Sexology in Midwifery Edited by Ana Polona Mivcek Sexology in Midwifery Edited by Ana Polona Mivcek D3pZ4i & bhgvld, Dennixxx & rosea (for softarchive) Stole src from http://avaxho.me/blogs/exLib/ Published by AvE4EvA Copyright © 2015 All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Technical Editor AvE4EvA MuViMix Records Cover Designer Published: 15 April, 2015 ISBN-10 953-51-2041-7 ISBN-13 978-953-51-2041-4 C ontents Preface Chapter 1 Do midwives Need Sexology in Their Undergraduate Study Programme? Study Among Graduates of Midwifery Programme who Attended Sexology Co urse by Ana Polona Mivÿek Chapter 2 Raising Children for a Healthy Sexual Relationship in Adulthood by Anita Jug Doÿler Chapter 3 Promotion and Health Education for Healthy Sexuality by Andreja Kv as Chapter 4 Midwifery Students’ Perception of Intimate Touch in Clinical Practice by Tita Stanek Zidaric and Metka Skubic Chapter 5 Sexual Activity during Pregnancy in Childbirth and after Childbirth by Teja ÿkodi Zakÿek Chapter 6 The Exp erience of Pregnancy, Childbirth and Motherhood in Women with a History of Sexual Abuse by Tanja Repic Slavic and Christian Gostecnik Chapter 7 Female Sexuality and Medicine – Sexualisation of Everyday Life, Desexualisation of Childbirth by Zalka Drglin Chapter 8 Towards Unprejudiced Midwifery Care — Midwifery Students’ Views on Homosexuality by Barbara Domajnko Chapter 9 Breaking Down Taboos Concerning Sexuality among the Elderly by Doroteja Rebec, Igor Karnjuÿ, Sabina Licen and Katarina Babnik Preface Midwives support women during the reproductive period of their lives. Dimensions of midwifery work include, in addition to the physiological aspect, psychological and spiritual issues. Midwifery activities mean involvement in the most intimate sphere of clients' lives. Women's perceptions of partnership, sexuality, pregnancy and birth are affected by their personal experiences and by the culture they live in. The same factors also influence the midwives' perception of these issues. It is therefore crucial for the midwives to be aware of certain areas of their work that have a sexual inclination and clarify their own eventual prejudices regarding sexuality, since these can affect their provision of holistic, individual and competent care to women and their families. This book deals with different aspects of sexuality that can have an influence on everyday midwifery work. It might also be of interest to different groups of people - midwives in clinical settings, midwifery educators, midwifery students and also other health professionals who manage women during the reproductive period. Chapter 1 Do midwives Need Sexology in Their Undergraduate Study Programme? Study Among Graduates of Midwifery Programme who Attended Sexology Course Ana Polona Mivšek Additional information is available at the end of the chapter http://dx.doi.org/10.5772/59007 1. Introduction The midwife is recognized worldwide as being the person who is alongside and supporting women giving birth. The midwife also has a key role in promoting health and well-being of childbearing women and their families before conception, antenataly and postnataly, includ‐ ing family planning [1]. The role expands to the field of family planning and promoting sexual health [2]. Since midwives work on the field of perinatal health, but also in the field of gynaecology and reproduction, they face different situations that are closely connected with sexuality. Despite the fact that our societies become much more open and relaxed regarding the sexual issues, there are still hindrances to discuss the issue freely with someone you are not familiar with [3,4]. So women do need trust in midwives, before they open to reveal the concerns, problems or hesitations on the topic. And midwives should be educated in how to manage delicate situations, concerning sexual problems. Definition of Midwives acknowledge midwives’ role in managing sexuality [5] and International Confederation of Midwives request this competency to be met within the undergraduate education [6], but on the other side, midwifery textbooks are very parsimonious on this topic [1,7]. In order to equip the Slovenian midwifery students with knowledge and skills about managing sexuality issues, the subject Sexology in midwifery was introduced into the undergraduate midwifery programme in 2004. It ran continuously every year until today. This chapter presents the results of the evaluation of the subject, by the graduates of midwifery, who attended the course. 2 Sexology in Midwifery 2. Background The focus that this chapter deals with, lays in the cross-section of midwifery and sexuality, however these two components is hard to separate completely. The state of the motherhood is obviously bound up with definitions of sexuality. The interlinking with sexual identity, sexual activity and motherhood is very complex tangle to unpick [8]. Midwifery is closely connected with sexuality of a couple; the birth is the take of the period that started with the sexual act. As sexual intercourse is not just the physical act, also pregnancy, birth and processes after the birth cannot be considered only bodily – they are multidimensional in its nature, affecting emotions, social and spiritual aspects of individual. These effects are not limited only to woman, but affect the family as a whole. The intercourse, pregnancy, childbirth, breastfeeding and establishment of new relationships after the birth are very intimate milestones of the family life. As Price [9] acknowledges: “The physical changes of woman are linked also to her views of her sexual self”. Her changing physical shape reveals that she is recognized by others as a sexual being [10].This process affects all aspects of her life. The midwife that actively enters in the life of the couple/family during these periods must be therefore consciously aware of the emotional value of these periods for the clients. Already in 1975 World Health Organization acknowledged [11]: “Opportunities for the provision of sex information and counselling are particularly likely to arise in services for maternal and child health, family planning, mental health, community health, abortion and sterilization, and sexually transmitted diseases”. 2.1. Midwifery There are many subthemes of midwifery that are closely connected to the management of issues of sexuality, however because of the above reasons, the author exposed the most evident connections, such as empathy or emotional work, communication skills and ethics. 2.1.1. Empathy and emotional work Empathy is essential for the effective provision of midwifery care [12]. However, in case of dealing with sexuality issues, is even more crucial. It helps midwife not to invade in womens’ intimacy. In relating empathy to the therapeutic relationship of a midwife, it is seen to require midwife to be intuitive, with the woman then being able to show the depth of her under‐ standing of another person [13]. It was Hochschild who was the first person exposing the importance of emotions in work, however, his work was largely focused on commercial organizations. Emotional work in midwifery is of great importance, however largely unrecognized. Midwives need to work in a sensitive way in order that woman’s feelings are acknowledged and responded to. To do this effectively, midwives also need to be aware of their own feelings, as their unrevealed inside conflicts can affect communication and relationship with women [14].