Possibilities for dialogue on sexuality and sexual abuse--midwives' and clinicians' experiences

Objective: to describe midwives' and clinicians' experiences of the possibilities and obstacles for dialogue with young women on sexuality and sexual abuse, focusing on the possibilities.

Design: qualitative study with interview data analysed by qualitative content analysis.

Setting: South-west Sweden.

Participants: a purposive sample, consisting of 15 midwives, six gynaecologists and five general practitioners aged 30-65 years, was chosen in order to obtain as many different experiences as possible. The participants' professional experiences varied, ranging from five to more than 35 years, and they were employed at youth clinics, primary health-care centres, gynaecology clinics, a specialist sexual medicine centre and antenatal care centres, situated in small and large cities.

Findings: the participants described the respectful encounter that can be created when young women meet midwives and clinicians in the context of a gynaecological consultation. In this situation, there was a potential to strengthen women while attempting to improve their sexual health. Support from the organisation and the use of personal skills and assets were found to be promoting factors for dialogue. Lack of organisational support or communication skills and difficult emotions complicated the situation, which might, in turn, restrain midwives and clinicians from raising sexual issues.

Implications for practice: increased knowledge, support and opportunities for reflection concerning dialogue regarding sexual issues might evoke the interest and intent of health professionals to approach these issues. Guidelines regarding dialogue about both sexuality and sexual abuse should be routine in health-care services.