One-quar­ter of Aus­tralian women expe­ri­ence an unin­tend­ed preg­nan­cy in their life­time, with rates 1.4 times high­er in rur­al and remote com­mu­ni­ties¹. About a third of these unin­tend­ed preg­nan­cies end in abor­tion¹. Com­pared to some forms of con­tra­cep­tion which rely on reg­u­lar user com­pli­ance to be effec­tive, long-act­ing reversible con­tra­cep­tion (LARC) is high­ly effec­tive, has high­er con­sumer sat­is­fac­tion and longer con­tin­u­a­tion rates². 

Pre­vent­ing unin­tend­ed preg­nan­cy is an impor­tant ini­tia­tive in the Aus­tralian Nation­al Women’s Health Strat­e­gy 2020 – 2030³. LARC and ear­ly med­ical abor­tion (EMA) (using mifepri­s­tone fol­lowed by miso­pros­tol up to nine weeks ges­ta­tion) are safe and effec­tive but few pri­ma­ry care clin­i­cians pro­vide either of these ser­vices. Bet­ter clin­i­cian access to LARC and EMA edu­ca­tion, train­ing and ongo­ing sup­port would assist clin­i­cians pro­vid­ing this care⁴⁺⁵.

To sup­port clin­i­cians in pro­vid­ing LARC and EMA care to com­mu­ni­ties, the SPHERE NHM­RC Cen­tre of Research Excel­lence in Sex­u­al and Repro­duc­tive Health for Women in Pri­ma­ry Care launched the Aus­tralian Con­tra­cep­tion and Abor­tion Pri­ma­ry Care Prac­ti­tion­er Sup­port (Aus­CAPPS) Net­work in July 2021 for prac­tice nurs­es, gen­er­al prac­ti­tion­ers, and com­mu­ni­ty phar­ma­cists work­ing in women’s health. 

The devel­op­ment of Aus­CAPPS is sup­port­ed by an exten­sive part­ner and advi­so­ry net­work that includes Aus­tralian Pri­ma­ry Health Care Nurs­es’ Asso­ci­a­tion, Phar­ma­cy Soci­ety of Aus­tralia, Roy­al Aus­tralian Col­lege of Gen­er­al Prac­ti­tion­ers, Roy­al Aus­tralian and New Zealand Col­lege of Obste­tri­cians and Gynae­col­o­gists, and oth­er key stake­hold­ers in women’s health. AHPRA ver­i­fied clin­i­cians can join Aus­CAPPS and access net­work­ing oppor­tu­ni­ties with peers and experts, a data­base of providers of LARC and EMA ser­vices, a resource library, access to webi­na­rs and pod­casts, and links to LARC and EMA train­ing providers.

Aus­CAPPS will assist in answer­ing clin­i­cian ques­tions about pro­vid­ing LARC and EMA care and pro­vide week­ly expert clin­i­cian post­ing on the dis­cus­sion forum, with sup­port by med­ical direc­tors in fam­i­ly plan­ning. Exam­ples of Aus­CAPPS mem­ber post­ing includes ​“Can any­one direct me to evi­dence sur­round­ing safe tim­ing of tam­pon use after EMA?” and ​“I have today received a refer­ral from a GP for assess­ment for implanon NXT for an 11 year old. Haven’t spo­ken to her or par­ent as yet, but won­der­ing what oth­ers think of this…” Addi­tion­al­ly, exam­ples of the week­ly expert clin­i­cian post­ing includes top­ics such as ​“Mire­na use in per­i­menopause” and ​“In addi­tion to a clin­i­cal his­to­ry, what do you use to con­firm suc­cess of an ear­ly med­ical abor­tion?” as well as many oth­er key issues relat­ed to women’s sex­u­al and repro­duc­tive health.

Nurse-led LARC and EMA care is safe and an afford­able way to enhance pri­ma­ry care access for these ser­vices in rur­al com­mu­ni­ties⁶. To sup­port your clin­i­cal prac­tice in women’s sex­u­al and repro­duc­tive health care, you can join the Aus­CAPPS Net­work by vis­it­ing the Aus­CAPPS | Med­cast web­site at med​cast​.com​.au/​c​o​m​m​u​n​i​t​i​e​s​/​a​u​s​capps. It takes five min­utes to reg­is­ter. We now have over 1100 mem­bers! For more infor­ma­tion, email auscapps.​trial@​monash.​edu

Ref­er­ences

1. Taft AJ, Shankar M, Black KI, et al. Unin­tend­ed and unwant­ed preg­nan­cy in Aus­tralia: a cross-sec­tion­al, nation­al ran­dom tele­phone sur­vey of preva­lence and out­comes. The Med­ical jour­nal of Aus­tralia 2018;209(9):407 – 08. doi: 10.5694/mja17.01094

2. Black KI, McGeechan K, Wat­son CJ, et al. Women’s sat­is­fac­tion with and ongo­ing use of hor­mon­al long-act­ing meth­ods com­pared to the oral con­tra­cep­tive pill: Find­ings from an Aus­tralian gen­er­al prac­tice clus­ter ran­domised tri­al (ACCORd). Aus­tralian and New Zealand Jour­nal of Obstet­rics and Gynae­col­o­gy 2021;61(3):448 – 53. doi: 10.1111/ajo.13319

3. Aus­tralian Gov­ern­ment Depart­ment of Health. Nation­al Wom­en’s Health Strat­e­gy 2020 – 2030, 2018.

4. Aus­tralian Health­care and Hos­pi­tals Asso­ci­a­tion. Con­sen­sus State­ment: Reduc­ing unin­tend­ed preg­nan­cy for Aus­tralian women through increased access to long-act­ing reversible con­tra­cep­tive meth­ods, 2017.

5. Devane C, Ren­ner RM, Munro S, et al. Imple­men­ta­tion of mifepri­s­tone med­ical abor­tion in Cana­da: pilot and fea­si­bil­i­ty test­ing of a sur­vey to assess facil­i­ta­tors and bar­ri­ers. Pilot Fea­si­bil­i­ty Stud 2019;5:126. doi: 10.1186/s40814-019‑0520‑8 [pub­lished Online First: 20191108]

6. Tom­nay JE, Coel­li L, David­son A, et al. Pro­vid­ing acces­si­ble med­ical abor­tion ser­vices in a Vic­to­ri­an rur­al com­mu­ni­ty: a descrip­tion and audit of ser­vice deliv­ery and con­tra­cep­tion fol­low up. Sex­u­al & Repro­duc­tive Health­care 2018: 16, 175