Abortion access in parts of Australia remains ‘very dire’,experts say

Accessing abortion is still a postcode lottery for women across regional Australia 12 months after South Australia became the final jurisdiction in the country to make abortion legal,experts say.

As reverberations were felt internationally with the overturning ofRoe v Wade in the United States,former NSW Minister Andrew Constance warned it served as a timely reminder of the need to safeguard laws decriminalising abortion from those who would seek to reverse them.

Protests have erupted in the US after the overturning of Roe v Wade by the Supreme Court.

Protests have erupted in the US after the overturning of Roe v Wade by the Supreme Court.AP

“As the Leader of the (NSW) House when this conscience vote occurred,I can assure you there are people in parliament today who would take any opportunity to do so,” Constance toldThe Sydney Morning Herald andThe Age.

The decision by the US Supreme Court to overturn the landmark decision of 1973 brings to an end the constitutional right to an abortion and is expected to severely curtail women’s reproductive rights across the United States.

Victoria decriminalised abortion in 2008 and NSW did the same in 2019. However,experts said efforts to ensure equitable access to abortions in regional communities have not kept pace with the legislative change.

Western Australia was the first state to make abortion legal in 1998 for pregnancies up to 20 weeks. However,it has not been fully decriminalised and remains within the criminal code.

Monash University research fellow in global and women’s health Dr Shelly Makleff said a lack of access to abortion in regional Australia was a “real problem” and “unjust”.

Makleff said surgical abortion was mostly available only in urban areas,meaning patients faced increased costs to cover travel,accommodation and time off work.

Only 10 per cent of Australian GPs were registered to provide medical abortions,Makleff said,meaning this option was also largely unavailable for regional communities that still grapple with high levels of stigma around the procedure.

“That’s very dire,” she said. “I’ve heard stories through my research of someone calling their GP office and the receptionist not even letting them talk to the GP about their options.”

In addition,Makleff said the gestational age limit for medical abortions differed in every state,creating further confusion and barriers to access.

Abortion clinics have begun shutting down across the United States as several States already move to ban the procedure after yesterday's Supreme Court ruling.

To address the inequality of abortion access between rural and urban populations,Makleff said there needed to be changes to the Medicare system to reduce costs,and increased training to ensure all medical professionals have the necessary qualifications to perform abortions.

“Every GP should be able to give every person who walks in the door that has a pregnancy,planned or unplanned,the options they need. And that’s not the situation right now. And that’s partly because of medical training … and partly because of historical criminalisation and related stigma.”

The current medical training system for abortion was “opt-in” and Makleff said education should be restructured to encompass every medical professional.

Around the country,Makleff said Victoria was “quite ahead of the game” in terms of accessibility whereas in Tasmania there was “almost no provision at all”.

“The Northern Territory actually has been doing great job of advocating to expand access and creating training models,” she said. “NSW is relatively new,it’s just been decriminalised.

“It is a patchwork system,there is a lot to improve upon. But of course,we are still very lucky that decriminalisation is now right across the country.

Makleff,who relocated to Australia two years ago from San Francisco,said the Roe v Wade decision was “really devastating”.

A slogan written on an abortion rights demonstrator’s body,outside the US Supreme Court on Saturday.

A slogan written on an abortion rights demonstrator’s body,outside the US Supreme Court on Saturday.Bloomberg

Constance said improved access to abortions must be made a national priority.

“As a man,I cannot imagine what it must feel like for a woman to have to make a decision whether to terminate a pregnancy,” he said. “This difficult decision is often worse for women in the regions because of a lack of access to support services.

“This must be fixed by the national government working with the states.”

Acting Greens leader Mehreen Faruqi,who led an early failed attempt to decriminalise abortion in NSW,said access remained “hugely difficult” in regional areas.

“Ultimately,we need to treat abortion services like other healthcare and ensure they are provided through our public hospitals and covered by Medicare,” she said.

Bendigo and District Aboriginal Cooperation chief executive Raylene Harradine said the disparity in access to abortion for regional communities was even greater for First Nations women.

“Some of our communities don’t have their own transport,so that can be really challenging. But also access to really good health services as well,” she said.

Harradine called for cultural awareness training to be extended to the medical fraternity,as a range of health services,including abortion,could re-traumatise patients.

Incoming Victorian health minister Mary-Anne Thomas,who is the member for the regional seat of Macedon,said she was aware of the inequity between regional and urban areas for abortion.

“Ensuring equity of access to healthcare services will be top of mind for me in my role,” she said.

Victorian Premier Daniel Andrews said his position on abortion is “very well known”.

“I was very proud to play a small part in those changes to our laws to remove the common law offence and to appropriately decriminalise access to reproductive healthcare that every Victorian women should be able to access,” he said.

Andrews said the point about regional communities lacking access to abortion procedures,was “not lost on me” and criticised anti-abortion activists who protest patients entering clinics.

“Protest is fine but getting up in peoples’ faces in those sort of circumstances,it’s just wrong. It’s just wrong. Perhaps worse than wrong actually,” he said.

Maxine Morand introduced the bill to decriminalise abortion in Victoria as then Minister for Children and Early Childhood Development.

“I can remember them protesting outside my electorate office with posters saying Maxine Morand,Minister for Childhood Destruction,” she recalled.

“I think the pro-lifers may be emboldened but there are limited avenues to achieve any wind back in the current Victorian law.”

Cut through the noise of federal politics with news,views and expert analysis from Jacqueline Maley.Subscribers can sign up to our weekly Inside Politics newsletter here.

Carrie Fellner is an investigative reporter for The Sydney Morning Herald.

Charlotte Grieve is an investigative journalist.

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