Since the world’s first IVF baby was born in 1978, assisted reproduction has become an option for people experiencing difficulties in conceiving a child and is now more accessible to non-metropolitan couples.
A lecturer in human services and social work in CSU’s School of Humanities and Social Sciences
, Dr Bell recently completed her PhD on The experiences and support needs of non-metropolitan women who have used assisted reproductive clinics
Assisted reproductive services in Australia are often delivered via privately owned clinics and most of these are based in large metropolitan centres. There are currently 72 accredited clinics in Australia listed on the Fertility Society of Australia website. Some of these primary service providers also deliver services into non-metropolitan areas via outreach, or satellite clinics and a few larger regional towns have their own primary clinic.
“Satellite clinics are often based in private hospitals or consulting rooms in regional centres and most seem to visit once every three months or so,” explains Dr Bell. “How they’re organised is variable and dependent on local facilities. Some regional centres have their own full-time clinics. If you look at the websites of large IVF service providers, you can see that some of them have several ‘satellite’ clinics located in regional centres. These satellite clinics are usually available only intermittently and may not have the capacity to provide the full range of options to service users. It is quite a complex sector.”
Dr Bell’s qualitative project focused on the experiences and support needs of women living in non-metropolitan areas. In addition to general locational disadvantages these women often experience additional, specific service delivery issues and Dr Bell believes their voices have been particularly quiet in the discourse of assisted reproduction.
“I have always been interested in highlighting womens’ health and gender issues,” Dr Bell said. “Assisted reproduction raises so many issues for us all, socially, legally, ethically and with access for people in regional areas improving in some ways, I was interested to see if the quality of service provision was evolving as quickly as access to the technology.”
Dr Bell interviewed 29 regional women who had used assisted reproduction services and their experiences were varied. Many of the research participants said that clinics gave ample technical information on the assisted reproduction process but, with such complex information to digest, plus the emotional and financial investment to take into consideration, women felt the need for more consistent face-to-face consultation and follow-up.
“Some of the women said they’d felt ‘rushed’ when visiting their clinic and that they would have appreciated better access to an independent, appropriately qualified support worker, such as a social worker, counsellor or psychologist,” Dr Bell said. “Another issue for some women, especially those in smaller towns, was lack of privacy. In many cases, the women had no choice but to spend time in generic waiting rooms of regional health facilities which, they felt, jeopardised their anonymity.
“Regardless of whether participants had positive or negative experiences overall, the overarching theme emerging from their stories was that assisted conception services must be delivered with respect for the privacy, dignity, self-determination and human worth of service users, their partners and families,” Dr Bell said. “A more consistent human rights approach to service delivery in the sector is needed as is a multidisciplinary approach to service delivery, including ongoing psychosocial support.”
Dr Bell stresses that previous social research has also identified some of these themes, but even after three decades of assisted reproduction, and despite biomedical developments in the technology, the manner in which it is delivered by some clinics isn’t necessarily improving at the same rate.
“Service providers have so much to gain from the people using their services.There are real opportunities for improved service delivery “and whilst some providers do take their clients’ experiences into accountthere’s still room for improvement in many areas, including some regional areas,” states Dr Bell. “Based on what the women said, I’d like to see a much more holistic approach in assisted reproductive service delivery with access to social workers and psychologists on-site. Accessible, comprehensive information needs to be available, privacy should be obtainable and clients’ comfort taken into consideration. This should be the basic standard.”
The latest report
from the Australian Institute of Health and Welfare & National Perinatal Statistics unit is the source of reliable statistics about assisted reproduction.
According to the Fertility Society of Australia
, one in six Australian couples experience infertility. In 2008 alone, there were 61,929 assisted reproductive technology (ART) cycles attempted in Australian and New Zealand. With an overall success rate of 17.2%, taking into account all age groups, approximately three percent of all babies born in Australia each year are born after assisted reproduction procedures.
The Fertility Society of Australia site has links to the Reproductive Treatment Accreditation Committee information as well as information on the current number of clinics
in Australia and their locations.
For interviews contact CSU Media.