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Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study.
Hum Reprod. 2015 May; 30(5):1146-55.HR

Abstract

STUDY QUESTION

How is the reproductive life plan (RLP) adopted in midwifery contraceptive counselling?

SUMMARY ANSWER

A majority of midwives adopted the RLP in their counselling, had predominantly positive experiences and considered it a feasible tool for promoting reproductive health.

WHAT IS KNOWN ALREADY

The RLP is a health-promoting tool recommended by the Centers for Disease Control and Prevention in the USA for improving preconception health. It was recently used in a clinical setting in Sweden and was found to increase women's knowledge about fertility and to influence women's wishes to have their last child earlier in life.

STUDY DESIGN, SIZE, DURATION

An exploratory mixed methods study among 68 midwives who provided contraceptive counselling in primary health care to at least 20 women each during the study period. Midwives received an introduction and materials for using the RLP in contraceptive counselling. Three months later, in the spring of 2014, they were invited to complete a questionnaire and participate in a focus group interview about their adoption of the RLP.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Data collection was through a questionnaire (n = 53 out of 68; participation rate 78%) and five focus group interviews (n = 22). Participants included both younger and older midwives with longer and shorter experiences of contraceptive counselling in public and private health care in one Swedish county. Quantitative data were analysed for differences between users and non-users, and qualitative data were analysed by qualitative content analysis to explore the midwives experiences and opinions of using the RLP.

MAIN RESULTS AND THE ROLE OF CHANCE

Sixty-eight per cent of midwives had used the RLP in their contraceptive counselling. Four categories emerged through the focus group interviews: (i) A predominantly positive experience; (ii) The RLP-a health-promoting tool; (iii) individual and societal factors influence the RLP counselling; and (4) long-term implementation comprises opportunities, risks and needs. The most common reason for not using the RLP was lack of information.

LIMITATIONS, REASONS FOR CAUTION

There was general lack of experience of using the RLP with women from different cultural backgrounds, with non-Swedish speaking women and, when a partner was present. Due to the non-random sample, the limited knowledge about non-responders and a short follow-up period, results apply to short-term implementations and might not fully apply to long-term implementation.

WIDER IMPLICATIONS OF THE FINDINGS

The use of RLP in contraceptive counselling appears a feasible way of promoting reproductive health. Results from the USA and Sweden indicate it is a promising tool for midwives and other health professionals involved in reproductive counselling, which deserves to be explored in other nations.

STUDY FUNDING/COMPETING INTERESTS

Grants were received from the Medical Faculty at Uppsala University and the European Society of Contraception and Reproductive Health. There are no competing interests.

TRIAL REGISTRATION NUMBER

N/A.

Authors+Show Affiliations

Department of Public Health and Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden jenny.stern@pubcare.uu.se.Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.Department of Public Health and Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.Uppsala University Hospital, SE-751 85 Uppsala, Sweden.Uppsala University Hospital, SE-751 85 Uppsala, Sweden.Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.Department of Public Health and Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25771220

Citation

Stern, J, et al. "Midwives' Adoption of the Reproductive Life Plan in Contraceptive Counselling: a Mixed Methods Study." Human Reproduction (Oxford, England), vol. 30, no. 5, 2015, pp. 1146-55.
Stern J, Bodin M, Grandahl M, et al. Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study. Hum Reprod. 2015;30(5):1146-55.
Stern, J., Bodin, M., Grandahl, M., Segeblad, B., Axén, L., Larsson, M., & Tydén, T. (2015). Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study. Human Reproduction (Oxford, England), 30(5), 1146-55. https://doi.org/10.1093/humrep/dev048
Stern J, et al. Midwives' Adoption of the Reproductive Life Plan in Contraceptive Counselling: a Mixed Methods Study. Hum Reprod. 2015;30(5):1146-55. PubMed PMID: 25771220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study. AU - Stern,J, AU - Bodin,M, AU - Grandahl,M, AU - Segeblad,B, AU - Axén,L, AU - Larsson,M, AU - Tydén,T, Y1 - 2015/03/13/ PY - 2014/08/24/received PY - 2015/02/12/accepted PY - 2015/3/16/entrez PY - 2015/3/17/pubmed PY - 2016/1/21/medline KW - contraceptive counselling KW - family planning KW - planned pregnancy KW - preconception care KW - unplanned pregnancy SP - 1146 EP - 55 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 30 IS - 5 N2 - STUDY QUESTION: How is the reproductive life plan (RLP) adopted in midwifery contraceptive counselling? SUMMARY ANSWER: A majority of midwives adopted the RLP in their counselling, had predominantly positive experiences and considered it a feasible tool for promoting reproductive health. WHAT IS KNOWN ALREADY: The RLP is a health-promoting tool recommended by the Centers for Disease Control and Prevention in the USA for improving preconception health. It was recently used in a clinical setting in Sweden and was found to increase women's knowledge about fertility and to influence women's wishes to have their last child earlier in life. STUDY DESIGN, SIZE, DURATION: An exploratory mixed methods study among 68 midwives who provided contraceptive counselling in primary health care to at least 20 women each during the study period. Midwives received an introduction and materials for using the RLP in contraceptive counselling. Three months later, in the spring of 2014, they were invited to complete a questionnaire and participate in a focus group interview about their adoption of the RLP. PARTICIPANTS/MATERIALS, SETTING, METHODS: Data collection was through a questionnaire (n = 53 out of 68; participation rate 78%) and five focus group interviews (n = 22). Participants included both younger and older midwives with longer and shorter experiences of contraceptive counselling in public and private health care in one Swedish county. Quantitative data were analysed for differences between users and non-users, and qualitative data were analysed by qualitative content analysis to explore the midwives experiences and opinions of using the RLP. MAIN RESULTS AND THE ROLE OF CHANCE: Sixty-eight per cent of midwives had used the RLP in their contraceptive counselling. Four categories emerged through the focus group interviews: (i) A predominantly positive experience; (ii) The RLP-a health-promoting tool; (iii) individual and societal factors influence the RLP counselling; and (4) long-term implementation comprises opportunities, risks and needs. The most common reason for not using the RLP was lack of information. LIMITATIONS, REASONS FOR CAUTION: There was general lack of experience of using the RLP with women from different cultural backgrounds, with non-Swedish speaking women and, when a partner was present. Due to the non-random sample, the limited knowledge about non-responders and a short follow-up period, results apply to short-term implementations and might not fully apply to long-term implementation. WIDER IMPLICATIONS OF THE FINDINGS: The use of RLP in contraceptive counselling appears a feasible way of promoting reproductive health. Results from the USA and Sweden indicate it is a promising tool for midwives and other health professionals involved in reproductive counselling, which deserves to be explored in other nations. STUDY FUNDING/COMPETING INTERESTS: Grants were received from the Medical Faculty at Uppsala University and the European Society of Contraception and Reproductive Health. There are no competing interests. TRIAL REGISTRATION NUMBER: N/A. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/25771220/Midwives'_adoption_of_the_reproductive_life_plan_in_contraceptive_counselling:_a_mixed_methods_study_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dev048 DB - PRIME DP - Unbound Medicine ER -