Changes to NSW abortion laws were aimed at making the procedure widely available but three years later public hospitals still have not stepped up and women are being forced to travel hundreds of kilometres for expensive private practitioners.
Religious values, economic constraints and the failure of sympathy appear to have joined forces to stymie women from easy statewide access to the procedure. The Abortion Law Reform Act 2019 removed abortion from the Crimes Act and allowed for pregnancy terminations at up to 22 weeks and beyond 22 weeks if two medical practitioners agreed. Supporters of the change hoped decriminalisation would remove legal barriers that prevented healthcare services from performing terminations.
Yet only two hospitals – John Hunter Hospital in Newcastle and Wagga Wagga Base Hospital in the Murrumbidgee Local Health District – currently run abortion services. Of the 15,973 abortions performed in NSW between October 2019 and September 2020, only 0.7 per cent were carried out in public hospitals, according to NSW Health.
So, why the public hospital “go slow” on abortions? As the ’s health editor Kate Aubusson reports, some medicos and academics believe that public hospitals are bowing to the wishes of pro-life senior staff or fear a rush of abortions would cripple already overstretched resources.
Dr Emma Boulton, director of sexual health practice Clinic 66 in Chatswood, told Aubusson that money-strapped public hospitals did not wish to set a precedent by opening their doors to abortion care for fear of being inundated with cases. Further, their willingness to take on these patients depended on the obstetrics and gynaecology teams, who can harbour a faith-based ethos, are staunchly anti-abortion or believe it’s a social problem characterised by irresponsible women who cannot manage their contraception. Boulton said: “If a particular personality happens to be a leader of that team, then a woman is just not going to be able to get through.”
Kirsten Black, professor of sexual and reproductive health at the University of Sydney, said the only way a woman could get a surgical abortion at public hospitals was if she suffered a medical complication or needed a late-term termination. “We have had decriminalisation, but women still face serious hurdles to exercising their reproductive rights,” she said.
Always a contentious issue, abortion was decriminalised in NSW after a long, bitter campaign that ended in the spring of 2021 with the third-longest bill debated in the history of the upper house, stretching over five days with 102 amendments and 26 divisions. In Australia, the debate over women’s reproductive rights appears largely settled. South Australia became the last state to decriminalise abortion in 2021. The balance in Australia has swung in favour of secular values over religious ones, not just on abortion but also on LGBTQ rights and voluntary assisted dying.
But the redoubt in NSW public hospitals flies in the face of women’s growing political power, not only on abortion but on issues from childcare to domestic violence. Advocacy group Australian Clinicians for Choice surveyed 650 NSW residents in January and February and found 68 per cent believed public hospitals should also provide abortions.
That they do not is down to the current government. A spokesman for the Minister for Women and Regional Health Bronnie Taylor belatedly told the she would ask NSW Health to finalise a current review into options to expand public abortion and reproductive health services. But surely giving women access to abortions at NSW public hospitals is a first-order priority for the incoming government. A minimum option would be the provision of abortion clinics in each of NSW’s 15 local health districts.
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