Women are forgoing food and delaying bills to pay for abortions as costs remain in the hundreds of dollars despite the introduction of an abortion drug, a national study reveals.
Researchers led by La Trobe University’s Judith Lumley Centre delved into the experiences of women who had medical or surgical abortions through a private group of clinics and found a third suffered financial difficulties as a result.
The study published on Monday in the Australian and New Zealand Journal of Public Health comes as the federal government reviews rebates payable on surgical abortions and the Victorian government prepares to introduce a new scheme to make abortion more accessible.
When abortion drug mifepristone, known as RU486, was included on the Pharmaceutical Benefits Scheme in 2013, reducing its price to under $15 for healthcare card holders, the hope was more women, particularly the disadvantaged and those in regional areas, could access abortion through their local doctor.
But up to two years later – when the women were surveyed in the six months to April 2015 – only 35 per cent of those eligible had chosen a medical abortion, with one in 10 saying they had not even known about it.
The study also revealed that related tests and medical care associated with the drug, which is distributed in Australia through the Marie Stopes Foundation, still added up to about the same price as a surgical abortion, an average cost of $450 to $500 out of pocket for early terminations. Medical abortion cost more upfront than the surgical option.
Some 2326 women were surveyed after attending one of 14 Dr Marie Clinics located in NSW, Victoria, the ACT, Queensland and Western Australia, where public abortion lists are limited, restricted to exceptional cases or don’t exist.
The Dr Marie clinics are estimated to perform a third of all abortions in Australia, according to the study, co-written by Dr Marie medical director Philip Goldstone, as well as researchers from Monash and Sydney universities.
“These results indicate that the potential for medical abortion services will remain limited unless knowledge, financial and geographical barriers to obtaining early care are adequately addressed,” they wrote.
While a third of the total survey group reported difficulty paying for an abortion, 1500 women answered a question about whether they had to forgo necessities to meet the cost. Thirty-five per cent said they had. Among those, 71 per cent had delayed paying bills and 35 per cent said they had skipped food and groceries.
On top of direct costs of the service, 41 per cent of the women faced significant added expenses for travel, accommodation, childcare and GP referrals.
“We thought that offering medical abortions would make it more accessible and more affordable and what this study shows is that neither of those things are happening to the degree we thought they would,” Professor Angela Taft, from the Judith Lumley Centre said.
A requirement that women must attend two medical appointments, the second to check the pregnancy had terminated, may also be a deterrent, she said, adding there was growing evidence women could test themselves with a pregnancy kit, while the drug could be provided through nurses.
“We have consistently lost beds for surgical abortion in this state [Victoria] because the hospitals have been contracted out to religious organisations who refuse to do vasectomies and abortions,” she said.
“There ought to be public options available for women seeking abortions and allowing nurses to do that safely and in public facilities is going to reduce that financial burden and make it more accessible.”
Dr Susie Allanson from the Fertility Control Clinic, another private clinic in Melbourne, said while access needed to be increased, clinical care should not be compromised.
She said the introduction of a Medicare item number for medical abortion, increasing the rebate on the surgery and steps to ensure more public hospitals were offering the services would help.
A federal Health Department spokeswoman said the rebates payable for surgical abortions, set in 2012, were among those being re-evaluated by the Medicare Benefits Schedule Review Taskforce.
The Victorian government is expected to announce this year a statewide sexual and reproductive health strategy to improve access to contraception and termination services.
A spokeswoman for Health Minister Jill Hennessy said the strategy would
“focus on what action the government can take to increase access to reproductive services in primary and community care settings, as well as in public hospitals.”
Source: The Courier