Opening doors: Rethinking access to sexual & reproductive health services

The 224,928 women and girls living in the Barwon South West of Victoria are diverse in age, income, ability, culture and rurality. Some live in tiny surf towns like Cape Bridgewater or farming townships like Nullawarre, others live in regional centres like Geelong or Hamilton. The region also has some of the highest and lowest poverty rates in the state, so some local women experience extreme financial hardship while others are financially stable. 

Despite these many differences, there is one thing that connects Barwon South West women – the impossible task of trying to access sexual and reproductive health services.

Trying to schedule or afford an appointment with a sexual and reproductive health specialist in our region can be difficult. It can take up to two hours, and hundreds of kilometres, to attend a cervical screening, IUD insertion or maternal child health appointment. New research from Women’s Health and Wellbeing Barwon South West and Deakin Rural Health confirms what our community has known for a long time – that wait times are high; distances are long, information is hard to access and there simply aren’t enough appointments available.

This ‘perfect storm’ of barriers can make it very challenging for women to receive proper sexual and reproductive healthcare.  

Women in regional and rural areas are also worried about privacy and being judged by healthcare providers, especially when it comes to STI testing. Tight-knit communities that look out for each other can be a great strength. But this can come at a cost. Privacy can be harder to maintain when ‘everyone knows everyone,’ including staff at the pharmacy and GP clinic. Only 43 GP services were publicly listed for STI screenings across the Barwon South West region.

Across the region, there are only 24 medical termination of pregnancy providers. In the Glenelg Shire, one of the most remote corners of the region, the number of local patients asking for a medical termination of pregnancy is higher than the number of prescriptions written. This suggests women are travelling elsewhere to access abortion services.

These barriers mean that there are women in our region with unwanted pregnancies who are unable to access the services they need. In some cases, they may not even be aware that the service exists.

These experiences impact women and girls, as well as local service providers. Some GPs and nurses want to offer more sexual and reproductive supports but worry about backlash from the community – it can be isolating being the only one in town offering a stigmatised service. GPs and nurses also speak about the fear of performing a procedure, something going wrong, and the closest hospital being hours away. It’s a big responsibility to hold.

Despite these challenges, lots of things are working – mostly thanks to incredible local initiatives. Things like nurse-led models of care, STI self-collection, free sanitary products and culturally safe services enable women to have better experiences when accessing a service.

We also have a passionate, local group of sexual and reproductive healthcare workers who are committed to changing things from within. They provide each other with peer support and networking, to normalise sexual and reproductive healthcare in the Barwon South West.

The road to improving access to these crucial services is complex and long. But we know that by working alongside the incredible women, gender diverse people and healthcare providers across the Barwon South West – we are on the right track.

Note: we wish to acknowledge Sarah Wood (Deakin Rural Health) as the lead researcher on Mapping Access to Sexual and Reproductive Health Services in Regional Victoria.