Women’s experiences of accessing a medical termination of pregnancy through a Queensland regional sexual health service: a qualitative study

Abstract

Background An estimated 25% of Australian women will undergo induced abortion. Few studies have explored Australian women’s experiences of accessing medical termination of pregnancy (MToP). This study explored the experiences of women accessing MToP through a regional sexual health service in North Queensland. It aimed to determine the aspects of the process from seeking information about abortion to completion that worked well and to identify areas for improvement. Methods. Semi-structured telephone interviews with 11 women who accessed MTOP at Cairns Sexual Health Service (CSHS) were conducted. Interviews were recorded and transcribed verbatim. A deductive analysis approach was used to analyse the data. Results. Most women had little prior knowledge of MToP or access options and used the Internet to source information. Accessing MToP through a sexual health service was considered positive, non-judgemental, discrete and low-cost despite challenges of fitting in with appointment times and obtaining off-site ultrasound. GPs did not always provide referral; some women described experiences of stigma, discrimination and judgemental care during consultation and when obtaining ultrasounds. Concern for women living in more rural/remote areas was raised. Potential solutions including increased provision through rural general practitioners (GPs) and telehealth. Conclusion. Our study highlights the need for greater awareness of abortion options and access points among the community and healthcare providers. Access through sexual health clinics in regional settings is accepted; however, other options such as increased provision through rural GPs, primary health clinics, telehealth and nurse-led models of care could help overcome some of the barriers faced by rural and remote women.

What women want from local primary care services for unintended pregnancy in rural Australia: a qualitative study from rural New South Wales

“…Other studies in rural Australia have focused on women's experiences of abortion services once reached and the perspective of service providers about the delivery of care, including provision via telehealth (Doran and Hornibrook 2016;Dawson et al 2017;Hulme-Chambers et al 2018;Fix et al 2020;Ireland et al 2020;Cashman et al 2021;Mazza et al 2021;Malatzky and Hulme 2022). These studies have also found results similar to ours, that multiple systemic challenges exist for rural women when accessing services.…”

“…In a study examining access, equity and costs of induced abortion in Australia, the strongest predictor of late presentation (beyond 9 weeks) was living ≥4 h from the abortion clinic (Shankar et al 2017). Access barriers are well documented in relation to abortion care in Australia (Dawson et al 2017;Hulme-Chambers et al 2018;Fix et al 2020;Ireland et al 2020;Cashman et al 2021;Mazza et al 2021); however, little is known about the role of local generalist primary care providers in rural settings as the first point of contact for women seeking advice or services for unintended pregnancies.…”

Late termination of pregnancy at a major Queensland tertiary hospital, 2010–2020

“…These clinical scenarios were rare in our study, and usually arose at extremely pre‐term gestation ages when management, particularly regarding the advisability of feticide, was tailored to the individual. Finally, we could not investigate barriers to late termination of pregnancy service, such as financial, family, community, and social opposition, as well as domestic violence and mental health problems 17‐19 …”

“…Finally, we could not investigate barriers to late termination of pregnancy service, such as financial, family, community, and social opposition, as well as domestic violence and mental health problems. [17][18][19]…”

Opportunities for Increasing Access to Effective Contraception in Australia

“…58 The COVID-19 pandemic facilitated the creation of MBS items for telehealth, which has made these services more accessible across Australia. 59 However, many women remain unaware of the availability of telehealth as a mode of delivery for reproductive health services, 60 61 highlighting the importance of raising awareness of this option among both women and practitioners.…”