Barriers to accessing assisted reproduction for diverse and minority groups in Aotearoa New Zealand: Findings from a qualitative study

INTRODUCTION: There is now an extensive body of international research on fertility help -seeking. While this body of work has historically centred the experiences of dominant ethnicities and heterosexual and cisgender couples and families, our study attends to the experiences of individuals and couples from diverse and minority groups in Aotearoa New Zealand, for which, to date, there is little research. In the article, we report delays and disparities accessing assisted reproduction for these groups to advocate for fertility care based on reproductive justice.METHODS: The article draws on semi-structured interviews and talanoa from a qualitative study conducted during 2020 and 2021 with 39 Ma over bar ori, Pa over bar keha over bar , and Pacific people residing in Aotearoa New Zealand who have experienced fertility issues for social or medical reasons and have sought reproductive assistance, using a range of procedures and treatments, to create families.FINDINGS: To better understand the reproductive journeys of people from these groups we report the challenges identified by study participants in the process of decision-making around accessing assisted reproduction and fertility treatment help-seeking. Importantly, we document a range of situational and structural fertility barriers that point to stratified reproduction relating to affordability, delays and long wait times for resources and services, discrimination, and non -inclusive care.CONCLUSION: To address these issues, we recommend improvement to fertility treatment services and delivery that is culturally accessible, responsive, and equitable. This entails attending to the structural constraints that prevent people from accessing and obtaining the resources needed to realise their family building goals.