HEALTH

As Trump Poses Risk To Abortion In U.S, What Are Australian Women's Abortion Rights?

U.S. women are worried, so what exactly are our rights down under?

18/11/2016 12:20 PM AEDT | Updated 18/11/2016 6:10 PM AEDT
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Roe v. Wade could be overturned if Trump appoints a 'pro-life' Supreme Court Judge.

As women's abortion rights have been brought back into question with President-elect Donald Trump talking about appointing a pro-life Supreme Court Judge, the issue has been brought back to the forefront of global public discourse.

In the U.S. at the moment, Roe v. Wade -- the court decision that legalised abortion in the U.S. -- acts as an overriding federal decision allowing abortion around the country but a pro-life Supreme Court bench could overturn Roe v. Wade.

If it is repealed, the law will be put back onto the states which could leave many pro-life states voting against abortion -- forcing women to travel to another state to terminate an unwanted pregnancy.

In Australia, there is not an overriding federal power and women's abortion rights currently lie in the legislation of the states and territories. So what are Australian women's rights around the country?

The Huffington Post Australia spoke to Dr Caroline De Costa, a Professor of Obstetrics and Gynaecology at James Cook University about our rights, the risks and the costs.

The Laws Differ In Each State And Territory, And In Some It's Still Criminal

Abortion was criminalised in many states in the 19th century, and since then Victoria, ACT and Tasmania have decriminalised abortion. South Australia and Western Australia have made substantial reform since then while it is still a criminal offence in New South Wales and Queensland.

"It's still a crime to have an abortion, to perform an abortion and to assist in an abortion in QLD and NSW. People don't realise that," De Costa told HuffPost Australia.

However, it is unlikely anyone in this day and age would be prosecuted so women are still able to get abortions in these states. It all comes down to a couple of cases in the 60s and 70s, where some doctors in NSW, Victoria and Queensland were prosecuted for performing abortions but were acquitted by a judge.

Abortion Laws In Australia States And Territories

NSW: Remains a criminal offence, but if a doctor is satisfied an abortion is required (for economic, social, medical or mental health reasons) they can terminate a pregnancy.

QLD: Remains a criminal offence, but women can get an abortion up to 22 weeks if deemed necessary.

ACT: Legal and available on demand.

SA: Legal up to 28 weeks if two doctors agree that women's mental or physical health is at risk or if there is a foetal abnormality.

TAS: Legal on demand up to 16 weeks, but beyond 16 weeks two doctors have to agree.

VIC: Legal on demand up to 24 weeks, but beyond 24 weeks two doctors have to agree.

WA: Legal on demand up to 20 weeks, but beyond 20 weeks it has to be approved by the health minister and special panel.

NT: Legal up to 14 weeks if two doctors agree, and is legal up to 23 weeks if abortion is due to a medical emergency.

"Those cases form the basis -- still in NSW and Queensland -- for our defence if we were charged with an abortion," De Costa said.

"We depend on case law, and those judgements, so its very unsatisfactory. Medicine has changed dramatically, and has got much safer and the law has not kept up with the developments of the practice of abortion."

What this legal grey area has caused is reservations within the medical practice to be involved in terminating pregnancies.

"Many doctors feel it should be changed, they want to be able to refer women requesting termination of pregnancy to safe, legal, professional services but often they don't want to be involved themselves," De Costa said.

What Types Of Abortion Are There?

There are two different types of abortion, and it all comes down to the timing of the pregnancy termination and a personal choice.

Surgical Abortion is a surgical procedure requiring local or general anaesthetic to remove the pregnancy from the uterus.

"Most abortions are done within the first trimester -- the first three months of pregnancy -- or much earlier," De Costa said.

When women reach later terms, medical abortion is preferred over surgical, said De Costa, but surgical can be performed at some specialised clinics and hospitals.

"It's generally done later because there's a severe foetal abnormality, or because the woman has developed some medical condition which deems it dangerous for her."

Medical Abortion involves taking two different medications called Mifepristone -- which is commonly referred to as RU486 -- and Misoprostol.

De Costa said doctors can supply women with the medications to take at home up to nine weeks into the pregnancy -- only if the woman feels comfortable and has a support person with her. This is approved by the TGA.

"If it's later pregnancy it needs to be done in a clinic or hospital. The process is like a natural miscarriage, that happens," De Costa said.

"They can be used in the first trimester, second trimester and rarely they may be used in later pregnancy. Medical abortion is used more commonly in later abortion."

What Are The Risks Associated With Early And Late Term Abortions?

Abortions are very safe when approved and performed by a medical practitioner but, like any medical procedure, there is always some risk.

De Costa said the risks with surgical abortion up to 14 weeks are generally less than one in 100,000.

"This risk isn't death, but of bleeding and the need of transfusion, and of damage to the uterus or to the cervix and the need for repair," De Costa said.

Medical abortion poses a minimal risk to health when performed up to nine weeks into the pregnancy. The minimal risk is of hemorrhaging and infection which is why women are given antibiotics at the time and told to report to the doctor if they have a fever.

If an abortion is performed at 24 weeks or upwards, this will be done in a specialised hospital with maternity foetal medicine specialists, who are experienced in dealing with women and partners before and after the procedure.

"These women are women who have wanted pregnancies and then they've had a diagnosis made with foetal abnormality and its very traumatic to go through the decision making and the process," De Costa said. "So they need to be appropriately helped."

Abortions after 20 weeks make up about one percent of all abortions in Australia, with 95 percent occurring in the first trimester.

What Are The Costs (And Does The Public Health System Cover It)?

There is a medicare rebate for pregnancy termination but, generally, women will pay several hundred dollars which all comes down to that legal grey area again.

"Because there's this grey area where a lot of doctors don't want to do it, in most states -- apart from South Australia -- it is very difficult to access abortions through the public system, particularly in the first three months," De Costa said.

"For most women, they have to go to the private sector. There are good services provided by commercial organisations and so it is expensive."

Late term abortions are performed "more readily in the public system" but there's also travel costs for women in rural areas which isn't always covered by medicare.

"Most women will be paying several hundred dollars for a surgical abortion and in many cases for a medical abortion as well."

So What Is The First Step If You Are Considering An Abortion?

De Costa said, after confirming the pregnancy, the most important steps are to talk to a partner (if there is one), friend or family member and reach out to a GP.

If women have any concerns or queries about abortion, safe and reliable advice can be found at these organisations.

Children by Choice

Sexual Health and Family Planning Australia

Dr. Marie, Marie Stopes clinic

Australian Women's Health Network

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