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Discussing contraception is considered part of midwives’ scope of practice in Australia,
yet most midwives receive minimal training in conducting these discussions. There
is a lack of guidance available in Australia on how and when midwives should discuss
contraception with women, and little is known regarding midwives’ experiences.
As part of a larger study of midwife-led provision of contraceptive implants, we conducted
semi-structured interviews with 13 hospital-based midwives and discussed their experiences
of providing contraception information.
Midwives perceived that most women found discussing contraception with a midwife to
be highly acceptable, including those from cultural or religious backgrounds that
may be stereotyped as being uninterested in contraception. Despite this, several midwives
stated that due to the busy clinical environment, they tended to prioritise speaking
to women they viewed to be most interested in postpartum contraception, including
those of high parity, who had an unintended pregnancy, or were experiencing financial
disadvantage or psychosocial stressors. Midwives’ approaches to initiating contraception
discussions varied widely. Most favoured introducing contraception into wider conversations
about pregnancy spacing and women’s plans for the future, in order to establish rapport
and provide context to the discussion. Midwives felt that more than one conversation
was necessary to allow women to consider the information before making a decision.
Our findings suggest that most women are open to discussing contraception with a midwife,
and that midwives are able to use different strategies to integrate these conversations
into their practice. However, many women may still miss out on contraceptive information
due to time pressures faced by midwives and cultural stereotypes that inform which
women they prioritise for these discussions. National guidelines are needed that incorporate
provision of contraception information as part of core midwifery practice, as well
as provision of training and strategies to initiate and tailor contraception discussions
to meet women’s individual needs.
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© 2022 Published by Elsevier Inc.
