Insured women's access to infertility care: A comparative survey study

Reconciling the disparity between advancements in diagnostic and therapeutic treatments for infertility and a woman's ability to access these treatments is of particular concern for nurses and health policy makers. Annually, there are 55 million women of childbearing years and on average 9.1% (5.3 million) of these women will experience infertility. Outcome measures, in terms of live birth rates for the assisted reproductive technologies (ARTS) that are now used to treat infertility, have tripled in the past decade. Yet, access to these treatments for the infertile population has been arbitrary, inconsistent and not on par with access to care for other illnesses.; The organizational structure responsible for 72% of health care services in the United States is the private sector insurance industry. Three quarters of all American women are covered by some type of health insurance, However, 86% of all private sector insurance excludes comprehensive infertility care.; This study examined the process of accessing infertility care in the context of Mithaugs Theory (1996) of Equal Opportunity. The goals were to (a) examine insured women's perceptions regarding a fair chance to access infertility care, elicited from not only responses on the Indicators of Access to Infertility Care Scale but also from selected telephone interviews and to (b) assess the influence of the social opportunity context (mandated infertility insurance state vs non mandated infertility insurance state). Participants were insured women who sought treatment for infertility.; A comparative survey method was employed to examine the responses from women who lived in states that had comprehensive mandates and those that did not. Theoretically, comprehensive infertility insurance mandated states were seen as a form of ‘social redress’. Social redress adjusts circumstances that are beyond the control of some individuals making the circumstances more ‘equitable’.; It was found that access barriers create a sense of ‘unfairness’. The results of this study extend the literature by providing support for Mithaugs Theory (1996) and helps to articulate the need for nurses to be involved in ameliorating inequities in accessing care that women need and at women need and want.