While the majority of Australians support a woman’s right to choose, abortion still faces opposition from some parts of the community (Image Source: Jessica Franze)
By Jessica Franze
Abortion has long been viewed as a topic unsuitable for public debate by those who think it is uncivil to talk about womens’ health and sexuality.
But what many may be surprised to learn is that abortion remains in South Australia’s (SA) criminal law—in between the abduction of children and offences relating to public order—with life imprisonment as the maximum penalty.
In December 2018, Greens MLC Tammy Franks introduced a bill to parliament to remove abortion from the criminal law and regulate it like other healthcare.
In February, the Marshall Government announced the SA Law Reform Institute (SALRI) would examine the state’s abortion laws to ensure informed debate, after both major parties indicated the bill would progress to a conscience vote.
SALRI Director, University of Adelaide’s Professor John Williams, said in a statement the institute would consult with “the community, health providers and interested parties” to suggest “potential models for reform”.
This is not the first time SA’s abortion law has come under scrutiny.
South Australia was the first to provide a safe medical model for abortion access 50 years ago, however, the law now lags behind other Australian states.
In SA, there are exceptions where abortion is lawful: where two doctors agree the woman is more at risk of mental or physical harm if the pregnancy continues, or there is substantial risk the child would suffer serious abnormalities.
While women are free to seek an abortion, they do not have the right to decide to have an abortion.
Rather, two doctors must examine the pregnant woman and agree that one of the exceptions in the law applies to make the procedure lawful.
As the law is open to uncertain interpretations, this leaves some health professionals reluctant to provide abortion services out of fear of prosecution.
Brigid Coombe, Co-convenor of the South Australian Abortion Action Coalition (SAAC), a group lobbying MPs for improved access to abortion services, has worked in sexual and reproductive healthcare for the past 30 years.
Ms Coombe said the reform bill seeks to allow women to decide what happens to their bodies.
“The service would be provided on the basis of her informed consent, not on the opinion of the providing doctor,” Ms Coombe said.
While the reforms do not remove doctors’ right to refuse to perform an abortion on the basis of a “conscientious objection”, it would require them to refer a woman seeking an abortion to alternate abortion services.
Currently, the two-doctor consent process is not required by any other medical procedure in SA.
Emily Christie, a 31-year-old woman whose abortion experience drove her to speak out on the need for improved abortion access, said she was surprised to learn the two-doctor consent process does not apply to other medical procedures, including those with well-known health risks.
“My friend had breast implants recently… and she had to go to one doctor’s appointment, and that’s it. It blew my mind that that was easier,” Ms Christie said.
A further barrier faced by women seeking abortions is that a woman must have been a resident of SA for at least two months to access an abortion.
Tammy Franks MLC said the requirement of SA residency was designed to prevent “abortion tourism”, but the law is out of step with current practice.
“When you’re pregnant, two months is a hell of a long time… it’s caught out people who are travellers in various ways, whether that is international students, tourists and so on,” Ms Franks said.
An abortion must take place in a “prescribed hospital” or healthcare centre, restricting women living in rural and remote areas from accessing an early medication abortion (EMA).
These women face additional barriers of having to travel long distances, often at great personal cost, to access abortion services.
EMA involves taking a series of prescription medications to induce abortion, and is recognised by the World Health Organisation (WHO) as a safe alternative to surgical abortion for pregnancies up to nine weeks.
If the reform bill passes, women seeking an abortion will be able to access EMAs from their GP.
Ms Coombe said the current law also prevents South Australian women from accessing EMAs via new technologies, such as telemedicine (i.e. postal service).
“The Northern Territory changed its laws in 2017, [meaning] we’re now the only Australian state where women can’t access EMA via telemedicine,” Ms Coombe said.
While current law means abortion is only available up to 24 weeks’ gestation, the law reforms seek to allow women the autonomy to decide whether or not to have an abortion, with the support of healthcare professionals.
SA health data indicates the majority of abortions (91.9 per cent) occur within the first 14 weeks of pregnancy, with only 2 per cent over 20 weeks’ gestation.
Many factors may impact the timing of the decision to abort a pregnancy.
These range from late diagnosis of foetal abnormality to irregular menstrual cycles that make pregnancy symptoms unclear; physical or mental illness; and difficult personal circumstances, such as domestic violence.
Some women must abort their pregnancy under the pressure of a looming gestational deadline, while others are altogether prevented from accessing an abortion.
The reform bill also creates a 150 metre “safe access zone”, protecting women from harassment and intimidation around healthcare centres that provide abortion services.
Ms Christie, who said the unwavering support of her friendship group helped her make the decision on whether to seek an abortion, said she felt concerned about the current lack of safe access zones, particularly for women without this kind of support.
“When I had my termination, I had to walk past protestors, and I think that was a difficult part of the experience,” she said.
“It makes me worried… about [the lack of safe access zones] making [women] vulnerable walking past those protestors who engage them in a conversation; that they may be swayed in their decision if they are not sure or not supported.”
Research has consistently shown that about 80 per cent of Australians support womens’ access to safe and legal abortions independent of age, sex or political affiliation.
Although religion impacts people’s attitudes toward abortion, only 10 per cent of people who identify as religious are opposed to abortion in all circumstances, while 80 per cent support allowing abortion in some circumstances.
Part of the reason for this widespread public support for abortion is that one in three Australian women have an abortion in their lifetime.
No method of contraception is 100 per cent effective, however, the WHO estimates that even with perfect contraception use, there would still be six million unintended pregnancies every year.
High levels of public support for a woman’s right to choose is also the case in the United States where 69 per cent of Americans oppose the overturning of Roe v. Wade, a 1973 US Supreme Court decision which ruled that the US Constitution protects a woman’s right to abortion without undue restrictions.
Nonetheless, conservative states all across the US are now implementing anti-abortion laws, known as the “Heartbeat Reforms”, that threaten the right to safe, legal abortions.
In May, Alabama’s Republican majority state senate voted 25 – 6 to pass a near total abortion ban, the most restrictive abortion law in the US.
The bill, passed by an all-male majority, makes abortion illegal at any stage after detection of a foetal heartbeat, with no exemptions for rape or incest.
The reform sparked outrage internationally, with hundreds of locals taking to the streets in protest.
A report released by US policy research organisation The Guttmacher Institute found abortions are just as prevalent in countries with strict anti-abortion laws as those where women have the greatest access.
The DIY (or “backyard”) abortion involves opening the cervix of a pregnant woman through insertion of a sharp object, such as the wire of a coat hanger or knitting needle, to cause miscarriage.
Unlike legal abortion, this often leads to uterine perforation, infections, infertility and occasionally the death of the woman.
Ms Franks said the US example served as a timely reminder of our need to rewrite the narrative on women’s autonomy and give women freedom in their reproductive decisions.
Specifically, it highlights why abortion should be considered a personal, medical decision, not a political one left in the hands of legislators.
“Women don’t have autonomy over their own bodies and we can’t take it for granted,” Ms Franks said.
“The idea that we should not change [the law] because we should trust what will happen in the future, I think is a complete fallacy.”
In April, the High Court affirmed the constitutional validity of “safe access zones” in Victoria and Tasmania, a decision Ms Franks is hopeful will trickle down to SA’s laws.
“I am hopeful that MPs will take the time to understand… that decriminalisation isn’t deregulation,” she said.
“Health laws will still apply; it’s just the act of an abortion won’t attract criminal penalty.”
SALRI is expected to deliver its recommendations to Parliament by the end of August, with a date for the conscience vote yet to be decided.