One in Six
I think everyone can remember their first sex-education class. A gaggle of giggling teenagers all shoved in a room on a Wednesday afternoon, a tired teacher at the front of class trying to control the cohort. We’ve all placed condoms on bananas, and we’ve all been lectured about safe sex, but the topic of unwanted pregnancy remains firmly off the cards.
Still, one in six Australian women will have an abortion by the time they are in their 30’s.
On March 2nd 2021 abortion was officially decriminalised in South Australia. After years of tireless and thankless campaigning, women across the state could breathe a collective sigh of relief. It wasn’t an easy fight. Nor a straightforward one, as conservative politicians refused to relinquish their tight grip on a woman’s right to body autonomy. Finally, these matters rest in our own hands. But still, the battle is far from over.
*Name changed for privacy reasons, voice used with consent
Claire* is a 24-year-old marketing whizz, a former SAPSASA soccer guru and a true country girl at heart. Originally from the town of Renmark, Claire had been living in Adelaide since she attended boarding school, and was in her final years of a marketing and international business degree when she discovered she was pregnant in 2019.
Having just started dating again, Claire had fallen head over heels for a guy who was not only caring, but enamored by her. Yet, while the two were swept up in the ecstatic high of a new relationship, the unthinkable happened - the condom split. Taking emergency contraception, Claire assumed she was in the all clear.
A month later, her period was late.
“Sometimes the symptoms of being pregnant are really similar to right before you get your period, so I had convinced myself it was that,” Claire explained.
“But there was that little voice in the back of my head saying ‘I’ve not felt this feeling before.”
Wanting to abate those anxious whispers, Claire took a pregnancy test. To her surprise, two pink lines appeared. It was positive.
“I was shocked when I found out I was pregnant because we had been careful,” she said.
“I was like how is this possible -this is literally impossible, we took all the right measures, we did all the right things.”
What Claire didn’t know was that the antibiotics she was taking interfered with the morning after pill, a side effect the chemist neglected to tell her.
The blissful bubble Claire had found herself in burst, the idea of motherhood becoming a sobering thought. The life she had always imagined for herself was just at the tips of her fingers, and being only 22 at the time, she decided to have a surgical abortion.
“It was something that I knew I had to do pretty much straight away, I never questioned the other side, I never allowed myself to because I think if I did it would’ve been harder,” said Claire.
Despite one third of Australian women terminating a pregnancy in their lifetime, abortion still resided in South Australia’s criminal code in 2019, the ripple effect of criminalisation creating a lack of resources across the state.
Claire waited an anxiety-inducing two and a half weeks before she could get an appointment at the Pregnancy Advisory Centre (PAC) – the only dedicated abortion service in SA.
“That was hard - knowing you couldn’t sort it out straight away,” said Claire, “but [PAC] were so helpful.”
“Instead of some white-coat doctor it just felt like it was your mum you were talking to, it made it so much easier.”
Claire’s story is only one of the thousands of women from different backgrounds who’ve attend the Pregnancy Advisory Centre since its opening in 1992. Today, it still remains the only publically funded specialist abortion service in Australia. At the helm of PAC for a decade was Brigid Coombe, who left in 2012.
For the eighteen years that Brigid worked at PAC she strived to create a space that depicted abortion for what it truly is - a vital health service.
“It was incredibly challenging, but we wrote the rules. So we could aim high - and we did,” said Brigid.
Brigid is everything you’d expect her to be: she is warm, and at times brutally honest, but nevertheless passionate about her line of work. She rides her bicycle everywhere, appearing as a flurry of fluorescent yellow, a shiny button reading ‘abortion is healthcare’ clipped to the front of her jacket.
Brigid Coombe
A State in Decline
South Australia’s hesitancy towards abortion reform is puzzling considering the state’s progressive past. In 1969, SA included surgical termination into the legislation, a first in Australia’s history, in a bid to stop back-yard abortions.
Then, the law stipulated that two doctors could approve termination on the basis of foetal abnormalities or an imposing risk to a woman’s mental and/or physical wellbeing. Further, abortion had to be performed in a prescribed hospital, with the individual being a resident in South Australia for at least two months.
But what was once seen the gold standard for abortion practice in Australia, the legislation soon became outdated as medicine and societal opinions continued to advance.
Using the archaic legislation to their advantage, Brigid describes how powerful politicians gradually eroded the inner-workings of abortion services through their conservative chokehold. The law, which was once interpreted in shades of grey, was rendered black and white, plunging the once progressive state into a backwards spiral.
Frustrated by politicians overbearing control, Brigid and her co-workers only solution was to seek a legislative reform. Yet their pleas fell on deaf ears, the conversations behind closed doors even more disheartening.
Speaking to John Hill, Labor’s Minister for Health in the late 2000’s, Brigid recalls their discussions pertaining to possible abortion amendments. While a progressive himself, he believed change was impossible, the far right of the Labor party too immersed in the Catholic Church. Hill insinuated that the prospect of the debate was too nasty, and that any push for reform had to arise from the public itself.
“It was brutal. I was so angry, and it took me really a long to time for me to get over that.”
“Lucky I ride a bike,” Brigid quipped, “I get rid of all my anger.”
The South Australian Abortion Action Coalition campaign
The Long and Windy Road to Decriminalisation
As South Australian laws continued to constrict termination services, Brigid and her academic colleague, Barbara Baird - a professor at Flinders University – refused to be deterred. They were determined to free abortion services from their stifling restraints.
Both knew the path to decriminalisation wasn’t going to be easy. Victoria had engaged in a four-year battle before abortion was removed from the criminal code in 2008, with a similar story seen in Tasmania.
Nevertheless, it was a journey both women were willing to take, co-convening the SA Action Abortion Coalition in 2015 (SAAAC).
South Australia still remained under the ALP when the advocacy group was first initiated. Waiting for the inevitable switch in government, SAAAC focused their efforts on building support through community education first.
By the time 2018 rolled around, SAAAC had developed into a powerful collation of talented medical professional, politicians and lawyers, ready to start lobbying for the much needed reform. Greens MLC, Tammy Franks, first introduced the original bill written by SAAAC in late 2018.
“The anti-abortionists went completely ballistic because it was only about 10 lines,” said Brigid.
“We said healthcare regulates healthcare. Abortion is healthcare. End of Story.”
The legislation never crossed the line.
Determined to bring SA in line with the rest of Australia, Attorney-General, Vicki Chapman, submitted a further inquiry into abortion reform to the South Australian Law Reform Institute (SALRI). She re-introduced the Termination of Pregnancy bill in late 2020.
What followed was a contentious 22-hour debate in the Lower House, resulting in a landslide win of 29 to 15. Several amendments, such as a ban on sex-selective termination, were implemented into the bill, despite being refuted in the scientific literature. The Upper House approved the bill on March 2nd this year.
Ms. Chapman called it a “historic day for women.”
Yet whilst this sequence of events looks simple on paper, it was anything but.
“For people outside of abortion politics, I think there’s a naivety about just how nasty people will be,” said Brigid.
SAAAC, March 2nd 2021
Body Politics
Abortion still remains one of Australia’s lasting taboos, the divisive topic of unwanted pregnancy termination rendering itself almost a political hand grenade, challenged only by euthanasia and sex work. Brigid believes this a direct result of the culture Australia has cultivated.
“Australia is a highly misogynistic society,” claimed Brigid.
“And that’s what abortion stigma is: the patriarchy fighting back in Australia.”
Consequently, the Termination of the Pregnancy bill became the ultimate litmus test for misogyny within South Australia’s Parliament.
While recent studies say 80% of South Australians supports a woman’s right to choose, shame and stigma seeped into the unfolding political discourse inside parliament. As South Australia inched closer to legalisation, several male politicians announced themselves spokesperson for the ‘unborn’, declaring at the crux of the debate an infant was still involved.
“As if a woman having an abortion isn’t fully cognisant of that, and it’s so demeaning to suggest that we need them to remind us,” said Brigid.
Every person who voted against legalising abortion in South Australia – bar one – was a man.
Both houses hold a male majority. Women’s right to bodily autonomy, their right to choose what path is best for them, rested in the palms of their male counterparts.
“It is not really an intellectual experience; it is visceral and it is so upsetting and infuriating,” explained Brigid.
This experience is not unique to South Australia, New South Wales engaged in a bitter dispute, with three Liberal backbenchers attempting to topple NSW Premier, Gladys Berejiklian, from her leadership.
Former Prime Minister Tony Abbott weighed in on the NSW bill, calling it “infanticide on demand” at a 2019 pro-life rally in Sydney, further fuelling the anti-abortion agenda.
The misogynistic rhetoric that lies in the underbelly of parliamentary sittings frames abortion as a shameful practice, painting those who terminate a pregnancy to be inherently selfish.
“But it’s because women take parenthood and mothering so seriously, that they say no. No, it's not a good circumstance,” Brigid said.
Brigid believes we can shatter the remnants of abortion stigma that still remains in Australian society by turning our attention to how abortion services are being provided nationwide.
“You privilege an area of health care to make up for stigma,” she said.
By creating an environment that champions a compassionate, patient-focused practice, grounded in individual autonomy, the shame and secrecy that shroud abortion will begin to fade into a relic of the past.
Pro-Choice rally, NSW, 2019
Looking forward
While the shackles have been lifted from abortion services nationwide, decriminalisation and accessibility have not become synonymous, as Australia’s patchwork quilt of abortion legislation continues to marginalise individual’s ability to use services.
SAAAC have begun turning their attention towards rural accessibility. Regional Australians are 1.4 times more likely to experience an unplanned pregnancy, yet in SA, only 2% of abortions are performed outside of metropolitan Adelaide. Horror stories of interstate plane flights from Tasmania, to 500km round-trips across the country, continue to emerge as abortion accessibility is slim pickings elsewhere in Australia. By upskilling and educating GP practices about EMA, SAAAC hopes that more community services can be established in rural areas.
Abortion via telehealth became a focal point last year, with Marie Stopes – Australia’s leading abortion provider – reporting a 200% increase in the service in comparison to 2019. Early medical abortion via telehealth revolutionised women’s access to termination services in 2020, a sliver lining in the midst of the COVID-19 pandemic, breaking down the conservative barriers that remain prominent in rural locations. We must ensure these practices continue post-pandemic.
Nationally, there has been a groundswell push to integrate abortion services into the public health system and implement nurse-led medical termination across the country.
South Australia and the Northern Territory remain the only states who publically cover the costs of termination and permit any health professional to provide EMA. In other states, certain procedures cost upwards of $700 in the private sector. Once potential travel and time off work is factored into the cost, abortion ultimately ends up an expensive practice, potentially excluding those in lower socio-economic brackets.
Further still, Western Australia remains the only state to not enact safe access zones outside abortion clinics.
An individual’s right to abortion should not reside on their income or their postcode. An individual’s right to maintain bodily integrity is sacrosanct.
We cannot let the façade of equality that decriminalisation has cast blind us from reality. The fight for reproductive autonomy is far from over. We’ve only just begun.