CW: discussion of abortion

Most Australians who have never had to terminate a pregnancy are silently complacent on the issue of access to reproductive options, and those who have done so are mostly silent. We live in a reasonably progressive country and because of this we assume that abortion will be safe and accessible should we need it. Sadly this assumption does not always ring true.

The silence around abortion is hurting Australian women. It’s stopping us from fighting to remove extant barriers to access, isolating people who have terminated a pregnancy and stripping those facing the decision to terminate of support and options.

Discussions on this topic are almost always had in the abstract; we talk about believing in a woman’s right to choose, but nobody wants to be personally connected with the act of terminating a pregnancy.

I had a surgical abortion in Tasmania during my mid-semester exams in year 12. I was 18, terrified and largely alone because I was too scared to discuss what was going on with my family or friends. I had heard the statistics, I knew that I was undergoing a procedure which thousands of other women access every year, and yet I had never heard anyone talk about their own experience. It felt like I was the only one, and it came with extreme feelings of shame and isolation.

No one should have to feel that way because the truth is that everyone reading this knows someone who has had an abortion, whether or not you have talked about it. You will come into contact with someone who has ended a pregnancy almost every day.

This is personal to everybody, and we need to talk about it.

What does it mean to have an abortion?

Abortion is the deliberate termination of a pregnancy. The termination may be medical or surgical.

Medical abortion is carried out by taking a pill such as RU486 which induces a miscarriage.

Surgical abortion is basically what it sounds like – surgery performed under general anaesthetic which removes the fetus and placenta from the uterus.

Is abortion legal in Australia?

An overwhelming majority of Australians support ready access to abortion in the first trimester (when most abortions are performed) and the legality of abortion is not often discussed, but the reality is that state-based abortion law is complex and largely outdated.

In South Australia, abortion is allowed when it is necessary to protect the physical or mental health of the woman. The procedure must be approved by two doctors and performed in a hospital.

Queensland declares abortion to be legal if necessary to avert serious danger to a woman’s life or health (above and beyond the “normal” risks of pregnancy and childbirth), or in the case of a fetal defect so serious that the baby would die shortly after birth.

Victoria and Tasmania decriminalised abortion in 2008 and 2013 respectively, now allowing early term abortions to be performed “on request”. Western Australia allows the same subject to counselling by a medical practitioner.

In the Northern Territory, abortion is legal until up to 14 weeks if approved by two medical practitioners and performed in a hospital.

The New South Wales’ Crimes Act 1900 continues to criminalise abortion, although the courts have interpreted this so as to hold abortion legal so long as a doctor has a reasonable and honest view that for “any economic, social or medical ground or reason”, the abortion was necessary to “preserve the woman involved from serious danger to her life or physical or mental health which the continuance of the pregnancy would entail.” Dr Suman Sood was convicted in 2006 of two counts of performing an illegal abortion for failing to enquire for a lawful reason. Abortion law reform may be on the cards for NSW with Greens MP Mehreen Faruqi introducing a bill to reform NSW abortion law into parliament on 11 August 2016.

Is abortion accessible in Australia?

The introduction of protest-free exclusion zones around abortion clinics in the ACT, Victoria and Tasmania, which protect patients from being harassed by anti-abortion protesters, is an example of where we have made positive steps in this area. Unfortunately, barriers remain, and the experience of many women seeking to terminate remains far more difficult than any of us should feel comfortable with.

Abortions are expensive. Medicare provides partial coverage but the gap is consistently around $300.00 to $600.00. The procedure is understandably time-sensitive (for legal, emotional and health reasons) so it is not an option to ‘save up’ the money to terminate a pregnancy.

My experience was that in Tasmania there was no access to RU486, and there were no doctors living in the state who performed abortions. I was told that there was a doctor who flew in fortnightly who could perform the procedure, which meant I had to wait a full two weeks and did not have a choice of treatment between medical or surgical. This was while living in Hobart, a state capital – the situation for women in rural and regional areas is far worse, with many having to travel significant distances with little support.

Despite being available since 2006, RU486 has not been readily accessible to many women, who are instead told that they must undergo a surgical procedure. This is wholly inappropriate when a cheaper, safer and less distressing option is available.

A telephone service announced last year would allow access to RU486 via phone and mail, with a view to improving access, particularly in rural and regional areas. However, this will not be available in South Australia, ACT or the Northern Territory, as in these jurisdictions a woman must undergo her abortion in a hospital.

The answer to the question of whether abortion is legal and accessible in Australia is: Yes, sort of, but we can and should do far better.