For free and accessible abortion
By Kathy Newnam
With abortion set to be decriminalised in Victoria before the end of the year, there are renewed opportunities for abortion rights supporters to retake ground that has been lost since the height of the abortion rights movement in the 1980s, when it won gains including court decisions in Queensland, Victoria and NSW that liberalised the interpretation of anti-abortion laws, enabling women to legally access abortion. Those rulings reflected the strength of public opinion in favour of abortion access — a product of the long years of campaigning by abortion rights supporters. This support remains strong — more than 80% of people in Australia support a woman’s right to choose.
Currently, abortion remains subject to criminal law in all states and territories except the ACT, which removed abortion from its criminal code in 2002. These laws provide a cover for anti-abortionists to restrict access. As recently as 1998 two Perth doctors were charged with performing an “unlawful abortion” under the Western Australia Criminal Code (in which the term “unlawful” was not defined) for having performed an abortion in 1996 at a Perth clinic. This sparked an intense campaign that led to substantial reform to the WA abortion laws.
While this reform led to the repeal of the four sections of the Criminal Code relating to abortion, another section was added, the main restrictions of which related to the WA Health Act, which was also amended to include the definition of a “lawful” abortion. The amended Health Act makes allowance for abortion if a woman will face “serious personal, family or social consequences” or “serious danger to [her] physical or mental health” if the abortion is not performed or if the pregnancy will cause “serious danger to her physical or mental health”. If these conditions are not met, a woman must give “informed consent”. This is a significant restriction because “informed consent” requires two doctors to be involved; the doctor who provides the counselling or refers a woman to counselling cannot be the doctor who provides the abortion.
Another restriction added that after 20 weeks of pregnancy two medical practitioners from a panel of six appointed by the health minister have to agree that the mother or unborn child has a severe medical condition. These abortions can be performed only at a facility approved by the minister. Women under the age of 16 who are still supported by at least one parent have to inform one parent. While it is possible to apply to the Children’s Court to waive this requirement, this would be an extremely daunting prospect on top of the difficulties of accessing an abortion for someone under 16.
Furthermore, the WA Health Act states that no “person, hospital, health institution, other institution or service” is under a duty to provide or participate in performing an abortion.
The outcome of the WA campaign in 1998-99 highlighted the importance of the demand for the complete repeal of all anti-abortion laws. There is no need for specific laws relating to abortion. It is a simple medical procedure and should be treated as such in law and in medicine.
The current debate around the moves in Victoria to decriminalise abortion will centre on three models put forward by the Victorian Law Reform Commission. These are:
Model A: a codification of the current legal standing of abortion after the Menhennit ruling of 1969, which found that abortion was “lawful” if continuing the pregnancy would pose a risk to the woman’s mental or physical health.
Model B: Abortion would be a women’s decision up to 24 weeks of gestation, after which it would be lawful only if the woman’s mental or physical health was at risk from continuing the pregnancy.
Model C: complete decriminalisation.
Campaigning for the adoption of Model C offers a major opening for the abortion rights campaign, and not only in Victoria: these changes also raise the need for decriminalisation of abortion in other states and territories. Such a campaign is necessary to fight against any compromises that could be made, as happened in WA.
Attacks on access
Currently South Australia is the only Australian state where women can access free (bulk-billed) abortion, at a Pregnancy Advisory Centre (a free-standing clinic in the public health system, where 85% of abortions in SA are carried out). In other states, the cost of abortion has risen sharply over recent years since Tony Abbott, the Howard government’s health minister, brought about changes to interpretation of Medicare and bulk billing in 2005.
In Queensland, the cost of an abortion ranges from around $260 up front (for concession cardholders in Brisbane) to $810 in Cairns for abortions under 12 weeks. The costs rise steeply every two weeks after 12 weeks gestation. Only $260 is available on the Medicare rebate — around $100 less than for comparable operations. In NSW costs have increased since the closure in 2002 of the Bessie Smyth clinic, the only feminist-run abortion clinic in Australia. The policy of Bessie Smyth — never to turn a woman away — kept pressure on other providers to keep costs low.
On top of the costs for the procedure itself, there are also the associated costs — time off work, childcare and travel expenses, which are particularly an issue for women in regional and rural areas. In Queensland, for example, there are only 13 abortion clinics, and a number of them operate using the same doctors — some regional clinics open only once a fortnight. Queensland clinics provide abortion only up to 15 weeks gestation. Women requiring abortions later than 15 weeks have to travel to Victoria.
The use of Mifepristone (RU486) is still not an option for any but a few women in Australia. Regulation of the “abortion drug” was returned to the Therapeutic Drugs Administration in 2006. Despite this, no pharmaceutical company has applied to import and distribute it, leaving it to individual medical practitioners to jump through the hoops themselves by applying directly to the TGA. Consequently, RU486 is currently available only on a limited basis from one doctor in Cairns.
Currently, medical schools do not carry out compulsory training in abortion procedures. This is despite the fact that it is one of the 10 most commonly performed operations in the country. As well as restricting access, because fewer and fewer doctors are trained in the procedure, it allows the anti-abortion lobby to exploit the lack of direct experience in the medical profession, with misinformation campaigns about the supposed complexity of the operation.
The restriction of abortion access is a tactic pursued by the anti-abortion lobby, as public support for abortion rights prevents the anti-abortionists from achieving their goal of banning the procedure. On June 18 Liberal Senator Guy Barnett moved a motion in the Senate to end Medicare funding for abortions after 14 weeks of gestation, with the claim that abortion for “psychosocial reasons” is “effectively abortion on request”. In other words, the move is based on a fundamental opposition to abortion itself, not just late-term abortion.
Barnett’s motion has not received support from the government (or even from within the Liberal caucus). However, Labor federal health minister Nicola Roxon told reporters in response to the motion that she “would like to see our abortion rate reduced”, reflecting the reactionary view that abortion should be seen as a problem, rather than a solution to the problem of unwanted pregnancy.
[Much of the information for this article is from a public meeting organised by the Pro-Choice Action Collective held in Brisbane on May 31, which was addressed by Marg Kirkby from the Women’s Abortion Action Campaign and Cait Calcutt from Children by Choice.]