Academic calls for nurses and midwives to help improve abortion care in Australia

07 July 2022

Qualified nurses and midwives could help address the lack of abortion care services around Australia if federal and state laws and processes were refined.

That's according to CQUniversity's Lydia Mainey' an expert in abortion care and gender-based violence' who says the lack of abortion health care in regional Australia could be resolved with a 're-think' of how services were offered.

She said amending the outdated laws could help to minimize the stress' and often trauma' of unplanned pregnancy.

While abortion has been decriminalised in most parts of Australia' access to services has not improved' and in regional Queensland access has declined.

Ms Mainey is urging federal and state authorities to update the laws and processes to allow for greater access to abortion care.

Many regional areas in Queensland' and around Australia' have recently lost private providers' and not all public health services in the regions provide abortion care.

Ms Mainey said it was a problem that had caused psychological and social harm to pregnant people who had already faced complexities such as low socioeconomic status' remote geographic location' domestic violence or being a single parent.

"There is a strong association between domestic violence and sexual assault' unplanned or untimed pregnancy' and abortion in Australia. In fact' research has shown that Australian people who accessed abortions were three times more likely to be affected by gender-based violence.

"Despite abortion being the most commonly performed gynaecological procedure in Australia (one in four women/people will have an abortion in their lifetime) not all public health services provided abortion care'" she explained.

"Consequently' many people are forced to access abortions through the private sector which is costly and often hundreds of kilometres away.

"Alternatively' they have to travel to a metropolitan hospital to access abortion through the public system."

"For some people' particularly those impacted by psycho and social complexities' these barriers are immense.

"People sell their cars or take out loans to access abortion care through the private system; some people are forced to continue with their unplanned or mistimed pregnancy; and some people source clandestine abortions."

Ms Mainey said it wasn't uncommon for people to source abortions through unofficial channels in Australia due mainly to lack of access and stigma.

"One of these unofficial channels is sourcing abortion drugs from off-shore'" she explained.

"Another is through healthcare workers themselves. These channels are more convoluted and involve a health care worker breaking a policy and procedure within the workplace or breaking the law.

"For example' many faith-based organisations will not provide abortions (or many contraception procedures such as vasectomies or tubal ligations). However' some health providers are sneaking people into hospitals under false diagnoses to have abortions."

Ms Mainey said there are too many barriers for people seeking this very "safe and straightforward procedure".

She said Australia needs to develop a national abortion care set of guidelines based on the World Health Organisation's policy and that Federal and State hospital funding should be linked to abortion services.

"In other words' health services should not get their full allocation of funding unless they provide abortion care."

She said a revision of the Therapeutic Goods Administration risk management profile of the abortion drug Mifepristone also needs to happen to enable nurse practitioners to provide medical abortions.

Ms Mainey is also advocating for changes in legislation to allow nurses and midwives to perform surgical abortions and for nurse practitioners and certified midwives to prescribe abortion medications.

"These changes must be supported by sufficient funding as well as comprehensive evidence-based education and training of health professionals."

Lydia Mainey has recently completed her doctoral thesis which explored the experiences of nurses and midwives who provide abortion care for people victimised by gender-based violence.