As a doctor with more than twenty years’ experience providing abortions in NSW, I’ve heard my fair share of anti-choice rhetoric over the years. However, the debate surrounding the Reproductive Health Care Reform Bill has taken this rhetoric to a new level; one that does not represent the reality of abortion care in this state.
Wild and baseless claims have been made that have fraudulently linked decriminalisation of abortion to fictions where women will be aborting up to birth, and where women from certain cultural backgrounds will suddenly be engaging in gender-selective terminations.
What is being said cannot go unchallenged.
Recently the NSW Lower House grappled well into the evening with a debate that went significantly off the track on the issue of terminations for gender selection.
What became abundantly clear from this debate was that many people believe that terminations based on gender are commonplace and that legislation must address this issue.
A study from Latrobe University released last year was cited as being evidence that it was commonplace and that decriminalisation would open the floodgates to the practice. The study did not make this conclusion, nor could it identify the contribution of terminations of pregnancy to the issue of prenatal gender selection.
While the amended bill that passed the house has included provisions for further research and review of the issue, the way this has been positioned sets a very dangerous tone because it is not based on evidence. It also clearly casts aspersions on multicultural communities when it comes to accessing abortion care.
This same study recommended that gender discrimination, in all its forms, should be tackled in order to dissuade prenatal gender selection. I would argue that flawed assertions aiming to block an important piece of legislation that stops the criminalisation of women based on their reproductive health decisions is one such form of gender discrimination.
Further, I believe that placing restrictions on abortions that are based on little to no evidence will unfairly penalise those seeking a termination, particularly if they are from certain migrant communities.
What the evidence tells us categorically is that restrictions placed on abortions that have no medical basis do nothing to protect a person’s reproductive health and wellbeing. In fact they make it worse.
This is the scientifically validated view of the Guttmacher Institute, the World Health Organisation, the Lancet Commission and the Bixby Centre for Global Reproductive Health to name a few.
The Reproductive Health Care Reform Bill is an important piece of legislation. It deserves to be debated and afforded careful consideration. However the final result must be grounded in fact.
As the Parliamentary Debate continued I listened, in between seeing patients seeking terminations. At times I found it very difficult to reconcile some of the debate with the reality of what was taking place with my patients in front of me.
Abortion on demand up to birth for any reason
As someone who has worked in abortion care for a while, I am used to hearing the terrible phrase ‘abortion on demand up to birth for any reason’. And last week, that term was used a great deal.
It’s generally used to describe terminations at a later gestation and it characterises them in such a flippant way.
When it comes to working with a patient who is needing to access a termination at a later gestation, I can tell you that the decision-making process, the anxiety, guilt and fear is very real and very serious.
I have never seen that decision entered into lightly and I have never in my career seen decriminalisation be the impetus for making a decision to have a termination at a later gestation. Never.
Later gestation procedures are rare, complex and there is a lot of support required by the patient and their loved ones when they do access one.
When someone chooses to have a termination, they do so for their own reasons. They do not make the decision lightly, at any gestation. As a society, we need to make sure that the way we treat them when they do make that decision is with dignity, respect and care that is compassionate. The legislation that underpins it should, like all health practices, be grounded in science and provide for the mental and physical wellbeing of the person making the decision.
I applaud the 59 members of the parliament who supported the bill in the NSW Lower House. They met each challenging amendment with evidence-based arguments. As the bill progresses, I implore the members of the Legislative Council to take the same approach when they cast their vote.
The final vote will have real consequences for people seeking a termination in NSW. We owe it to the people of this state to ensure this legislation is fair and based in reality.
Dr Philip Goldstone is the Medical Director of Marie Stopes Australia.