Reproductive Healthcare Service Accessibility in Alberta
In the rural parts of Alberta, accessing reproductive clinics, professionals, and services may feel like a labyrinth with no clear outcome. In certain rural areas, the nearest contraception or abortion clinic may be hours away, and the financial strain that comes with travelling to that clinic may outweigh the potential benefit of accessing those surfaces. This can have devastating effects on the livelihood of women, and in many cases there is no clear answer to address this gap .
As a medical student that has been able to appreciate the vast distinction between healthcare in an urban versus rural setting, I have realized that the challenge to this issue goes beyond just a question of accessibility. There may also be cultural stigma, confidentiality issues, and systemic inequity driven by trauma on certain populations such as indigenous women.
In order to tackle this multifaceted issue, the first step is to understand the issue - where exactly does the problem lie, and what are the gaps that need to be filled? The second step is to actually come up with potential solutions that may assist women in accessing reproductive healthcare without consequences. In combining this two step approach, women in both rural and urban centers may be able to access a relatively equal level of reproductive health services.
Given the high density of reproductive clinics here in Calgary (compared to rural centers), challenges faced by the populous in the city may include finding a compatible appointment time, or finding the clinic with the best online reviews. But in rural areas, specialized clinics that offer abortion, contraception counselling, and family planning may not be as concentrated. With a potential lack of availability or even a lack of the clinic itself, women may have to travel hours to get care. The issue in this matter is three-fold: 1- it is incredibly inconvenient for women to have to endure this amidst an already stressful concept of reproductive health; 2- the distance from centers may delay interventions that are time dependent (e.g. emergency contraception and abortion); 3- the economic burden for this kind of endeavour could be massive, as the woman may have to endure costs ranging from gas, childcare, loss of employment income, and accommodation.
From a student and advocate perspective, it is clear that there are high level changes required to address such a problem. Having said that, I can think of a few initiatives that may get the ball rolling. First, having mobile clinics where medical students can go volunteer for brief periods of time (e.g. 1 week) under the supervision of a preceptor may go a long way for women waiting to get reproductive health counselling. It would also serve as a great way for students to get experience “shadowing” in a unique environment. Another strategy to help women in rural areas may be to introduce travel bursaries for those that do not have the financial means to travel for services. By filling out a quick application, women may have the chance to get funding to go to a certain clinic and have their concerns heard. Finally, incorporating more Telehealth medicine would not only lessen the burden that women in rural areas have to face in obtaining reproductive health services, but it would also be a great way for physicians in urban centers to expand their patient pool in a manner that does not come at a great cost. These three solutions, despite not encompassing all issues, would still definitely ensure a push towards equitable access to healthcare irrespective of geographical or economic barriers.
Another issue that women in rural Alberta may have to deal with is the fact that the idea of certain reproductive healthcare services (e.g abortion) are surrounded with a significant amount of negative stigma. In certain areas where some political ideologies may be more dominant than others, women may find it difficult to break through that barrier. An issue that arises in tandem with stigma is the idea of proximity to others in the community. Given the small sizes of many rural areas, the community can be very tight knit, and therefore people may talk about those who do not want to be the topic of conversation. The lack of openness as well as the lack of important education around reproductive health further perpetuates misinformation and stigma, creating a never ending cycle.
The solution for putting a stop to this stigma goes beyond creative initiatives. In addition to being part of rural health delivery programs, medical students can play a crucial role in advocacy and education, namely by participating in outreach programs to dispel myths and reduce stigma in communities. These efforts, combined with patient centered care, are instrumental in ensuring that all women feel supported in making informed decisions about their health.
In conclusion, there are several gaps in the realm of reproductive health service accessibility in rural areas. Education of rural communities to prevent stigma, expanding healthcare into lesser populated areas of Alberta, and introducing more telehealth measures are some of the many ways we can work towards bridging the massive gap that exists today, but it starts one step at a time.
