The impact of financial and geographic barriers to fertility service in Newfoundland and Labrador

Abstract

In Newfoundland and Labrador (NL) accessing fertility services is challenging for many residents, as a result of lack of service availability within the province, geographical distance from location of services, and out-of-pocket expenses for both treatment and travel. The purpose of this study was to explore the challenges experienced by fertility patients in NL and how these challenges affect treatment. Semi-structured, indepth interviews were conducted with female patients across Newfoundland and service providers from NL Fertility Services to gather the perspectives of both patients and providers. We developed a conceptual framework that considers patient group, therapeutic goal, and barriers when determining treatment impacts. We found that for heterosexual women (in couples) looking to become pregnant, the most commonly cited barriers were costs, including financial, opportunity, and emotional, geography, lack of service availability, nature of services, physical environment, partner separation, and social stigma. We also found that these factors created patient and provider-driven impacts on treatment.