‘Tsunami of abortions’: Public hospitals accused of blocking terminations

Public hospitals have been accused of stonewalling women seeking surgical abortions where senior staff are staunchly pro-life or fear an influx of abortions could cripple their already overstretched resources.

Dr Emma Boulton, the director of sexual health practice Clinic 66 in Chatswood, said her staff were given a gamut of excuses from public hospitals in both Sydney and regional NSW when they needed to refer women with complex cases or late-term pregnancies for terminations.

All local health districts in NSW should have referral pathways for abortion, but private abortion providers say this hasn’t happened. Credit: istock

“First thing they ask is ‘where is she from?’ and if she’s not from the hospital’s local health district it’s a definite no-no,” she said.

A public hospital’s willingness to take on these patients depended on the obstetrics and gynaecology teams, who can harbour a faith-based ethos, are staunchly anti-abortion or believe it’s a social problem characterised by irresponsible women who cannot manage their contraception, Boulton said.

“If a particular personality happens to be a leader of that team then a woman is just not going to be able to get through,” she said.

Boulton, whose clinic charges $950 for a surgical abortion of which the patient gets up to $450 back from Medicare, said hospitals were worried about “a tsunami of abortions” on their already overstretched resources.

“Hospitals don’t want to set a precedent by opening their doors to abortion care. They don’t want to be saddled with a whole lot of work, and they don’t want to be dedicating operating theatres to termination lists,” she said.

A spokesman for NSW Health said all local health districts were required to develop referral pathways to timely abortion access if they did not provide abortions, but Boulton said this had not happened.

Clinic 66 is frequently forced to turn away women from across the state and interstate because they cannot keep up with demand.

“We try to fit in as many women as we can, but when it comes to complications, it is just not safe to be [performing abortions] in a private day surgery,” she said.

‘If a particular personality happens to be a leader of that team then a woman is just not going to be able to get through.’

Dr Emma Boulton, director of sexual health practice Clinic 66

Anna Noonan, a University of Sydney researcher examining abortion access in western NSW, said there was an unspoken rule in some public hospitals about who did or did not deserve to have an abortion.

“If it’s a non-viable pregnancy or a miscarriage, no worries. If it’s a circumstance of rape or sexual assault, we hear they’ll do it once. Why does there need to be a reason? That’s the issue, and that’s the hardest thing to change,” Noonan said.

“We’re hearing that people are carrying pregnancies to term who didn’t feel they can manage and care for [a child] simply because they cannot get access to abortion services.

“The implication on the woman, family, potential child and community is immense. That is quite extraordinarily unacceptable.”

Professor Deborah Bateson, of the University of Sydney and co-founder of the advocacy group Clinicians for Choice, said hospitals were not the ideal settings to manage early-term abortions, but it was critical to have transparent pathways to public hospitals for surgical abortions for women who needed them.

Data from MSI Australia (formerly Marie Stopes Australia) shows 78 per cent of abortions its clinics provide are below nine weeks.

GPs were best placed to provide these via medical abortion (taking medication to induce a miscarriage), Bateson said. Yet fewer than 1500 of Australia’s 37,000 GPs are certified medical abortion prescribers nationally.

“We know that GPs don’t feel supported in providing medical abortions if they don’t have that public hospital access should someone who’s not eligible or past the gestational limit [of nine weeks] for a medical abortion, or some complication,” Bateson said.

A review by NSW Health aimed at improving access to reproductive health services, particularly in rural and regional NSW is underway.

A spokesman for the Minister for Women and Regional Health Bronnie Taylor said she would ask NSW Health to finalise, as a priority, a current review into options to expand public abortion and reproductive health services.

“Access to reproductive health care, including safe termination of pregnancy services, is a human right and crucial to promoting and safeguarding women’s health,” the spokesman said.

Labor NSW health spokesman Ryan Park said, if elected, Labor would make sure women seeking a termination have safe and clear access to abortion.

“Women have a legal right to safe and accessible terminations in NSW and the government has failed to make sure that we have in place at our public hospitals a clear and transparent pathway available for women,” Park said.

Greens Women’s Rights Spokesperson Jenny Leong MP said it was unacceptable that women seeking abortion faced massive barriers three years on from the decriminalisation of abortion.

“Leaving our public healthcare system struggling without funding is an anti-choice, political choice,” Leong said.

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