<p>Characteristics of focus group participants.</p>

Background Sweden’s National Strategy for Sexual and Reproductive Health and Rights (SRHR) emphasises equitable access to contraception and abortion services. Despite this, immigrant women in Sweden experience lower contraceptive use and higher rates of unintended pregnancies and abortions compared with native-born women. Midwives, as primary providers of contraceptive counselling and prescribing, play a central role in promoting reproductive autonomy and informed choice. Aim To explore midwives’ reflections on how to optimise contraceptive counselling for immigrant women in Sweden. Methods Eleven focus group discussions were conducted with 50 midwives from public and private midwifery clinics in Malmö, where one-third of residents are foreign-born. Data were analysed using qualitative content analysis. Findings The overarching theme, “Building bridges for empowerment and informed decision-making,” captured midwives’ commitment to promoting women’s autonomy while navigating systemic and cultural challenges. Five sub-themes emerged: overcoming the discrepancy between mission and reality; addressing organisational weaknesses in the care chain; enhancing knowledge and capabilities; reinforcing competence and trust in communication; and involving men without undermining women’s autonomy. Midwives highlighted structural barriers, limited resources, and time constraints that hindered person-centred and culturally sensitive care. Conclusion Optimising counselling for immigrant women requires systemic changes, including revised funding structures, expanded multilingual resources and strengthened 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.研究背景 瑞典性与生殖健康及权利（Sexual and Reproductive Health and Rights，SRHR）国家战略强调公平获取避孕与堕胎服务。尽管如此，与本土出生女性相比，瑞典移民女性的避孕使用率更低，非意愿妊娠及堕胎率更高。助产士作为避孕咨询与处方开具的主要提供者，在促进生殖自主与知情选择方面发挥着核心作用。 研究目的 本研究旨在探讨助产士对如何优化瑞典移民女性避孕咨询服务的思考。 研究方法 研究招募马尔默市公立及私立助产诊所的50名助产士开展11次焦点小组讨论，该市三分之一的居民为外国出生人口。数据采用质性内容分析法进行分析。 研究结果 核心主题为「搭建赋能与知情决策之桥」，体现了助产士在应对系统性与文化挑战的同时，致力于提升女性自主权利的承诺。研究共提炼出5个子主题：克服使命与现实之间的偏差；应对护理链条中的组织性短板；强化知识与能力建设；提升沟通能力与信任度；在不损害女性自主权利的前提下吸纳男性参与。助产士指出，结构性障碍、资源匮乏与时间限制，均阻碍了以患者为中心且兼顾文化敏感性的护理服务开展。 研究结论 优化移民女性的咨询服务需要开展系统性变革，包括调整资助结构、扩充多语言资源以及强化专业发展。破解上述障碍可提升女性的能力水平，助力其实现生殖自主，这与努斯鲍姆的能力方法（Capability Approach）相契合，并有助于推动性别平等。