Access to abortion a 'postcode lottery' for disadvantaged women, experts warn


Abortion is legislated differently in each state in Australia. Different laws can affect the cost and accessibility of terminations when women need it most.

Melinda* was working at a pizza shop and earning just $250 a week when she fell pregnant.

The 19-year-old was living in rural New South Wales with her family, who were also struggling financially. She wasn't sure how they would react to her having an abortion, so she didn't ask for help.

Melinda booked a termination at a private clinic 200km from home, it would cost $500. She didn't have the money for the procedure, travel and accommodation. So she waited three more weeks to save. By this time she was in the second trimester and the clinic couldn't help. So she had to travel to Sydney, which cost even more.

Melinda's situation is not unique. A women's health centre in metropolitan Sydney routinely helps women like Melinda access terminations they simply cannot afford.

"Women who come to us have typically rung a clinic only to find they cannot afford the cost," said Jo, a support worker for the centre.

It is always a difficult decision for the women, and this adds to the burden and responsibility.

"We help them get the services they need."

In 2016, Jo's centre helped 140 women. In this last year 650 women have accessed their support. That's an increase of more than 350 per cent.

"This may be because the economic situation is worse in the state, and more people are aware of our services," said Jo.

'I want to help these women but we are not funded to do so'

Dr Emma Boulton is an abortion provider in Sydney. She says her clinic receives at least one call a week from women who simply cannot afford the procedure. 

"We frequently get calls from agencies, advocates or clinics trying to help women who are disadvantaged," she said.

"They will present to their local medical practitioner seeking to terminate a pregnancy because they feel they are unable to continue.

But they do not have the funds to pay for a termination through private providers, which is unfortunately the only choice in NSW.

Terminations in NSW can cost anywhere between $100-$1000.

Dr Boulton is the owner of Clinic 66, a sexual health service providing abortions in a state where its technically illegal.

Abortion is listed in the NSW Crimes Act, with penalties of up to 10 years imprisonment for women, doctors and anyone who assists.

However, it's generally regarded as lawful if performed to prevent serious danger to the woman's mental and physical health, which includes economic and social pressures.

Terminations are generally unavailable in the public healthcare system in NSW. This means private centres like Dr Boulton's clinic is left to provide services for most women.

"It's very hard for government providers to justify a service that is technically illegal," she said.

Private providers can be costly and hard to access for women living remotely. Private clinics don't have after-hours treatment for post-surgery complications.

Clinic 66 offers support for disadvantaged women when it can.

"Unfortunately we are not funded to provide care. I do my best as an ethical practitioner, I want to help these women but we are not funded to do so," Dr Bolton said.

A 'postcode lottery'

Abortion in Queensland was criminalised until last December, when the Termination of Pregnancy Bill came into effect.

Decriminalisation meant medical practitioners, including public providers, could provide services without fear of prosecution.

Children by Choice in Queensland provides counselling, information and referrals for women seeking terminations.

Manager Holly Brennan said the number of women seeking financial guidance to access abortions has decreased with decriminalisation.

"In many ways we are looking at a good news story," she said.

But Ms Brennan says the need is still high, with the most marginalised women still calling for help.

"It is a postcode lottery, not all services in Queensland are set up and ready to go. It depends on where you live on what access is available and what an abortion costs."

The more remote women, and those experiencing domestic and family violence have the most need.

"Many women who find themselves pregnant who are living in fear of violence are calling for help," she said.

'Decriminalising in NSW will help women'

Jo, who works at a women's health centre in NSW, will continue to help women get access to abortion when they need to. But she says decriminalising in NSW will help women access timely and cost-effective help.

Services may be able to bulk bill an abortion, which will allow for greater access for women in regional areas.

"It will help remove stigma and raise awareness of where these services are available," she said.

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