OPINION PIECE: PATCHWORK ABORTION LAWS A LOTTERY FOR WOMEN

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THE HON TANYA PLIBERSEK MP
DEPUTY LEADER OF THE OPPOSITION
SHADOW MINISTER FOR EDUCATION AND TRAINING
SHADOW MINISTER FOR WOMEN
MEMBER FOR SYDNEY

THE HON CATHERINE KING
SHADOW MINISTER FOR HEALTH AND MEDICARE
MEMBER FOR BALLARAT

PATCHWORK ABORTION LAWS A LOTTERY FOR WOMEN

Every Australian should have access to the health services they need. Full stop. This shouldn’t be a controversial statement, but when it comes to reproductive health services, it seems it still is. Abortion is one of the most common medical procedures that Australian women will experience in their lives. But our patchwork of abortion laws and holes in service provision mean more and more women are having to travel interstate.

Tasmania’s only provider of surgical terminations closed this month, leaving women to travel to Victoria to access the reproductive health services they need. This isn’t an isolated situation. It’s just another example of the unfinished business of reproductive health in Australia.

In 2016, the only private practitioner performing surgical terminations in Cairns retired. The clinic had serviced all of Northern Queensland, so women are now flying to Brisbane and Sydney, often at great expense.  For some women, this would be the first time they had left their remote communities, and their first time on a plane.

Malcolm Turnbull’s weak response last week when asked about the closure of Tasmania’s only provider of surgical terminations was completely inadequate. Access to the full range of health services is an issue that needs Federal Government leadership.

Labor’s addition of the drug RU486 to the Pharmaceutical Benefits Schedule in 2013 has improved access to medical terminations. But medical terminations are only available up to nine weeks and are not always the best option for the patient. Women should have the choice of medical or surgical termination.

At the moment there are many barriers to accessing both medical and surgical options. Location, cost, and the law are some. Depending where a woman lives, she might come up against all three. Roughly 80 per cent of terminations are done in private clinics. There are substantial gaps in public hospital provision. The availability of surgical terminations continues to be an issue for women in rural and regional areas - no matter which state they live in.

In many regional and remote communities, sometimes the only GP in town can’t or won’t help. Less than 1.5 per cent of GPs are trained to offer medical terminations. Medical terminations are already expensive – provision through private clinics drives up the cost. With the PBS subsidy, RU486 costs around $39 ($6.40 with a health care card) but the average price women actually pay upfront for a medical termination is $560. Travelling to the nearest city, or interstate, means extra costs for transport and accommodation. For a woman on a low income with little support from her family or community, this may be too much. It seems tragic that a woman would bring a child into the world for no reason other than she couldn’t afford to have a termination.  

And there’s another major issue – the ridiculous situation where abortion is a crime for half the women in Australia, but not for the other half. This is because abortion is still in the criminal code in Queensland and New South Wales. The recently re-elected Palaszczuk Government is awaiting advice from the Queensland Law Reform commission on legislation to decriminalise abortion. In practice, it’s still possible to get a termination, but it makes things much more difficult and can dissuade medical practitioners who don’t want to navigate the risk.

That’s why we were so disappointed with Malcolm Turnbull’s deflection of the issue last week.  There needs to be an urgent national review of the availability of sexual and reproductive health services. Not-for-profit organisations like Marie Stopes are doing good work to advance women’s reproductive and sexual health options, but these organisations can’t do it alone. We need state governments to step up where there are gaps, and if they won't the Federal Government needs to intervene.  

We wouldn’t accept someone having to travel to another state for a hip replacement or a broken bone – we shouldn’t accept them having to travel to another state for a termination. More needs to be done.  It’s time for the Federal Government to show leadership and step up so that women can access the health care they need – wherever they live.

This piece was originally published in The Sydney Morning Herald on Tuesday, 30 January 2018