Introduction by Croakey: Amid increasing threats to reproductive rights in Australia, a new report by Women’s Health Victoria reveals inequities in abortion and contraception care across the state.
The report, titled Realising access: abortion and contraception inequities and enablers in Victoria, highlights several challenges facing women and gender diverse people in Victoria in accessing sexual and reproductive health services.
An analysis of calls made to Victorian sexual and reproductive health service, 1800 My Options, in its first six years of operation (2018-2024), shows that the proportion of service seekers was greater from high disadvantage local government areas in metropolitan Melbourne (based on the Index of Relative Socio-Economic Disadvantage) than low disadvantage LGAs.
Also, the report shows that more calls were made from regional and rural LGAs that are known to be under-serviced, including the Northern Grampians and Gippsland. There were 16 percent more calls received from service seekers in high disadvantage regional and rural LGAs compared to low disadvantage regional and rural LGAs.
Overall, the majority (87%) of calls to 1800 My Options were regarding abortion services, followed by calls about long-acting reversible contraceptives (4%).
Mary-Anne Thomas, Victoria’s Minister for Health, said in a statement:
Abortion and contraception are healthcare and they should be accessible for any woman, no matter where she lives – it’s why we are continuing work to transform our health system, giving women more options. This includes establishing 1800 My Options, adding to our network of Sexual and Reproductive Health Hubs, and expanding access to abortion in public hospitals.”
Meanwhile, recent public debate about abortion in South Australia and Queensland – where it has become an important election issue – has significant impact on the healing journey of individuals with lived experience, as Dr Sarah Birtwistle, public health academic at University of Queensland, outlines below.
Sarah Birtwistle writes:
Six years following the introduction of the Termination of Pregnancy Act in Queensland, abortion has once again found itself on the political agenda.
The largely uncontested issue of women’s reproductive rights has recently been thrust front and centre in the upcoming Queensland state election.
While it has been suggested this topic is not one to sway voters, there is a sense of unease that if the Liberal National Party (LNP) are successful in their bid to win, they could allow a conscience vote – should a private member’s bill be introduced, as recently done in South Australia – to repeal current abortion law.
Following repeated questioning on the matter over the past week, David Crisafulli, leader of the LNP, said yesterday his party will “not be changing that legislation” and he “believes in a woman’s right to choose”. However, according to the ABC, Crisafulli has “failed to rule” out whether the LNP would allow a conscience vote on a private member’s bill if introduced by Katter’s Australian Party.
Given that many members of Crisafulli’s party voted against Queensland’s Termination of Pregnancy Act in 2018, the prospect of moving backwards when it comes to women’s reproductive rights has become a frightening reality.
Perhaps more so given recent news that South Australia’s upper house narrowly voted down late-term abortion law amendments, with nine votes in favour of the bill and 10 against – highlighting the deep divides that exist on the topic within parliaments.
Before the Termination of Pregnancy Act came in effect on 3 December 2018, having an abortion in Queensland was subject to the Criminal Code and the McGuire ruling, which stipulated that unless abortion providers deemed the women’s physical or mental health to be at risk, the abortion was considered unlawful.
Social and cultural stigma
While the Termination of Pregnancy Act supports reproductive freedom by promoting women’s right to choose, abortion continues to be shrouded in broadly applied social and cultural taboos, which can then be reinforced via policies.
Proposals to restrict abortion contribute to an existing narrative that abortions, unless medically necessary, are ‘sinful’. This is harmful, least not because such ideas can perpetuate stigmatisation and increase negative attitudes towards this group which, in turn can induce feelings of shame, isolation, hopelessness and a reluctance to speak out and seek support.
Evidence indicates that fears of stigmatisation cannot only reduce feelings of perceived social support to help inform abortion decision-making and avoidance of using needed reproductive services, but can also limit one’s ability to share their abortion story following the event.
This is something I can attest to firsthand. I had an abortion in March 2018 and this was a secret I kept for many years. Whilst the reasons for doing so were complex, ultimately, I worried about being judged. The abortion was the correct decision for me – but, I found the experience both traumatic and complex to navigate.
I experienced a double burden of grief, trying to cope with, and grieve for, the loss whilst simultaneously dealing with the role I had played in the termination.
I often found myself questioning my right to grieve – did I have the right to be sad when I had decided to end the pregnancy? But I was sad, and unable to discuss the pain I felt in fear of others validating the questions I so feared. This made coping with the experience that more challenging.
Seeking support
After battling depressive episodes, I sought professional support, which was incredibly helpful. They listened, provided clarity, but most importantly for me, they validated my feelings of grief and recognised the trauma I had experienced.
Through these simple acts of connection, they allowed me to start my healing journey, but also supported and provided me with the confidence to speak about my abortion without shame.
Sharing stories has the power to connect individuals both with and without a shared experience, offering comfort, support, and a sense of healing, particularly for sensitive and emotive topics.
However, with discussion on whether current laws decriminalising abortion should be revised or even repealed at the forefront of political debates, does this pose a threat to one’s feeling of safety and security to share their experience? Given that for some, there could be a real threat to both physical and psychological safety, this is of great concern.
As it stands, it is difficult to predict what will happen to abortion law should the LNP win the state election; only time will tell.
However, what we do know is that there are several women’s services available within Australia offering support to women considering, or who have had, abortions.
Such services provide non-judgemental counselling services for multiple concerns, including, how one is feeling after an abortion.
Such services are low/no-cost, and dependent on the service, offer support in multiple modes, including over the phone, video link and face-to-face, allowing communication in ways that are both accessible and comfortable.
Accessing such services may help navigate the complexities one may feel after having an abortion, and provide a confidential and safe space to help aid the healing process, importantly, blocking out outside noise.
Dr Sarah Birtwistle is an academic in Public Health at the University of Queensland with an interest in women’s reproductive rights.
See Croakey’s archive of articles on women’s health