Situational Report: Sexual and Reproductive Health Rights in Australia

Marie Stopes Australia, Updated 17 April 2020

Situational Report: Sexual and Reproductive Health Rights in Australia – A request for collaboration and action to maintain contraceptive and abortion care throughout the SARS-COV-2 / COVID-19 pandemic

Executive Summary

We are in a context of increased risk of unplanned pregnancy, reproductive coercion, sexually transmitted infections, lack of pregnancy options and a multitude of barriers to healthcare. Access to contraception and abortion throughout the pandemic will mitigate broader public health risks for years to come. 
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At Marie Stopes Australia, during the pandemic we have had to:

 Cancel surgical abortion care lists- meaning women and pregnant people have had to continue with their pregnancies or are likely to seek a termination at a later gestation
 Reduce our national gestational limit for surgical abortion to 22 weeks
 Face increased costs in the provision of regional healthcare, having no other option than to charter private flights for clinical staff
 Continuously scramble for Personal Protective Equipment (PPE)
 Reduce in-clinic list capacity to enable physical distancing
 Reduce contraceptive services in order to prioritise abortion access
 Reduce financial support for clients experiencing financial hardship
 Face increased risk of staff fatigue and burn out
 Evolve models of care in an effort to maintain access to care. To address this situation, we need to review legislation and policy, evolve models of care, maintain people’s rights to access care and make healthcare more affordable.

Key recommendations at this point in the pandemic include:
 All Governments, health and hospital services, and health clinics must consider abortion an essential service with Category 1 classification
 Provide access to medical abortion via telehealth for people living in South Australia
 Increase medical abortion provision to 70 days/10 weeks gestation, supported by the  Pharmaceutical Benefits Scheme (PBS)
 All accredited sexual and reproductive healthcare providers should have access to the National Medical Stockpile for PPE
 Intrastate travel support is needed for clinical staff in order to maintain surgical abortion provision in regional and remote clinics
 Do not criminalise women and pregnant people who attempt unsafe abortion

[This report contains] further detail on these points and a longer list of recommendations that Australia will need to consider in o order to maintain sexual and reproductive health
rights throughout the pandemic.

 

 

NEW Fact Sheet for Health Professionals – Contraception During the COVID-19 Pandemic.

SHINE SA, 15/4/2020

SHINE SA have released a new Fact Sheet for health professionals: Contraception During the COVID-19 Pandemic.

Contraception is an essential service during the COVID-19 pandemic. This includes the provision of emergency contraception, access to long acting reversible contraception (LARC) and management of complications of LARC. Health professionals can continue to facilitate access to contraception via telehealth consults and limited face-to-face consultations where possible.

This Fact Sheet provides advice for health professionals on the provision and management of contraception during the COVID-19 pandemic. This includes LARC, combined hormonal contraception, emergency contraception, progestogen only pill and depot medroxyprogesterone acetate (DMPA).

Position Statement on LARC access during the COVID-19 pandemic

SHINE SA, April 7, 2020

SHINE SA, along with Family Planning VictoriaFamily Planning NTFamily Planning TasmaniaSexual Health and Family Planning ACTSexual Health Quarters, and True Relationships & Reproductive Health have co-signed a Position Statement on LARC access during the COVID-19 pandemic.

Extended use of and ongoing access to LARCs during the COVID-19 pandemic

Provision of contraception is essential during the COVID-19 pandemic to prevent unintended pregnancies. This is particularly important for individuals most at risk, including young people due to their high levels of fertility, people with serious health conditions, and for those who are post-abortion. Long Acting Reversible Contraceptive methods (LARCs) are more effective than shorter acting methods and increased community access and uptake is associated with lower abortion rates.

Ongoing access to LARC insertion is essential during the pandemic

Contraception is essential health care and all efforts should be made to continue the insertion of LARCs during the pandemic. To reduce the risk of infection with COVID-19, this may require different approaches to insertion such as a wearing mask during insertion of contraceptive implant or using an inserter-only approach for IUD insertion (with an assistant outside the room for emergencies).

Summary of recommendations during the pandemic

  • All efforts should be made to continue access to insertion of LARCs during the pandemic, particularly for younger people, people with serious health conditions, and post-abortion
  • The etonogestrel implant (Implanon NXT) can be extended off-label for use up to 4 years
  • The 52mg LNG IUD (Mirena) can be extended off-label for use up to 6 years
  • The 19.5mg LNG IUD (Kyleena) cannot be extended beyond 5 years
  • Standard sized T shaped banded copper IUDs can be extended off-label for use up to 12 years
  • 5-year copper IUDs (Load 375 and Copper T short) can be extended off-label for use up to 6 years
  • Additional use of condoms and/or a contraceptive pill should be discussed with users for whom the risk of an unintended pregnancy is unacceptable during extended use.

 

TREATY BODIES: FIVE YEARS OF RESEARCH SHOW INTERNATIONAL LAW INCREASINGLY PROTECTS LGBTI PERSONS’ RIGHTS

ASIA PACIFIC ALLIANCE FOR SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS (APA),  2020

The United Nations Treaty Bodies are an authoritative source of international law, and have steadily contributed to protecting the human rights of LGBTI persons. A review of their activities in 2017 and 2018, released by ILGA World, shows that references to sexual orientation, gender identity and expression, and sex characteristics (SOGIESC) made by the committees have hit an all-time high.

The report on  United Nations Treaty Bodies: References to Sexual Orientation, Gender Identity, Gender Expression and Sex characteristics’ is a comprehensive annual compilation and analysis of all the SOGIESC references made by nine UN Treaty Bodies (CESCR, HRCtee, CEDAW, CRC, CAT, CRPD, CERD, CMW and CED) in 2018, produced by ILGA.
It investigates the Treaty Bodies’ General Comments (interpretations of the international human rights treaties), Individual Communications (complaints brought by individuals or organisations), Lists of Issues (issues and questions sent to the States parties before the main review) and Concluding Observations (country-specific concerns and recommendations).

In 2018, Treaty Bodies made a record high of 138 SOGIESC references and recommendations. This is more than 2.5 times growth from 2014, and active participation of CS groups was one of the important factors contributing to this.  

How did Asia Pacific countries fare?   Here’s all the AP countries under review in 2018, by treaty. 

Highlighted countries received recommendations on LGBTI and/or had civil society reports that mentioned LGBTI :

·         2018 Committee on Economic Social and Cultural Rights :  Bangladesh, New Zealand (read more on p22)

·         2018 Human Right Committee (ICCPR) : Lao 

·         2018 Committee on the Elimination of Discrimination against Women:  Australia, Cook Islands, Fiji, Lao, Malaysia, Nepal , New Zealand, R of Korea, Samoa  (read more on p. 44)

·         2018 Committee on the Rights of the Child:  Lao, Marshall Islands, Palau, Solomon Islands, Sri Lanka (read more on p 57)

·         2018 Committee Against Torture:  [Canada*], Maldives, Russia,  Viet Nam, (read more on p 64)

·         2018 Committee on the Rights of Persons with Disabilities: Nepal, Philippines, Russia (read more on p 73)

·         2018 Committee on the Elimination of Racial Discrimination: China, Iraq, Japan, Nepal, R of Korea  (read more on p 80)

·         2018 Committee on Migrant Workers:

·         2018 Committee on Enforced Disappearances:  Japan (read more on p 90)

NOTE: Central Asia was not included in the above listing. Canada was included as there is a member organisation there.

 

Responding to LGBT conversion therapy in Australia: report

GLHV@ARCSHS, La Trobe University & Human Rights Law Centre, 2018

This report highlights the nature, extent and impact of LGBT conversion therapies in Australia.

The report is designed to help government, support services and faith communities to better respond to those experiencing conflict between their gender identity or sexual orientation and their beliefs.

Factsheet on the new The Marriage Law Survey (Additional Safeguards) Bill 2017

The Equality Campaign, 18/09/2017

The Marriage Law Survey (Additional Safeguards) Bill 2017 was introduced into parliament (and passed) at the end of last week. Included as a part of the bill was a series of temporary measures to protect people from vilification, harassment or threats of harm during the current postal survey campaign.

Also included as a part of the bill is a series of requirements in relation to campaign materials (including any form of external communication) and advertising, that are papplicable to any individual or organisation during the postal survey campaign period.

Measures and requirements that have been introduced into the bill are only applicable until the date in which the Australian Bureau of Statistics is due to announce the results of the Marriage Law Postal Survey, on 15 November 2017.

The attached fact sheet has been prepared by the Equality Campaign to assist stakeholders with activities for the upcoming campaign period. Included are the responsibilities and considerations that organisations need to review prior to distributing any material or communicating in any form that has the intent of encouraging participation in the Marriage Law Postal Survey or encouraging a vote one way or the other. The fact sheet contains essential information and new requirements that are applicable for the next eight weeks. Please note that these provisions took effect from Thursday 14 September 2017.