Women seeking abortions latest casualty of stressed health system
Women in regional centres face major challenges accessing abortion services, but those in Queensland’s second most populous city also find it a struggle.
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Queensland women forced into unwanted pregnancies, and in some cases turned away from hospitals or forced to travel thousands of kilometres, are the latest victims of the state’s under-pressure health system.
It’s been five years since the Queensland Government moved to fully decriminalise abortion in the state, but women's health advocates and doctors say a lack of funding and 15 hospital and health services running their own race when it comes to service delivery means your postcode determines your level of access.
While delivering abortion services – specifically surgical abortion (post nine weeks) – to some of the most remote parts of Queensland comes with challenges, including a lack of available facilities and clinicians, even women in cities are facing major hurdles.
Women on the Gold Coast are among the most poorly cared for when it comes to termination services, with the only pregnant people able to access free abortions in the Gold Coast Hospital and Health Service being healthcare card holders, according to Children by Choice and private abortion provider MSI Australia.
Children by Choice CEO Daile Kelleher said that policy meant other vulnerable women who may be experiencing domestic and family violence, were under financial strain, sexual assault victims or those suffering mental anguish were unable to access the vital free service.
But a spokeswoman for Gold Coast Health said it did offer termination of pregnancy services to people without healthcare cards, including women with “complex healthcare needs, and those experiencing significant financial or social barriers to accessing services”.
Ms Kelleher, whose organisation offers free, unbiased advice on all pregnancy options, recently supported a woman from Central Queensland who was trying to flee a violent relationship.
HAVE YOU RUN INTO BARRIERS TRYING TO ACCESS AN ABORTION? EMAIL JILL POULSEN
“She wanted an abortion which was part of her planning to leave that partner and not be stuck with them in some sort of shared parenting arrangement and she was able to access a funded termination through Queensland Health by travelling to Brisbane, but the patient travel subsidy that she could access wouldn’t allow her four-year-old child to travel with her,” she said.
“So it was not suitable for her to actually leave this relationship and not return … there needs to be consideration given to the additional barriers and challenges of regional women, but certainly women that are experiencing domestic and family violence or reproductive coercion and abuse and or some sort of control over their finances or medical appointments.”
Experts say the stigma surrounding abortions remains a significant barrier for women seeking reproductive options, particularly in small or religious communities, where privacy may be hard to maintain and the fear of judgment is extreme.
Royal Australian College of General Practitioners deputy Queensland chair Dr Cathryn Hester said another issue affecting women was the fact that South Brisbane’s Mater hospital refused to offer full reproductive services to women based on its religious affiliations.
The Mater also has the contract to provide the flying obstetrician and gynaecology service to regional and remote parts of the state.
“They do not provide the full gamut of women’s health care, they do not provide basic contraception care, and they certainly do not provide termination pregnancy care,” she said. “Honestly, I just find it amazing that much of the state-funded health care in this state actually just completely misses these really important aspects of women’s health care.”
A spokesman for Queensland Health said all of its hospital and health services had referral pathways in place enabling access to termination of pregnancy services.
“We recognise there are challenges in accessing termination of pregnancy services in some regions, and we are working on exploring solutions,” he said.
“However, unlike smaller jurisdictions, Queensland faces distinct healthcare challenges due to its large size and decentralised population.”
Five years ago there were eight private abortion clinics – there are now only three.
Data gathered by Australia’s largest private abortion provider – MSI Australia – reveals that despite common misconceptions the average woman seeking a pregnancy termination is aged in her 30s and already has at least one child.
“The majority of these people have also been on contraception but they're part of that five or six per cent failure rate, depending on their contraception,” MSI Australia managing director Jamal Hakim said.
The average cost of a surgical abortion for women accessing private clinics is around $700, increasing with every week of gestation, and about $600 for a medical abortion – medication that is taken at home if you are under nine weeks’ pregnant.
Past 20 weeks gestation it can cost between $8000 and $10,000.
Up to 22 weeks, a woman can request a termination of pregnancy for any reason under Queensland law.
After 22 weeks, two doctors must agree the termination is appropriate in the circumstances.
But Dr Hester said doctors could be just as confused as patients when it came to what services were offered in each health district and which patients would and would not have to pay out of pocket costs.
“From a GP point of view, we just want really clear, really transparent pathways because termination of pregnancy clearly constitutes a vital part of women’s healthcare,” she said.
“It shouldn’t be some opaque backdoor process that nobody seems to know about. These are women’s health care issues and can be provided by GPs in the community very safely, if they have appropriate backup.”
AMA Queensland president Dr Maria Boulton said early, timely access to pregnancy choices was a fundamental healthcare right, not a privilege based on location or income.
“The barriers to timely pregnancy choice are very real for women across Queensland. Queensland Health has a critical role to play in ensuring equal and safe access to these services no matter where you live,” she said.
HAVE YOU RUN INTO BARRIERS TRYING TO ACCESS AN ABORTION? EMAIL JILL POULSEN
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