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Bakgrund: Preventivmedelsrådgivning ingår i barnmorskans yrkesprofession. Långverkande reversibla preventivmetoder (Long-acting reversible contraception, LARC) är de mest effektiva metoderna för att hindra en oönskad graviditet. Trots det är kortidsverkande reversibla metoder (Short-acting reversible contraception, SARC) de mest använda bland kvinnor i Sverige.

Syfte: Syftet med studien var att undersöka om strukturerad preventivmedelsrådgivning ökade kvinnors användning av LARC, jämfört med rutinmässig rådgivning.

Metod: Klusterrandomiserad kontrollerad studie på barnmorskemottagningar i Sverige. Interventionsgruppen erhöll strukturerad preventivmedelsrådgivning med betoning på LARC, kontrollgruppen mottog rutinmässig rådgivning. Data har insamlats genom webbaserad enkät.

Resultat: De kvinnor som erhöll strukturerad preventivmedelsrådgivning valde LARC i högre utsträckning än kontrollgruppen. Bland de kvinnor som inte tänkt LARC som metod innan besöket, valde fler kvinnor LARC efter rådgivningen (p= .0038).

Slutsats: Strukturerad rådgivning kan motivera kvinnor att välja säkrare preventivmetoder.

Klinisk tillämpbarhet: Genom strukturerad preventivmedelsrådgivning kan kvinnor göra informerade val som leder till högre användning av säkra preventivmetoder

Background: Midwifes have an important assignment in contraception counselling to help women avoid unintended pregnancies. Short-acting reversible contraception (SARC) are the most common methods used by women under the age of 29 in Sweden. Women in this age are also the most frequent representatives in abortion statistics. Long-acting reversible contraception (LARC) is the most effective contraceptive methods available.

Aim: The aim of the study was to evaluate if structured counselling could increase woman’s use of long-acting reversible contraception, compared to routine counselling.

Method: The design was a cluster randomized trial conducted at maternal health clinics in Sweden. Clinics were randomized to give either structured contraceptive counselling (intervention) or to remain with their standard contraceptive counselling (control). Data from participants was collected through electronic surveys at the first visit and during follow-up.

Findings: Women receiving intervention chose LARCs to a higher extent compared to women receiving standard counselling. Among women that had not intended the use of LARC as a method prior to the visit, more women in the intervention group chose LARC after counseling (p= .0038).

Conclusion: Structured counseling can affect the initial choices of women when it comes to choosing more effective methods of contraception.

Clinical applicability: Through structured contraceptive method counseling women can make informed choices that lead to increased use of safe contraceptive methods.