Only three out of 220 public hospitals in New South Wales are routinely providing abortions, leaving some towns more than 160km away from their nearest service, new research by the University of Sydney has found.
The research mapped out where both surgical and medication abortions were available throughout the state, noting whether the locations were private or public.
Are abortions legal in NSW?
Although abortion is legal in all states and territories in Australia, the laws differ from state to state. In NSW, pregnant people can seek an abortion from doctors with informed consent for up to 22 weeks. After that, abortion services must be accessed in a hospital or approved health facility by a practitioner who has consulted with another medical practitioner.
While the World Health Organisation recommends that all public hospitals provide abortion services, it’s not a routine, regular thing to find abortion services at public hospitals. In fact, even finding hospitals and practitioners that provide the service can be incredibly difficult. According to a report by The Guardian, there are only three public hospitals openly providing abortions outside of an emergency: Broken Hill Hospital, John Hunter Hospital in Newcastle and the Royal Women’s Hospital in Sydney.
If these are not viable options for pregnant people across the state, another option is to go to one of 13 private abortion providers. These services reportedly start at $775 with a medicare card.
What is an abortion desert?
The findings revealed that the state is filled with “abortion deserts”. This is a term developed by US researchers to describe when the nearest service is more than 100 miles, or 160km away.
For people who live in an abortion desert, it’s not as simple as booking an appointment. It requires access to transport, a minimum four-hour trip by car, possibly overnight accommodation and additional travel costs beyond the actual abortion.
With so many other factors to think about, it makes accessing an abortion so much harder and disproportionately disadvantages people who don’t live in a major city like Sydney or along the coastline.
“There are a whole lot of service gaps around abortion that people in the general population really don’t know about until they try to access one,” Dr Anna Noonan, a researcher who specialises in rural health, told The Guardian.
“There is research about where abortion services are, and the experiences of the people who access those services. But what we hardly ever hear is what it is like to not have access to the service at all.”
Why is it so hard to find abortion services?
Although it’s most likely that more than three of 220 hospitals perform abortions, the issue is that they don’t publicly list these services in a directory. Or, if they are publicly listed, it’s not entirely clear in which circumstances the abortions would be provided.
The Guardian contacted all 15 local health districts in NSW with public hospitals to enquire about which of them performed surgical abortion, the circumstances in which they’d perform the procedure and what would happen if the service wasn’t available. The publication reported that none of the districts and NSW answered their inquiries.
Without this transparent information, it is incredibly difficult for pregnant people to make informed decisions about their own abortions — especially when so much more planning is involved for those in rural areas to access abortion services.
To make matters more dire, a report by Family Planning Australia revealed that women in regional and rural NSW seek medical abortions at a rate more than double the rate of city women. In 2022, there were 10 medical abortion prescriptions for every 1000 women in remote NSW, compared to the 4.2 medical abortions for every 1000 women in major cities.
According to Dr Madeleine Belfrage from the University of Sydney’s Social Sciences and Humanities Advanced Research Centre, there could be a pretty effective fix.
“Seeing the sheer size and magnitude of abortion deserts across such a vast expanse of NSW shocked our team,” she said per The Guardian.
“Perhaps even more shocking was how much the abortion deserts would shrink if all public hospitals provided this care.”
If all public hospitals in NSW provided free and public abortion services, the abortion deserts would drastically decrease in NSW, making abortions more accessible to those in rural and regional areas.
