Providing comprehensive contraceptive services in primary care at a rural Federally Qualified Health Center in the USA: adapting to patient need in a culturally conservative, rural environment

Abstract

Introduction: In the USA, approximately 45% of pregnancies are unintended. Accessing quality contraceptives can be a barrier for some individuals, especially low-income, uninsured, minority or younger women. These problems are exacerbated in 1 of 8 services offered, lack of knowledge about birth control, misinformation and misconceptions, education on birth control, and care model. Conclusion:The cultural context of Southwest Virginia, including the cultural conservatism and stigma associated with talking about sex, has a big impact on people's willingness to access contraceptive services. Stigma limits educational opportunities being offered in schools, therefore limiting people's knowledge about services and birth control methods. This FQHC has adapted to their surrounding culture by ensuring that every woman seeking primary care at the FQHC is screened for contraceptive need, offered contraceptive counseling and comprehensive contraceptive methods. This FQHC's integration of contraceptive services is a model that can be replicated by other FQHCs, by local health departments, and by private physicians.

Women’s Health Provider Perspectives on Reproductive Services Provision in the Veterans Health Administration

“…Civilian virtual contraceptive services are quickly expanding and small companies are filling the gap left by traditional health systems 21 . In line with other rural, federally qualified health centers, VHA CBOCs need to screen each veteran for reproductive needs and provide appropriate education and comprehensive contraceptive options that may not be available across rural communities 22 . Finally, the VHA preferentially communicates with veterans via mailings.…”

“…21 In line with other rural, federally qualified health centers, VHA CBOCs need to screen each veteran for reproductive needs and provide appropriate education and comprehensive contraceptive options that may not be available across rural communities. 22 Finally, the VHA preferentially communicates with veterans via mailings. Increasing text message scheduling capacity or making e-mail opt-out rather than opt-in could meet the needs of the electronically savvy veteran population.…”