Decreasing reproductive and abortion care barriers: findings on the student health center's role from a student survey

Abstract

Background College-aged young adults in the US have low utilization and high need for reproductive healthcare. Multiple barriers to reproductive care exist. University Student Health Centers (SHCs) provide varying degrees of reproductive products and services. Recently, California legislated that public university SHCs add medication abortion to their care. Methods To examine existing attitudes and barriers to reproductive healthcare for public university students, we conducted an anonymous online survey at a large, diverse, urban coastal California State University. Students were asked about numerous barriers accessing reproductive services in general and at the SHC, which we categorized into three groups: stigma, access and system. Respondents were also asked about knowledge and preferences for accessing and recommending various services. To understand the extent to which inequities exist, we compared differences across racialized/ethnic identity, gender identity, anticipated degree, and living distance from campus using chi-squared tests. Results The majority of survey (n = 273) respondents experienced stigma and access barriers in general healthcare settings which made obtaining reproductive healthcare for themselves or their partners difficult (stigma barriers 55%; 95% CI 49%–61%; access barriers 68%; 95% CI 62–73%). Notably, students reported statistically significant lower rates of access barriers at the SHC, 50%, than in general reproductive healthcare settings, 68%. There were limited differences by student demographics. Students also reported a high willingness to use or recommend the SHC for pregnancy tests (73%; 95% CI 67–78%), emergency contraception pills (72%; 95% CI 66–78%) and medication abortion (60%; 95% CI 54–66%). Students were less likely to know where to access medication abortion compared to other services, suggesting unmet need. Conclusions Our study provides evidence that students face barriers accessing reproductive healthcare and that SHCs are a trusted and accessible source of this care. SHCs have a key role in increasing health, academic and gender equity in the post-Roe era. Attention and financial support must be paid to SHCs to ensure success as state legislatures mandate them to expand reproductive and abortion care access.

Just in case: undergraduate students identifying and mitigating barriers to their sexual and reproductive health needs

“…Finally, the availability of Just in Case increased students’ perception of access to over-the-counter emergency contraceptives on campus, with a 28% increase in post-survey respondents who indicated “Easy Access.” There was also a change in those participants who responded to having “Minimum Access” and “No Access.” The availability of products in Just in Case and the connected health promotion and education activities comprising this larger initiative likely shaped this change in response. This finding supports previous research studies showing that college and university students prefer access to contraception and sexual health resources via a comfortable environment [ 43 , 50 ] and discreet ways [ 20 , 21 , 51 ]. When implementing a mail-order contraceptive delivery program for college students, Butler and colleagues [ 52 – 54 ] found that receiving condoms and other sexual health aids via this modality allowed more discretion than a traditional campus health center setup, which in turn increased students’ ease when ordering sexual health supplies while decreasing high-risk behaviors via increased condom usage.…”

“…Studies have stressed the importance of health centers in college and university settings in reducing sexual health disparities in student populations [ 20 ]. Students are more likely to visit a university health care center for their sexual health and family planning needs than other settings [ 11 ].…”

The Kit: Undergraduate Students Identifying and Mitigating Barriers to their Sexual and Reproductive Health Needs

“…The availability of products in The Kit and the connected health promotion and education activities comprising this larger initiative will likely have shaped this change in response. This nding supports previous research studies showing that college and university students prefer access to contraception and sexual health resources via a comfortable environment [38,45] and discreet ways [20,21,46]. When implementing a mail-order contraceptive delivery program for college students, Butler and colleagues [47][48][49] found that receiving condoms and other sexual health aids via this modality allowed more discretion than a traditional campus health center setup, which in turn increased students' ease when ordering sexual health supplies while decreasing high-risk behaviors via increased condom usage.…”