The Accessability of Abortion in Australia
While it barely needs to be said that abortion in Australia is far more accessible than for our sisters in America, I do want to delve into the process of abortion here at home. There is an inequality when it comes to cost and availability between the states. Some women in some states are able to get an abortion and get change from a $50 note, whilst others need to fork out more than $8,000. Some women don’t need to cross state borders to access a termination, others do.
The most affordable option for an abortion is the a tablet, RU486 or Mifepristone which is effective up until nine weeks of pregnancy. It does involve an ultrasound at an accredited clinic or hospital to determine gestation and confirm that the pregnancy is not ectopic. If proceeding with the termination, the woman is given RU486, and then another tablet- Misoprostol to take 24 hours later. This process brings on heavy cramping and bleeding, terminating the pregnancy.
While Julia Gillard was Prime Minister, one of her last acts was to add RU486 to the Pharmaceutical Benefits Scheme. According to the PBS website this costs $42.50. This price though, is dependent on many factors including location. However, only 10% of Australian doctors, and only 1% of regional doctors are able to prescribe this medication.
The second option for an abortion in Australia is a surgical abortion. This is a day surgery, mainly performed in private clinics. Once the nine week gestation mark is hit, this option is the only option for pregnant women in the country. These surgeries are mostly available in metropolitan areas, meaning regional and rural women must travel to access, many women choose to go interstate depending on gestational limits.
While in the article below I give the listed costs of abortions throughout the country- it is the hidden costs that add dollars to the cost. The price of an abortion increases with the weeks of gestation the woman is, meaning a woman who found out at six weeks and accessed a medical abortion is paying substantially less than a woman who found out at 21 weeks and had to have a surgical abortion.
Other costs come in the form of taking time off work, travelling to an appropriate clinic, finding someone to look after your other children, and seeking mental health support.
Women who live in Australia on temporary visas face even more barrier to accessing abortion. The Australian government gives no support to these people and forces them to foot the entire bill for this process. Something that may cost upwards of $8000.
Not only are there very limited, trained professionals who are able to perform abortions accross the country, the healthcare sector is tired. It’s depleted. Access to abortion services are even more limited becuase the healthcare industry is overwhelmed.
Abortion in Western Australia
WA is regarded as having the most restrictive abortion laws in the country, with abortion still falling under the criminal code. In WA, abortion is legal up until 20 weeks of pregancy and must be performed by a medical practioner. Women under 16, or classified as a dependent minor are required to have their parents notified, OR they can make an application to the Children's Court for an order that the custodial parent not be consulted. To have an abortion in WA you MUST have a referral from a GP.
If the pregnancy has progress past twenty weeks and the women has a severe medical condition that “justifies” an abortion, a panel of six medical practitioners that have been appointed by the Minister convenes and two of those six must agree to the termination. The abortion must be performed at an approved facility.
If the pregnancy has not progressed past 24 weeks, the women may consider heading east to Victoria where abortion is legal.
When it comes to getting the abortion there must be two different doctors involved. The first is the referring doctor that is responsible for advising of medical risks and the availability of government funded psychological counselling. The second doctor is the one to provide the termination.
There are two main providers of abortion in WA- Nanyara and Marie Stopes Australia. Both offer surgical terminations up until the 20 week mark, and medical until 9 weeks. According to the MSI Australia (Marie Stopes) website a surgical abortion costs from $650 with a Health Care Card and from $680 with a Medicare card. You will also need to add the cost of your chosen contraception wether it be an injection, implant or IUD.
A medical abortion can be performed in clinic and by the phone. In clinic is from $550 with a Health Care card and $590 with Medicare, this includes blood tests, ultrasounds, follow up appointments and treatment. Done by phone is from $401.10 with a Health Care Card and $432.70 with a Medicare Card. This price includes the cost of medication sent via the post.
Abortion in Victoria
The gestational limit in the state of Victoria is 24 weeks, a termination beyond this time is possible if two practitioners agree it is appropriate. If a GP has an objection to abortion for any reason such as religion, beliefs ect, they MUST refer to another practitioner who does not object.
A medical abortion can be provided up to nine weeks along and is available at some private GPs, community health services and private clinics. Medical abortion can also be accessed by Telehealth, to discuss the process, provide referrals and the script for medication. A surgical abortion can be provided up until 24 weeks of pregnancy and is available in some hospitals and private clinics, mainly in the metro area.
I have found an abortion provider in Melbourne, The Womens Clinic. On their website they explain that they offer both surgical and medical abortions but also state that they discount their fees for those with a current health care card and those in need. A surgical abortion up until 11 weeks will cost $400 with a Medicare card, $350 with a Health Care Card, past that 11 weeks the fees vary. They list their medical abortion feed as $290 with both Medicare or a healthcare card, this includes an ultrasound.
Abortion in New South Wales
In the state of New South Wales abortion is legal up until 22 weeks gestation providing that informed consent is given. A termination after 22 weeks may only be carried out in an approved health facility or hospital and only by a specialist doctor in consultation with one other medical practitioner. Again, any medical practitioner with a conscientious object must refer to or transfer care.
Young women under the age of sixteen, and those with intellectual disabilities do not need to inform their parents or guardians, but are encouraged to bring a support person to the appointment with them. They have the same rights as any other women and just need to give informed consent.
Gynaecology Centres Australia is a private clinic providing abortions in five locations accross NSW and ACT. On their website they state that they no longer provide medical abortions in order to focus on surgical abortions and the complexities of such. They also state that at all GCA clinics a current Medicare card will cover more than 50% of the cost of the surgical abortion. The centre performs surgical abortions up until 14 weeks, costing upwards of $550.
Abortion in the Northern Territory
The NT has been praised for the access their women have to abortion services in the state. Women are able to access abortion up until 24 weeks of pregnancy and thereafter with the support of two doctors who agree the process should be continued for medical reasons. Previously, it was illegal for an abortion to be provided after 23 weeks unless it was deemed the procedure would save the womens life.
The cost of a medical abortion in the Northern Terrioty is completely free if you hold a current Medicare card. Further to this, in some cases the government will help you cover costs if you need to travel to access an abortion. Family Planning NT reportedly receives hundreds of calls every week, from women all over Australia who want to utilise this process.
Marie Stopes Australia also offers their services to the Northern Territory, however, they do only offer medical abortions by phone for women up to eight weeks of pregnancy.
A medical abortion is only available to women who reside within a two hour drive of a facility that could, if necessary provide emergency medical care. Outside of these areas, a surgical abortion is used.
Abortion in Queensland
In the state of Queensland a woman can access an abortion upon request up until 22 weeks, she does not need to disclose any reason to her doctor. After the 22 week point the abortion may be performed if two medical practioners agree that the ermination should be performed.
Children by Choice, a non-profit organisation that receives some funding from Queensland Department of Justice and Attorney-General. This organisation has a financial assistance program for disadvantaged women in Queensland who are unable to afford termination services. Women living in regional or remote Queensland who need to travel in order to receive an abortion may also have access to the Queenland Health Patient Travel Subsidy Scheme.
If a women is under the age of 18, she does not need to have the consent of their parents in order to access an abortion. They simply need to show maturity and understanding of the procedure and their decision. Should the woman not be able to show maturity the Supreme Court may be able to authorise the termination. A parent or guardian is unable to give consent in this situation. A decision maker for someone with impaired capacity is also not able to give consent for a termination. QCAT and the Supreme Court of Queensland may also authorise a termination.
According to Womens Agenda out of pocket costs for a surgical abortion is, on average $620. Telehealth medical abortions sit at around $430. Options Clinic is a private abortion clininc in Queensland that only offers medical terminations up until nine weeks of pregnancy. On their website they state that the terminations start at $400, for an overseas visitor it will cost $875.
In August of this year an article published by the Brisbane Times revealed that some Queensland doctors were lying to their patients seeking abortion, telling them that abortion remained to be illegal.
Abortion in South Australia
Abortion was only removed from the South Australian criminal code in 2021, this allowed terminations up to 22 weeks and six days gestation. This made them the last sate in the country to decriminalise abortion, however it did take them 15 months to enact the law in July 2022.
With the enactment of the law the state came more into line with other areas of Australia. The enactment meant that you could request an abortion up until 23 weeks wiothout the approval of two doctors, medical abortlons could be accessed by telehealth and the procedure could be provided outside of a hospital. It also scrapped the rule that patients needed to have been a resident in SA for more than two months in order to gain access to healthcare. The conscientious objection rule for doctors was also enacted.
Aware Women's Health in SA are a clinic offering medical abortions only. To access a medical abortion you will need two or three appointments with their doctors, ranging from 20 minutes to 45 minutes each, they may ben conducted via telehealth. Their website prices the termination at $250 with Medicare, and $530 without it. On top of that the medication costs $45 with a Medicare card, $450 without.
While we are leaps and bounds ahead of other places on Earth, there still needs to be changes in the system in regards to abortion access. Dr Judith Dean completed research recently on the accessibility to abortion in Australia. The research revealed the case of a 24-year-old woman who told her cousellor she considered self-abortion and suicide when she was told how much her abortion would cost. Another case spoken about in the research was the mother of a teenage girl who recalled her daughter attempting to induce an abortion on her own by self harming.
Through legislation the general access to abortion in Australia has improved. This legislation though, it does not mean accessibility for all.
