Exploring contraceptive care practices at Rural Health Clinics in the southern United States

• Published in: Sexual & reproductive healthcare 2021-09, Vol.29, p.100629-100629, Article 100629
• Main Authors: White, Ashley L., Merrell, Melinda A.
• Format: Article
• Language: English
• Subjects: Qualitative research; Reproductive health; Rural health
• ISSN: 1877-5756; 1877-5764
• DOI: 10.1016/j.srhc.2021.100629

•In the USA, Rural Health Clinics fill contraceptive service gaps for rural communities.•Participating clinics reported typical contraceptive patients as low-income women less than 22 years old.•Participating clinics had limited capacity to offer a full range of contraception. With declining numbers of obstetrician-gynecologists operating in rural areas across the United States, primary care providers have stepped in to fill contraceptive service gaps. Many of these providers operate in Rural Health Clinics; however, little is known about the provision of contraception in these clinics. This exploratory qualitative descriptive study used a purposive sampling strategy to recruit South Carolina Rural Health Clinic providers from across regions and income levels. Eleven providers participated in semi-structured, in-person interviews. Contraceptive care practices were identified using a combination of inductive and deductive coding. Participants described their typical contraceptive patient as a low-income woman under 22 years. While providers were open to providing contraception, their on-site services were limited. Each included clinic offered the oral contraceptive pill and the shot, but only one offered the implant, and none offered the intrauterine device. Rural Health Clinic providers have limited capacity to offer a full range of contraception due to financial, training, and staffing constraints. Despite these limitations, Rural Health Clinics remain a contact point that helps meet national recommendations for increasing access to reproductive health services for rural women. Efforts to increase access to contraceptive care for rural women must include resources for these providers.