The recent trial of a Queensland couple who obtained an abortion has given new impetus to the debate on access to terminating pregnancies.
But health practitioners say the lack of reliable data is making it extremely difficult to know just how many abortions occur in Australia, or to understand why women are seeking them.
There have been some attempts to collate national data, but they are limited.
A parliamentary research brief from 2005 tried to find how many abortions occur, but ran into the same problems with data collection that persist today.
Medicare figures are unreliable because they include all aborted pregnancies, including miscarriages and foetal deaths.
And the Medicare figures do not include abortions unless they are claimed under the Medicare rebate.
The sexual-healthcare provider Marie Stope International estimates one in five pregnancies in Australia end in abortion.
Caroline de Costa is a professor of obstetrics and gynaecology at James Cook University’s School of Medicine in Cairns.
Professor de Costa says reliable figures would let health practitioners assess abortion in the same way as other medical procedures.
“We can look and see how many are done, where they’re done, what the complications are, and, more importantly, why they’re done, and then, ultimately, what can we do to try to reduce these numbers”, she says.
“It would seem that our numbers are very high compared to many European countries which have liberal abortion services but also have much better contraceptive services and information, and better sex education.”
SA alone in counting data
South Australia is the only state or territory to collect and publish comprehensive data.
Sexual Health and Family Planning Australia chief executive Naomi Knight says the South Australian data is valuable.
But Ms Knight says the information cannot just be extrapolated across Australia.
And she says the lack of reliable figures makes it difficult to develop abortion policy.
“Certainly, when we look at the UK experience, where they were able to determine that the number of abortions occurring every year was incredibly high and not something that the community was happy about, they were able to develop a whole range of policy settings”, she says.
This “meant that contraception is free, and there’s a whole range of programs set up to support women in making decisions that don’t end up in unplanned pregnancies.”
Much of the political debate on abortion law focuses on the number of abortions each year – despite the fact only rough estimates are available in Australia.
But the US sexual-health research organisation The Guttmacher Institute says legal restrictions on abortion do not affect how often they occur.
Laws make little difference
The institute reports, worldwide, a woman’s likelihood of having an abortion is similar whether she lives in a country where abortion is generally permitted or in a country where it is illegal.
Marie Stopes International says that is generally the case in Australia as well.
Marie Stopes Jill Michaelson says the differences in abortion law between states and territories make little difference to access.
“It doesn’t seem to have any effect on what women’s choices are. I think, you know, we have to get this back to what the reasons are for women seeking an abortion and it is their own wishes and their own choices that determine really what the outcome is, rather than what the law is.”
Professor Caroline de Costa says, even when women live in states with more restrictive laws, such as Queensland or NSW, they often travel to regions with more liberal laws, like Victoria, for abortions.
De Costa says women are looking further afield as well.
“I have anecdotal evidence that women are seeking medications from the Internet, buying drugs overseas. It is quite easy to access these drugs on the Internet, or through people buying them over the counter”, she says.
“They’re widely available in South-East Asia, for example, and in other parts of the world. So I’m quite sure it’s possible for women to get the drugs and to be using them at home.”
The lack of consistency among Australia’s states and territories also has implications for the country’s overseas-aid program.
A significant part of the program deals with sexual health and family planning.
Australia’s aid guidelines stipulate women overseas receiving Australian aid should be able to access the same services available to Australian women.
But Naomi Knight says it’s complicated.
“Where we have differences across state and territory jurisdictions, that makes it difficultfor international programmers determining what exactly will be available to women, and that’s an evolving policy area at the moment”, Knight says.
“I think getting some consistency certainly would support and promote better sexual- and reproductive-health outcomes for Australian women as well as those women in our regional neighbourhood.”