Barnmorskors erfarenheter av att vårda kvinnor med lokaliserad provocerad vulvodyni

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Sammanfattning: Background: Localized provoked vulvodynia (LPV) is often a hidden problem that negatively impacts on young women and their relations physical, emotional and socially. There are limited studies about midwives’ experiences of caring for women living with LPV in adolescent health services in Sweden. Midwives knowledge in sexual and reproductive health is important for the development of the care for these women.Objectives: To describe midwives experiences of caring for women living with localized provoked vulvodynia seeking care in adolescent health services.Methods: A qualitative interview study of eight midwives working in adolescent health services in Sweden using individual interviews and inductive content analysis.Results: The midwives experiences of caring for young women living with LPV is described in the main category: Understanding that the women struggles with external as well as internal pain which has an impact on the entire person. Three generic categories were identified. The category Meet the woman where she is concerns establishing trust and being perceptive, encourage dialogue about sexual health, and deal with challenges such as women’s wishes for a quick solution with the midwife’s knowledge that LPV could take time to treat. In the category Current norms of sex and sexuality have significance for the woman emerges that social expectancies about sex has an impact on women's sexual relations, and body images that are hard to achieve including lack of knowledge about their own body has a significance for LPV. The category Adapting the care to the unique woman includes an understanding of that the women’s pain can be an expression revolving other problems, that the team surrounding the woman is essential, that treatment is adapted individual, and to involve potential partner.Conclusions: The midwives experiences consist of seeing the complexity of LPV and how it is expressed in the unique person. It involves giving care beyond the obvious external physical pain and being open-minded and see that the women carry inner emotional pain, such as a feeling of inadequacy and guilt. The midwives strive to support the woman to put herself first and focus on pleasurable sex. They encourage her to explore her own sexuality, stop practicing heteronormative sex that venture to maintain and aggravate her pain. Further studies of midwives’ experiences are needed in other context of care in Sweden, for example in maternity care, also studies of women's experiences living with and being cared for LPV isrequired. The midwives care requires to meet women with an openness and listen to their stories. Furthermore, confirm their pain and encourage dialogue about body awareness, sexuality and norms, and working multidisciplinary.Key words: Localized provoked vulvodynia, sexual and reproductive health, midwife, experiences, care, norms, young women, sexuality, adolescent health services.

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