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.

 

 

Concerns for women after SA closes two centres for surgical abortion

ABC News, 19/09/2019

Two of South Australia’s surgical abortion services have been shut down over the past 18 months, amid community concerns about the impact on women seeking care.

In January, services were relocated from the main abortion provider in the state, the Pregnancy Advisory Centre in Adelaide’s inner-western suburbs, moving all surgical abortions to the Queen Elizabeth Hospital (QEH).

SA Health is now looking at relocating the abortion service permanently to the QEH during the hospital’s redevelopment.

 

 

Later-term abortions: Stigma versus reality

Sydney Morning Herald,  

“We consider ourselves to be potential targets for domestic terrorism.”

That’s the reason one abortion provider gave for not wishing to be named when asked for comment about the situation facing later-term abortion providers in Australia.

Despite the backlash from some sectors of the community, Dr Jane Baird says her job is very satisfying.Dr Jane Baird

The barriers to medical abortion [in Australia]

Australian Journal of Pharmacy,  08/06/2017

Australian women are choosing medical abortion less often than international peers because there are barriers to access, argue two experts.

in countries where mifepristone has been available for some time, about half of women seeking to terminate a pregnancy choose it over surgical termination. Access in Australia is relatively recent, and at this stage only about a third of women seeking abortion choose the medical route.

 

Access, equity and costs of induced abortion services in Australia: a cross-sectional study

Australian and New Zealand Journal of Public Health, January 2017, doi:10.1111/1753-6405.12641

Objectives: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation.

Methods: Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression.

Conclusions: Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice.

Implications for public health: Policy reform should focus on reducing costs and enhancing early access.

Access abstract here (for full text access, please see your librarian)