In the nation of the “fair go”, we’re anything but, when it comes to abortion care

“Some women want to be in their hometown, in their own surroundings, somewhere comfortable”.

These are the words of one our patients at the Marie Stopes Maroondah clinic. Amy had to travel interstate to access a termination of pregnancy and she has felt every bit of stigma and judgement that we, as a society, continue to thrust upon women seeking such a service.

I have spent the last month travelling across Australia visiting our clinics, speaking to our nurses, doctors and patients about the barriers that women face when they are accessing a procedure that one in four Australian women are likely to need in their lifetime.

Abortion is still a contested issue in Australia. Our laws reflect a complicated tangle of regulations that are more a reflection of the appeasement of fringe interest groups than the needs of women.

Where abortion is not considered a crime, public hospitals have differing protocols as to when and how abortion care should be carried out. In the middle of it all is the woman. Not only has she made what is likely to be one of the hardest decisions of her life, she is now faced with a rather confused pathway to access an abortion. This confusion only intensifies as her gestation progresses.

As a nation, we have an issue with abortion. We often talk about it in hushed tones. We stereotype women as careless when most have become pregnant while using contraception. We struggle to talk about it in a public policy debate without someone resorting to horrendous characterisations of women. Even some of our elected officials in the highest government in the country are comfortable peddling untruths that seek to confuse, hurt, manipulate and brand women and healthcare professionals as murderers.

Recently we hosted a journalist from ABC Background Briefing at the Marie Stopes Maroondah clinic (you can listen to the podcast episode here). She spent two days with women who were, for various personal reasons, accessing a mid-trimester termination. This procedure is complicated, it takes three days and there is a tight-knit team of healthcare professionals who provide round-the-clock care for the women.

We rarely host journalists unless we completely trust them and this instance we built trust with this journalist. The women that access this service are the ones that three Australian Senators recently made vile assumptions about under parliamentary privilege. So to say this is a stigmatized service is an understatement.

What those two days showed her was the complexity of abortion access in Australia.

Women have been turned away from public hospitals in States where is it legal. Others were forced to travel because they could not legally access the service in their own State. The sad fact is that the stories of these women are not unusual. Each week we see women who have had to navigate a broken system to access an abortion.

A service that one in four Australians will need in their lifetime is a service that is worthy of national consistency in its delivery. It should not be a service that is subject to confused laws, regulations and funding arrangements. A service that one in four Australians will need should be a service that is provided as primary healthcare.

For more than a year, Marie Stopes Australia has advocated strongly for national reform of abortion provision. Our work over the past year has revealed that public hospitals, under increasing pressure to respond to chronic disease, are struggling to provide abortion services, if at all. It has revealed that there is a disconnect between abortion law and policy and actual service provision. It has shown that a woman’s access to a service is dependant on her postcode.

For too long, abortion in Australia has been quietly dealt with like a patchwork quilt. The time has come to reform the system. We need a federally funded, federally directed approach to abortion care that provides consistency, clarity and equity for women across Australia. We need a system that delivers abortion care through primary healthcare, and we need to do this in a mature, measured and compassionate way. Because at the heart of all of this are real women, dealing with real decisions that will impact on their lives and the lives of their families. It is time to listen to women like Amy and provide abortion care in a fair and equitable way.

Michelle Thompson is CEO of Marie Stopes Australia, a national not-for-profit provider of sexual and reproductive health and advocacy.