Legal but not in reach: The state of abortion in AustraliaFeb 1, 2023
Australia’s position as America-lite, a little sibling stumbling along the line between voracious neoliberalism and violent abnegation of its own history, comes into distinct relief every so often.
One such recent occasion is the overturning of Roe v Wade, and what would’ve otherwise been the 50th anniversary of the right for folk in the United States to make choices about their own health and reproductive capability. This has not come to pass.
In contrast to the harrowing tales of illegal terminations across the US, abortion has been fully decriminalised across Australia since 2021. But just because something is legal, does not make it within reach.
For many living in rural or remote areas, the lack of general practitioners (GP) who are able to administer either surgical or medical abortion means that women and others needing reproductive healthcare do not always have access to it. As of 2019, only 1345 out of 35,000 practising GPs across Australia were certified to administer an abortion; in total less than four per cent.
A proposal by MS Health – Australia’s largest independent reproductive healthcare provider outside of the public system – to expand access through training pharmacists, nurses, midwives, and Aboriginal and Torres Strait Islander healthcare workers to prescribe medical abortions, and removing recertification requirements for GPs (which currently must be renewed every three years) offers a chance to remove the lottery of access.
Medical abortion is the use of the mifepristone and misoprostol pills to terminate a pregnancy, known as the MS 2-step. The use of these drugs is regulated by the Therapeutic Goods Administration (TGA), which has the final say on the application by MS Health.
When conducted properly, a medical abortion is a safe, private and simple procedure that allows a person to end a pregnancy up to nine weeks of gestation. And as opposed to surgical abortions, which require being admitted to a clinic or hospital for the procedure, they can be done at home.
When I was growing up in country NSW, a doctor had the right to refuse access to a medical abortion on account of their religious beliefs. Though the legislation has since changed, the reality of GP shortages across rural and regional Australia means that you may very well be unable to find another doctor within the necessary timeframe. Many may not refer you on to another certified provider.
Removing barriers such as administrative burdens, the lottery of geography, and potential religious bias in the provision of reproductive healthcare would create life-altering possibilities for people otherwise forced to go through with pregnancies. Particularly while Australia’s healthcare system remains so strained, enabling easy and straightforward access to abortion is an ethical prerogative.
First published in Missing Perspectives January 30, 2023