Contraceptive Counselling for Immigrant Women Provided by Midwives in Sweden

Background: Immigrant women in Sweden face unique challenges in accessing sexual and reproductivehealth and rights (SRHR ) services, particularly in contraceptive counselling. Despite a well-establishedsystem led by midwives, barriers related to cultural sensitivity, health literacy, and the healthcaresystem's adaptability to diverse needs persist. Understanding immigrant women's perspectives on SRHRservices is essential to address these challenges and support reproductive autonomy, contributing toSweden’s commitments under Agenda 2030 and Universal Health Coverage (UHC).Aim: The overall aim of this thesis was to gain a better understanding of contraceptive counselling forimmigrant women provided by midwives in Sweden, both from the provider and the user perspective.Methods: Individual interviews were conducted with 10 midwives, 19 immigrant women and 21accompanying partners. Focus Group Discussions (FGDs) were conducted with 50 midwives. In allpapers the data was analysed using qualitative content analysis.Results: The studies reveal that contraceptive counselling for immigrant women provided by midwivesin Sweden is shaped by factors such as limited health literacy, language barriers and unfamiliarity withthe healthcare system. Trust, cultural sensitivity, and the involvement of male partners emerged asimportant elements. Midwives face challenges due to systemic limitations, including lack of resources,language support and culturally adapted materials, which hinder their ability to meet diverse patientneeds.Conclusion: Improving midwife-led contraceptive counselling for immigrant women requires a holisticapproach, addressing systemic barriers, enhancing health literacy support and acknowledging the roleof male partners. Providing midwives with adequate resources and training is essential for accessibleand effective SRHR services, supporting Sweden’s goals of Universal Health Coverage and genderequality by fostering reproductive autonomy and reproductive justice for immigrant women.