Women’s sexual and reproductive health: Working to deliver better care

A new women’s sexual and reproductive health brains trust, based at Monash University, aims to close “profound” evidence gaps and improve Australian women’s access to sexual and reproductive health services.

Professor Danielle Mazza is the director of the new SPHERE Centre of Research Excellence in Women’s Sexual and Reproductive Health in Primary Care – a collaborative network of national and international experts and researchers working to transform a complex area of healthcare targeted at Australia’s 5.6 million women of reproductive age. She's also the head of Monash’s Department of General Practice.

SPHERE is a five-year program funded by the federal government through the National Health and Medical Research Council.

"The research indicates that we need to deliver better sexual and reproductive healthcare to women."

“We'll give this area of women’s health a significant emphasis, and talk about the multifaceted nature of it,” she says.

“It’s not just about providing contraception, it’s also about providing abortion care and pre-conception care when those are needed. If we want women to achieve optimum sexual and reproductive health, then we should be helping women achieve the reproductive goals they desire, the number of children they want, and when they want to have them. This requires comprehensive primary care.”

Monash University’s Professor Jane Fisher – a Finkel Professor of Global Public Health and Professor of Women’s Health in Monash’s School of Public Health and Preventive Medicine – is a chief investigator on the project, as is Dr Safeera Hussainy, an adjunct senior lecturer at the Department of General Practice.

Professor Fisher will focus on research into sexual and reproductive healthcare for women with chronic diseases who, she says, “describe their sexual and reproductive healthcare needs as being poorly understood or addressed”.

Practice not perfect

Professor Mazza says GPs will be a primary focus of SPHERE’s work because of their “integral” role in the delivery of sexual and reproductive health services to women. However, she says general practice has some catching up to do.

“From a GP’s perspective, I think practice hasn’t caught up with the evidence,” she says. “The research indicates that we need to deliver better sexual and reproductive healthcare to women. For example, there hasn’t been much emphasis given to pre-conception care.

“To date we've focused on how to help women once they're pregnant, but increasingly the research tells us that so many health issues can arise during the pre-conception period or very early in the pregnancy.

“Equally,” she says, “we know that many of the causes of bad outcomes in a pregnancy in terms of premature labour or a small baby are avoidable if inter-conception care is provided to women, which is defined as the care provided between pregnancies to improve health outcomes for both mother and baby.

“These things have not been emphasised in GP training out in the field. Likewise, women aren’t properly aware of the need to discuss their health or any pre-existing health issues before becoming pregnant . Women don’t really think about these issues until they are pregnant.

Lack of awareness

“In terms of contraception, women often don’t know about the most effective methods," Professor Mazza adds. "They might think the pill is right for them because it’s what their friends or family use, or because their GP has recommended that method. But they might not know about intrauterine devices [IUDs] or contraceptive implants, which are very effective at preventing pregnancy, and their GPs may not be talking to them about those devices.

“So women don’t get the opportunity to avail themselves of the most effective contraceptive for them.”

Medical abortion has been available in Australia for several years now, and is a very safe and effective way of terminating a pregnancy prior to nine weeks' gestation, she says. But very few GPs provide this service, and many women don’t even know it is an option.

“SPHERE will support GPs to become providers, reducing the barriers to access that currently exist. Women trust their GPs, and turn to them for advice about these issues.

“SPHERE will assist GPs to provide the best possible care to women and ensure that safe, effective, evidence-based care is available and accessible for all Australian women.”