Termination of pregnancy has been noticeably absent from the conversation this election cycle.
It may be framed as a state issue, but a coalition of 40 peak bodies in women’s health say there’s a place for abortion policy this federal election.
Much like in the post Roe-vs-Wade US, responsibility for termination of pregnancy legalisation and legislation in Australia falls to state and territory governments.
The procedure is now legal in all jurisdictions, but there are no protections at a Commonwealth level to keep it that way.
So far this campaign season, neither Labor nor the Liberals have made any commitments relating to termination of pregnancy.
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Back in 2019, Labor pledged that it would make federal funding for public hospitals conditional on the availability of abortion access; it later abandoned this policy and has since taken the position that abortion is a matter for state and territory governments.
Opposition leader Peter Dutton previously told ABC Radio National that he is personally supportive of a woman’s right to choose, but has not released policy to that effect.
The Greens have pledged to support free public abortion care by investing $100 million per year to ensure all publicly funded hospitals provide abortion services.
None of the other minor parties have had a significant stance on abortion, although United Australia Party senator Ralph Babet has voiced opposition to abortion in the past.
A joint statement cosigned by 40 peak bodies including the RACGP, Australian Nursing and Midwifery Federation and the Australian Women’s Health Alliance released earlier this week called on all political parties and candidates to commit to ensuring affordable and accessible abortion care.
Specifically, the statement asked that the MBS provide appropriate remuneration for healthcare providers to deliver affordable abortion care and that funding went toward building workforce capacity by working with medical and professional colleges to provide sexual, reproductive and maternal healthcare training.
It also demanded that public hospitals provide abortion care as part of standard reproductive health services.
RACGP Victoria chair Dr Anita Muñoz noted the existing bipartisan funding pledge to cover more contraceptive choices for women, which includes training for long-acting reversible contraceptive insertion and removal.
“We need to see the same support from all political parties to ensure affordable and accessible abortion care,” she said.
Professor Kirsten Black, a gynaecologist and sexual health researcher, questioned why the federal government would take exception to abortion policy when it was willing to fund other sexual health initiatives.
“If they’re able to make all these promises in terms of contraceptive access and training federally, why can’t they do the same for abortion?” she told The Medical Republic.
“Abortion is a fundamental part of sexual and reproductive health.”
Because abortion has not been integrated as part of normal healthcare provision in public hospitals, Professor Black said, some GPs hesitate to provide medical termination of pregnancy.
“If there’s no pathway for management of complications, that makes them nervous,” she said.
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At the moment, there are also limited formal training pathways for specialists and GPS to upskill in abortion care.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has a pathway, but there are very few places across Australia that can actually provide the training due to the lack of public hospital services.
“There has to be national leadership [on abortion], otherwise we are at risk of what happened in the United States,” Professor Black said.
“[The federal government] can provide leadership in this regard, they can provide direction to the states that [abortion] should be incorporated and that they need to find the budget … they do that for other kinds of health issues.”
GP turned politician Dr Amanda Cohn, who represents the NSW Greens in state parliament, introduced a bill earlier this year seeking to allow nurses and midwives to prescribe medical abortion for pregnancies up to nine weeks.
It would also give the state health minister the power to compel public health services to offer termination of pregnancy services and would require conscientious objectors to refer on their patients.
Several Labor members have expressed support for the bill, but debate will resume in May.
