It was unsurprising to American women that their new president moved so swiftly to limit women’s access to reproductive autonomy. Less than a week into his regime, President Trump has reinstated a Ronald Reagan policy known as the “global gag rule”.
Abortion wars are, of course, a visible hallmark of American politics, where denying a woman’s right to choose has long been used as a wedge by Republicans to chip white voters away from supporting Democrat candidates. But while a thumping majority of Australians support women’s abortion rights – around 80%, according to reliable polls – the gap between what we say we believe in here and what we legislate is larger than many would imagine.
The danger of balance-of-power politics in our own system of government has made women’s bodies expendable to the politics of placating crossbenchers. Australia even implemented a “global gag” rule of its own when the former Liberal prime minister John Howard did a deal with conservative Catholic senator from Tasmania, Brian Harradine in 1996. Only when Obama overturned a Bush-era gag in 2009 did Labor’s Rudd government finally get around to rescinding Howard and Harradine’s work.
There’s an issue of restriction that also hits closer to home. For a pro-choice country, Australia’s provision of abortion is limited by a hodge-podge of clashing jurisdictional legislation and some old-fashioned under resourcing.
It may surprise many Australians to learn that even though the ACT, Tasmania and Victoria have recently passed legislation that prevents anti-choice activists harassing women around health clinics, only the ACT allows women to access safe, legal abortion-on-demand at any time.
Victoria and Tasmania both provide conditional services based on length of gestation; and South Australia, Western Australia and the Northern Territory make it legal only with certain caveats. In New South Wales and Queensland, abortion remains in the criminal code.
It’s a position both defiant of popular opinion – in Queensland, four out of five voters support abortion rights – and reality. The Australian family planning organisation, Children by Choice, cites studies that half of Australian pregnancies are unplanned, and lists the complex reasons that compromise women’s access to effective contraception (beyond the very real possibility, too, of simple contraceptive failure): lack of agency in relationships, lack of information about contraception, lack of access to it in isolated or rural areas, cost, privacy concerns, cultural dislocation, effects of alcohol or drugs, the imposition of a medical practitioner’s beliefs. Violent relationships. Forced sex. Coercion.
But these considerations have not been enough to either rewrite the law or improve present circumstances in New South Wales, where campaigner Claire Pullen from Our Bodies, Our Choices NSW is one of many agitating for a realisation of rights. Although provision is made for women to access abortion if medical professionals and/or a court determine a pregnancy poses “serious harm” to the woman in question, there are, says Pullen, three barriers to access that remain in the way. “The first one is the legal barrier,” she says, “Since court rulings on this issue in the 1970s, no one’s been charged or convicted with administering or purveying an abortion. But you only need one activist police commissioner for that to end … and we’re due for a whole new set of police commissioners here.”
What this means is women seeking terminations are obliged into seeking referrals, as well as administrative and physical access to clinics that will perform surgical procedures. “The second barrier is geography,” Pullen explains, “Vast swathes of regional New South Wales have no accessible local services – at the one regional clinic in Albury, women patients have been subjected to notorious levels of harassment by anti-choice picketers.”
The third barrier, she says, is resourcing. “There are no public hospitals that officially offer abortion services in this state,” says Pullen, “there are only private clinics. New South Wales has some of the biggest public hospitals in Australia, with excellent ob/gyn doctors and services, but as they don’t get public funds to perform abortions, they’re more or less obliged to refer patients to the Marie Stopes clinic across the road.”
It’s not the only obstruction women face for meeting their healthcare needs. “We could also consider the stigma, the stalking and the public harassment that women endure when they’re accessing these services as a fourth barrier,” says Pullen. “Women outside clinics often face a line of people with graphic and inaccurate signs – they’re handed plastic foetuses by protestors, told they are going to hell and shouted at by fanatics. We don’t have an exclusion zone bill like they do in Victoria, although Penny Sharpe in the NSW upper house is fighting to get one through.”
The situation is similarly dire in Queensland, says Kate Marsh, the spokesperson for Children by Choice in Queensland. The geography of that enormous state combines with its archaic legislation to seriously limit women’s access to abortion providers, whether surgical or medicinal. “The understanding about when abortion is lawful is based only on case law,” says Marsh. “Because there’s no judicial definition of ‘serious harm’, many doctors are understandably reluctant to become involved in providing termination of pregnancy.”
If it seems crazy that the abortion pill – which accounts for almost 100% of abortions in Norway, and two-thirds in the UK, is only used in 23% of Australian terminations – legal restrictions explain why. “For medical abortions – which is the use of the abortion pill – you can only legally access those services if you’re before nine weeks gestation,” says Marsh of present Queensland law. “And outside of [Queensland’s] south east corner, there are only two providers of surgical abortions – in Rockhampton and Townsville.”
This isn’t just bad news for women in Cairns, or the state’s vast west, explains Marsh. “The services in Rockhampton and Townsville only operate one day a fortnight, because they fly doctors up from Brisbane and sometimes from interstate, depending on who is available.
“Even for women who identify their pregnancy early, to be able to confirm it with a doctor, access an ultrasound – and some of these women in remote communities have to travel just to get an ultrasound – and then wait for an available appointment at a clinic, that can push women past the point of the gestational cut-offs imposed at those clinics, which is 15 weeks. There are a couple of clinics (in the south east) that go up to 17 weeks, and there is one clinic on the Gold Coast that goes up to 19 weeks. After that, you’re flying to Melbourne.”
What this means for rural, isolated or Aboriginal and Torres Strait Islander women in remote communities is not only dangerous, but medically, physically, existentially disempowering. “It’s very much dependent on your local hospital, the individual personnel who staff that hospital and who you talk to when you get there,” says Marsh. “We have women who have been pregnant as a result of sexual assault, whose local hospital has refused to accept a referral from their GP to assess them.”
While Children by Choice fundraises to provide access to transport for women in these situations, their resources and their scope to help all who need it is limited. Beyond what her organisation can provide, receiving help, says Marsh, is a “postcode lottery” of geographical and economic privilege.
“Queensland health told a parliamentary inquiry last year that just under 300 abortions were performed in public hospitals in 2015 – and the figure for private clinics that same year was around 11,000,” says Marsh, “Women who live in metro areas and who have money, a credit card, or have friends and family to support them – they can get an abortion, no problem. But people who are disadvantaged, or who very young, may not have friends and family they can call on, women in remote areas or women experiencing violence – it’s a different situation.”
“It sounds like a nightmare,” I say to her when she tells me this.
“It is,” she says, “It is a nightmare.”
Never mind America, access to abortion is a "nightmare" for many Australians | Van Badham
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