Alabama or Gilead? - Australia's Abortion Legislation
Margaret Atwood’s dystopian future is seemingly progressing to reality in Alabama, where Governor Kay Ivey signed the most restrictive abortion regulations in the USA into law on Wednesday after it passed the Alabama Senate on Tuesday night. While controversial, judicial control over women’s reproductive rights is an ongoing issue in Republican lead states, where similar bills have been proposed under the eye of the Trump administration.
What is abortion and what does it involve?
Abortion is the intended termination of pregnancy.
Medical termination: Medical termination is a safe method of termination that involves no surgical intervention. As an option, it can be utilized up until 9 weeks gestation, and can be done in the comfort of your own home. It includes a combination of medications, mifepristone and misoprostol, which work together to physiologically terminate and expel the pregnancy. In the early stages of pregnancy, this is a commonly preferred option as it is non-invasive and 99% effective (Australian Government Department of Health, 2018).
Surgical termination: Surgical termination, as the name states, is the termination of pregnancy through 'suction aspiration', whereby the pregnancy is removed from the uterus through a gentle suction apparatus. The procedure requires an anaesthetic and is necessary for pregnancies at over 9 weeks gestation. The procedure is routine, and safe, and takes less than 15 minutes (Australian Government Department of Health, 2018).
Under the implementation of such law in Alabama, abortion at any stage of pregnancy is illegal unless it poses a serious health risk to the mother. Further exceptions are applied in the event of ectopic pregnancies, or if the foetus is found to have a lethal anomaly, however there are no exceptions to victims of rape or incest. Unsurprisingly legal action has been facilitated by pro-choice organsiations such as Planned Parenthood in efforts repeal the controversial, oppressive bill (Glenza, 2019).
Over the past 12 months we’ve seen some progressive changes around the world in terms of abortion accessibility, notably in Ireland. At home we’ve had successes in the support for and reinforcement of safe access zones surrounding abortion providers. Pressure to change the archaic abortion legislation in New South Wales was widely discussed during their recent state election, however despite the best efforts of advocates and supporters, not a lot of progress has been made.
Are there any regulations surrounding termination in Australia?
The laws for abortion differ between each Australian state and aren't nationally streamlined - We'll start firstly by going through the legality of things for each state:
Victoria: Abortion is legal - until 24 weeks gestation termination is accessible to all through a registered practitioner, and after this time with the approval of two relevant medical practitioners.
New South Wales: Abortion is illegal, however if a risk to the woman's physical or mental health is acknowledged by medical practitioners it can be accessed. Social and economic factors must be legally considered when assessing necessity for termination. Unfortunately, a bill put forward by the Greens in 2017 to legalise abortion in NSW was voted down in parliament.
Queensland: As of 3rd December 2018, abortion is legal up until 22 weeks gestation after previously being restricted by similar legalities to NSW (Brilliant news!!). Following 22 weeks, consultation with two approving medical practitioners is required.
South Australia: Abortion is legal if performed in a hospital or registered clinic up until 28 weeks gestation if two doctors agree that continuing with the pregnancy would be detrimental to the woman's mental or physical health, or if foetal abnormalities are present. The patient must be a South Australian resident, unless the case is an emergency.
Western Australia: Abortion is legal up to 20 weeks under the condition that the woman is offered counselling services, and if under the age of 16 years, a parent/guardian has been advised. After 20 weeks, termination is not illegal, but is very restricted, whereby two doctors from a statutory panel must agree that either the woman or the foetus has a severe medical condition that justifies termination of the pregnancy.
Northern Territory: Abortion is legal up to 23 weeks, whereby approval from one medical practitioner is required until 14 weeks, and two medical practitioners thereafter. Following 23 weeks, a woman's life must be endangered by continuing with the pregnancy for termination to be considered lawful.
ACT: Abortion is legal however needs to be performed within a ministerial approved medical facility by an approved medical practitioner.
Tasmania: Abortion is legal up until 16 weeks gestation - after this it is still legal with the approval of two medical practitioners. Tasmania's only surgical abortion practice was closed in early 2018 and pressure has been mounted onto the state government to assist in the provision of local surgical termination services. In addition to this there are very few registered medical practitioners providing abortion services. In response there is a travel assistance scheme to assist women to travel to Victoria to receive care (Children by Choice, 2018; Willis, 2018).
The Future of Abortion Policy in Australia
As with many aspects of the Australian health system, it would be fantastic to see abortion policy streamlined throughout the nation to ensure equal accessibility throughout the states. Raising the discussion at a parliamentary level however is somewhat of a concern, especially when consideration is applied to the increase in conservative MP’s sitting in the houses. This could lead us into territory resemblant of the current situation in the USA.
The next step at present for abortion policy in Australia is to have the regulations in New South Wales progress to meet those in other states as we saw in Queensland last year. I would also like to see an increase in accessibility to abortion resources, with more GP’s trained to provide medical termination, particularly in regional or rural areas.
What to do, where to go, who to call?
There are a few options here, and they're not necessarily restricted by the laws within your home state as outlined above.
One option is to speak to your GP - you may have already spoken with them to confirm the pregnancy - and have them refer you off to a facility that will be able to assist you. If you hold a pension or healthcare card and live in a state where abortion is legal, you can be referred as a priority patient into the public system who will arrange an appointment for you that will be covered by Medicare. If you don't hold either of these cards, but have Medicare, you can be referred to the public system, but they may advise you to go elsewhere if they don't have the capacity to treat you. If you can't go through the public system for whatever reason, you can be referred to a local private clinic. You will receive a Medicare rebate for services provided by these clinics, but there may be out of pocket fees associated.
Another option is the The Tabbot Foundation, who will provide you with medical termination medication over the phone if this is deemed an appropriate option for you, in all states except South Australia. Start by getting in touch with them - they'll assist you in organising an ultrasound and blood test as soon as possible. Following this, you'll speak with a doctor over the phone who will talk you through the medical abortion process, and the risks associated. If everything is in order, you'll receive your medication in the mail. If you live in a major city, you'll likely receive your parcel the following day. If you live rurally, you can have the discrete parcel sent to a local post-office for collection within 48 hours if at home delivery is not an option. You'll get 24 hour p/day over the phone care if you need it, and plenty of support and follow up. The organisation pride themselves on being a safe, reputable medical provider, free from the judgement and poor experiences women can sometimes have when going ahead with abortion. The service costs $250, plus $75 for the medication. If you're eligible with Medicare all scans and tests will be covered with no out of pockets fees.
In addition, the Marie Stopes Foundation are active providers of contraception and abortion services world wide. Like the Tabbot Foundation, Marie Stopes can provide medical abortion services via phone consultation, but they also offer in clinic services as well, including surgical and late stage termination, and have a fantastic financial hardship support program. You can find a clinic close to you by clicking here.
Australian Government Department of Health. (2018). Abortion - Health Direct. Retrieved December 2018, from https://www.healthdirect.gov.au/abortion
Glenza, J. (2019). Which states are seeking to make abortion illegal and who is behind it? Retrieved 16th May 2019, from https://www.theguardian.com/us-news/2019/may/14/abortion-ban-legislation-alabama-will-it-pass
Children by Choice. (2018). Australian Abortion Laws. Retrieved December 2018, from: https://www.childrenbychoice.org.au/factsandfigures/australianabortionlawandpractice
Willis, O. (2018). Is Abortion Legal in Australia? It's Complicated. Retrieved December 2018, from:https://www.abc.net.au/news/health/2018-05-26/is-abortion-legal-in-australia/9795188