Seven out of 10 Victorian local government areas have no surgical abortion provider and one in five have no medical abortion provider, a new report shows.
The Realising Access report released on Thursday by the not-for-profit Women’s Health Victoria also found “service deserts” most profoundly affect women in high-disadvantage regional areas. Women in such areas are 300% more likely to seek abortion services later than nine weeks, meaning they require a surgical abortion for which there are even fewer providers.
The WHV report is the first time that data at this scale from abortion and sexual and reproductive health service seekers has been published in Australia. There is no specific Medicare number for abortions, meaning there is no accurate information about the rate of abortions in Australia.
Dr Nisha Khot, the vice-president of the peak body for obstetricians and gynaecologists, said the report was all the more worrying because Victoria was the leader in Australia when it comes to access to sexual and reproductive health services.
“If the leader has these problems, imagine what these other states might be going through,” Khot said.
The report analysed the de-identified data from all calls between 2018 and 2023 to WHV’s phone line 1800 My Options, which offers free and confidential information about contraception and pregnancy options, including abortion, and sexual health. Of those 30,344 calls, 87% were seeking abortion services.
It also analysed the service’s map of 725 registered sexual and reproductive health providers, alongside indicators from the Victorian Women’s Health Atlas and population data from the Australian Bureau of Statistics.
Of the 79 local government areas in Victoria, 53 (67%) did not have any listed surgical abortion providers, 31 (39%) did not have any medical abortion dispensing pharmacies, and 15 (19%) did not have any medical abortion providers (practitioners or hospitals).
Medical abortions are drug-induced terminations which can be administered up to nine weeks gestation, whereas surgical abortions, a day-surgery procedure to remove the pregnancy tissue, can be performed up to 20 weeks gestation, depending on the state’s legislation.
Access to sexual and reproductive services was even worse within Victoria’s 24 regional and rural high disadvantage LGAs, where almost half (45%) did not have any medical abortion providers, more than half (60%) did not have any medical abortion dispensing pharmacies, and nearly a third (29%) did not have any providers of intrauterine devices (a long-acting contraception).
Khot said the lack of access to medical abortions was especially concerning because it is safer for women, and endorsed the report’s recommendation for no-cost or low-cost contraception.
Compared with abortion seekers living in a metropolitan low disadvantage LGA, those living in high disadvantaged metropolitan areas were 17% more likely to be over nine weeks gestational age, the report found. Those living in low disadvantaged regional areas were 200% more likely, and those living in high disadvantaged regional areas were 300% more likely.
Carolyn Mogharbel, the manager of 1800 My Options, said women living in metropolitan low disadvantage LGAs could often access services in nearby LGAs. But in high disadvantage LGAs, particularly in regional areas, which are clustered next to one another, the situation was “profoundly” difficult.
“It means that if you’re in one of those regional high disadvantage LGAs you can’t just travel, for example, 200km to the next LGA,” she said. “You’ll have to cross several LGAs to be able to access that service.”
Sally Hasler, the chief executive of Women’s Health Victoria, said it was “unacceptable” – but not a coincidence – that the most disadvantaged and marginalised communities with the least access to contraception and abortion were the same which experience an increased demand for abortion over nine weeks.
“The lack of choice that women from under-served communities have starts with their access to contraception and goes all the way through to their right to choose if, when and how to have an abortion.”
The report comes as several states debate abortion, sparked by conservative politicians seeking to re-examine the issue. Abortion is featuring heavily in the Queensland state election and South Australia’s parliament narrowly rejected a motion last week that would have wound back abortion care.
Victoria’s health minister, Mary-Anne Thomas, said the report spoke to the complexities and importance of work under way in Victoria, including expanding access to abortion in public hospitals.
“Although we have fabulous support in Victoria in our government for abortion access and abortion rights, when those kind of discussions are happening in other states and internationally, it increases the stigma and the shame around abortion, and it makes people worried about seeking medical care,” Mogharbel said.
