The federal government is facing growing calls to provide greater access to contraception, and free medical and surgical abortions at all public hospitals.
A final senate inquiry hearing into universal access to reproductive healthcare has heard there is significant need to develop a national abortion fund in the upcoming federal budget.
The proposed fund would provide people across the country who are living in financial distress with a pathway to sexual and reproductive health care, and bridge gaps in the public health system.
The Greens, who chair the inquiry, as well as a number of industry and health groups, have been vocal about the need for this kind of fund.
While abortion has been fully decriminalised in all jurisdictions, access and cost remain a barrier for many Australians seeking abortions — particularly those in regional, remote and rural areas.
In 2019, the Labor party made an election pledge for taxpayer-funded abortions to be offered in public hospitals.
The federal Greens have accused the now-Labor government of walking away from its previous commitment to provide free abortion access.
Greens Senator Larissa Waters said the federal government should make it a requirement for public hospitals to make abortion available, as part of funding agreements.
"If you got federal money, then you had to provide abortions if you're a hospital — now that makes perfect sense to me and probably to anybody else who goes to a hospital expecting to get medical treatment," Senator Waters said.
"Unfortunately, the federal Labor Party, now that they're in government, have walked away from that commitment."
Prime Minister Anthony Albanese told Melbourne radio 3AW in July last year that he was not re-considering the policy.
He said at the time that while public hospitals are funded by the Commonwealth, it was up to the states to deal with the services offered — a shift away from the party's previous policy.
Senator Waters said reproductive healthcare was continuously neglected and the federal government should intervene.
The ABC sent questions to the Assistant Minister for Health Ged Kearney about whether the government would commit to the policy, but the questions were not answered.
"The Senate inquiry is considering these issues and we look forward to hearing their findings," Ms Kearney said in a statement.
Greater powers for nurses and midwives
The inquiry heard that nurses and midwives were calling for powers and training to prescribe medical abortions and contraception.
The Nursing and Midwifery Board of Australia found there are over 36,000 midwives in Australia, but only 908 endorsed to prescribe scheduled medicines.
Dr Zoe Bradfield is the vice-president of the Australian College of Midwives and said giving midwives increased powers would remove barriers around access.
"It is a missed opportunity and an untapped potential in this scope-fulfilled workforce to be able to provide this expertise around sexual and reproductive health," Dr Bradfield told the inquiry.
The inquiry also heard evidence about accessibility issues around long-acting reversible contraceptives (LARCs), which were labelled effective but costly.
The federal government has previously said these issues were due to long wait times in the public hospital system and labelled it a responsibility of the states.
"People are sick of hearing that it's somebody else's fault — they just want governments to look after them and provide basic services like health care, including reproductive health care," Senator Waters said.
An ABC investigation found many people getting an intra-uterine device (IUDs) inserted were having painful and upsetting experiences, and claimed they had not received enough information about the available pain relief options.
Senator Waters said more research around IUDs was needed to prevent similar experiences in the future.
"We need fulsome training for our medical practitioners so that they're inserting these devices in a way that is minimising pain," she said.
"And fundamentally we need to improve the health literacy of people so that they know that that pain can be minimised with proper insertion."
MSI Australia is the only national, not-for-profit provider of abortion, contraception and vasectomy care.
Head of Policy and Research Bonney Corbin said there should be a Pharmaceutical Benefits Scheme review of contraception for all genders — with a particular focus on under-utilised contraceptive methods.
"It's embarrassing that in Australia we have so few affordable men's contraceptive options," Ms Corbin said.
The inquiry report is set to be handed down in the coming weeks.
