Registered Midwives’ Experiences and Self-Assessed Competence with Sexual Health Counselling

Background: Pregnancy and the postpartum period raise many sexual health concerns for women. Registered midwives (RMs) care for an increasing proportion of Canadian pregnancies. The study objective was to assess RMs’ experiences providing sexual health counselling. Methods: A 22-item questionnaire exploring RMs’ experiences, competence, and comfort, as well as barriers to discussing sexual health, was distributed electronically to British Columbian RMs. Results: Of 330 RMs, 91 (28%) responded. The majority of midwives reported discussing sexual health concerns with greater than 75% of clients (49/91 53.8%). Most estimated the time spent was less than 30 minutes over the pregnancy (69/91 76%). Common topics were sexual activity postpartum (82/91 90.1%), contraception (89/91 97.8%), and cervical cancer screening (86/91 94.5%). Less than half discussed sexual problems, including pain or low desire. RMs rated themselves highly competent and comfortable addressing sexual health. However, many identified lack of training, time, and cultural differences as barriers. Respondents cited desire for community resources and training in the areas of contraception, pain and, low desire. Conclusions: British Columbian RMs feel confident addressing many sexual health concerns during pregnancy but cited lack of training as a common barrier. Investment in educational resources for RMs may help to improve sexual health care for all Canadian women. This article has been peer reviewed.