A recent report from the Australian Commission on Safety and Quality in Healthcare showed that Bourke, Cobar, and Coonamble have the highest hysterectomy rates in NSW. 

Hysterectomies, as a treatment for non-cancerous conditions, are declining in Australia, however, in rural and regional areas they are still high.

Bourke, Cobar, and Coonamble have the highest age-standardised hysterectomy rate in NSW at 428 per 100,000 women during 2021-2022. 

The age-standardised rate for NSW is 217 per 100,000 women. 

A hysterectomy is an operation that removes the uterus and in some cases the ovaries and fallopian tubes as well. 

In the past, hysterectomies have been recommended to women who suffer from heavy menstrual bleeding. 

Women who suffer from heavy menstrual bleeding may experience fainting, infertility, passing clots, and periods that last more than eight days. 

A new study released by the Australian Commission on Safety and Quality in Healthcare shows that treating heavy menstrual bleeding with a hysterectomy is not recommended. 

"Although hysterectomy stops menstrual bleeding, it is a major surgical procedure and generally not recommended unless less-invasive options fail or are inappropriate, or if the woman chooses it," the report states. 

Hysterectomies typically require hospital admission and recovery time can take around four to six weeks and may involve long-term complications and unplanned readmission. 

"When the uterus is removed, it has an impact on the body in terms of the balance of hormones in the system. The changes that occur can create a different set of issues for many women who have hysterectomies," CEO of The Healthy Communities Foundation Australia Mark Burdack said.

He added that the higher rate of hysterectomies in rural and regional areas may often be linked to a lack of primary and specialised health services that are available to women in metropolitan areas. 

 "The factors aren't genetic but have more to do with the level of access to care that women are able to receive in  rural and regional areas for conditions that can lead to hysterectomy as a surgical solution." 

"We know there is a whole range of pharmaceutical and medical interventions that can take place that will alleviate the symptoms of heavy menstrual bleeding that are often not accessible to women in rural and remote areas."

He said that in metropolitan areas, doctors have the option of referring patients with complex issues to a doctor who focuses on that field. 

"In a rural town, if the only GP within 100 kilometres is a GP that doesn't have that knowledge then women are forced to incur additional expenses to get access to the right type of medical expertise."

Medicare covers hysterectomies, however, some interuterine treatments are not covered.

"For some women, the socio-economic costs that are associated with travelling to get care, as well as, the costs of treatments are not viable for them." 

Another factor that adds to the gap between rural/regional and metropolitan female reproductive healthcare is that the medical workforce is often male in rural and regional areas, according to Mr Burdack, and some women may not feel comfortable speaking to a man about reproductive healthcare matters. 

Mr Burdack said that mobile health clinics, such as the Healthy Community Foundation's Mobile Health Clinic, can offer rural and regional women access to specialised healthcare that supplements already existing health services. 

"They are the services that can be provided on a scheduled basis so that women in rural and regional areas do not end up with more limited choices than women in other parts of the country."