Imagine if you could end up in court, just for doing your job. That is the daily experience of the men and women who provide abortion in NSW and Queensland.
A new study of abortion providers in the two states found they live in fear that their work, performing what is one of the most common medical procedures in the country, could land them in court.
As one NSW practitioner put it: “The bottom line is, for me, working here in a public institution, looking after women who don’t have anywhere else to go, that’s what my job is ... and at some stage, I will be in court, I think. No doubt.
The situation is made all the worse by the fact that screening for chromosomal abnormalities, such as Down syndrome, is routinely offered to women; the guidelines from our peak medical body, the National Health and Medical Research Council, instruct GPs to offer the tests to every single pregnant woman they treat.
But this is all despite the fact that if a problem is found, they could face criminal prosecution if they terminate the pregnancy on that basis.
While they say that before testing doctors should have a “full discussion” with women about the implications of the possible results, including methods of termination, the woeful state of abortion laws in some parts of Australia are basically ignored.
Nowhere does it mention, for example, that a woman in NSW is only allowed to proceed with an abortion if having the child would present a serious threat to her life or mental health.
Or that NSW law outright bans abortion, and it is only the decisions of judges in various cases over the years that have broadened the occasions when it can be provided.
That’s because doctors feel that if the woman does decided to have a termination they must “construct a case” to show the abortion is legal, says Kirsten Black, a doctor and senior lecturer at the University of Sydney who co-authored the research paper.
“Doctors feel they have to create a case for mental illness, essentially,” she says. “Women in NSW are offered screening ... but once they are diagnosed with a foetal abnormality, there is no easy pathway for them to terminate the pregnancy.”
If they decide to terminate the pregnancy before 20 weeks, there is usually little impediment to them getting the procedure. But after 20 weeks hospital ethics panels start getting involved, and the process becomes harder.
The result of all these hoops, Black says, is that there are huge inequalities between the access women have to abortion.
“The vast majority have to go private,” she says. “I think there’s really big inequality of access, both between rural areas and urban areas ... you have to pay and it’s expensive”.
Yet abortion is one of the most common medical procedures in Australia, with Black estimating about 70,000 are performed every year.
Over the course of her lifetime, one in four women will have an abortion.
“It’s important, it’s a common health issue and there should be more access to publicly funded services,” she says.
So we have laws, in NSW and Queensland, that are essentially making liars out of doctors, criminals out of women who want to act on the results of a test the government says they should be offered. And is furthering the health disparities between rich and poor, city and country.
Victoria changed their abortion laws back in 2008, and the sky didn’t fall in. The ACT changed theirs back in 2002.
Why can’t NSW and Queensland catch up?