Legal or not, the threats to safe abortion never lessen

If we’re learning anything from the draconian bills that seek to criminalise abortion in the United States at the moment, it’s that safe abortion access is never permanently guaranteed, and that goes for Australia too. The other message is that Christian right-to-lifers have the patience to play a long game when it comes controlling the reproductive rights of women and other pregnant people.

Handmaids
Illustration by Anna and Elena Balbusso from The Handmaid’s Tale reissue

In 2011, US Christian anti-abortion campaigner Janet Porter and her Faith2Action organisation first dreamed up what would be used as a model for the six week abortion ban manipulatively being called the “heartbeat bill”. According to the Faith2Action website, Porter “is the author of the pro-life Heartbeat Bill, which ensures that ‘if a heartbeat is detected the baby is protected.’”

This ban was passed in the US state of Georgia this past week. It wasn’t the first state and a number of others are considering doing the same. There was a time when this bill was considered too extreme to touch, even for dedicated anti-abortion lawmakers. However, according to sexual and reproductive health organisation Planned Parenthood, “in 2019 their (the bills’) numbers have increased at an unprecedented pace”.

It’s also far from the only violent abortion ban threatening the lives of women and other pregnant people across the US.  In the state of Alabama, a separate piece of legislation has passed that makes abortion a crime with jail terms of up to 99 years for those who perform one. It won’t make exceptions for cases of rape and incest.

The language used to describe the six week abortion ban as a “heartbeat bill” is an example of the bread and butter of the anti-choice movement – manipulation as a form of persuasion. Planned Parenthood points out “the biased language in these bills has no basis in medicine or reality”. 

On its website,  it says, “at six weeks of fetal development, there is no “heart” that beats — instead, there is detectable activity within a 4-millimeter wide growth known as a fetal pole.”

Gynaecologist Dr Jennifer Gunter is quoted, “the politicians know exactly what they are doing [as the term ‘heartbeat’] is a way of making a 4mm thickening next to a yolk sac seem like it is almost ready to walk”.

Abortion access under serious threat in the United States means the lives of those who need them are under serious threat, particularly those who are from the country’s most marginalised communities. With the Supreme Court stacked with conservative judges right now including Brett Kavanaugh, reproductive rights activists are mobilising amid fears far-right momentum will overturn the landmark Supreme Court’s 1973 Roe vs Wade decision which affirmed safe and legal abortion as a constitutional right.

In Australia it’s tempting to brush off the developments in the US as shocking and unlikely to happen here but we cannot afford to be that foolish or complacent. Abortion isn’t the kind of issue where once it is legal, we can take our foot off the pedal when it comes to advocacy. Moral policing and stigma mean abortion is under threat everyday, even when the law permits it.

Abortion access across Australia is varied and governed by State and Territory law. Marie Stopes Australia has a list of current Australian abortion law, accurate as of February 2019 which you can check to see how many hoops you’ll have to jump through where you live. Hint: the more isolated you are geographically and the more marginalised, the more hoops and the narrower the space to jump through.

In my home state Victoria, abortion is legal on request up to 24 weeks and after that, legal with the approval of two doctors. You can generally access a medical abortion up to nine weeks which involves taking prescribed medication in doses over two days which induces symptoms similar to a miscarriage. After nine weeks, your option is a surgical abortion which is performed under anaesthetic as day surgery. As the state where the laws facilitate an ease of access many other states don’t have, you’d be forgiven for thinking you don’t have to worry in Victoria; getting an abortion will be easy. However you’d be wrong, especially if you live in regional and rural parts of the state.

Women’s Health Victoria launched the website and non-directive telephone helpline 1800myoptions a year ago. Since then, phone operators have taken over 5000 calls, mostly from people seeking information on abortion. The website has a map of Victoria, where people can click on options for abortion services, long acting reversible contraception (LARC) and the morning after pill. Pins on the map drop to show where services are located.

The vast swathes of Victoria which are left without an abortion service pin on the map is startling although this doesn’t necessarily mean there is no abortion in these areas. Dedicated 1800myoptions staff members are constantly engaging with GPs and community health clinics to encourage them to be publicly listed on the site. If they aren’t comfortable with that, there is an option to be privately listed. However women and pregnant people seeking abortion services would only find out about privately listed providers if they call the hotline, not if they just look at the map. 

The lack of abortion visibility on the 1800myoptions map in some areas and reluctance from providers to be publicly listed is an indicator of the difficulty there can be getting an abortion in regional areas. If you live in the north-west tip of the state in Mildura, you’re a six hour drive or eight hour bus ride from Melbourne with no train service. There is one pharmacy listed on 1800myoptions as a supplier of the medical abortion pill which means there is obviously at least one doctor who will prescribe, although depending on your information access that may be hard to find out who. The regional centre isn’t big, so there’s a chance you may bump into someone you know at the pharmacy. But you might not make it to the pharmacy if you go to your doctor and they conscientiously object to assisting you with abortion medication or a surgical referral. By law, conscientious objectors in Victoria are required to refer a patient on to another doctor who will advise them of abortion options. But we know, this doesn’t always happen.

All of the above is complicated enough. However let’s factor in barriers for those who are Aboriginal and Torres Strait Islander, from cultural and linguistically diverse backgrounds, living with disability, experiencing intimate partner violence; those whose partners are exercising control over their reproductive autonomy and are blocking them from an abortion… the list goes on. For those who experience multiple layers of marginalisation or disadvantage and live regionally, the harshness of the system increases. Add to that levels of anxiety about an unplanned pregnancy, fear of being judged, other children to care for and the safe choices decrease quickly.

With the Federal Election this Saturday, workers in the sexual and reproductive health space have a close eye on the result, after Labor promised in March to deliver Australia’s first National and Reproductive Health Strategy if it wins government. In it, the party outlined measures including consistent provision of surgical abortions in public hospitals, and more support to doctors to provide medical terminations. For those in the sector there are still many questions around what it would look like, and with abortion law determined by state, there will inevitably be exceptions to some of the measures. Overall, Gina Rushton has done a great job breaking down what both big parties are promising for reproductive health in the election here.

The hostility we face in Australia when it comes to abortion access currently may not be as overt as what’s happening in the states; but it is just as harmful. It doesn’t matter what abortion access barriers look like or whether they are written in law, the fact they are there in the first place compromises the health and safety of all who seek them. Criminalising abortion or making legal abortion hard to access doesn’t “save children” and it will never stop them.  All it does is enact violence against women and people exercising a right to healthcare.

Natalie Cavallaro is a sexual and reproductive health promotion worker from regional Victoria. She writes about things that make her angry and curious. You can find her contact details here

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