This topic may contain sensitive terms, information and opinions that may cause upset or distress. This is a matter of opinion in relation to the Queensland Law Reform and its decision to review and potentially legalize abortion. If you or anyone you know are affected, there are help lines, websites and information at the bottom of this post.
Recently I had the great opportunity to attend the Amnesty International UQ presents ‘International Women’s Day: Abortion Right Panel Discussion’ surrounded by like minded people.
Abortion rights and reforms in Australia is something I felt I knew about, however it was easy for me to acknowledge a gap in my understanding of its legalization and the law, like for example how each state and territory have different legislation for abortion, as it is not deemed a federal case under public health law (spoiler alert: it should be).
Being from a medical background the ‘ifs, whys, and whats’ where more or less answered for me – having cared for women post surgical abortions and assisting with intra-uterine fetal death birthing, the biological and emotional component made sense, but where most people (myself included) fall slack, is in understanding Queensland’s abortion laws, and what they mean for public health, reproductive rights, and women statewide.
In 2017 NSW parliament voted against a bill put into senate asking to legalize abortion and removing the 100 year criminal code, despite years of reform and debate over the topic. In January 2018 the Queensland Law Reform Commission put fourth a similar bill to review pregnancy termination laws. They are specifically looking at how to decriminalize abortion performed by medical practitioners and modernize these laws. These are expected to be in place by June 30th 2018. So far, numerous support groups, MPs and Australians have supported the decision, with a late 2017 survey found a whopping 82% of Australian are in favor of abortions being made safely available and most of Queensland members of parliament being verbal and open about their pro-choice stance: at first glance it appears change may be coming.
The public and political scrutiny over something that is personal and life changing to all those involved has been removed from the privacy and grief of the women having to deal with her choices, and instead become a public circus debating what women can and cannot do with their bodies, health, and lives. While it is a public health issue it is a private matter, and one that requires positive, smart discussions that empower, encourage and assist women. In light of this, I thought I would compile an educational list of 8 things you probably didn’t know about abortions in Queensland and around the world, and how these laws impact women, reproductive rights, and the system around you:
Video by MamaMia, via YouTube
- Abortion is still very much illegal in Queensland
Abortion has been illegal in Queensland since 1899 – a time before women were allowed to vote, so it is safe to assume it wasn’t women who voted in favor of strict abortion laws.
There are specific laws in the criminal code stating ‘an abortion may be performed if there is a direct risk to a women’s physical or mental health’, specifically in legislation these abortions are refereed to as ‘therapeutic terminations’. However that terminology creates a grey area about what exactly is bad for your mental or physical health. On one hand this grammatical loop hole allows medical professionals to bypass the system and provide safe abortions, however it also allows a medical professional to dictate what they decide is bad for a woman’s mental and physical health. Yet despite potential medical access, accessing an abortion in Queensland is very much still illegal, and is written into our criminal code with a prison sentence of up to 7 years for those who access abortion and those who assist with the procedure. You may ask, why are there abortion clinics then? Great question: remember the grammatical loop hole? It is legal for doctors to provide abortions if it is unsafe for the woman to continue the pregnancy and clinics are required for these procedures providing a licensed medical professional does them. These ‘therapeutic terminations’ require medical assistance and while surgical abortions fall under this category, medical abortions (like the RU486 drug) do not, making it difficult for doctors to prescribe medical terminations for women. Instead, these women must opt for an invasive, costly, and risk carrying procedure at 10 weeks gestation rather than a much safer, one-a-day tablet she could have had the day after her urine stick glows pink. This muddying of terminology and stalemating of medical assistance, creates boundaries in patient safety, access, and a woman’s right to choose
- They are difficult to get
If you thought the uncertainty of medical prescription availability was where it ended, you’d be wrong. Aside from the points made in the video above (where in some states, doctors can veto a woman’s decision to have an abortion) finding available appointments, doctors who can perform the procedure and abortion clinics themselves is difficult.
If you’re not from a major city and instead, from somewhere regional like Mount Isa, you will need to fly to your nearest clinic, which are in Cairns, or Brisbane CBD – they are it.
Clinic options are limited to women living in regional and remote areas and a lack of financial freedom, transport options, and other socioeconomic factors may make it increasingly difficult for women to access medical or surgical abortions. Even in the case of clinics in major cities, not all of them are open often, with some only open for procedures one to three days a week. One speaker at the Amnesty event pointed out, that prior to 1983 the only abortion clinic was Sydney, and charities like Children for Choice were solely responsible for organizing plane tickets, accommodation and the cost of the procedure for women around Australia. As late of 2016, Children for Choice were creating Facebook fundraisers to assist with financial aid for women accessing abortions. It would appear at first glance abortions are currently only readily available if you live near a clinic, if you have money, and have access to a doctor who is willing to refer you – these unavoidable external factors influence a woman’s access to healthcare, which is a basic human right
- Abortions are expensive as hell As I mentioned there are charities set up to assist with funding for women requiring abortions; but without that funding, women could see themselves out of pocket from $345 to $3000 depending on the type of abortion needed and clinic it happens in (not including if you are flying to Brisbane from Mount Isa). To add insult to injury, Medicare does not carry any rebates for women seeking terminations (or for a number of women’s gynecological health services) and clinics are unable to apply private health care fees to day surgery procedures due to the grey-spaced-red-tape of legalities. There are rebates and discounts for women on the Single Parent Pension and Health Care Card but only for abortions under 12 weeks and these rebates are decided on by Centerlink and are not a one-size-fits-all return. These financial factors influence women’s ability to access abortions safely and legally. If legalized under Commonwealth law, abortions could be billed under Medicare and provided in tertiary hospitals providing the best and most adequate care available country wide
- We cannot measure the statistics accurately
We cannot actively measure the effect and prevalence of abortion in Australia, especially Queensland. This is a major problem from a public health point of view as it makes it difficult to determine access, use of services and demand. It also makes it difficult to collect data to substantiate claims how much abortion is needed, accessed, or to measure how dangerous it really is. The unfortunate act of continuing to wrap abortion in red tape and making it illegal makes it very hard to estimate how many Australian women are having abortions. To create confidentially and avoid the prospect of going to prison, medical practitioners have to record it differently on the hospital coding system, simply to hide it. Further to this, due to it being criminalized there is not one specific procedure used for the abortion process. The Medicare codes used to account for surgical interventions are related to gynecological services, a unique combination of various services equate to the total procedure of a ‘therapeutic termination’. By averaging the total, it is estimated between 60,000 to 80,000 abortions are performed each year in Australia however this number may be higher, with an estimated 15,000 abortions performed in Queensland every year
- Legalizing abortion does not mean more abortions
A common misconception is legalizing increases frequency. On a global scale, in countries like Germany, the Netherlands, Ukraine, Czech Republic, Russia, and China (and many others); abortion rates decreased on average by 20,000 cases per year (approximately a minimum 20%) once abortion was legalized at a federal level. This is mostly due to the legislative changes abortion law reforms have on reproductive medicine, making new changes to contraception access, sexual education, and giving more empowerment to women when making decisions over their productive rights. The World Health Organization (WHO) estimate over 200 million women globally do not have access to contraception, the highest group at risk existing in developing countries are in Asia and Africa, while it found women living in poverty in first world countries carried the same level of risk as their third world counterparts
- Women from all walks of life require abortions
Most women who access abortions are between they ages of 21-29, over half come from deep religious backgrounds, 70% are living low-income or below the poverty line, and 35% are married – further to this abortions are also sought after by women who are victims of sexual assault and domestic abuse. Quite simply, women who access abortions are women who know what resources they have, what impact their life would have and what they can and can’t handle: smart women making smart choices
- Contraception is not always fool proof
The title to this point speaks for itself. No contraception is 100% perfect and can fail even if used correctly – in fact most people will have a story of contraception gone wrong, women forgetting to take their pill at the same time every day, or perhaps it ‘fell off’ (ya’ll know exactly what I am referring to!). It is unrealistic to expect sexually active women to not potentially experience a pregnancy. Australian and New Zealand research found over half of the women who presented for abortions in 2005-2008 had used contraception prior to pregnancy; in a similar study, almost 1 in 4 Australian men who used condoms reported experiencing at one breaking during intercourse. Of course let us not forget the real big factor, which is in some situations women may not be in the position to negotiate the use of contraceptive use either from drug or alcohol use, lack of power in the relationship, domestic violence, or being coerced or forced into sex. Other barriers include difficult access to contraception including rural and remote locations, cost, privacy concerns, health practitioners refusing to prescribe chemical contraceptives due to personal beliefs (it happens), domestic violence where partners control oral contraceptives (also happens), or a lack of information about options (definitely happens)
- Abortion is a global public health issue and a women’s right issue
Around the world, only 134 of 196 countries provide abortions if there is risk to a women’s physical health, and only 54 allow abortions on request. There is much medical evidence that suggests carrying a pregnancy to term is more dangerous for your health than a termination; and while the last woman to die from birth complications in Australia was 2015, on average 500,000 women die around the world giving birth – this doesn’t include the estimated 3 million that die AFTER birth from birth related complications such as hemorrhage, stroke, sepsis, organ failure, and cardiac arrest to name a few. It is estimated 54,000 women die each year from home-based and non-medical (illegal) abortions. Some countries go as far as denying women any access to abortions under any circumstances even if it to save her life. That means that under many circumstances including rape, incest, fetal abnormality or physical harm, a woman must carry a pregnancy to full term in 35% of the countries of the world.
All in all, incorrect information and inappropriate access to services remove a woman’s right to choose how she accesses healthcare services available to her. Governments, outdated rules and mediocre service availability negatively impact freedom and autonomy of reproductive health. No matter which side of the pro-choice versus pro-life debate you sit on, it can be agreed that the control of a woman’s reproductive system should not be one controlled by government vote. This public debate removes the privacy and difficulty of a tough decision, and drags it into the public sphere dictating results as matter of opinion, instead of objectively measuring the long term impact and ramification of forced pregnancy versus the choice of abortion. This is not just a woman’s health issue, this is a public health issue. With a continuous global death rate, known persecutions and increasing risk to the freedoms and health of women around the world, abortion law reforms need to change for the better to create a more even distribution of services, and decriminalize the actions chosen by a woman deciding her own fate, future, and health. It is’t 1899 anymore.
There are plenty of opportunities to discuss the Queensland Abortion Reform – feel free to access https://prochoiceqld.org.au/getinvolved/ to see how you can get involved in your local area if you would like.
Feel free to read more on the topic here:
Fundraising helps women access abortions (MamaMia): https://tinyurl.com/y936r63y
Queensland abortion laws are most repressive in the world (Courier Mail, Opinion editorial): https://tinyurl.com/ydbzza5c:
Queensland women forced interstate for abortions (ABC News): https://tinyurl.com/lnph4sw
Abortion laws force woman to stay with abuser (ABC News): https://tinyurl.com/y9sc8jxj
Worldwide, an estimated 25 million unsafe abortions occur each year (WHO): https://tinyurl.com/y9vybwha
Or for advice, counselling, or questions, contact:
Charity and registered pro-choice help center: https://www.childrenbychoice.org.au
Queensland’s Pro-choice group website: https://prochoiceqld.org.au
Global initiative and online safe space for abortion discussions and topics globally: https://www.womenonweb.org/