Image by Christine Sandu

Abortion Care is Healthcare

HOW TABOO WITHIN SOUTH AUSTRALIA HAS AFFECTED WOMEN IN NEED OF ABORTION CARE

 

ABORTION HAS ALWAYS BEEN A CONTENTIOUS ISSUE. SINCE IT WAS FIRST LEGALISED IN SOUTH AUSTRALIA IN 1969, THE SHAME SURROUNDING IT HAS WAXED AND WANED, CHANGING WITH THE GENERATIONS. THE SOUTH AUSTRALIAN DECRIMINALISATION OF ABORTION IN 2021 BROUGHT THESE DEBATES INTO THE PUBLIC CONSCIOUSNESS ONCE AGAIN, WITH SOCIETAL TABOO AT THE FOREFRONT, BUT LITTLE MIND PAID TO WHAT THAT STIGMA ACTUALLY MEANT FOR SOUTH AUSTRALIAN WOMEN.

 

When Clara went to have an abortion in 2018, there was no doubt in her mind that she was doing the right thing. 22 years old, no degree, working casually, and a boyfriend she knew wasn’t the one, the situation she found herself in was less than ideal and one she did not feel comfortable bringing a child into. With nothing but support around her, she went through with the only option she felt worked for her, in what felt like a daze.

 
 

Only now, three years after the procedure, does Clara feel any of the effect of the stigma surrounding abortion that is so pervasive in our society.

 
 

The taboo and misinformation surrounding abortion has a real effect on those seeking abortion care and the politicians legislating it. The guilt that Clara felt after her abortion is, unfortunately, not uncommon, partly due to how abortion is debated in the public sphere. For a long time, pregnancy termination was considered a moral issue. For South Australians, however, the narrative was reshaped during the 2020/21 debate over the Pregnancy Termination Bill. The move to decriminalise abortion was a huge win for abortion advocates, and their mantra was clear from the start: Abortion Care is Healthcare.

 
 

That is Dr Barbara Baird, a researcher from Flinders University and an expert on abortion and women’s studies in Australia. She played a major part in the decriminalisation of abortion in South Australia through her work with the South Australian Abortion Action Coalition and has been involved in abortion activism for over 30 years. Her seminal work ‘”I had one too…” An Oral History of Abortion in South Australia Before 1970’, details the stories of women and their illegal abortions. These women passed down through mothers, daughters, and friends the methods in which they aborted their pregnancies. While pregnancy termination was illegal and incredibly taboo, sex happened. Consequently, pregnancy and abortion would sometimes result.

 

For some women, the societal pressures weighed heavily on their minds throughout their termination experience and into later life. Prior to the legalisation of abortion and the more widespread availability of birth control, those who were unmarried and sought contraceptive advice were often told “be celibate”. Those who were unsuccessful and ended up pregnant were told by doctors to keep the pregnancy and adopt out the child. Abortion, to many doctors, was unthinkable, only necessary when the mother’s life was endangered. So, the abortions that South Australian women sought, as detailed in Barbara’s book, were illegal. The home abortions were performed either by themselves, by friends or family, or by known abortionists, ranging from the mundane to the horrific and were often done in secret.

 
 

Today, the law, society, and quality of care has changed. Women are now afforded better access to safe and legal abortions in South Australia, but the law is still permeated with the moral caveats that restrict access. Prior to the 2021 reform, women seeking abortions needed the approval of two doctors, confirming that carrying the pregnancy to term would be detrimental to her physical or mental wellbeing. Term limits also make seeking and accessing abortion care more difficult. The RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) recommend the removal of term limits altogether, with evidence suggesting that this would ultimately lower the rates of late term abortions. However, anti-abortion sentiments still lurk throughout legislatures, where the fear is that abortions would be allowed up until birth with no term limits. In reality, late term abortion care is very rarely needed and is usually prompted by the indication of a foetal abnormality.

 

Catherine Kevin, an advocate for abortion access in South Australia, found her own pregnancy made difficult when her daughter was diagnosed with a duplex kidney, a condition associated with other foetal abnormalities and syndromes. At that time, the term limit for South Australia abortions was 24 weeks, creating stress for both Catherine and her medical team.

 
 

The term limits on abortion care access means that there is often less time to understand what potentially could be wrong with the foetus. Not only that, but they are also often not in line with medical evidence. Removing term limits gives medical practitioners and patients time to investigate potential problems further before considering termination. But through debate and legislation, the fear that a woman may change her mind 8 months into a pregnancy still overrules the best practice of healthcare for those who are pregnant and in need of late term abortions.

 

What is often lost in the lawmaking process is the human element. Political parties designate issues such as abortion as a conscience vote, because they believe these issues to be of a moral nature, when it is simply not the case. The fears and myths surrounding pregnancy termination block those who need access to abortion care both through the legislative process and through real life practice. The clearest example of this is the legalisation of early medical abortions. The medication required for an early intervention medical abortion was legalised in Australia in 2006 but was not made available on the public pharmaceutical benefits scheme until 2014. This not only limited the types of available abortions to Australian women, but it also limited who could get them, as early medical abortions are much easier to procure than surgical terminations if you live in a rural or remote area. This absence of public responsibility affects those trying to access abortion care and is exemplary of how the political rhetoric and the stigma surrounding pregnancy termination can slow down the passing of legislation.

 

This stigma is perpetrated not only by politicians, but by the media and public as well. During the 2000s, the development of the pro-choice but anti-abortion movement emerged. Essentially stating that other women can have abortions; women who are poorer, younger, have less understanding or education. Characterising these women as inferior for terminating their pregnancies brought about a new sort of stigma, creating a distinct “us and them” dynamic. This, though, has been challenged by the rise of social media and the readiness of the younger generation to share their stories of abortion, both online and in more traditional media. The rise of the “unwillingly pregnant woman” has reshaped the discourse around abortion, as something necessary for some people, rather than something they should be apologetic about and have to justify.

 

The change in society regarding the stigma of abortion has been slow, but steady. Since the legalisation and subsequent decriminalisation of abortion across Australian states, access to abortion services has improved, as has the access to accurate information. Slowly, people have given weight to the idea that abortion care is healthcare, not something shameful and secret to be hidden away.


Clara’s abortion proved this.

 
 

For Clara, talking to me about her abortion was just an extension of talking to me as her friend. There was no shame in chatting about it over a cup of tea. There was no fear of anyone else hearing what she had to say, which is a testament to the change that has occurred in the last 50 years since abortion was legalised in South Australia. The stigma still persists, but the willingness of the younger generations to speak about their experiences, even in a casual way among friends, does wonders in breaking down the barriers that might be preventing other people from opening up about their own experiences.