Calling for a national taskforce on abortion access by Dr Syahir Soffi | The Road to Abortion Equity

The Federal Senate has established an Inquiry into universal access to reproductive healthcare. The Inquiry was called because the government has acknowledged we have a crisis of sexual and reproductive health access.

On Wednesday 9 November 2022, we hosted an online forum to explore what the inquiry terms mean, how it applies in practice and provided a submission template which you can download here to assist people in writing their own.

Dr Ahmad Syahir Mohd Soffi gave the following speech at our webinar, which you can watch here.

Good afternoon everyone, I’d first like to acknowledge that the Larrakia people are the traditional custodians of the land from where I’m speaking today and I pay my respects to their elders past, present and emerging.

Today I encourage you to submit recommendations that public funding should be used to provide no-cost abortions in primary care and public hospitals to any pregnant person, when requested for any indication at any gestation, with a choice of all available abortion methods.

This might sound like a dream, but this is what is already happening in the NT, where most abortions are accessed as no-cost.

No-cost early medical abortions can and should be provided in primary care, as this is the most accessible and preferred by pregnant people, when it is affordable.

In the Northern Territory, Medicare card holders have had access to no-cost early medical abortions since July 2017 and it is now the preferred choice for many, making up almost three-quarters of all abortions performed in the Northern Territory in the first twelve months after the policy’s introduction.

However, there will always be demand for in-facility abortions, and this should be available in all public hospitals with obstetrics and gynaecology services.

Public hospitals already manage miscarriages, stillbirths and abortions in specific circumstances, like when there is a fetal condition.

Public hospitals providing these services already have the staff and resources to then provide abortions for any indication until at least 22 weeks.

So why are they still allowed to opt out?

If surgical capacity for 2nd trimester surgical abortions are not available, then in-hospital medical abortions can be provided safely and effectively at any gestation.

Therefore, availability of in-hospital medical abortion up to 22 weeks should be a minimum standard of care for all hospitals with birthing services.

For the less than one per cent of abortions that occur after 22 weeks, a feticide service to induce a stillbirth before performing an abortion is usually required.

There is a misconception this can only be performed by subspecialists in maternal-fetal medicine, or MFM.

But the truth is, the majority of feticide procedures can be performed safely and effectively by proceduralists such as myself, who are not MFM subspecialists.

This is very important for access in rural and regional areas, as subspecialists are often based in large urban centres.

In the Northern Territory, Royal Darwin Hospital has provided a state-wide feticide service since 2018 without an MFM subspecialist, and we haven’t had any unsuccessful procedures so far and no significant complications.

This capacity to provide feticide has ensured access to no-cost abortion beyond 22 weeks for any indication in the Northern Territory, making it one of the few places in Australia and the world where this is available.

It is also important for public hospitals to provide abortions because it is an essential training site for all healthcare workers wanting to work in abortion.

But it’s not enough to only provide no-cost abortion procedures.

Public funding should also cover the cost of travel and accommodation to access abortions, when it is not available locally.

This is absolutely vital for people living in rural and remote areas, who already have to travel for other healthcare due to limited local resources.

The funding should also cover any interstate travel for abortion, as some people in Australia still have to travel thousands of kilometres across state borders to access abortions because of the inequitable differences in our abortion laws and service provisions across the States and Territories.

Abortion access should not be based on people’s postcodes but unfortunately this is still the case.

We are not that different from America!

Publicly-funded abortion travel assistance schemes should also cover the cost of a support person if that is requested as this is a trauma-informed and culturally-safe way to provide abortion that acknowledges the psychosocial needs of pregnant people.

Again, this is something that is already being done in the Northern Territory through its Patient Assisted Travel Scheme (PATS) and that should be adapted in other jurisdictions.

To wrap up, I hope I’ve convinced all of you that access to comprehensive, publicly- funded, no-cost abortions is possible and should be available to anyone living in Australia.

I encourage all of you to include in your submissions this recommendation:

The Australian Government should establish a National Taskforce on abortion access to address abortion equity across all States and Territories.

Thank you.

Syahir (they/them) is a sexual and reproductive health doctor who lives and works in Larrakia country (Darwin). They are a passionate advocate for trauma-informed abortion healthcare, and is a proceduralist providing first and second trimester surgical abortions and feticide procedures for second and third trimester in — hospital medical abortions.

They are the Clinical Lead of the Pregnancy Options Service at Royal Darwin and Palmerston Hospitals, the referral centre for complex abortion healthcare in the Top End, and Medical Director of Family Planning Welfare Association Northern Territory, the main provider of early medication abortion in Greater Darwin.

They chair the Northern Territory Termination of Pregnancy Working Group, a multi-agency advisory group that advises the NT Department of Health on abortion-related policies and service improvement initiatives; and is a member of the the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Sexual and Reproductive Health Special Interest Group (RANZCOG SRHSIG) and the SPHERE Coalition. Syahir is completing a Masters in Global Health, in pursuit of specialist training in Public Health Medicine.