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Thursday, 11 October 2012
Page: 8089


Senator URQUHART (Tasmania) (19:37): Women should have the right to a legal, accessible and affordable abortion in Australia. Women should have the right and the opportunity to make decisions about their bodies. According to a survey by the Australian National University, over 80 per cent of Australians support a woman's right to a safe and legal abortion.

The campaign recently took a leap forward with the Therapeutic Goods Administration registering the drug mifepristone—better known as RU486—and a second drug, misoprostol, for wider use in Australia. The drugs provide for the medical termination of a pregnancy and are permitted for use up to a maximum of 49 days gestation. This is a landmark decision for reproductive rights in Australia and will give many more Australian women greater control over their lives.

RU486 is available and widely used in the United Kingdom, most of Europe, the United States, China, Israel and much of the Middle East, New Zealand and many other countries. While RU486 was legalised in 2006, it has only been available in Australia under an 'authorised prescriber' process set up by the TGA. This meant that there were only around 187 doctors who were approved by the regulator to import and prescribe the drug to bring about medical terminations. These doctors are predominantly concentrated in urban areas in mainland Australia and, as far as I am aware, none are located in Tasmania. This severely hampered access to the drugs for Tasmanian women, and lessened opportunities for them to make decisions about their own bodies. The recent decision to place it on the Australian Register of Therapeutic Goods will enable Tasmanian women to have the opportunity to consider a medical termination with a support network around them.

The application to the TGA was made by the reproductive health group MS Health, a not-for-profit pharmaceutical subsidiary of Marie Stopes International. I congratulate the Marie Stopes organisation for its leadership on this issue—it is a world-leading not-for-profit sexual and reproductive healthcare provider. Its members work in 42 developing countries to deliver reproductive and maternal healthcare services to reduce maternal deaths and ensure that women and men are able to reduce the impact of poverty by managing their family size.

The drugs will now be able to be prescribed by a doctor who has completed a Marie Stopes training course specific to medical terminations. The training course will cover issues including the appropriate selection, counselling, patient consent, risks and adverse effects, and follow-up requirements. Comprehensive information will be available to women, including: counselling on the likely signs and symptoms she may experience, as well the risks; the need for follow-up within 14 to 21 days after intake to confirm the abortion is complete; that the medical termination may fail; other methods of termination if needed; direct access to 24-hour telephone aftercare provided by registered nurses located in Australia; and further reminder SMS messages with call centre details and warnings about symptoms of concern.

This measured and thorough approach will see more women now being able to sit down with their local doctor and discuss their options. The TGA said its decision to register RU486 had 'followed the TGA process for all new registrations—assessment for efficacy, safety and quality for its intended indications'. Too many people have been forced to travel long distances and to face new doctors at a time of great stress. Now more women will be able to have these conversations and make these important decisions closer to their homes.

We would not be in this position today without the brave stances of four female senators during 2005 and 2006 to cosponsor a bill to lift a ministerial veto on the importation into Australia of the abortion pill RU486. Senator Claire Moore from the Labor Party, Senator Judith Troeth from the Liberal Party, Senator Fiona Nash from the Nationals and Senator Lyn Allison from the Democrats sponsored the successful bill. Successful cross-party sponsorship of legislation is extremely rare. This was an historic event in Australian parliamentary history for both women's rights and parliamentary procedure. I thank all four for their courage in the face of intense lobbying from those opposed to the bill.

There was also tremendous lobbying in support, and I need to make note of Dr Caroline De Costa, who is the Professor of Obstetrics and Gynaecology and Director of the Clinical School at James Cook University School of Medicine in Cairns. Dr De Costa is deeply involved in improving outcomes for Indigenous maternal health and has been a strong advocate for reform of abortion law.

Since 2006, over 20,000 Australian women have used RU486 to medically terminate their pregnancy. These women would not have had this option if it were not for the courage of these four senators, the support provided to them by other parliamentarians and the support of the wider community. The vote in the Senate was 45 for and 28 against, such a significant majority that it was permitted to pass through the House of Representatives 'on the voices'.

While many thousands of women have been able to access RU486 in Australia's major centres, women in rural and regional Australia have not had the same choice between a surgical or medical abortion. For many of them surgical abortion meant being hundreds and sometimes thousands of miles away from their families, but many also had concerns about the risks associated with surgery. Enabling greater access to RU486, thanks to the decision of the Therapeutic Goods Administration, will give women in rural and regional Australia this choice.

I stress that the evidence from across the world shows that providing the option to take RU486 does not increase the number of abortions. The decision to have an abortion is difficult and not to be taken lightly. It is about giving women the choice.

Recently, a young woman from a rural community presented to a doctor in a small country hospital some distance from her home requesting termination of pregnancy. She was the mother of two children aged under three years, both delivered before 32 weeks gestation because of severe pre-eclampsia. Her partner was unsupportive. At presentation she was eight weeks pregnant. The doctor was sympathetic to her request but was unable to arrange surgical termination in the country hospital. He advised her that she would need to travel, by bus and at her own expense, several hundred kilometres to the nearest large town where an abortion could be performed in a private clinic. The cost would be more than $700. This was completely beyond this woman's resources. At 26 weeks of pregnancy she presented again to the country hospital, severely ill with pre-eclampsia. She was transferred by air to the town in which she might have had the pregnancy terminated, where she underwent emergency caesarean section in a public hospital. The infant died within 24 hours, and the woman spent several days in a high-dependency unit. The cost of her transfer and hospitalisation was covered from the public purse. This woman's story could have been very different if Australian women had better access to medical abortion.

Unfortunately, in six of eight jurisdictions, abortion is controlled under the criminal code and federally RU-486 is not covered under the Pharmaceutical Benefits Scheme. It is only in Victoria and the ACT that abortion is not in the criminal code. In Tasmania, under sections 134 and 135 of the code, women and doctors are liable for criminal charges for unlawful abortion. From 1925 to 2001, there was no definition of unlawful abortion and no criteria for lawful abortion. While it had never actually been prosecuted, it had been held that interstate rulings were applicable for Tasmanian law. This was amended in 2001, through the efforts of Labor Attorney-General Judy Jackson, to provide for criteria under which abortion could be carried out and therefore define 'unlawful abortion'.

We must acknowledge that with abortion sitting in the criminal code it represents a risk to practitioners and a risk to the patients that they may be prosecuted if they do not follow the specific criteria. The message is that you are not able to make a decision about your own body purely for health reasons. The message is that you may be a criminal, you may be doing something wrong, just because you do not feel that you can proceed with the pregnancy. Regulations must be in the correct place in the realm of the health experts, not in the realm of criminal lawyers.

At the recent Tasmanian Labor conference, a motion was passed urging the state government to act immediately to remove abortion from the criminal code. I understand that the Tasmanian Labor caucus are looking to bring this legislation to the Tasmanian parliament in coming months. I support them in their efforts because removing abortion from the criminal code should mean that abortion is offered in public hospitals in Tasmania, significantly lowering the costs and increasing the accessibility.

Now that RU486 is registered by the TGA, the next step for the federal government must be to list it on the Pharmaceutical Benefits Scheme. Women have the right to health care and women must have the right to choose.

Senate adjourned at 19:48