On Sunday, the results came through in the Republic of Ireland’s referendum on abortion. With an overwhelming 66.4 per cent majority, the nation’s voters elected to repeal the eighth amendment – the part of their constitution that effectively prohibited women from terminating a pregnancy.
Throughout the campaign, repeal advocates echoed stories of women forced to travel to the UK – at significant emotional and financial cost – in order to obtain a safe, legal abortions. A pregnant 15-year-old who took a boat there with her mother; a couple whose child would not have lived beyond 20 weeks; an 18-year-old who was simply not financially or emotionally equipped to have children.
Yet these stories are not unique to Ireland. Here in Australia, the varying legislation state-to-state often sees women travelling hundreds of kilometres, crossing borders in order to avail themselves of more lenient conditions.
In fact, while rates of abortion are lowering in Australia (an ABC investigation estimated around 65,000 are performed each year), it seems the number of women travelling to procure them is on the rise. Marie Stopes Australia, a nationwide non-profit abortion provider, told Mamamia it recorded a 22 per cent increase in the number of women venturing interstate to access medical and surgical abortions in the past year.
When it comes to restricted abortion access, the finger can largely be pointed in three directions: toward Queensland and New South Wales, where abortion is still listed in the respective criminal codes; and Tasmania, where abortion is legal, but as of 2018 there are no longer any clinics offering the procedure.
What is the status of abortion law around Australia?
In Queensland and New South Wales abortion remains a criminal act punishable by time in prison, and it has been that way since 1899 and 1900, respectively.
In the sunshine state, an unlawfully obtained abortion carries a maximum penalty of seven years for the patient and up to 14 for the doctor. In New South Wales, it’s up to 10 years for both.
Though both states do allow doctors to legally perform an abortion if they deem the pregnancy is a risk to a woman’s physical or mental health, neither deems rape, incest or foetal abnormality as grounds for a lawful abortion.
While prosecution is relatively rare, it does happen. In 2017, a 28-year-old NSW woman was convicted and sentenced to a three year good behaviour bond, after she procured an at-home medical abortion with pills she purchased online. According to The Sydney Morning Herald, the woman's boyfriend had urged her to terminate the pregnancy.
In all remaining states and territories abortion is lawful, though each has its own caveats and conditions (see this breakdown), including strict caps on how far the pregnancy has progressed. Victoria is the most liberal in this regard. There, abortion is legal within the first 24 weeks of pregnancy. It is also lawful beyond that, but requires approval of two doctors who the must agree that the procedure is in the patient's best interests.
When the law, funding and stigma combine.
As CEO of Marie Stopes Australia, Michelle Thompson, argues, these "patchwork" state laws and regulations are not only confusing, but limit women's ability to access abortion services in their home state or territory. Depending on how far into the pregnancy the woman is, the reason for her desire to terminate and the associated costs, she may be forced to travel.
But that's not the only factor driving this so-called 'termination tourism'. As Thompson notes, it's the stigma that's behind the lack of funding for services.
"Governments often tend to shy away from discussions about abortion provision and its funding and delivery through the public health services is patchy. Much of the provision of abortion is done in private clinics because it is just not publicly available. If a private provider shuts down (as was the case in Cairns and Tasmania) women can lose surgical abortion access and this may cause them to have to travel," she said.
"Stigma is probably the biggest issue that drives both the funding issue and the patchwork law issue. We really need to be more mature and more progressive when it comes to delivering abortion care."
The impact of restricted access to abortion.
Research shows that in most cases, an abortion does not negatively impact a woman’s mental wellbeing long term. But being denied access to an abortion can.
As sexual and reproductive health specialist Dr Catriona Melville has previously explained to Mamamia: “What we do know is that women who are denied access to abortion that does increase their stress levels and causes anxiety and actually compounds an already challenging situation,” she said. “That particular study showed that when women were denied an abortion there was a significant impact on their mental well being. They had more symptoms of anxiety, lower self-esteem and lower life satisfaction.”
Kate Marsh, spokesperson for Queensland-based counselling service Children By Choice, also noted the potential physical risks: "Restricted access also often results in delayed presentation, so women are accessing procedures later in pregnancy than they would if abortion was available closer to home."
And as Dr Melville said, “The scientific evidence is there that essentially the earlier you can access abortion the safer it is."
Help make the change.
According to those on the ground, not only is the 'why' clear around changes to Australian abortion access, so is the 'what'.
"Many things need to change, but chief among them are full decriminalisation in every jurisdiction, proper training pathways for medical practitioners (at the moment it does not form part of tertiary study and doctors are left having to find someone to train them in most cases), and an increase in the Medicare rebates available for surgical abortion procedures," said Children by Choice's Kate Marsh.
Marie Stopes Australia's Michelle Thompson agrees: "We must reform abortion funding and provision across the country."
She added, "The simple solution to this is to move funding from the State health sphere back to the Federal health sphere. Then make sure you have uniform funding, through primary health care, to ensure that women can access abortions no matter where they live. If you move this funding, you will actually drive nationally consistent regulations and laws.
"We need to treat this as a national issue and provide a national response."
To demand this response, contact your State and Federal MPs. To help fund vital support and counselling services now, you can donate to a not-for-profit unplanned pregnancy organisation of your choice.
If you are in need of support relating to an unplanned pregnancy, help is available. Please call Marie Stopes Australia's support line on 1300 336 043 to speak to a trained counsellor. Crisis support is also available via Lifeline on 13 11 14.