Supporting Rural Women Experiencing Unintended Pregnancy and Abortion

Project Summary

CERSH has been working across Northeast Victoria, Goulburn Valley and the Loddon Mallee regions in partnership with a range of organisations and practitioners to establish the systems required to provide medical termination of pregnancy (MToP) in primary health care settings.

Although law reform and the registration of mifepristone on the PBS in 2013 have removed some barriers to services, rural workers still report poor access to abortion in rural areas. Barriers for rural women accessing first trimester abortion include a lack of local services; travel to cities for abortion care and associated costs; and concerns about privacy and confidentiality. MToP provision is still rare in rural Victoria with few GPs prepared to provide MToP in general practice and very few bulk-billing providers.

In 2012 The Royal Women’s Hospital (RWH) began to initiate partnerships with a range of rural services to decentralise abortion services in Victoria. In August 2013, Dr Paddy Moore, RWH, presented this work at the CERSH Rural Sexual Health Conference. In response to the strong interest at the conference, and consequent consultations and needs assessment, CERSH commenced work to increase coordinated access to MToP in rural locations and provide rural women with affordable alternatives.

Project Objectives

The objectives of this work, since 2014, are threefold:

  1. To train and resource both public and private practitioners enabling them to provide timely support to rural women experiencing unplanned pregnancy.
  2. To coordinate the mechanisms and resources required to establish MToP services in primary care settings that are coordinated, affordable, address structural issues for women, and that are part of a comprehensive sexual and reproductive health service response.
  3. To create evidence which informs rural sexual and reproductive health policy and service delivery.

2017 Progress Update

The CERSH program of work in 2017 has focused on the following:

  • Completion of three pieces of research, publications in peer reviewed journals and summary reports for the sector – go here for published articles
  • Profiling abortion service system development at the SEXrurality conference held in August 2017 – go here to access conference presentations
  • Establishment of a Clinical Network for MToP practitioners in partnership with Murray PHN and The Royal Women’s Hospital – go here for more info on the Clinical Network
  • Consultation with existing MToP providers, Murray PHN and state-wide services to determine an appropriate mechanism to disseminate details of MToP providers and referral pathways to relevant workers.
  • Commencing the development of an online learning module for clinicians focused on establishing MToP systems in rural locations.
  • Continued endeavor to tackle the complex issue of providing information about rural abortion providers in the public domain.

2018 Progress Update

As of May 2018, the CERSH program of work this year has focused on the following:

  • The online learning module for clinicians focused on establishing MToP systems in rural locations is now available as part of the Rural Sexual Health Care modules – the module is: Service Delivery of Medical Termination of Pregnancy in the Rural Context and can be accessed here.
  • The Rural Victorian Clinical Network is continuing in meet in 2018. The first meeting for 2018 focused on: Case studies for trouble shooting complications; Case study from a rural community health service on MToP process and contraception take-up; 1800 My Options Service – Women’s Health Victoria. An overview of a new website and phone service 1800 My Options for all Victorian women wanting sexual and reproductive health information. The second meeting of the year is scheduled for Monday 18 June.
  • CERSH, in partnership with Mallee Children & Youth Area Partnership, Sunraysia Community Health Service, The Women’s and Family Planning Victoria facilitated a training day on 26 April in Mildura for 39 participants from a range of health and community sector organisations. The day provided foundation knowledge about unplanned pregnancy, supporting women’s decision-making, abortion options, clinical practice and medico-legal issues; an overview of the progress towards decentralisation of abortion services throughout Victoria, successes and challenges; and an opportunity to discuss the local Mallee service system and future opportunities – see below to access copies of the presentations given
  • The above training forum was followed by an evening program for 13 GPs, nurses, and Practice Managers. Facilitated by Dr Paddy Moore from The Women’s, this session explored the role of rural GP practices in managing medical termination of pregnancy in the Mildura region, and provided an update about medical termination of pregnancy procedures & GP training requirements for MTOP. The training was coordinated by CERSH, The Women’s, Mallee Children & Youth Area Partnership, and Murray PHN.

Project Contact

For more information on this project please email cersh-admin@unimelb.edu.au

Project Update August 2017

Read a full update of this project, written in August 2017.

Presentations and Resources

The following presentations and resources are taken from the Mildura training forum held in April 2018:

Contraception and Abortion: Let's make access easy

Presentation by Dr Paddy Moore, Women's Hospital

Early Medical Abortion: opportunities and challenges

Presentation by Dr Paddy Moore, Women's Hospital

Unplanned Pregnancy Choices

Presentation by Melissa Chadwick, Family Planning Victoria

Resource: RWH Pregnancy Advisory Service

Activities to help with decision-making: pros & cons

Resource: RWH Pregnancy Advisory Service

Activities to help your decision-making: feelings & values