Experiences Accessing Contraception and Barriers to Care in Rural Montana

Background and Purpose: The past few years have seen a dramatic decrease in the ability of individuals to exercise their reproductive rights, particularly related to abortion and contraceptive access. These changes have often especially impacted people living in rural areas, who have decreased access to reproductive and sexual healthcare resources to begin with. While concerns have often focused on the increased physical distance people face in accessing reproductive healthcare, less attention has focused on other spatial factors, such as lack of transportation or the impact of weather conditions that also contribute to contraceptive access.

Methods: A qualitative descriptive research methodology was used to conduct qualitative semi-structured interviews with 25 self-identified women from across Montana. Interviews were conducted from January to March 2023, took place via zoom, and averaged 45 minutes in length. They were transcribed verbatim and analyzed with NVivo software.

Results: In describing their experiences accessing contraceptive services, the following themes were identified: (1) Impact of stigma in accessing care; (2) Physical barriers to accessing care; and (3) Provider-related barriers.

Conclusions and Implications: The reproductive justice framework is used to contextualize these findings and they are being used to develop StoryMaps to illustrate barriers to holistic contraceptive care for rural populations. These results showcase the experiences of rural perinatal people in accessing contraceptive services and highlight how barriers such as a lack of providers are compounded by additional barriers such as stigma and winter weather. Opportunities to increase access to contraceptive care are also described.