The issue of abortion has recently as politicians have debated the 2019 (NSW), a series of reforms that would remove abortion from the Crimes Act 1900 and permit abortions for any reason up to 22 weeks. Beyond that point, a termination could be performed with the approval of two doctors.
The bill, tabled by independent MP Alex Greenwich with the support of 15 cross-party MPs, has generated fierce debate both within the government and the community. The public, however, appears comfortable with decriminalisation, with showing that 77 per cent of NSW voters support the bill.
While the legislation passed the NSW Legislative Assembly in August, Premier Gladys Berejiklian to mid-September.
Amid an emotional public debate, a quick look at the effect of decriminalisation of abortion in other states gives a clearer picture of what these reforms really mean for abortion in NSW.
What happened in other states?
NSW is one of the last states to remove abortion from its criminal law provisions. Among its neighbours, , as did .
Opponents of decriminalisation in NSW fear that the Reproductive Healthcare Reform Bill will lead to a ‘flood’ of abortions in the state. But have the number of women seeking abortions risen since the laws were introduced in Victoria?
Australia does not collect national statistics regarding abortions. What statistics we do have come from a range of sources, including Pharmaceutical Benefits Scheme data and the number of claims made against the Medicare item number for surgical abortion.
The best snapshot of any trends in terms of abortion comes from South Australia, the only state to gather data regarding pregnancy terminations. According to the report, the rate of terminations fell from 17.9 per 1000 women aged between 15 and 44 in 1999 to 13.2 in 2016.
Dr Philip Goldstone, medical director of , a service that provides abortion up to 24 weeks at its clinics in Victoria, attributes the decline to better contraception.
"So, [the rate] is declining, and that's partly due to better access to the more effective, long-acting, reversible contraception such as IUDs and implants," says Dr Goldstone.
Legal reform hasn’t necessarily improved access to abortion either. In Queensland, abortion access on factors such as a person’s location and length of gestation. While public hospitals must provide a pathway for a patient seeking a termination, this often involves travelling to another region to access a private clinic.
An referred to a 2017 qualitative study that examined the impact of the 2008 Reproductive Health Care Reform Bill in Victoria. It found that "abortion law reform had been a positive event, but little had changed about the practical provision of abortion."
It's a point echoed by Kathleen McNamee, Medical Director of Family Planning Victoria. “In terms of access, decriminalisation didn’t make a difference,” she says. “There’s limited access [to surgical abortion] in some of the public hospitals, but they’re extremely stretched.”
McNamee believes that decriminalisation has contributed to an increase in GPs offering medical abortions, where a patient is prescribed abortion drugs to terminate a pregnancy up to 63 days gestation. “We don’t have exact figures…but there are a lot more medical terminations happening in general practice,” she says.
Abortion after 20 weeks
Opponents to the NSW Bill have claimed that the reforms would allow the termination, for any reason, of full-term pregnancies, and see an increase in the number of 20-week-plus abortions – .
Second- and third-trimester abortions are very rare and are performed on the grounds of either foetal abnormality or maternal health and psychosocial reasons. Only ; nine in 10 happen before 14 weeks.
The introduction of a two-doctor approval process at 22 weeks would create a regulatory limit in NSW where there currently isn’t one. At present, "the common law precedent…allows for a doctor to perform a termination if he considers it appropriate, taking into account the woman's physical, psychological, social circumstances at the time and if continuing the pregnancy poses a risk to the woman," explains Dr Goldstone. "But there's no mention of gestation limits in New South Wales, and women are not having terminations up to birth."
A commonly cited statistic in the debate claims that post-20-week abortions in Victoria have increased by 39 per cent since 2008. The reveals this figure to be wrong. In fact, proper analysis of available statistics showed that in 2017, "post 20-week abortions made up 0.41 per cent of all births, representing a decrease of 9 per cent since 2008."
"Women don't just suddenly decide at 30 weeks that they don't want to have this baby that they've been carrying for five months," says Dr Goldstone. "It just doesn't happen."
