Abstract

Background: Natural Family Planning (NFP) empowers women through education on charting and interpretive skills toward self-knowledge, health reasons, and family planning purposes. They learn to be in control of their reproductive health and approach fertility as a normal biological process. Substantive literature supports its comparative effectiveness with contraceptive methods but remains a myth to clinicians and users.
This study aimed to understand clinicians' perceptions regarding offering NFP to patients as part of reproductive health care by exploring clinicians’ knowledge, describing perceptions of effectiveness, and identifying enabling and deterring factors.

Methodology: Basic Interpretive qualitative research design was appropriate for obtaining an in-depth description of this phenomenon. Fifteen participants, doctors and nurses from diverse cultural and educational backgrounds, were selected - purposeful and snowballing sampling techniques - and interviewed. Transcribed data were analysed, identifying recurrent themes through categorization.

Results: Participant characteristics did not influence their perception of NFP. They had confused information on NFP methods and no knowledge of modern NFP. The need to bridge the knowledge gap, competency, and preparedness to render holistic reproductive health care were motivators. Being empowered would change negative attitudes, beliefs, and practices favoring NFP. Including NFP as policy and its advocacy would enhance reception by clinicians and users.

Conclusion: Policy, effectiveness, and professional culture emerged as major themes influencing participants to choose NFP or not as an option for a woman’s reproductive health care. Underlying these themes is the necessity to train competent clinicians to offer a holistic approach to reproductive health care. Early education of male and female children would prepare responsive and sexually responsible adults. Matching policy with advocacy would enhance attaining national health goals. Medical and nursing professional board should work towards an all-inclusive curriculum.

1. Natural Family Planning (NFP) empowers women to be in control of their reproductive health and approach fertility as a normal biological process.

2. Trained and competent clinicians who can provide NFP services will advance patients' autonomy and advocacy.

3. Early education of male and female children would prepare responsive and sexually responsible adults.

Iron Deficiency (ID) and Iron Deficiency Anaemia (IDA) are significant public health problems affecting the worlds' population, with up to 3.6 billion persons affected (Camaschella, 2019) . The burden of illness is comparable to mental health illness (Safiri et al., 2021). As it is primarily a women’s health issue, its impact, particularly in primary care is magnified. Despite these alarming figures, ID remains poorly diagnosed and treated. In 2021, the World Health Organisation (WHO) called for its member countries to urgently implement Patient Blood Management (PBM) within its health systems (World Health, 2021). The expected outcome of PBM is reduction of blood transfusions and better utilise scarce health resources globally, thereby reducing the impact of anaemia and vitally improving the quality of life of individuals.
PBMs' inherent notion is that ID and IDA are better managed, which therefore necessitates that primary care takes a leading role in this charge. Primary care is best suited to lead these initiatives due to the vast numbers of affected persons in the community; the principles of management align naturally to the key principles of primary care (access, coordination, comprehensiveness, community and person centredness ) (Starfield et al., 2005)and; recent treatment advances allow for the appropriate management of most cases of ID/IDA within primary care. Furthermore, adequate consideration should be given to prevention in order to achieve long term health outcomes, and primary care is naturally well positioned to lead these ventures.
This presentation will
1. Outline current advances in the management of ID,
2. Describe the theoretical basis of why primary care should manage ID/IDA
3. Describe the synergy between the principles of primary care and PBM
4. Discuss strategies for early detection, treatment and monitoring, using a case study of a successful model in Australia
5. Briefly outline preventive initiatives for ID.

1. Iron deficiency is a common problem with significant adverse health outcomes
2. Iron deficiency is a problem that is better and more effectively managed in primary care
3. Primary care is well positioned to contribute to patient blood management programs and lead preventive initiatives

Background:
Access to publicly-funded abortion in Australia is limited, with a considerable proportion carried out by private providers. There are no nationally reported data on public abortion services, and referral pathways are poorly coordinated between hospital and primary care sectors. HealthPathways is an online system for use in primary care that provides information on referral pathways to local services. The aim of this study was to describe abortion referral pathways for each HealthPathways portal in Australia.

Methods:
A review of Australian HealthPathways content on abortion was undertaken between January – June 2022. For each HealthPathways portal, data were extracted on referral options to abortion services.

Results:
17 out of 34 Australian HealthPathways consented to be included. Nearly half (47%) had no public services listed for surgical abortion, and 35% had no public services for medical abortion. The majority (64% for surgical abortion, 67% for medical abortion) emphasised that public services should be considered only as a last resort. There was variation in information regarding gestation-specific options, the time-critical nature of referrals, and the importance of women’s own preference when deciding between medical or surgical abortion.

Conclusion:
Despite few remaining legal restrictions to abortion, many regions across Australia either do not have public abortion services or do not provide information about them. There is an urgent need for transparency around public abortion service availability, clear guidelines to support referral pathways, and commitment from State and Federal governments to expand the availability of accessible, no-cost abortion in Australia.

1. A significant proportion of Australian regions either do not have public abortion services or do not provide information about them
2. Many Australian public abortion services are linked with messaging to direct referrers away from their services and towards private providers
3. There is a need for transparency around public abortion service availability and clear guidelines to support abortion referral pathways in Australia

Aim
To investigate the knowledge, attitudes and practices of Australian general practitioners (GPs) regarding early medical abortion (EMA) provision.

Content
Although GPs are the first point of contact for women seeking early medical abortion in Australia, only about 10% are certified to prescribe EMA medication. As part of the Australian Contraception and Abortion Primary Care Practitioner Support (AusCAPPS) Network, a mixed-methods study aimed at improving access to long-acting reversible contraception and EMA in primary care, we undertook a national survey from July to October 2021 to explore GP EMA knowledge, attitudes and practices. Data were analysed using counts and proportions.

Of the 500 GPs who completed the survey, 78% (n=388) identified as female, 54% (n=270) were from metropolitan areas, and most resided in Victoria (31%,n=156) or New South Wales (30%, n=148). Most GPs (84%;n=418) felt that it was acceptable for them to provide EMA but only about half (54%,n=272) felt they had the knowledge to provide counselling in relation to EMA. While 23% (n=116) of those surveyed were registered prescribers of EMA medication, 22% (n=111) provided an EMA service delivering on average of 5 EMAs per month (SD=10.6). EMA service delivery via telehealth was only 8% (n=41) of all GPs.
To support evidence-based practice for women seeking the management of unintended pregnancy and address knowledge gaps, a unique national online Community of Practice, the AusCAPPS Network will be presented. This platform enables peer and expert networking, the ability to locate a provider near you, and access to resources and training in the provision of EMA care.

Goals
1. To present Australian GP knowledge, attitudes and practices in EMA provision
2. To discuss the gaps for Australian GPs to provide EMA services
3. To discuss ways GPs can be supported to provide EMA services, through and online community of practice.

1. Understand the current knowledge, attitudes and practices of Australian GPs in regards to early medical abortion provision.
2. Understand the gaps in Australian abortion care services.
3. Gain insight into how they can be supported to deliver abortion care through the Australian Contraception and Abortion Primary Care Practitioner Support (AusCAPPS) Network.

A group of experts (from a wide range of professions and lived experience experts) have developed a postpartum support planning template and resource through a Delphi method research project. The template represents consensus by the expert group and answers an important question; how can we plan for better support for mothers beyond birth?

This presentation will include narrative story telling of one GPs experience with using the template in general practice.

Becoming a mother, a transition known as matrescence, is a monumental time in a woman’s life. It is a time that is crowded with new learning, identity shifts, uncertainty, brain and body changes, cognitive changes, and relationship changes. Access to support is the cornerstone to the health and wellbeing of mothers during the first three months after birth, a time known as the fourth trimester. Mothers commonly reflect that they felt inadequately prepared for the postpartum period, and many wish that they had spent more time planning for support beyond birth.

The wellbeing of new mothers is intimately entwined with their access to support from others. Lack of social support is an important predictor of postpartum women’s health status. When there is scaffolding around mothers to support them in the fourth trimester, families are equipped with the steppingstones they need to navigate the many challenges of this significant time. Physical health, mental health and identity changes are, at the same time, a common challenge as well as an opportunity for expansion and growth.

The long-term relationships between general practitioners and families are an opportunity for supporting mothers to prepare and plan for support in the fourth trimester.

1. Antenatal care in general practice could more effectively help mothers to prepare for the postpartum.
2. How women are supported in the postpartum is the cornerstone of their health and wellbeing.
3. Early identification of additional support needs can change the trajectory of a woman's experience in the postpartum.