Midwives adapt contraceptive counselling for young women with ADHD in Sweden

Midwives in Swedish youth clinics say a single counselling strategy does not work for every girl and young woman with ADHD who seeks contraceptive advice, according to a qualitative interview study published in BMC Women’s Health. The study, led by Margareta Johansson with co-authors Alida Haglund and Nina Asplin, was published on 26 October 2026 as an open access research article.

The researchers interviewed ten midwives who provide contraceptive counselling to girls and young women with ADHD. The interviews lasted an average of 34 minutes, and the team analysed them using Braun and Clarke’s reflexive thematic analysis. The participating midwives were aged 31 to 62 years and had between six months and 24 years of experience working in youth clinics located across four of Sweden’s six healthcare regions.

The analysis produced one overarching theme: adapting contraceptive counselling to individual needs despite limited ADHD-specific support. Within this, the midwives’ experiences were organised into three themes: striving to provide person-centred counselling, navigating counselling in response to increased support needs, and recognizing the importance of ADHD-specific knowledge and resources to support counselling.

The study’s background notes that despite accessible services, unmet contraceptive needs persist among young women in Sweden. Young women with ADHD may have diverse sexual and reproductive health needs, and previous research has identified challenges related to healthcare access, communication, and contraceptive use. Less was known, however, about how midwives themselves experience providing contraceptive counselling to this group, which the study aimed to describe.

In their conclusions, the midwives described adapting contraceptive counselling to perceived individual needs through changes in communication, consultation structures, access to care, and interprofessional collaboration. They also described a need for stronger ADHD-specific education and evidence-informed professional guidance to support their work.

According to the authors, support for counselling should provide a structured professional foundation while allowing flexibility to respond to individual circumstances and preferences. This reflects the study’s central finding that midwives adapt their approach to perceived individual needs rather than applying a uniform strategy.

The study is a qualitative exploratory study based on interviews with a small group of ten midwives in Swedish youth clinics, and its findings describe the experiences and perceptions of these participants rather than measuring clinical outcomes. The authors note that the midwives described a need for stronger ADHD-specific education and evidence-informed professional guidance, pointing to gaps in the resources currently available to support contraceptive counselling for girls and young women with ADHD.

As an early-shared, peer-reviewed accepted version, it is subject to further edits before the final Version of Record replaces it.

Subject of Research: Midwives' experiences of providing contraceptive counselling to girls and young women with ADHD in Swedish youth clinics

Article Title: “One counselling strategy does not fit all”: Midwives’ experiences of providing contraceptive counselling to girls and young women with ADHD – a Swedish qualitative interview study

Article References: Johansson, M., Haglund, A., & Asplin, N. (2026). “One counselling strategy does not fit all”: Midwives’ experiences of providing contraceptive counselling to girls and young women with ADHD – a Swedish qualitative interview study. BMC Women's Health. https://doi.org/10.1186/s12905-026-05043-4

Image Credits: AI Generated

DOI: 10.1186/s12905-026-05043-4

Keywords: ADHD, contraceptive counselling, midwives, youth clinics, Sweden, qualitative study, thematic analysis, sexual and reproductive health, person-centred care, BMC Women's Health, counselling, strategy