O4 - Providing unplanned pregnancy care and Early Medical Abortion to marginalised groups at the Kirketon Road Centre (KRC) - a walk in targeted primary health care service in Kings Cross, Sydney

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Social and financial marginalisation are barriers to accessing reproductive health services including medical abortion. KRC’s multidisciplinary team provides unplanned pregnancy care and Early Medical Abortion (EMA) to targeted population groups in a walk in clinic, at lower cost, making EMA more accessible. Eligibility is assessed using KRC EMA guidelines by an appropriately qualified nurse, midwife or doctor. People attend low cost imaging and clinical assessments and pathology tests are free. Medication packs and MS-2 Step are supplied by a local pharmacy for a dispensing fee, or at cost price if without Medicare. Appointments are face-to-face and telehealth. People who are not eligible for EMA at KRC are referred to appropriate services. Since November 2021, nurses, midwives and doctors from KRC have worked collaboratively to provide unplanned pregnancy care. Eight people, including one who travelled 95 km, have accessed EMA at KRC. People have been referred by a peer-based sex worker organisation, or have attended KRC for unplanned pregnancy support unaware that EMA was available. Aboriginal people, people who sex work, at risk youth, homeless people and people from culturally diverse backgrounds have attended. EMA would otherwise have been inaccessible to these people. Feedback has been overwhelmingly positive with many people expressing a sense of relief their needs were being met. Some clients opted for long acting reversible contraception (LARC) insertion which led to upskilling of staff and the development of a working group to expand nursing and midwife involvement in contraception provision at KRC. Access to safe medical abortions is a critical part of sexual and reproductive health yet access to these services is often hampered by social marginalization, stigma and cost. Implementing EMA services which address these barriers is a priority if we are to provide universal access to comprehensive abortion care.