Each year for the past 12 years the Rural Health Scholars, comprised of University of Massachusetts medical students, have made a presentation to the Island on issues of concern to the Vineyard population, such as substance abuse, homelessness, and healthy aging.
This year the nonprofit Friends of Family Planning of Martha’s Vineyard obtained a grant to help fund the Rural Health Scholars, and on Oct. 26 they made a presentation to the community at the Edgartown library on “Assessing Sexual and Reproductive Health Care on Martha’s Vineyard.”
Getting students access to more sex education, making family planning materials more accessible, and an observation about the lack of access to abortion services were among the findings of the Scholars.
Dr. Dan Pesch, ob-gyn at Martha’s Vineyard Hospital and chairman of the Rural Health Scholars, presented the scholars to the audience: Adam Baskin, R.N., Lauren Colwell, Jesse Laughlin, Ashley Millette, Ciarra Nickerson, Heather Patrick, R.N., Cesar Rodriguez, and Arielle Stopa.
The mission of the Scholars was to find reproductive and sexual health services available on the Island, determine any gaps that might exist in the services, and give recommendations on how to fill in those gaps.
The Scholars performed interviews with 69 service providers and Island residents. The questions covered such subjects as contraception, STD prevention, infertility, sexual assault, domestic violence, and resource availability. The interviews were done over the span of two weeks.
In the course of these discussions, the Scholars said that certain issues emerged: Standardized screening and treatment for mental health care, especially for postpartum women; training for medical providers in caring for the LGBTQA community; improving access to care for underrepresented groups; reproductive health education in schools; access to termination of pregnancy; access to speciality medical care; health services transparency.
The Scholars identified more than a dozen resources currently available to Islanders. The most highly utilized were Family Planning Clinic of Martha’s Vineyard, Island Health Care, Martha’s Vineyard Community Services, Martha’s Vineyard Hospital, and Vineyard Healthcare Access.
After analyzing the information from the interviews, the Scholars explained that they would be giving recommendations that focused on four distinct areas. Below are highlights from the recommendations in those areas.
Integration of care
The Scholars suggested that there needs to be an effort to improve, integrate, and standardize communication between Family Planning, Friends of Family Planning, and the community about the services that Family Planning offers.
There need to be standardized screenings for depression and anxiety for perinatal and postpartum women.
And there needs to be a Sexual Assault Nurse Examiner (SANE) nurse available for patients who have experienced sexual assault.
Education and prevention
Currently there are just two sexual education sessions available for high school students, for a total of 2½ hours in their sophomore year. The Scholars recommended integrating sexual education into the curriculum earlier in the students’ school career, and increasing the duration of sex education. According to the Scholars, the students were open to this approach and encouraged more dialogue.
In addition, since 11 percent of MV Family Planning users are not proficient in English, it was recommended that more translated information be available on the Island, and that perhaps more interpreters be made available at schools.
Improve visibility of reproductive resources
One of the quotes from the public interviews was, “[My friend] said they wished there was a women’s health fair every year that provided info about all issues in reproductive health — make sure it’s family-friendly.”
The Scholars recommended that a reproductive health education fair be held at an easy-to-access central location such as a library or farmers market, and that an effort be made to integrate health education into pre-existing cultural and school events.
Outreach to vulnerable populations
The Scholars recommended that there be increased training for LGBTQA medical services and counseling for medical providers. They suggested utilizing free webinars offered by the National LGBT Health Education Center and making clinical spaces more welcoming to the LGBTQA community by displaying flags and symbols that represent inclusivity.
In an effort to further reach out to vulnerable populations, the Scholars suggested that travel funds be made available for off-Island specialty care for transportation to specialty clinics, overnight stays in distant areas, and for ferry tickets to travel off-Island.
The Scholars’ presentation concluded with a discussion of abortion access. There are no abortion services available on the Island, and on average, women from Martha’s Vineyard travel between 90 and 101 miles to access abortion services. The majority of women nationwide travel less than 25 miles to access these services.
While one interviewee said, “Fortunately we’re in Massachusetts, where there are options, we’re not forced into a situation where we can’t provide options.” But as the Scholars pointed out, having to travel to Boston and perhaps having to spend the night in a hotel is not always an affordable option.
Should abortion be made available on the Island? While many respondents thought it would be good to have the choice, others had concerns about confidentiality; even if the service was provided, some questioned whether women would feel comfortable accessing it within the tight-knit Island culture.
In a phone conversation with the Times, Dr. Pesch said that moving forward, the Friends of Family Planning will be following up with the Scholars’ recommendations, and that they have the funding and the resources to do additional research and bring in experts as need be.