Reprod. Health Matters. 2006; 14: 119-128