Women in regional areas seek medical termination of pregnancy at double the rate of their city counterparts, despite barriers to access.
Close to one in three local government areas across New South Wales do not have any doctors providing medical termination of pregnancy, according to new data from Family Planning Australia.
Despite all bar one of the provider-less LGAs being outside of greater Sydney, women in remote areas were far more likely than their metro-based peers to seek medical abortion.
While there were just 4.2 medical abortion prescriptions per 1000 women living in New South Wales’ cities in 2022, there were 10 medical abortion prescriptions per 1000 women living rurally.
Family Planning Australia senior researcher Dr Emmalee Ford told The Medical Republic that the figures highlighted a mismatch between supply and demand.
“There’s a nine-week window to receive MS-2 Step for early medical abortion, so if they can’t find a provider in their area, people might be traveling,” she said.
“They might be accessing [a prescription] via telehealth, [but they also need to access] local services like ultrasound or blood tests.
“It can really push out that nine-week window and cost a lot of extra money and extra stress, and waste time.”
Efforts have been made to map out Australia’s abortion deserts before – particularly by the Monash University-affiliated SPHERE centre of research excellence – but Dr Ford said the Use of medical abortion services in New South Wales Australia between 2018-2022 report was a new level of detail.
“We haven’t really seen these access deserts in New South Wales before on this level,” she said.
“It is really good to help us plan where health services need to be and what more work needs to be done.”
The five rural LGAs with the highest proportion of medical abortions were Moree Plains, Oberon, Carrathool, Walgett and Cowra, where more than 14 women per 1000 accessed the service.
Only Moree Plains and Cowra had prescribers of medical abortion in 2022.
Of the metropolitan LGAs, the places with the highest proportion of medical terminations were Lithgow, Campbelltown, Penrith, Blacktown and Wollondilly.
Fewer than eight women for every 1000 sought an abortion in these areas, and each LGA had at least one provider.
“There’s a disparity between provider location and where the patients are, and that really is the headline of the story,” Dr Ford said.
“It’s not a one-to-one ratio, though – there’s a lot of prescriptions coming out of the city, but there’s also a few regional hubs where there are a lot of prescribers.”
Related
There have been several changes in medical abortion provision since the data was collected in 2022, however – the biggest one being that in August 2023 the TGA removed the need for doctors to have prior training in order to prescribe the drug.
“These legislative changes are likely to lead to increased access to abortion services by increasing the number of practitioners and health professionals providing these services, including doctors, pharmacists, and nurse practitioners,” the authors wrote.
“This report aims to present the rate of prescription for medical abortion in NSW between 2018 and 2022.
“Moreover, this report will allow for the generation of statistical data before the recent lifting of restrictions in Australia surrounding MS-2 Step delivery in 2023.”
