What women want from local primary care services for unintended pregnancy in rural Australia: a qualitative study from rural New South Wales
Anna Noonan A B * , Kirsten I. Black A B , Georgina M. Luscombe C and Jane Tomnay DA Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
B SPHERE Centre for Research Excellence, Department of General Practice, Monash University, Notting Hill, Vic. 3168, Australia.
C School of Rural Health (Dubbo/Orange), The University of Sydney, Orange, NSW 2800, Australia.
D Department of Rural Health, The University of Melbourne, Shepparton, Vic. 3630, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22134
Submitted: 28 June 2022 Accepted: 28 September 2022 Published online: 26 October 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Under the generalist model of health care in rural Australia, general practitioners (GPs) are often the first point of contact for women seeking health services for unintended pregnancy, including pregnancy decision-making support and options advice, antenatal or abortion care. Rural women are more likely to experience unintended pregnancy in Australia, yet little is known about how well local rural primary healthcare services currently meet their needs.
Methods: To address this gap, this qualitative study explores through in-depth semi-structured interviews, the experiences of 20 rural women managing an unintended pregnancy, and their expectations of, and satisfaction with, the quality of care they received. The Framework Method was used to organise data and conduct an inductive thematic analysis.
Results: Three themes related to management of unintended pregnancy in a rural primary care setting were identified: (1) women expect informed and efficient care once services are reached; (2) women desire greater choice and aftercare; and (3) comprehensive reproductive health should be part of rural primary care. Participants indicated an awareness of the limitations of the rural health system, yet a firm expectation that despite access delays, all of their reproductive health needs would be met. Choice, time efficiency, and aftercare were identified as gaps in the current primary care service experience. A desire for greater attention to rural reproductive health, including improved contraception, was also emphasised.
Conclusions: Rural women with unintended pregnancy experienced gaps in service quality and described a lack of woman-centred care in their local rural health setting. This study offers insight into how rural primary care providers can better support women to make decisions about and reach their preferred services for unintended pregnancy.
Keywords: abortion, early pregnancy, healthcare access, primary care, reproductive health, rural health, unintended pregnancy, woman-centred care.
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