Researching to improve sexual and reproductive rights

Sexual and reproductive health is critical for our overall health and wellbeing but is often taboo and under-researched. Through her work, Dr Emmalee Ford is diving into this topic and opening discussions to improve rights and public health outcomes.

Emmalee’s academic qualifications include a Bachelor of Science (Honours), a Doctor of Philosophy in Medical Biochemistry and a graduate certificate in data science - all from the University of Newcastle.

Her research focuses on improving sexual and reproductive health and rights within Australia and the wider Pacific region, and her key areas of interest include the education of young people, community workers, healthcare providers and the general public, and improving access to health services.

“We know that if people have access to the level of care they need at the right time, we can help solve problems like eliminating cervical cancer, reducing the spread of syphilis, preventing unplanned pregnancies, and more,” shares Emmalee.

From infertility to period apps

Emmalee started studying fertilisation and pregnancy during her undergraduate degree sparking her interest in this area.

“It amazed me how intricate this process was. It suddenly became hard to believe that anyone ever got pregnant at all. I learned a lot about how my own body worked. I also learned that infertility is a rising problem in our society.”

These revelations propelled her into a PhD journey where she would explore the mysteries of reproduction and confront the growing challenge of infertility head-on.

Emmalee began lab work to uncover the biological mechanism linked to why we become infertile: how eggs grow and die in the ovaries.  Though trained as a traditional molecular biologist, she also began to incorporate public health research into her work.

Her public health research included researching period apps that track menstrual cycles or provide fertility ratings to avoid or plan pregnancies. In addition, she studied how we understand fertility and reproductive health information in Australia, exploring new ways to bridge the gaps.

Reproductive research recognition

While completing her PhD, Emmalee was recognised as an inspiring leader in her field, with an Australia Day Honour from the National Council of Women (NCW) of NSW. She also received the Most Valuable Postgraduate Award from the University of Newcastle Student Association (UNSA)

Furthermore, Emmalee’s PhD research on the ovary was included in the International Menopause Society’s white paper on a condition that causes early menopause (called premature ovarian insufficiency).

This inclusion means her work is playing a part in helping clinicians and researchers understand premature ovarian insufficiency, what options patients have and what additional research needs to be done to improve health outcomes.

During her PhD, Emmalee reached out to state-based sexual health organisations to help target her solutions to problems around knowledge and awareness in a way that could make the most impact. This includes the one she now continues to work with and others she still collaborates with interstate.

“As a researcher, having the perspective of the people who provide services - doctors, nurses, educators, really broadened my view for what research was and how we can use different approaches depending on the real-life circumstances in healthcare and education,” Emmalee shares.

Uncovering priority areas

As part of her current work, Emma gathers and creates data about sexual health in NSW and Australia. She’s using this research to generate priority areas and develop ways to increase access to services and/or improve health outcomes.

Recently, she examined cervical cancer screening in western NSW for a report at probably the most important reproductive and sexual health event in the world: the United Nations Conference on Population and Development.

This research was used in discussions about a global approach to achieving the World Health Organization (WHO) cervical cancer elimination strategy.

Supporting sexual and reproductive rights

Speaking about her work, Emmalee says her focus is on supporting sexual and reproductive health and rights in Australia. This involves combating taboos, improving knowledge and awareness and even shifting the culture of our society.

“It’s a lofty goal, but there are some critical sexual health issues that need solving through this approach: domestic violence, reproductive coercion, access to abortion, elimination of cervical cancer, screening and treatment for STIs and BBVs, the list goes on.”

“Our reproductive systems are so critical to our overall health and wellbeing. They’re responsible for the future of humankind, and yet they are so secretive and under-researched.”

Despite this, funding has always been a challenge. Emmalee explains that traditional funding sources are highly competitive, and this field of research has been historically underfunded. This is essentially down to the fact that people don’t die from infertility.

As a result, she’s built funds by choosing small opportunities with industry partners and pitching her ideas and solutions.

Engaging with young people

As part of her work, Emmalee is trying to improve the relationship between research and the beneficiaries of research. In other words, making sure the research they’re doing is being done in a way that is useful to the people they’re doing it for.

For example, to improve the number of young people using contraception in northern NSW, this means actually talking to young people in that area to find out what they think, how to interact with their communities, and better yet, support them to solve the problems.

To this end, in 2021, Emmalee set up an advisory group of young people who recently left high school to advise on her research about educating young people about fertility in sex education.

Schooling and the environments that young people find themselves in can be dynamic and specific, as she explains:

“The most sophisticated way for me to get sexual health info as a high school student in the mid-2000s was Yahoo Answers and Dolly Doctor. Now we have algorithmic content served on a silver platter that we don’t have to search for.”

“Who better to collaborate with than people who had recently had their sex education and are full of ideas for how to help their peers.”

The advisory group continues today and helps to guide research toward relevancy and impact.

A voice for change

Recently, Emmalee provided evidence to the Health Minister along with a group of experts, which led to keeping telehealth for sexual and reproductive healthcare as part of Medicare.

This Medicare item was introduced during COVID-19 for a temporary period, allowing patients to see a doctor without a pre-existing relationship. It was extended twice, for six-month periods. However, in the 2024 budget announcement, they were successful in locking it into a permanent Medicare number.

This win makes affordable telehealth available for sexual and reproductive health services.

Last year (June 2023), Emmalee was called by ABC News to provide commentary on the security of period tracking apps based on her research in the area. Our vital and personal health information is handled by a few tech companies, and there are real concerns about how the data is used.

She shared that period trackers are a great tool to have but that we’re always putting ourselves in the hands of companies trying to make money.

“I’m constantly advocating that people don’t rely on the algorithms in them and instead are taught from a young age to decode their Individual menstrual cycle patterns to make their own predictions! It’s safe and effective if done right.”

Educating clinicians; breaking taboos

Emmalee finds working in a sexual health organisation to research how to solve these big problems both exciting and rewarding.

She feels proud to be a part of a team that provides sexual health services to thousands of people in NSW and part of a team that educates hundreds of educators and clinicians to provide up-to-date and accurate information to thousands more in Australia and the Pacific.

But it’s the opportunities to talk about what she does and share her passion with others that really inspire her.

“It’s nice to break down the taboos that exist, to normalise things like periods and to show people the ways we can all be part of our healthcare and its research. If you have thoughts and experiences about healthcare, there are so many people who desperately want passionate people to tell them exactly that.”