BACKGROUND:
Sweden's gender equality and robust healthcare system prioritise access to contraceptives and free abortion services in its National Strategy for Sexual and Reproductive Health and Rights. However, immigrant women face lower contraceptive use and higher rates of unintended pregnancies than native-born women. Research highlights the importance of trust, cultural sensitivity, and communication in contraceptive counselling for immigrant women and their partners, who often influence contraceptive decisions. Midwives, as key providers of counselling, play a pivotal role in supporting women’s reproductive autonomy. This study explores midwives’ reflections about optimising counselling to empower immigrant women by expanding their freedoms, such as bodily integrity and decision-making autonomy.

OBJECTIVES:
To explore midwives' reflections on how to optimise contraceptive counselling for immigrant women in Sweden.

METHODS:
The study used a qualitative design, with focus group discussions (FGDs) among midwives in Malmö, Sweden, a city where about 30% of the population are of immigrant descent. A total of 11 FGDs were held with 50 midwives from private and public midwifery-led health clinics. FGD texts were analysed with manifest and latent content analysis.

RESULTS:
Midwives reported systemic barriers, such as the prioritisation of antenatal care over contraceptive counselling due to funding system, limited appointment availability, and challenges with online booking systems, particularly for immigrant women with low health literacy and language issues. Midwives highlighted complexities with involving men in counselling, which raised concerns about undermining women’s autonomy. They emphasised the need for culturally sensitive care, resources, and professional development.

CONCLUSIONS:
Optimising counselling for immigrant women requires systemic changes, including revising funding, improving access to multilingual resources, and ongoing professional development. Addressing these barriers will enhance women's capabilities and support their reproductive autonomy, aligning with Nussbaum’s Capabilities Approach and promoting gender equality.

KEY MESSAGE:
Midwives highlight how funding models and structural conditions shape contraceptive counselling, calling for system-level support to ensure equitable, responsive care. Poster session 4 (Group B)