In everybody’s interest but no one’s assigned responsibility: midwives’ thoughts and experiences of preventive work for men’s sexual and reproductive health and rights within primary care

Abstract

BackgroundSexual and reproductive health and rights (SRHR) have historically been regarded as a woman’s issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives’ thoughts and experiences regarding preventive work for men’s sexual and reproductive health and rights in the primary care setting.MethodsAn exploratory qualitative study. Five focus group interviews, including 4–5 participants in each group, were conducted with 22 midwives aged 31–64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis.ResultsOne overall theme emerged, in everybody’s interest, but no one’s assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife’s role and responsibility, and (iii) beliefs about men and women: same, but different.ConclusionsMidwives believed that preventive work for men’s sexual and reproductive health and rights was in everybody’s interest, but no one’s assigned responsibility. To improve men’s access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.

Men and sexual and reproductive healthcare in the Nordic countries: a scoping review

“…16 Midwives also expressed their limited knowledge about male SRH, which was considered essential if inviting men for SRH consultations. 17 Additionally, less experienced physicians (young and/or under training) felt uncomfortable dealing with sexual health consultations. 29 Additionally, the competing demands in the form of high workload and limited time hindered HCPs from discussing SRH with men.…”

“…The lack of focus on men might be explained by time constraints and no time being allocated to men’s concerns during visits. 17 Anyhow, the attitudes and behaviours of HCPs generally made a difference in men’s perception of their involvement or lack of involvement in healthcare. 38 Couples highlighted the need to treat partners on equal terms and to focus on them as a unit rather than solely on the women, 14,15,26,36 and they expected communication as inclusive with both partners.…”

“…Men’s engagement in reproductive healthcare seemed to be a complex matter; midwives valued men’s involvement, to a certain point, since they experienced over involvement as a possible sign of controlling behaviour or intimate partner violence. 17 The literature discussed men’s involvement and their lack of control and compromised autonomy in various situations in reproductive healthcare, especially during pregnancy and birth. For example, the inability to help or act during their partner’s birth made men experience lack of power and control.…”

“…16 Similarly, midwifery education and clinical training doesn’t regularly include andrology, which together with lack of time and organizational support hindered them from providing counselling to men. 17…”

“…16 Additionally, health and medical education in Sweden, as an example, does not have enough focus on men’s SRH. 16,17…”