Abortion rights and access in Australia: Implications of Roe v Wade

Angela Zhang

With the recent overturning of the landmark Roe v Wade decision by the Supreme Court of the United States, concerns regarding the implications for Australia and the rights of individuals to abortion services, including issues of access, have come to the forefront.

The situation in Australia

In Australia, abortion has been fully decriminalised in all states and territories except for Western Australia, which is still regulated by the Criminal Code. With respect to the particular procedures available, medical abortions are available in all states and territories until nine weeks’ gestation, while the availabilities of surgical abortions vary from 16 weeks in the ACT to 24 weeks in Victoria.

While the availability of procedures has been noted by some to demonstrate that Australia is comparatively tracking well, the different rules and levels of access in each state and territory arguably create a significant barrier for individuals. In particular, “abortion access is still a postcode lottery in Australia. To end the postcode lottery, we need to harmonise state and territory legislation”, said Jamal Hakim, managing director of MSI Australia, the national provider of abortion services in Australia.

Non-legal barriers

There are also non-legal barriers that remain in relation to abortion access. In their 2021 study, Penovic and Sifris found that three of the primary non-legal barriers were cost, geography and “deficiencies in practitioner attitudes, education and training”.

In particular, with the exception of South Australia and the Northern Territory, most public hospitals do not offer abortion services, requiring many individuals to seek the services of private clinics, paying hundreds of dollars out-of-pocket. This has notably generated significant cost discrepancies between providers, rendering abortion services inaccessible for many individuals. Even in the public system, barriers exist for individuals who do not have access to Medicare, or who are not eligible for government financial support, such as temporary visa holders.

However, increasing abortion provision by not-for-profit organisations such as Family Planning NSW (FPNSW) has notably reduced out-of-pocket fees for medical and surgical abortions. For example, the pricing at FPNSW has been set out as $352 upfront / $165 out-of-pocket for a medical abortion, and $836 upfront / $385 out-of-pocket for a surgical abortion. Nevertheless, even small fees can be a barrier, and services are not equitably distributed around Australia.

In particular, access to abortion services is also a “postcode lottery”, which could present significant difficulties for individuals living in rural and remote areas. This is often exacerbated by the need for such individuals to incur additional costs to overcome the barriers of distance, including transportation and accommodation costs.¹ Telehealth may alleviate this for some people, but will not be suitable for all.

Stigma is another significant deterrent in this space. For example, doctors may have concerns that they will be “blacklisted” from certain hospitals, or face personal attacks if they assist individuals access abortion services. Accordingly, some doctors may refuse to perform abortions or refer individuals on, while some pharmacists may refuse to supply medical abortion drugs, said Bonney Corbin, the head of policy at MSI Australia.

Access to abortion services is additionally affected by doctors' knowledge or training surrounding abortion, an area which has largely been absent from medical curricula in Australia, presenting another significant barrier to access.

There has also been an increasing recognition of the role of reproductive coercion and abuse in hindering access to abortion services. In its 2015 study, the Australian Institute of Family Services observed “a strong correlation… between unintended pregnancy and domestic and family violence”, noting numerous ways in which abusive partners were described to control women’s reproductive and sexual choices, including through rape, sabotaging or refusing to use contraception, and controlling access to abortion services.

Direct implications of Roe v Wade

Notably, Corbin stated that while the recent overturning of Roe v Wade could contribute to a stigma around abortion in Australia, leading to a culture of shame around reproductive rights, and granting US-inspired anti-choice movements in Australia “a large platform and a lot of noise”, it was unlikely to influence policy.

Nevertheless, “the politicisation of healthcare has real implications for access and what we see in the US is a perfect example of that”, said Penovic. In particular, while the situation in Australia is “very different” to that in the US, the various non-legal barriers to access arguably demonstrate a significant need for further change.

Ultimately, it is unlikely that the overturning of Roe v Wade will affect the existing legally protected rights surrounding abortion in Australia. However, the decision may have cultural impacts on existing attitudes towards reproductive rights. A cultural shift in attitudes, in conjunction with the existing barriers to access, may affect the achievement of reproductive justice if left unaddressed.