Midwifery and Sexuality

This first open-access book on midwifery and sexuality integrates sexual health into the care for the pregnant and postpartum couple. It addresses sexuality and intimacy from an education and prevention perspective instead of just focusing on treating problems, aiming to foster the development of sexual well-being and happy couplehood.

Sexuality and intimacy are essential elements in the bonding of the couple and the parents-to-be. That process can be seriously hampered by sexual problems due to mutual misunderstanding, fear and sexual troubles (especially when the natural processes of conceiving, pregnancy and delivery are disturbed). In this phase of life, disruption of intimacy, sexuality and sexual relationship is a significant risk factor for developing couple and family problems. The need for such a book stems from the very limited attention given to this health area in the daily practice of most midwives and related healthcare professionals. In building aclose relationship with the couple through frequent, intense, longstanding contact, the midwife acquires a perfect position to address sexuality and intimacy. 

With 36 authors from 14 countries, the book comprises five modules: 1. Sexuality; 2. Sexual aspects of the various phases of reproduction when things develop without complications; 3. Sexual aspects when those same phases deviate from physiology; 4. Special topics on sexuality relevant to daily midwifery practice; 5. Teaching, learning, skills and competencies with regard to sexuality. This new practical textbook guides healthcare professionals such as midwives, obstetricians, gynaecologists, nurses, general practitioners, pelvic floor therapists, etc., by offering both basic knowledge and skills on sexual health and wellbeing, combined with modern sexological knowledge, like the entirely new topic of sexual aspects of preconception care.

“The monograph "Midwifery and Sexuality" is a comprehensive scientific study on human sexuality addressed mainly to midwives. This valuable publication demonstrates the complexity of human sexuality and is a great addition to the available literature and can be extremely useful in improving the quality of integrated women's health care. It can be successfully used to implement the core curriculum in the fields of education of both midwives and other health care professionals. Midwifery and Sexuality is a book that is undoubtedly a source of valuable knowledge, which includes all aspects of human sexuality and should find many readers, especially among health care professionals. It may also be of interest to people not related to medicine, who are looking for reliable and credible sources of knowledge in this area.” (assist.prof. Małgorzata Nagórska, RM, MA, PhD, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland)

“The proposed e-book Midwiferyand Sexuality has been developed according to the latest requirements of the branch respecting conceptions of health care in midwifery. It takes into account new legislative norms regarding midwives' competencies. I greatly appreciate both the format and contentual aspects of the multimedia textbook and evaluate them very positively. The case histories within chapters make it possible for the reader to verify the knowledge gained and to identify information gaps in the presented themes of the e-book. The e-book interconnects theory and practice and leads midwives to independence, creativity, and reliability. It also informs about the appropriate implementation of diagnostic, therapeutic procedures, and interventions with limited access due to various reasons. … The proposed e-book should be considered as a valuable contribution, namely, as innovative approaches in academic education taking into consideration gaining practical skills including at least 50% of total hours of the midwifery study programme.” (assoc. prof. Martina Bašková, BMi., M.N., PhD, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia)

“The presented book is a beneficial pioneering work, not only for midwives, but for all those whose job involves work with women and couples. … An assistance with solving issues related to reproduction and sexuality, due to its anatomical and physiological context, belongs inseparably to the counseling practice and holistic care provided by a midwife to a woman and her family. Every midwife "as a woman's guide through life" should not only have appropriate professional knowledge in this field, but should also work on her personal development and gradually resolve within herself the questions related to her own sexuality, to birth and death. The five modules of the book "Midwifery and Sexuality" provide comprehensive information that can greatly assist care providers in their personal and professional development.I am a midwife, a university professor, and at the same time I provide holistic counseling to women. I can confirm that this book is great!” (assist.Prof. Radka Wilhelmová, PhD, Masaryk University, Brno, Czech)

Sam Geuens became a clinical sexologist by chance.  He started his University career studying Moral Sciences with a particular interest in semantics – the way people use words and play with their meaning.  Realising that sexuality and intimacy are full of semantic pitfalls and miscommunication,  he moved to clinical sexology after finishing his ethics degree.  He added psychotherapy and started working with people and couples experiencing various relationship and sexual difficulties.  He practised in the Netherlands and Wales before settling in Flemish institutionalised healthcare.

Ever since he has been practising medical sexology within hospital settings.  Many hospitals did and do not yet have departments focused on treating sexual difficulties.  So he started outpatient sexology clinics at the hospitals in Herentals, Hasselt and Heusden-Zolder.  In this last one, he is still counselling patients/couples with various sexual problems.

Working in this intersection of gynaecology, urology, psychiatry, and endocrinology has convinced him that our healthcare systems have a long way to go before taking people’s sexual health and well-being seriously.  Wanting to contribute to such a brighter sexual health future, Sam is active as a board member for both the Flemish Society for Sexology and the European Federation for Sexology, helping to get sexology and sexual health the attention it deserves in Flanders and the rest of Europe.

Ten years ago, he entered midwifery in a rather suiting way.  He was standing in the hallway of his hometown’s maternity ward, having just become a father for the second time, when getting a phone call from the University’s head of midwifery announcing that he got a job lecturing their midwifery bachelor students.

Since then, his primary focus has been training aspiring midwives at the PXL University College in Hasselt, Belgium, teaching them psychology and mental health related to reproduction & early childhood development, sexual health & well-being, communication & counselling skills and deontology & clinical ethics.  Aspiring midwives are always a thrilling and engaging bunch of students eager to learn and develop themselves.

He hopes this new textbook on Sexuality & Midwifery can help colleagues to integrate sexuality into their midwifery programs, help practising midwives to take up the sexual well-being of their clients and educate his fellow sexologists on all matters regarding sexuality and childwish, pregnancy and young parenthood.

At age five, when her brother was born, Ana Polona Mivšek decided to become a midwife when she had the privilege of meeting her mother’s birthing assistant.  It was precisely the year when midwifery education was abolished in Slovenia.  Without the opportunity to fulfil that dream, she went to the gymnasium.  In the last year, when she was deciding on her professional future, the government revived midwifery education, and the University of Ljubljana was accepting its first generation of midwifery students.  It felt as if she was called to become a midwife.

In 2000 she graduated as the first bachelor of midwifery in Slovenia.  Though she got a job in the delivery room of a maternity hospital in Ljubljana, her curiosity was not yet satisfied, and she applied for an MSc in midwifery.  Since this was impossible in Slovenia, she headed to Scotland, where she met her mentor, an aspiring midwifery researcher who became her role model.

A few years later, she began to teach at the University of Ljubljana, Faculty of Health Sciences, in the Department of Midwifery.  The following ten years were a hectic time - she became the head of the midwifery department, was the only midwifery teacher in Slovenia, was doing her PhD alongside her job, and in all this chaos, had a daughter.

In her midwifery practice, she became increasingly aware that sexuality doesn’t get adequate attention.  After completing her doctorate in 2012, with her daughter growing up, her thirst for knowledge was reawakened, which led her to take a course in sexology and establish a subject, ‘Sexology in midwifery’, as part of the undergraduate midwifery study programme.

In 2016, at the European Federation of Sexology conference in Dubrovnik, she spoke about the need for sexology in midwifery education and shared her experiences teaching this subject as an essential part of the midwifery curriculum.  There, meeting the co-editors, the seed of an idea for this book was planted.  It took a while - in midwifery terminology: during this “birthing process”, the editing team several times faced dystocia.  But midwives are patient and do not easily loose faith.  They are aware that good things take time to grow.  Now, this book is sent out among midwives, to thosewho teach and those in practice.  Editors hope they are planting a seed that can improve midwifery care. 

Woet Gianotten is a Dutch retired physician and registered psychotherapist.
His dream was to be a tropical doctor in Africa.  After graduating from Utrecht in 1967 as a physician, he spent a year in surgery and the tropical medicine course and moved to Gabon, West Africa, to work in a refugee camp with Biafran children.  His next job was in obstetrics in Rotterdam, where he, for several months, replaced the practice of a midwife in the Red Light district.  He then moved for three years to be the single doctor in a 110-bed upcountry mission hospital in Rubya, Tanzania.

In addition to much work in surgery and obstetrics, he built a maternity unit and a mother and child clinic.  When asked to lecture in the school for nurses and midwives, he discovered the joy of teaching, which he has done ever since. With the help of a midwife student, he assisted his wife, Erna, at the birth of their second child.  Their third and last child was born in their home with nobody else. 

He started training in gynaecology back in the Netherlands, hoping to return to Africa as a medical specialist.  However, after a year and a half, he had become so fascinated by the new fields of sexology and contraception that he quit gynaecology, a decision supported by his severe colour blindness.  Not being able to see someone turning pale or blue and not making a correct Apgar Score is a real handicap for a gynaecologist.  For a sexologist, however, it proved to be an asset since not being able to see the client blushing, one easily can continue asking difficult questions.

With Africa still pulling, he moved again to Tanzania to work in medical care and public health at Kilombero hospital.  He built and started a family planning clinic and taught the midwivesto insert IUDs and run that clinic independently.

Back in the Netherlands, he combined several jobs.  For 20 years, he worked in contraception and abortion care.  For 25 years, he worked in common sexology (where sexuality is not primarily influenced by disease or medical interventions).  He enrolled in psychotherapy training to better understand the non-physical connections and gradually ‘crossed the blood-brain barrier’.  For 15 years, he was intensely involved in sexual abuse in care and in an advisory role to the Dutch Ministry of Health.  

His third job was as a senior lecturer in Medical Sexology at the Rotterdam and Utrecht University Hospitals.  In medical sexology, cancer, chronic diseases, physical impairment or medical interventions play an important role in sexual disturbances.  Having an extra eye for ‘unmet needs’, he was part of the development of oncosexology and gerontosexology and being under the wings of gynaecologynaturally introduced him to reproduction sexology. 

In 2006, when obliged to retire from his University appointments, he was asked to continue in physical rehabilitation sexology.  Gradually he became a freelance national and international teacher and trainer in sexology.