‘I didn’t feel judged’: exploring women’s access to telemedicine abortion in rural Australia
Sarah Ireland 1 4 , Suzanne Belton 2 , Frances Doran 31 Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia
2 Menzies School of Health Research, Ellengowan Drive, Casuarina, NT, Australia
3 Southern Cross University, Military Road, East Lismore, NSW, Australia
4 Corresponding author. Email: Sarah.ireland@cdu.edu.au
Journal of Primary Health Care 12(1) 49-56 https://doi.org/10.1071/HC19050
Published: 24 March 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Regardless of geographical location, safe and legal abortion is an essential reproductive health service. Accessing an abortion is problematic for women in rural areas. Although telemedicine is globally established as safe and effective for medical abortion in urban settings, there is a paucity of research exploring access to telemedicine abortion for women in rural locations.
AIM: The aim of this qualitative research is to explore and better understand women’s access to telemedicine abortion in Australian rural areas.
METHODS: Structured interviews were conducted with women (n = 11) living in rural areas who had experienced a telemedicine abortion within the last 6 months. Phone interviews were recorded and transcribed verbatim. Data underwent a Patient-Centred Access framework analysis and were coded according to the domain categories of approachability/ability to perceive, acceptability/ability to seek, availability/ability to reach, affordability/ability to pay, and appropriateness/ability to engage.
RESULTS: Rural women had severely limited access to abortion care. The five domains of the Patient-Centred Access model demonstrated that when women with the prerequisite personal skills and circumstances are offered a low-cost service with compassionate staff and technical competence, telemedicine can innovate to ensure rural communities have access to essential reproductive health services.
DISCUSSION: Telemedicine offers an innovative model for ensuring women’s access to medical abortion services in rural areas of Australia and likely has similar applicability to international non-urban contexts. Strategies are needed to ensure women with lower literacy and less favourable situational contexts, can equitably access abortion services through telemedicine.
KEYwords: telemedicine; remote health; abortion; reproductive health; health-care access
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