By Rachel Eddie
Hundreds of women in rural and regional Victoria have no access to surgical and medical terminations close to where they live, forcing some to travel for hours to get an abortion.
Red tape to prescribe the abortion pill will be removed from this month, but reproductive healthcare providers say the change will not end the “postcode lottery” many women are faced with.
Sophie Ping, medical director of Ballarat Community Health, says western Victoria is “tragically under serviced”.Credit:
There are 17 so-called abortion deserts across Victoria, according to the Victorian Auditor-General’s Office based on data from phone service 1800 My Options, with the vast majority of those in the state’s west and north.
Upper house MP Sarah Mansfield, a former regional GP and the Greens spokeswoman for health services and reproductive health, said the state government needed to require public hospitals to provide abortion access, as was recommended by a Senate inquiry in May.
The Andrews government last year voted against such a proposal, put forward by former crossbench upper house MP Fiona Patten.
“Here in Victoria, it’s a postcode lottery,” Mansfield said. “Victorians shouldn’t have to travel across the state or empty their bank account to access basic healthcare.”
Dr Sophie Ping, medical director at Ballarat Community Health, said people often travelled hundreds of kilometres to access services in the regional city which was unable to meet local demand.
“People are travelling two to three hours to access these services,” said Ping, who has also worked across the Grampians region.
“There’s not enough services even if they do travel ... it is just tragically under-serviced.”
Ping said gaps in regional services was largely due to a lack of resources and capacity, with stretched local GPs and centres trying to meet other healthcare needs. Stigma was still attached to providing terminations, she said.
Using data from 1800 My Options, which provides free advice on accessing reproductive healthcare, the auditor-general in May found that there were 17 local government areas (LGAs) with no access to surgical or medical abortions.
Based on calls to the hotline, some of the greatest demand came from the growing outer metropolitan areas in Wyndham, Hume, Melton and Whittlesea.
Women living in Gippsland consistently reported travelling the furthest to get terminations, the Victorian Auditor-General’s Office said. Women’s Health Grampians, in its submission to the Senate inquiry, said it was not uncommon for women to travel four hours for a surgical abortion.
While there were 13 LGAs in which the abortion pill was never prescribed in 2021, according to Women’s Health Victoria, it was only prescribed a handful of times in others, meaning the option was not genuinely accessible there.
The abortion pill will this year be available to be prescribed by every doctor in Australia.Credit: James Alcock
The Senate inquiry heard that about 30 per cent of women in Australia, and half in remote areas, lived in regions without local GP provision of medical abortions.
From this month, all doctors and nurse practitioners will be able to provide the termination pill under changes announced by the Therapeutic Goods Administration. All pharmacies will be able to stock it.
Only about 10 per cent of doctors and 30 per cent of pharmacists were certified to deal with the abortion pill, known as MS-2 Step or RU486, prior to the announcement.
Shannon Hill, sexual health adviser at Women’s Health Grampians, said while the change would remove an administrative burden, “it’s not likely to create an avalanche of providers”.
“We’re not expecting that to be a quick change,” Hill said. “We need to do better to provide that service locally where possible.”
GPs may still be unwilling or under-resourced to provide access. Medical abortions can only be provided up to nine weeks in Australia, and practitioners often want their patient to be able to access a surgical termination in case of a complication.
Carolyn Mogharbel, manager at 1800 My Options, which receives state government funding, said the mapped data showed many people have to travel across multiple local government areas for services.
She described the 17 areas without access as abortion deserts.
“It’s not just that they’re remote simply in that LGA where they live. The nearest service is often several LGAs away,” Mogharbel said. “It’s a huge drive.”
The lack of local access created extra barriers for a range of women including those who may be unable to afford the cost of travel and accommodation, young people, people with caring responsibilities, complex medical conditions, or who were experiencing family violence, Mogharbel said.
Sometimes, people end up travelling to Melbourne when they could have accessed a service closer to home because they struggled to get information. That could also delay care and reduce the services available to them, she said.
Mogharbel welcomed the changes for prescribing the medical abortion pill. But she said the medication was not suitable for everyone and thus would not resolve the gaps in healthcare across the state.
The auditor-general found Victoria’s Department of Health did not know the total number of sexual and reproductive healthcare providers statewide, including their locations and services.
Professor Danielle Mazza, chair of general practice at Monash University, said the state needed to identify gaps and barriers in each local area to properly address them.
Mazza also called on the federal government to extend telehealth for the medical abortion pill, which was temporarily introduced during COVID-19, beyond its current expiry in December.
A Victorian government spokesman welcomed the Therapeutic Goods Administration’s changes to the medical abortion pill and said everyone deserved access to safe, legal and dignified reproductive choices.
“That’s why Victoria has the most progressive laws in the nation and a network of metropolitan, regional and rural health services which provide surgical terminations,” he said.
“We always listen to the expert advice and work closely with the health sector to ensure Victorians can access health services when they need it.”
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