Introduction: Women in South Australia (SA) have legal access to abortion. In 2013 in SA, 18.7% of abortions were on country women. A literature search identified that very little is known about this area of health care. Therefore, research was conducted to identify the issues that impact on access to abortion and sexual health services in rural South Australia. Methods: An ethically approved survey was emailed to rural and remote health care providers and promoted in newsletters, journals, and healthcare networks in 2013. Questions focused on sexual and reproductive issues such as access to contraception, pregnancy counselling, abortion and referrals, anonymity and knowledge. Data were analysed using simple descriptive statistics. Results: Forty health professionals responded; half were registered nurses, 17% general practitioners and the remaining â€˜other'. Access to contraception was mainly from a General Practitioner (GP). The main barriers to access were lack of confidentiality (40%), lack of community knowledge/education, travel distance (<50km), lack of medical staff/services and the cost of medicine/services. There were no local face-to-face pregnancy options counselling services. The majority of respondents (79%) either referred women to abortion services or knew someone who would, with nearly a quarter indicating they were aware of health professionals who would not refer women to abortion services. Conclusion: These findings have implications for clinicians, practice nurses, GPs and policy makers in rural and remote SA. Awareness of the issues of access to sexual health services need to be raised so that services can be more equitable for women in these areas. Keywords: abortion, access, sexual and reproductive healthcare Key messages: 1. Access to abortion and sexual and reproductive health care in rural and remote areas of South Australia are poor 2. Confidentiality barriers impact on women in rural and remote areas when accessing sexual health care 3. There is a lack of community knowledge/education on sexual and reproductive health in rural and remote areas which requires addressing.