Women are struggling to access basic reproductive healthcare such as contraception, abortion services and menopause support, new research suggests, with one woman telling HuffPost UK she has spent almost six months trying to get an IUD fitted.
The survey of more than 3,000 women, commissioned by The Royal College of Obstetricians and Gynaecologists (RCOG), found nearly four in 10 women have been unable to access contraception services locally and 60% of women have struggled to access unplanned pregnancy services locally, including abortion care and emergency contraception.
Anna Mackenzie, 25, who lives in Twickenham, told HuffPost UK she has been trying to get an IUD (coil) fitted for the past six months. “I finished my last pack of the pill in July and wanted to get a non-hormonal coil fitted, so made a GP appointment,” she explains.
Having recently moved to London, it took Mackenzie until September to register at a new GP and find an available appointment. And when she did, she was told she couldn’t have the IUD fitted. “I was told I would need to get a smear test done first, which was extra waiting time,” she says.
There is no medical reason for a woman to be told she must be up to date with cervical smears in order to have an IUD fitted, Jo’s Cervical Cancer Trust told HuffPost UK, but some GP surgeries appear to be recommending this to tackle low cervical screening uptake.
Mackenzie booked the next screening appointment available, which was another month later – but this was cancelled by her surgery. “In the waiting time, I ended up having to use emergency contraception once after a condom failed,” she says.
She is now back on the pill – which is not her preferred method of contraception – while she awaits cervical screening in order for her GP surgery to book a coil fitting. “After which, I will need to wait up to six weeks for the [cervical screening] results and then try to book for the coil again, so the whole process is half a year,” she says.
Others readers have told HuffPost UK they’ve given up altogether and are now paying for basic contraception.
“My GP has just been closed down so the whole town is going to the walk-in. I’m now going to buy pills from Superdrug,” Sophie Frost, 26, from Dartford, says. “Even when the GP was open, it was a struggle to get an appointment.”
To tackle the problem, the RCOG is calling for the introduction of “one-stop-shop” health clinics for women that offer a variety of sexual and reproductive healthcare services in one place, including contraception, STI testing, cervical screening, and treatment and advice about the menopause.
Crucially, these clinics should be open during the evenings and weekends, the RCOG says, adding that joined-up services would be “cost-effective” for the NHS in the long-term.
The charity has blamed “under-funding and fragmentation” for the current state of reproductive health services, adding: “Poor access to basic women’s health services leads to a rise in unplanned pregnancies, abortions, poor patient experiences and outcomes.”
The survey found more than a third of women did not attend their last smear test. This rose to nearly half (43%) among women with an income of less than £15,000, compared to 24% of women on higher incomes.
Only half of women said they are able to access services for sexually transmitted infections (STI) locally, while 56% of women said they are unable to seek help for menstrual health issues, such as for heavy/painful periods, nearby. And 58% of women cannot access menopause services.
Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, said the current, disjointed system does not work for doctors or women. She gave the example of a patient who came to her clinic needing a coil fitted, who was also due for her cervical smear test.
“This is the perfect opportunity to provide both services,” she said. “However, my clinic is not commissioned to provide smears, so I am unable to do so.
“Instead of having all of her needs met in one go, this woman now has to book two appointments for two different vaginal examinations. It is expensive, frustrating for me as a doctor and unfair for the woman. Something has to change.”