The Greens will introduce a bill to NSW Parliament in the next week proposing to allow trained nurse practitioners to prescribe medical abortions and remove mandatory reporting requirements.
Former regional NSW GP Dr Amanda Cohn, now a Greens MP in NSW parliament, will introduce a bill within the next week calling for abortion law reforms which she says will “enshrine access to abortion in our public health system”.
The bill has four aims: obliging local health districts to ensure abortion services are provided publicly; allowing nurse practitioners and enrolled midwives to prescribe medical abortions; removing mandatory reporting requirements for providers; and requiring practitioners with a conscientious objection to refer patients on.
In late 2024, staff at Western NSW Local Health District’s Orange Hospital were reportedly banned from providing surgical termination of pregnancy services for non-medical reasons.
This order was officially reversed within a week, with the LHD executive advising that the level of abortion services which had historically been provided at Orange Hospital had been restored.
Earlier this week, the NSW Health Statutory Review of the Abortion Law Reform Act 2019 was tabled in parliament.
It came with three key recommendations, one of which was that the government allow nurse practitioners and endorsed midwives to prescribe MS-2 Step for medical abortions in order to increase access to the service in rural areas.
Queensland, the ACT and Western Australia already allow nurse practitioners to perform medical terminations.
Dr Cohn said widening the pool of MS-2 Step providers was a “common sense” move.
“This review confirms what we already know – abortion is hard to access in NSW and this needs urgent reform,” she said.
“As a former prescriber of medical abortion, I know this is medically straightforward health care, but people are still blocked by cost, stigma, and geography.
“With reproductive rights rapidly being eroded in the US, it’s never been more important to enshrine access to abortion in our public health system here in NSW.”
The statutory review also noted widespread, significant issues with the requirement for practitioners to notify the Secretary of the Ministry of Health via a secure online form every time they perform an abortion.
“The key concerns raised were that the requirements are onerous to complete and add another unnecessary barrier to access, as there is no defined purpose or clear benefit to reporting,” the report said.
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“There was also substantial anecdotal evidence to suggest that reporting is not being routinely completed, raising concerns about the accuracy and quality of the data.”
Because the data is anonymised, there is no way to verify it against medical records to ensure validity
NSW Health recommended that the data notification requirements be reevaluated, but stopped short of recommending a legislative solution, as Dr Cohn has done.
AMA NSW, working with Family Planning Australia, has designed a model whereby additional funding and resources are provided to existing maternity and gynaecology services to embed termination of pregnancy care within existing service pathways.
“This not only builds capacity but places abortion services as routine reproductive healthcare,” AMA NSW president Dr Kathryn Austin said.
The doctors’ group is broadly supportive of increased access to termination of pregnancy services, but said it was opposed to provisions included in Dr Cohn’s bill which “force doctors to become involved in abortion care”.
“The Bill will potentially undermine the work AMA (NSW) and Family Planning Australia have done to develop a comprehensive clinical model which focuses on both primary and tertiary level care access,” Dr Austin said.
“Our proposed model operates under a self-referral capability, linking those in need of a termination to the right provider for them, whether outside the hospital system or at a tertiary centre.
“The focus should be on enabling those who require this form of reproductive care equitable access, not mandating all doctors provide the service.”
