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Reproductive Health Matters
An international journal on sexual and reproductive health and rights
Volume 23, 2015 - Issue 46: Sexuality, sexual rights and sexual politics
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Features: National perspectives

Medical abortion in Australia: a short history

Pages 169-176 | Received 31 May 2015, Accepted 30 Oct 2015, Published online: 04 Dec 2015
 

Abstract

Surgical abortion has been provided liberally in Australia since the early 1970s, mainly in privately owned specialist clinics. The introduction of medical abortion, however, was deliberately obstructed and consequently significantly delayed when compared to similar countries. Mifepristone was approved for commercial import only in 2012 and listed as a government subsidised medicine in 2013. Despite optimism from those who seek to improve women’s access to abortion, the increased availability of medical abortion has not yet addressed the disadvantage experienced by poor and non-metropolitan women. After telling the story of medical abortion in Australia, this paper considers the context through which it has become available since 2013. It argues that the integration of medical abortion into primary health care, which would locate abortion provision in new settings and expand women’s access, has been constrained by the stigma attached to abortion, overly cautious institutionalised frameworks, and the lack of public health responsibility for abortion services. The paper draws on documentary sources and oral history interviews conducted in 2013 and 2015.

Résumé

L’avortement chirurgical s’est pratiqué largement en Australie depuis le début des années 70, principalement dans des centres spécialisés privés. L’introduction de l’avortement médicamenteux a néanmoins été délibérément entravée et donc retardée sensiblement par comparaison avec des pays similaires. La mifépristone n’a été agréée pour importation commerciale qu’en 2012 et inscrite dans la liste des médicaments subventionnés par les pouvoirs publics en 2013. En dépit de l’optimisme de ceux qui s’emploient à élargir l’accès des femmes à l’avortement, la disponibilité accrue de l’avortement médicamenteux n’a pas encore corrigé le handicap dont souffrent les femmes pauvres et non métropolitaines. Après avoir relaté l’histoire de l’avortement médicamenteux en Australie, l’article s’intéresse au contexte dans lequel cette pratique est devenue disponible depuis 2013. Il avance que l’intégration de l’avortement médicamenteux dans les soins de santé primaires, qui placerait l’avortement dans de nouveaux environnements et élargirait l’accès des femmes, a été restreinte par la stigmatisation liée à l’avortement, l’excessive prudence des cadres institutionnalisés et le manque de responsabilité de la santé publique pour les services d’avortement. L’article se fonde sur des sources documentaires et des entretiens d’histoire orale menés en 2013 et 2015.

Resumen

En Australia los servicios de aborto quirúrgico son ofrecidos liberalmente desde principios de la década de los setenta, principalmente en clínicas especialistas particulares. Sin embargo, la introducción del aborto con medicamentos fue bloqueada deliberadamente y, por consiguiente, retrasada en gran medida en comparación con países similares. La mifepristona fue aprobada para importación comercial en 2012 y registrada como un medicamento subsidiado por el gobierno en 2013. Pese al optimismo de quienes buscan mejorar el acceso de las mujeres a los servicios de aborto, la mayor disponibilidad de los servicios de aborto con medicamentos aún no aborda la desventaja experimentada por mujeres pobres y no metropolitanas. Después de contar la historia del aborto con medicamentos en Australia, este artículo considera el contexto en el cual ha pasado a estar disponible desde el año 2013. Argumenta que la integración del aborto con medicamentos en el primer nivel de atención, la cual situaría la prestación de servicios de aborto en nuevos ámbitos y ampliaría el acceso de las mujeres, ha sido limitada por el estigma asociado con el aborto, por marcos institucionalizados demasiado precavidos y por la falta de responsabilidad del sector salud pública de los servicios de aborto. El artículo se basa en fuentes documentales y en entrevistas de historia oral realizadas en 2013 y 2015.

Acknowledgements

Funding for the oral history project drawn from here was given by the Faculty of Social and Behavioural Sciences, Flinders University.

Notes

* The Flinders University Social and Behavioural Research Ethics Committee approved the oral history project (no 5958) which produced these interviews, as part of a bigger investigation of the provision of abortion services in Australia from 1990 until the present. Interviewees were selected from the author’s networks based on their professional background and long experience. At the instigation of the author all are anonymous. Nevertheless, given the high public profile of many, their comments may identify them to others in the abortion and/or sexual and reproductive health fields in Australia and this was understood by all the interviewees when they consented to participate in the interview.

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