Experience of contraceptive care by midwives for nonpostpartum individuals in the Netherlands: A mixed methods study

Abstract

Since 2015, Dutch midwives have been authorised to prescribe all contraception. Initially providing contraceptive care to postpartum clients, they increasingly offer it to anyone. It remains unknown how this broader population experiences this care. Therefore, this mixed methods study aims to explore experiences of nonpostpartum individuals receiving contraceptive care from Dutch primary care midwives. At 15 practices in the Netherlands, participants were recruited to complete a survey and participate in an in-depth semi-structured interview, both based on Levesque's Conceptual Framework of Access to Health. Univariate and multivariate logistic regression analyses were applied to survey data (n = 91) and thematic analysis to interview data (n = 10). Most survey participants (87.8 %) received an intrauterine device during their appointment. A majority (58.2 %) rated their care a 10 out of 10. Giving full marks was significantly associated with a higher perceived income (adjusted OR = 3.19, 95 % CI = 1.21–8.81, p = 0.021), adjusted for appointment type and time since appointment. Participants reported receiving understandable information, being taken seriously, and having enough time during their appointment. Interviews revealed that participants especially appreciate how midwives make them feel at ease, midwives’ expertise, and the convenience of access. To conclude, given the positive experiences reported by nonpostpartum individuals with contraceptive care from midwives, efforts should be made to improve task sharing and to increase awareness of midwives as contraception providers. Future research should compare care experiences across all types of providers (including midwives, general practitioners, abortion doctors, and gynaecologists) amongst a more representative population.