Assessing women's sexual life after childbirth: the role of the postnatal check.
OBJECTIVE
to describe midwives' reflections on counselling women at the postnatal check with special focus on sexual life after childbirth.


METHODS
qualitative descriptive study with focus group discussions as the method of data collection.


METHODS
antenatal clinics in Stockholm greater catchments' area.


METHODS
during 2006 and 2007, a voluntary sample of midwives from 10 different antenatal clinics were invited.


METHODS
content analysis was undertaken through identification of codes, categories and themes.


RESULTS
Two themes emerged: balancing between personal perceptions of the woman's needs and the health system restrictions and strategies for counselling about sexual life after childbirth'. The midwives tried to create a picture for themselves of the woman coming for the postnatal check and her needs before the consultation. This picture guided the midwives, but lack of time and knowledge restricted them when counselling on sexual life after childbirth. Two different strategies in counselling were identified, one task-oriented and one subject-oriented. Demands and time restrictions led midwives to distance themselves from their clients. A task-oriented approach was more visible in midwives' encounters with foreign-born women, where linguistic difficulties, cultural diversity and narrow time frames restricted the midwives' effectiveness and/or sensitivity as caregivers. In contrast, the subject-oriented strategy meant 'getting in tune', i.e. listening to the woman when she expressed her feelings and emotions, encouraging the woman to be an active participant in decisions involving her care. This strategy is used for women who arouse midwives' empathy and when there is some form of recognition and understanding.


CONCLUSIONS
The picture created of the woman and her needs guided the midwives, but lack of knowledge and time limitations restricted counselling on sexual life after childbirth. Two counselling strategies were identified, one task-oriented and one subject-oriented. Balancing these two counselling strategies improves both the ethical aspects and the quality of the counselling.
Olsson
Ann
A
Department of Clinical Sciences, Division of Caring Science, Danderyd Hospital, Karolinska Institutet, Solna, Sweden. Ann.Olsson@ki.se
Robertson
Eva
E
Falk
Katarina
K
Nissen
Eva
E
D000328:Adult; D054521:Cultural Competency; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D009721:Nurse Midwives / Q000941:ethics / Q000523:psychology / Q000592:standards; D024802:Nurse's Role; D009723:Nurse-Patient Relations / Q000941:ethics; D036801:Parturition; D011181:Postnatal Care / Q000379:methods / Q000458:organization & administration; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D012649:Self Concept; D012731:Sex Counseling / Q000941:ethics / Q000379:methods / Q000592:standards; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011795:Surveys and Questionnaires; D016746:Transcultural Nursing