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In the wake of revelations that doctors in Wagga Wagga are refusing to perform abortions, the New South Wales government faces pressure to investigate access to reproductive healthcare across the state. By Justine Landis-Hanley.

NSW politicians call for access to abortions in Wagga

The New South Wales opposition this week demanded the state government recognise women’s limited access to abortion in the state’s rural and regional communities, including Wagga Wagga, and called on the Health minister to investigate access to reproductive healthcare across NSW.

The call follows a months-long investigation by The Saturday Paper into abortion access in the city of Wagga Wagga, which found it is almost impossible for a woman to get an abortion locally – in part due to doctors’ fear of professional and personal backlash from the town’s deeply religious community.

Neither of Wagga’s two hospitals, nor its private day surgery, provides surgical terminations to women who want one for social, financial or personal reasons. Very few local GPs prescribe the MS-2 Step – two tablets to induce a medical abortion – which can be used up to nine weeks into the pregnancy.

On Tuesday, Trish Doyle, shadow minister for Women in NSW, gave a notice of motion in the state’s legislative assembly that on the next sitting day she will move the house “acknowledges women living in rural communities such as Wagga Wagga have very limited access to abortion and are forced to travel hundreds of kilometres to obtain assistance, placing them under serious physical, psychological and financial pressure”.

Doyle will also demand additional resources be “provided at public hospitals to provide free and timely medical and surgical terminations of pregnancy to women, especially those living in rural and regional communities”.

Penny Sharpe, shadow minister for Family and Community Services, also wrote to NSW Health Minister Brad Hazzard, asking him to “take whatever action is necessary to ensure that the women in this large regional centre and surrounds are able to access this essential health service”.

Sharpe said she was particularly concerned that some medical professionals were refraining from providing medical abortions in Wagga because they feared “repercussions if a woman they have treated presents at the local public hospital with any complications”, an issue reported by The Saturday Paper.

On Thursday Hazzard said, “Services for terminations in the early phases of pregnancy across Australia are normally delivered through the private and not-for-profit sector, and I would certainly join with Penny in strongly supporting these providers to consider establishing an appropriate clinic in consultation with the usual local government requirements.”

Doyle, who grew up on the outskirts of Wagga and attended Wagga Wagga High School, told The Saturday Paper that when she and members of the shadow ministry visited the town in February, local women said doctors who conscientiously object to providing abortion “aren’t offering up any other pathway or saying, ‘Here is a handful of other doctors you can go and talk with.’  ”

Under the NSW Abortion Law Reform Act, registered health professionals who conscientiously object to providing an abortion themselves must give information to the patient on how to contact, or refer the patient to, a registered health practitioner or service provider who they understand will perform the procedure.

“To think that doctors are failing in their duty of care to provide simple access to healthcare, it’s shameful,” said Doyle.

“It’s 2020. If women are being forced into dire situations, if they are financially, psychologically damaged as a result of not being able to access healthcare … I think it is actually negligent to just lie to a woman and say it is illegal or say, ‘You can’t have that done… You have to have a baby.’  ”

Julie Mecham, a crisis and support worker at Wagga Women’s Health Centre, said lack of local abortion providers in Wagga is putting the lives of local women experiencing domestic violence at risk.

She said the lack of abortion access severely limits options for women who are trying to terminate a pregnancy without their abusive partner finding out, and women are more likely to stay in a violent relationship if they have a child with their partner.

Among NSW’s local government areas, Wagga is ranked 14th out of 120 for the rate of recorded domestic violence-related assault incidents, with 793 incidents per 100,000 people.

“I don’t think people get the seriousness of ensuring there are appropriate health services for women, because it really can be lethal,” Mecham told The Saturday Paper.

Doyle said she wants to set up a local forum in Wagga where women and those who support access to healthcare come together and support one another in finding solutions.

She hopes to find bipartisan ground with Hazzard, as both major parties were able to do during the state’s abortion decriminalisation debate, “and actually work out how we guarantee these procedures are made available … and get it done”.

In response to questions from The Saturday Paper, Jill Ludford, the chief executive of the Murrumbidgee Local Health District (MLHD), drew a clear distinction between the Wagga Base Hospital’s policy and the conscientious objection of individual doctors.

In regard to whether the MLHD acknowledges a fear of backlash among abortion providers in Wagga, Ludford said “any allegations are taken very seriously and investigated fully”.

She added: “Gynaecological procedures such as dilation and curettage (D&C) are performed at six MLHD hospitals which have visiting General Practitioner/Obstetricians and operating theatres.”

Ludford’s statement did not note that the MLHD covers 33 public hospitals, and did not specify whether the six hospitals that offer gynaecological services also provide surgical terminations for social, economic or personal needs.

Dilation and curettage refers to a procedure to remove tissue from inside the uterus, and is used to obtain abnormal tissue, such as a benign tumour or polyp, for examination, or to clear the uterus after a miscarriage or an abortion.

Multiple doctors and healthcare professionals in Wagga who spoke to The Saturday Paper confirmed that Wagga Base Hospital does not provide elective surgical abortions due to the religious objections of its staff.

The independent member for Wagga Wagga, Dr Joe McGirr, who previously described himself to Guardian Australia as “not pro-choice”, told The Saturday Paper that he acknowledges concerns about abortion access in Wagga, and is himself concerned that local doctors may not be providing termination services out of fear of retribution.

“I do not believe that doctors and other health professionals who wish to provide these services should be discriminated against and I am disappointed that this may be the case and this might be affecting the provision of services,” he said. “The conscientious beliefs of all practitioners should be respected.”

McGirr said he has taken up concerns raised with him regarding Wagga’s lack of abortion services with the minister for Health and the local health district but noted that “in general, abortion services are most often provided outside the public sector”.

But Dr Kirsten Black, professor of obstetrics and gynaecology at Sydney University, said now abortion has been decriminalised the NSW government needs to create a statewide solution to ensure equitable access to pro-choice providers.

“It’s important that abortion is provided in public hospitals to ensure greater access, but it’s also an issue of training doctors to be abortion providers,” she said. “If you don’t upskill practitioners as well, that is a problem for future provision.”

In the meantime, doctors from outside Wagga Wagga have offered to step in and travel to the town to perform surgical abortions, if the public hospital’s staff refuse to do so. The Saturday Paper understands that at least one doctor from Victoria plans to reach out to the Wagga local health network in the coming weeks to offer their services.

Doyle told The Saturday Paper that visiting medical officers, or VMOs, as they are known, “may be something that is put forward as an option and discussed”, but that “those decisions need to be made at a local level and supported from higher up”.

National Sexual Assault, Domestic and Family Violence Counselling Service 1800 737 732

This article was first published in the print edition of The Saturday Paper on Mar 7, 2020 as "Choice recognition".

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Justine Landis-Hanley is a Melbourne-based journalist. Her work has appeared in The New York Times, The Sydney Morning Herald and The Age.