Modern Australian
Men's Weekly

.

Early medical abortion is legal across Australia but rural women often don't have access to it

  • Written by Jane Tomnay, Assoc. Professor / Director of Centre for Excellence in Rural Sexual Health, University of Melbourne

Around one in six Australian women have had an abortion by their mid-30s. These women come from all age groups and demographics: some are mothers already, while others are child-free; some are partnered, others are single.

Abortion was removed from the New South Wales Crimes Act in October and is now legal in all Australian states and territories, under certain circumstances.

However, many women have difficulties accessing these services, especially in rural and regional areas. This needs to change.

Read more: One in six Australian women in their 30s have had an abortion – and we're starting to understand why

What is a medical abortion?

One option for women seeking a termination is to have an early medical abortion, as opposed to a surgical termination.

A medical abortion involves inducing a miscarriage using a combination of two oral medications – mifepristone and misoprostol – which can be used in pregnancies up to nine weeks.

Women can take the medications home, along with instructions of how the process works and possible complications to look out for, and a telephone number to call with any questions or concerns.

In 2013, mifepristone and misoprostol were subsidised on the Pharmaceutical Benefits Scheme (PBS). Since then, any GP has been able to provide an early medical abortion, as long as they’ve completed a free, online training course.

While these measures were hoped to improve access for women in rural and remote areas, medical and surgical abortion services remain concentrated in capital cities and major regional centres. So rural women must travel – often at great expense – to seek a medical or surgical abortion.

Early medical abortion is legal across Australia but rural women often don't have access to it Australian women sometimes have to travel long distances to get an abortion. Anna Jurkovska/Shutterstock

What’s the problem?

There are several barriers to early medical abortion in rural areas.

Some rural doctors have inconsistent knowledge about medical abortion, either not knowing what it entails or even, at times, that it’s an option. Others lack training in abortion. They may have missed out on it in their undergraduate studies and haven’t done any further training in the area.

Rural GPs sometimes lack support from the local hospital service to provide abortion care or if something goes wrong, which can deter them from performing medical abortions. Doctors in emergency departments may not have training about medical abortion and how it works, or may even object to abortion.

Rural communities also have higher numbers of overseas trained doctors who are more likely to have conscientious objection to abortion (65%) than doctors trained in Australia (15%).

Read more: Attitudes to women who have more than one abortion need to change

In rural areas, it’s often difficult to access affordable and timely ultrasounds. An ultrasound is required before the medical abortion to determine the gestation (which must be less than 63 days) and to ensure the woman doesn’t have an ectopic pregnancy (when the embryo implants in the fallopian tubes rather than the uterus).

Time ticks away for these women if they realise they have an unplanned pregnancy at, say, six weeks. They often have to wait up to a week or two to see a GP, have an ultrasound and blood tests, and undergo counselling before having the abortion. If it takes a week or two to get an appointment for ultrasound after seeing the GP, there’s a risk the woman may pass the 63 day cut-off and will need to have a surgical termination instead.

Early medical abortion is legal across Australia but rural women often don't have access to it Every step takes time, and this can push women over the 63 day cut-off. Bohbeh/Shutterstock

Some rural GPs therefore see the cost of providing abortion as unaffordable. Providing medical abortion takes GPs more time than a standard consultation to ensure all options for the woman are explored. Usually more than one consultation is required and the remuneration received through Medicare is minimal.

Another barrier women may face when seeking abortion in rural areas is community stigma. In rural communities, “everyone knows everyone” and women worry about their privacy and how people will judge them for choosing to have an abortion.

When you have fewer choices of health care professionals, you can also face institutional stigma if, for example, the closest hospital, pharmacist or sonographer (who performs the ultrasound) has ties to a specific religious group or clearly objects to abortion.

Read more: Don't blame and shame women for unintended pregnancies

What are the solutions?

GPs are often the first point of call for women with an unplanned pregnancy in rural areas. They are well placed to provide early medical abortion.

But nurses can also play an important role. In recent years, a number of small Victorian towns have successfully integrated early medical abortion into their community health services. These clinics are predominantly led by nurses, working with a GP.

Nurse-led early abortion services are safe, affordable and welcomed by women. Our clinical audit and interviews with women found no unexpected complications. Women were grateful to have affordable access in their own community and relieved they didn’t have to go to Melbourne or Sydney.

Better access to early medical abortion also requires the creation of a specific Medicare item number so GPs and nurses can be adequately remunerated for providing the service.

Finally, we need to increase the number of GPs and practice nurses who can provide medical abortions by providing better training. Early medical abortion needs to be seen as part of women’s sexual and reproductive health and should be incorporated into nursing and medical education at both the graduate level and in post-graduate specialist training.

This article was co-authored by Catherine Orr, Gateway Community Health, Wodonga.

Authors: Jane Tomnay, Assoc. Professor / Director of Centre for Excellence in Rural Sexual Health, University of Melbourne

Read more http://theconversation.com/early-medical-abortion-is-legal-across-australia-but-rural-women-often-dont-have-access-to-it-125300

How To Choose The Right Insulation For Your Space

Selecting the appropriate insulation for your home or building is a critical decision that affects comfort, energy efficiency, and present and future ...

7 Best Things to Do in Beaufort, Victoria

Beaufort is a charming small town in Victoria’s Goldfields, full of history, natural beauty, and warm, welcoming locals. Whether you’re passing th...

What to Expect During Divorce Mediation & Settlement

Divorce can be a difficult and emotionally draining process, but mediation and settlement often provide a constructive path forward. Instead of goin...

Navigating Disability Services in Perth: Your Questions Answered

Understanding the landscape of disability support can feel overwhelming, especially when you're just starting out. If you’re looking for support a...

How Veneers and Dental Implants Work Together for Full Smile Restoration

Modern dentistry has strong instruments that can produce life-changing outcomes when it comes to repairing a smile that has been impacted by tooth los...

Gen Z’s Are Going off Grid – But Is It Sustainable?

Australia’s cost of living crisis is causing Gen Z to get creative with frugal living options. Earlier this year, young couple Koby and Amelie wan...

The Risks of DIY Air Conditioning Installation and How to Avoid Them

Air conditioning is essential in Australia, especially during the scorching summer months, when homes and workplaces can become unbearable without rel...

How to Find Reliable Air Conditioning Services Near You in Brisbane Northside

Introduction In Brisbane’s hot and humid climate, air conditioning has become more of a necessity than a luxury. Whether it's keeping your home coo...

Enhance Outdoor Living with Lifestyle Awnings

Creating the perfect balance between indoor comfort and outdoor living is something many homeowners aspire to achieve. In recent years, Lifestyle Aw...

Why Buckets with Lids Are Essential for Safe Storage & Transportation

The right bucket can streamline transport and make handling easier day to day. With options suited to food, chemicals and construction materials, th...

Comfort and Style with Ceiling Fans Perth

While air conditioning is common, it is not always the most cost-effective or sustainable solution, particularly during long hot summers. For homeow...

How Professional Air Conditioning Services Improve Comfort and Efficiency

Air conditioning has become a fundamental part of homes and businesses, providing relief from sweltering summers and keeping interiors warm in winte...

The Value of Professional Rubbish Removal Services

From everyday waste to bulky items like furniture and appliances, finding the right way to dispose of rubbish is not always straightforward. This is...

Why Ugly Websites Sometimes Outperform Beautiful Ones

In the digital age, we're constantly told that first impressions matter, and nowhere does this seem more apparent than in web design. However, a cur...

TPD Claims & Super: What Does It All Mean?

Many Australians hear the term "TPD" in relation to their superannuation and feel completely lost. If you're scratching your head, wondering what it...

What Does Breastfeeding Feel Like? A Guide for New Moms

Frequently, numerous new mothers wonder, "What does breastfeeding feel like?" The feeling is different for each individual - a few describe it as a ...

Best Nail Care Routine for Frequent Nail Polish Wearers

For many people, nail polish is more than a beauty statement – it’s part of their everyday routine. Whether you love bold colours, chic neutrals...

Reinventing Research: How E-Libraries Are Changing Education Forever

A New Chapter for Learning For centuries libraries stood as temples of knowledge filled with shelves that smelled of dust and paper. Today the same...