AUSTRALIA: Medical Tourism Created By Outdated Abortion Laws

Lack of legislative uniformity may be forcing some women to travel interstate, says Medical Journal of Australia, as tests for foetal abnormalities improve

Improved technology has made testing for foetal abnormalities easier and more accurate, but inconsistent state legislation means women do not have equal access to abortion should they choose to terminate their pregnancy as a result, an editorial published in the Medical Journal of Australia on Monday says.

The lead author of the piece, Prof Caroline de Costa, said foetal abnormality was specifically mentioned in abortion legislation in Western Australia, South Australia and the Northern Territory, and was covered by the decriminalisation of abortion in Victoria, Tasmania and the Australian Capital Territory.

But despite Medicare-funded diagnosis of foetal abnormality now routinely being offered to pregnant women – with the implication that abortion may be an option if detected – abortion laws in Queensland and New South Wales do not refer to foetal abnormality.
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“The implication is that in those states, abortion for foetal abnormalities is illegal,” De Costa, an obstetrician and professor with James Cook University in Queensland, said. “The law has simply not kept up with medical developments.”

It meant when doctors carried out abortions for foetal abnormalities in Queensland and NSW, “we have to work our medical notes around the legislation”, De Costa said.

“We have to look at the mental health of woman and say it will be adversely affected without the abortion. That shouldn’t be happening, we should be able to say it’s because of the abnormality.”

Other doctors were too uncomfortable doing so and referred their patients elsewhere, she said. However, with the exception of Victoria, doctors with a conscientious objection to abortion did not have to refer patients. These factors were leading to extensive medical tourism to Victoria, De Costa said.

“Children by Choice, an organisation who give options for unplanned pregnancies, in the previous year sent 77 women from Queensland interstate for an abortion, and they’re not the only organisation doing that,” De Costa said.
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Other barriers were differences in the number of weeks in which women qualified for an abortion. Victoria offers the largest window, with a woman able to terminate her pregnancy at up to 24 weeks and with a doctor’s consent beyond that.

“In 2015, there is an urgent need for legislative uniformity across Australia so that law is in step with modern medical practice, and so that women, regardless of where they live, have equal access to abortion,” the editorial concluded.

Alexis Apostolellis, the Australian chief executive of Marie Stopes, a non-governmental organisation providing contraception and safe abortion services, said women throughout Australia should have equal right to choose how and when they have children.

“In order to enable a woman to have choice, legislation needs to remove barriers to her decision making,” Apostolellis said.

“Legislation needs to be fit to the times, and we support appropriate changes that enable women with a greater range of choices.”

The Queensland senator and Greens deputy leader, Larissa Waters, called on the state premier, Annastacia Palaszczuk, to bring the state’s abortion laws in line with Victoria’s.

“It’s incredibly disappointing that despite our gender-balanced state cabinet, the government is failing women by showing no signs of decriminalising abortion,” Waters said. “Our state’s abortion laws are the worst in the country.

“Women are only able to legally have an abortion in Queensland where a doctor finds their mental or physical health is at risk.

“Setting these legal hurdles limits the number of doctors who perform abortions and therefore restricts access, especially in regional areas.”