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Understanding reproductive health disparities

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In 2018 Public Health England (PHE) asked the public about their experiences with reproductive health problems and more than 7,500 women and people with female reproductive needs responded.

Many told us about their desire for reproductive health problems to be normalized, de-stigmatized and openly discussed. When they need help, they want to know when and how to seek the right care, and be confident that the care they receive will be well managed and communicated.

This feedback led directly to PHE’s work to improve how we measure progress in reproductive health, how we communicate about it, and how we support the health system to function better.

But while we heard many voices, the people who responded did not fully represent all parts of our society. Compared to the general population, we did not get a representative number of responses from women who identified themselves as Black or South Asian, those who lived in the most deprived areas, and those who were over 45 years of age.

That’s why all through July we are running new survey on reproductive health experiences with the London School of Hygiene and Tropical Medicine, and we want to make sure everyone has their say.

Making sure everyone is represented

The recent Report of the Commission on Racial and Ethnic Disparities He highlighted the distrust that many people of minority ethnic origin have in government services, including health care. Historical experiences of racism continue to “haunt the present,” which could reduce participation in government-run programs, such as health research.

We know that not all people have the same experiences when it comes to their reproductive health and well-being. These variations are normal in any group of people. But what is not correct is that women in certain demographic groups experience much worse outcomes in the early stages of pregnancy, infertility, childbearing, and gynecological conditions.

A recent study in the lancet showed that the risk of miscarriage for black women is 43% higher than for white women. The latest report on Maternal death showed that the rates were almost four times higher for women of black ethnic origin and almost two times higher for women of Asian ethnic origin, compared to white women.

People who are from ethnic minorities are also less likely to have a baby after fertility treatment. According to the Human Fertilization and Embryology Authority, Black patients ages 30 to 34 have an average birth rate of 23%, compared to 30% for white and mixed patients. While there are no definitive explanations for these differences, we do know that black patients begin IVF almost two years later than the average patient. Why this is the case requires further investigation, but could be due to barriers to accessing IVF services

Living in the most disadvantaged parts of the country is also associated with higher admissions for conditions such as pelvic inflammatory disease and ectopic pregnancy, higher rates of teenage pregnancy, and higher rates of abortions, which could indicate difficulties in accessing contraception in these areas.

Among lesbian and bisexual women, teenage pregnancy is higher than the national rate and cervical detection rates are also lower. There may be structural or social barriers that need to be addressed to ensure that all people feel secure in accessing the care they need or choose.

We also see differences between age groups, for example older women tend to have higher levels of unmet need for contraception and may not seek support for their changing contraceptive needs as they progress from perimenopause to menopause. We know that the pandemic has caused delays in access to reproductive health for some people.

But many of these disparities existed before and have worsened in the past year. The root causes are still not well understood despite being visible for a few years. To help us find solutions, we need to better understand women’s experiences by asking them directly.

Take the survey now

So what can you do? First of all, if you are a woman or have female reproductive needs, complete the survey! It is open until 29th July and it takes about 10 minutes. If you use social media, why not post a post about the survey to encourage your networks to complete it as well?

Second, if you have any ties to groups that work with women of color, socially disadvantaged, seniors, or young people, we’d love to hear from them to see how they can encourage others to share their experiences with us through the survey. .

Reproductive health affects more than half of the population for most of our lives; Let’s all talk about it more so that we can improve the experiences we have.

For more information on the survey, visit the survey website.

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