Women in rural and remote Queensland are facing major barriers to fertility care that are making an already difficult fertility journey even harder, new James Cook University research has found.
Published in the Australian Journal of Rural Health, the research highlighted long-distance travel, cost, limited local services and a lack of reliable information as major issues after interviewing 21 people who had experienced these fertility challenges.
Lead author, JCU PhD candidate and Rural Pharmacy Liaison Officer Amanda Mackay, said the findings showed geography could have a major impact on access to fertility care.
"One of our participants said 'access to fertility care shouldn't be determined by your postcode'," she said.
"We already knew accessing care in a rural and remote are for any medical condition is difficult, but the barriers to fertility care can be quite extreme.
"Women were making long trips away from home, often with very little notice – being told, 'Don't come down until Thursday', or 'We'd planned for Friday, can you get here Tuesday?'"
Mrs. Mackay said for people balancing work, children, partners and life on farms and stations, repeated trips to major centres are hugely disruptive.
"These people are working, have partners who work, and may have other kids or even stations and animals to care for. Someone must keep everything running while they're away," she said.
"If you live in Brisbane or Townsville, you might just take a few hours off work to see a doctor. For rural women, it's a completely different proposition."
Mrs. Mackay said some participants had to remain in cities after procedures because adequate monitoring was not available closer to home, while others could not afford treatment at all.
"Some women didn't access IVF at all because of financial concerns or simply not being able to afford it," she said.
"The research also highlighted major gaps in fertility information and support, with participants unsure when to seek help and reluctant to discuss fertility in small communities.
"Even knowing when to see a doctor – or who to see – was a challenge. Do I wait 12 months? Four years? At what point do I get help?
"There was a strong sense of a lack of basic information about fertility in general. No one talks about it. In rural areas - it feels more secretive, harder. It's considered taboo and there's a real stigma attached to it."
The researcher team highlighted that addressing those barriers could make fertility care more accessible while reducing the financial, emotional and practical burden on rural families.
"People wanted information available locally – a hub, a specific health professional, or a service they could go to without it being a big deal, just to get information and find out more," Mrs. Mackay said.
"Something like that could also help break down stigma and normalise fertility challenges – one in six Australian couples experience them, so it's not rare.
"They wanted fertility medications to be available locally, better-trained local health professionals, more use of telehealth so they didn't have to travel for every appointment, and better travel subsidies."
