The week before the International Day of the Midwife, ICM is highlighting the role midwives play in family planning with a blog series. This blog presents the work of a midwife in Sweden, where family planning is offered in special clinics.
Ulrika Rehnström Loi has worked as a midwife for over a decade. In Sweden, midwives are very independent and work in three different settings: in youth clinics for women and men under the age of 23 mainly for Family Planning, Sexual Transmitted Infections (STI) and abortion counseling and in clinics with the same services for women and men above 23 years of age, in the gynecologic ward, antenatal ward, antenatal care, ultrasounds, abortion care, and in the delivery and postnatal ward.
Ulrika has worked in clinics for women and men older than 23 years, where she was providing family planning services. Clients would come and seek her advice and it was her job to closely listen to the women’s needs and discuss which contraceptive method would be the most appropriate for her client. “Quite a few women in their 20ies choose an implant or an intrauterine device (IUD) because they are very busy with their life and don’t want to constantly remember to take the contraceptive”, explains Ulrika. Midwives in Sweden do not need to consult a physician to be able to prescribe and insert the contraceptive. Family planning and contraception is now an integrated part in the midwifery curriculum in Sweden and midwives are allowed to prescribe, insert and remove all contraceptives. ”I believe this approach makes contraception easier to access”, says Ulrika. She feels that easy access is crucial for effective family planning and women should be able to get immediate assistance. For this reason, she is particularly proud of the Swedish youth-clinics that are especially designed for women under the age of 23. These clinics are easily accessible, often located close to schools, open during hours conducive to the life-style of teenagers and with a cozy and homely appearance. The midwives in these clinics also work closely with other staff such as psychologists and other health workers to provide the best care for teenagers. The young women and men can just drop by without an appointment to come and see the midwife and discuss contraception methods or other sexual and reproductive health issues. Ulrika wishes, that this easy access would also be granted for women over the age of 23. She found it really frustrating when she was so busy that her appointments were booked out two weeks in advance. “A woman should not have to wait for a family planning session, she should be seen immediately, otherwise she might become pregnant in the meantime”, says Ulrika.
Ulrika is very passionate about midwifery and has decided to pursue a PhD. She believes that her education will strengthen midwifery as a whole because she will be able to discuss with physicians and other academics on a different level while providing the perspective of a midwife. Furthermore, she hopes to be working on the first of the tree ICM-Pillars of education, regulation, and association. “I will be a much better teacher to midwives with such a research backgrounds”, says Ulrika. In her thesis she is applying her experience in family planning as she is focusing on post-abortion care and contraception in Kenya.