Reimagining medical abortion in Australia: what do we need to do to meet women's needs and ensure ongoing access?

Mazza, Danielle

doi:10.5694/mja2.51979

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…There is a far wider range of barriers and facilitators that determine access to abortion. 3,21 Many countries need reform in areas such as: abortion being criminalised, spousal or parental consent requirements, conscientious objection by medical practitioners, a lack of funding or reimbursement and harassment by protestors. Most of these aspects of access are governed by statute law, government policy or religious doctrines and we do not have space here to discuss them.…”

Section: Service Deliverymentioning

confidence: 99%

Improving access to medicines for early medical abortion: learning from experiences of medicines licensing and service delivery

Rowlands,

Harrison-Woolrych

2023

BMJ Sex Reprod Health

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Section: Service Deliverymentioning

confidence: 99%

Improving access to medicines for early medical abortion: learning from experiences of medicines licensing and service delivery

Rowlands,

Harrison-Woolrych

2023

BMJ Sex Reprod Health

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The provision of abortion in Australia: service delivery as a bioethical concern

Emmerich

2024

Monash Bioeth. Rev.

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Despite significant progress in the legalization and decriminalization of abortion in Australia over the past decade or more recent research and government reports have made it clear that problems with the provision of services remain. This essay examines such issues and sets forth the view that such issues can and should be seen as (bio)ethical concerns. Whilst conscientious objection—the right to opt-out of provision on the basis of clear ethical reservations—is a legally and morally permissible stance that healthcare professionals can adopt, this does not mean those working in healthcare can simply elect not to be providers absent a clear ethical rationale. Furthermore, simple non-provision would seem to contravene the basic tenants of medical professionalism as well as the oft raised claims of the healthcare professions to put the needs of patients first. Recognizing that much of the progress that has been made over the past three decades can be attributed to the efforts of dedicated healthcare professionals who have dedicated their careers to meeting the profession’s collective responsibilities in this area of women’s health and reproductive healthcare, this paper frames the matter as a collective ethical lapse on the part of healthcare professionals, the healthcare professions and those involved in the management of healthcare institutions. Whilst also acknowledging that a range of complex factors have led to the present situation, that a variety of steps need to be taken to ensure the proper delivery of services that are comprehensive, and that there has been an absence of critical commentary and analysis of this topic by bioethicists, I conclude that there is a need to (re)assess the provision of abortion in Australia at all levels of service delivery and for the healthcare professions and healthcare professionals to take lead in doing so. That this ought to be done is clearly implied by the healthcare profession’s longstanding commitment to prioritizing the needs of patient over their own interests.

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Abortion care at 20 weeks and over in Victoria: a thematic analysis of healthcare providers’ experiences

Malek,

Homer,

McDonald

et al. 2024

BMC Pregnancy Childbirth

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Background In many countries, abortions at 20 weeks and over for indications other than fetal or maternal medicine are difficult to access due to legal restrictions and limited availability of services. The Abortion and Contraception Service at the Royal Women’s Hospital in Victoria, Australia is the only service in the state that provides this service. The views and experiences of these abortion providers can give insight into the experiences of staff and women and the abortion system accessibility. The aim of this study was to examine health providers’ perceptions and experiences of providing abortion care at 20 weeks and over for indications other than fetal or maternal medicine, as well as enablers and barriers to this care and how quality of care could be improved in one hospital in Victoria, Australia. Methods A qualitative study was conducted at the Abortion and Contraception Service at the Royal Women’s Hospital. Participants were recruited by convenience and purposive sampling. Semi-structured interviews were conducted one-on-one with participants either online or in-person. A reflexive thematic analysis was performed. Results In total, 17 healthcare providers from medicine, nursing, midwifery, social work and Aboriginal clinical health backgrounds participated in the study. Ultimately, three themes were identified: ‘Being committed to quality care: taking a holistic approach’, ‘Surmounting challenges: being an abortion provider is difficult’, and ‘Meeting external roadblocks: deficiencies in the wider healthcare system’. Participants felt well-supported by their team to provide person-centred and holistic care, while facing the emotional and ethical challenges of their role. The limited abortion workforce capacity in the wider healthcare system was perceived to compromise equitable access to care. Conclusions Providers of abortion at 20 weeks and over for non-medicalised indications encounter systemic enablers and barriers to delivering care at personal, service delivery and healthcare levels. There is an urgent need for supportive policies and frameworks to strengthen and support the abortion provider workforce and expand provision of affordable, acceptable and accessible abortions at 20 weeks and over in Victoria and in Australia more broadly.

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Reimagining medical abortion in Australia: what do we need to do to meet women's needs and ensure ongoing access?

Cited by 4 publications

References 13 publications

Improving access to medicines for early medical abortion: learning from experiences of medicines licensing and service delivery

Improving access to medicines for early medical abortion: learning from experiences of medicines licensing and service delivery

The provision of abortion in Australia: service delivery as a bioethical concern

Abortion care at 20 weeks and over in Victoria: a thematic analysis of healthcare providers’ experiences

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