Are Ontario Midwives Prepared to Respond to Their Clients’ Sexual Concerns? A Survey of Attitudes, Perceived Training, Knowledge, and Comfort



Ali McCallum, BHSc, MSc(HQ), RM; Alyssa Byers-Heinlein, HBSc, RM; E. Sandra Byers, PhD; and Caroline Pukall, PhD



Objective: Sexual health and well-being are vital components of overall health, quality of life, and relationship satisfaction and stability. Midwives have the potential to play an important role in addressing their clients’ sexual health concerns and promoting their sexual health. The goal of this study was to assess the attitudes, perceptions of training, knowledge, and comfort of midwives registered in Ontario with respect to addressing their clients’ sexual concerns.

Methods: We used a cross-sectional online survey (45 mins) of registered midwives in Ontario. An email containing information about the study and a link to the survey was sent to all midwives registered in Ontario in 2016 and members of the Association of Ontario Midwives (AOM) as part of the weekly “Midwife Memo” from the AOM, and was posted on a Canadian midwifery Facebook group. Participants were asked about their training and practice, attitudes toward their role in addressing their clients’ sexual concerns, perception of quality of sexual health training, and sexual knowledge and comfort.

Results: Of the 740 midwives registered in Ontario at the time of the study, 100 submitted responses yielding a response rate of 14%. Results indicated that participants felt strongly that midwives have an important role to play in addressing their clients’ sexual concerns and most participants reported that they would feel very or extremely comfortable addressing each of the 10 sexual health topics. Participants who rated themselves as more knowledgeable and comfortable addressing sexual topics had more positive attitudes toward doing so. However, the results also suggested that some midwives currently are not adequately prepared to take on this role. Many participants perceived gaps in how knowledgeable they would feel in addressing the sexual health topics. The topics that participants were most likely to feel knowledgeable about were postpartum issues, changes in sexuality over the lifespan, sexual health, sexual practices, and biological aspects of sexuality, whereas participants felt least knowledgeable about sex and disability, sexual problems/concerns/dysfunction, and experiences of sexual violence. Moreover, participants felt significantly less knowledgeable than comfortable talking about sexual issues.

Conclusion: These results suggest that midwives would benefit from training that provides them with information about sexual topics, translating this knowledge into practice, and strategies on how to be proactive on these topics in a way that is acceptable to their clients. Such training is likely to also increase midwives’ comfort discussing sexual issues.



midwifery, sexual health, comfort, knowledge, attitudes, training



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