Fair Agenda

Here’s what you need to know:

We must protect a patient's access to unbiased healthcare and information

The amendment: remove transfer of care or information requirements where a health professional ‘conscientiously objects’ to providing care

Why this amendment is harmful: A patient’s ability to access the care they urgently need shouldn’t be contingent on the personal beliefs of their health practitioner. For many patients, a rejection by a health practitioner without referral or information will be a major obstacle to their care. 

The provision in the current bill ensures patients are provided with info on where they can access care. The proposed amendment would remove the requirement for a doctor who opposes providing abortion care to tell the patient where they can get unbiased advice or assistance.

Imagine being a young girl in a rural area, having your doctor refuse to talk to you about the abortion you need, and not knowing where else you can get the help you need.

We need to ensure a compassionate model for care in the complex and distressing circumstances where a patient needs abortion care later in pregnancy 

The amendment: would limit the legal grounds for accessing abortion care after 22 weeks 6 days to only life-threatening situations, or cases of feotal anomalies incompatible with survival.

Why this amendment is harmful: The patients and families who need abortion care after this point in pregnancy are facing a range of deeply personal, difficult and distressing circumstances, which can vary significantly. They may be a child or person with disability who has been raped or sexually abused and has been too traumatised to seek help immediately, or by a carer or family member who has obstructed their access to care; or be a victim-survivor of domestic abuse whose access to early care has been obstructed by an abuser trying to trap them in the violent relationship.

This would condemn child victims of sexual abuse, incest and rape who are too traumatised to seek and receive care before the deadline to continue a pregnancy; or leave them only able to fund travel interstate to access care.

The very small proportion of patients whose circumstances lead to needing care after this point deserve compassionate responses, not further obstacles to accessing care they need. Doctors and other health professionals - not politicians - are best placed to assess the needs of each patient, day-by-day and case-by-case.

We must support all community members’ ability to access the abortion care they need without vilification or discrimination

The amendment: a ban on sex-selective abortion that punishes doctors who provide abortion sought on sex-selective grounds

Why this amendment is harmful: In practice, any ban that attempts to ban sex-selective abortion would create an expectation that medical professionals interrogate a patient’s reasons for needing abortion care in order to try and rule out sex-selection. Such a requirement would inevitably lead to profiling of patients from migrant communities and communities of colour; complicating care for those who need it.

The SA Law Reform Institute found that ‘There appears little, if any, evidence that abortions purely on the basis of gender are a real issue in Australia’. So rather than addressing discrimination, any attempt to ban sex-selective abortion is more likely to facilitate it.

As Democracy in Colour have written: “Many migrant communities and communities of colour already experience reduced access to healthcare and treatment outcomes, and we fear such an amendment risks amplifying racial profiling and discrimination in our healthcare system”.

We must trust patients to make their own healthcare decisions 

The amendment: introducing a requirement for health practitioners to provide every patient with information on counselling 

Why this amendment is harmful: Everyone must have the right to make decisions about their bodies without interference, including whether to seek counselling. Mandating counselling or making abortion conditional on an offer of counselling assumes that the patient does not have the capacity to make their own decisions about their health care.

There is no registration category for counsellors, nor is there a legal code of ethics and conduct against which the industry is governed. Some pregnancy-counselling services in Australia have previously been accused of misleading patients and promoting information that is incorrect or biased around abortion. This amendment would open the door for referrals to such biased counselling services, which may serve to delay access to abortion care - particularly for young and vulnerable patients who may believe counselling is mandatory in order to access the abortion care they need. 

Research shows that the majority of women who seek an abortion have already considered their decision at length and have discussed it with their friends and family, and, the majority of women who experience an unintended pregnancy do not wish to speak to a counsellor before deciding how to proceed. In fact, research from Women’s Health West, noting the personal experience of counselling in a mandatory setting in Victoria said “we found that compulsory counselling not only reinforced a lack of control, it sparked anger among women that they were assumed to be incapable of making a considered decision".

Fair Agenda supports the availability of independent, and unbiased counselling to those who request it - and such advice, support and counselling (if needed) are routinely provided to patients within the normal health care process. Referral for specialised counselling is offered when it is appropriate. 

We must protect compassionate palliative care for families who need it

The amendment: Would require medical professionals to intervene and try to ‘preserve the life of the baby’ where abortion care is provided after 23 weeks in pregnancy (unless there are serious anomalies or health issues with the pregnancy). 

Why this amendment is harmful: Patients and families can need abortion care later in pregnancy for a range of complex, distressing, and deeply personal reasons. A woman may have been diagnosed with cancer and need to end her pregnancy early in order to access appropriate treatment. 

Often, when a pregnancy needs to be ended early, families want to spend some precious minutes or hours holding their baby before it passes. In those circumstances, the medical team will induce labour, and families have a chance to hold their baby, while pain relief and palliative care are provided.

If this amendment was passed, medical teams would be required to intervene even if the baby had no chance of long term survival; potentially reducing the time a family can spend holding them before they pass. 

It is deeply offensive to the medical teams involved to suggest they aren’t already providing appropriate care in these circumstances.

We must ensure the accessibility of abortion services outside of cities

The Amendment: Would limit provision of surgical abortion care to incorporated hospitals except in emergencies.

Why this amendment must be opposed: Someone who needs to end a pregnancy should be able to access the care they need from an appropriate health practitioner, at any appropriately certified health facility.

Surgical abortion care is routinely provided at private clinics in other states, and such clinics enable patients to access surgical care closer to home. Parliament shouldn't entrench arbitrary limitations on where that care can be provided. 

Right now, surgical abortions in South Australia are provided in hospitals. But this law could lock in a requirement that is superceded by advances in medical techniques. Under health law sets, and constantly updates, this sort of requirement. But abortion law can last more than 50 years - it needs to be future-proofed.

Ensure patients retain decision-making authority on donations to medical research

The Amendment: Would seek to prohibit any contract or sale of fetal tissue after abortion care.

Why this is harmful: As with other situations of tissue and organ donation, a patient or family who has needed to end a pregnancy may take comfort in knowing that a donation of tissue could help others (for example towards medical research). The patient or family should have the right to make that decision in their circumstances. But the current wording of this amendment would likely operate to ban any such arrangement.

We must ensure the Bill is inclusive of everyone who needs abortion care 

The Amendment: limiting language of the Bill from applying to people to applying to women 

Why this amendment should be opposed: Safe, legal and compassionate access to abortion care should be available to everyone that needs it; and everyone should have the dignity to legally make decisions about their own body and healthcare.

Discriminatory healthcare policies that seek to diminish the capacity of any person in South Australia to control their healthcare decisions should be addressed, not embedded, within this reform.

No one should be denied reproductive autonomy or forced to carry a pregnancy against their will. Everyone, including trans, gender diverse and non-binary people, who needs access to abortion care should be included in this important reform.

To all members of the South Australian House of Assembly,

As organisations and services working for the wellbeing of South Australians, we express our concern about the harm being caused by keeping abortion in the criminal law, and register our strong support for the current Termination of Pregnancy Bill 2020.

Each patient knows what makes sense for their health, their body and their future. They should be able to feel safe and in control of their healthcare, and be free to decide whether and when to have a child. 

South Australia’s current abortion laws are no longer fit for purpose. They delay and complicate patient care, increase patient distress, and disproportionately harm members of the community who already face barriers to accessing healthcare. 

A patient who needs to end their pregnancy shouldn’t have to travel hundreds of kilometres from home, or cross state borders, to access the healthcare they need. And healthcare professionals should be able to provide their patients with the best care possible – without fear of criminal charges. 

We express our strong support for the Termination of Pregnancy Bill 2020 in its current form. The Bill promotes the autonomy, dignity and wellbeing of patients who need to end a pregnancy - by providing a pathway to a more compassionate reproductive healthcare system for South Australians. 

In particular, we note the profoundly personal and complex circumstances in which patients need abortion care later in pregnancy. Given this, we strongly support the approach outlined in the Bill, which enables patients and medical professionals to jointly make decisions about their healthcare needs after 22 weeks and 6 days in pregnancy. We consider the proposed Bill provides an approach that is both medically appropriate and compassionate for the patients facing these distressing circumstances. 

We also support the provisions to ensure a health practitioner’s personal beliefs don’t interfere with their patient’s access to timely abortion care. 

We urge you to support the Bill, and to oppose any amendments. We are aware of proposed amendments that would create barriers to many patients accessing timely, appropriate and compassionate healthcare; particularly in regional and remote areas. Such amendments go against the expert advice of the South Australian Law Reform Institute, and major medical bodies. All South Australians should be able to access the healthcare they need; when they need it; and where they need it.

We call on you to be on the right side of history, and vote yes for the Bill - for safe, legal and compassionate access to abortion care in South Australia. 

Sincerely,

Amnesty International Australia

Australian Education Union (SA Branch)

Australian Lawyers for Human Rights 

Australian Nursing and Midwifery Federation (SA Branch)

Australian Women Against Violence Alliance (AWAVA)

Australian Women’s Health Network

Democracy in Colour

Embolden SA (Coalition of Women’s Domestic Violence Services SA)

EMILY’s List Australia

End Rape on Campus Australia

Fair Agenda

Family Planning Alliance Australia 

Human Rights Law Centre

Marie Stopes Australia 

National Alliance of Abortion and Pregnancy Options Counsellors (NAAPOC)

National Foundation for Australian Women

MS Health

Public Health Association of Australia

Rationalist Society of Australia

RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists)

Rape and Domestic Violence Services Australia

Reproductive Choice Australia

South Australian Council of Social Service

SHINE SA

South Australian Abortion Action Coalition

South Australian Council for Civil Liberties 

SPHERE - NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care

The National Council of Single Mothers & their Children Inc

The Women Lawyers Association of South Australia (Inc)

WESNET (The Women’s Services Network)

Working Women’s Centre SA inc

YWCA

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You can send your MP a personal message of support for abortion reform at: www.voteprochoice.org.au

In this week's budget the Morrison Government failed thousands of women who are trying to escape domestic and family violence, and build safer futures.

The Morrison Government has committed *zero* dollars of new funding in the budget for the specialist services that so many victim-survivors rely on for their safety – and that still aren’t resourced to assist everyone reaching out to them for help.

These are services that have the ability to save and change lives – when they’re resourced. Survivor advocates have even written to members of the Government about the better and safer future that’s possible when these services are available.

But during this time when being safe at home is more important than ever; and when the pandemic and recession are compounding the domestic violence crisis – the Morrison Government has again decided not to properly resource the services that many women rely on to escape abuse and build safer lives.

It’s a decision to leave members of our community in danger.

It will mean many victim-survivors are left without the support they need to manage their safety in moments of great danger – as inadequate resourcing of many specialist domestic and family violence services leads to waiting lists of months for women who need safety support right now.

It will mean many women are unable to access safe at home programs – forced to make the impossible choice between fleeing their unsafe home and hoping they can access homelessness services, or staying trapped with their abuser.

It will mean many victim-survivors urgently needing refuge are left without access to appropriate physical shelter; and access to the specialist support staff they rely on for assistance with immediate safety management after they escape.

It will mean thousands of women needing legal assistance to help them protect their children; deal with financial abuse; or navigate the family law system will be left without the legal advice and support they need from specialist legal assistance services.

It will also mean women on temporary visas who are experiencing violence – who experts say are at most risk right now, as government systems give their abusers even more leverage to keep them trapped – will be left without any of the key changes experts say are needed for their safety.

What’s more, the National Forum for Family Violence Prevention Legal Services – the key specialist and culturally safe services for Aboriginal and Torres Strait Islander victim-survivors of family violence – has no funding certainty for their vital capacity building and coordination work beyond December. It is inconceivable to not be continuing to invest in capacity and expertise in family violence services during this time.

This budget is a decision to leave a heartbreaking number of women without the support they need to escape abuse and build safer futures, and that’s a disgrace.

Add your support to the campaign for full funding of family violence services at: https://www.fairagenda.org/family_violence_services

In response to Hannah Clarke's murder and the COVID-19 pandemic, domestic violence experts Australian Women Against Violence Alliance have advised governments that urgent action is needed in these areas: 

Proper funding of the specialist services women rely on for their safety

The time a woman tries to escape her abuser, or reaches out for help, can be incredibly dangerous. It’s vital she can access the help she needs, when she needs it. 

Even once the latest funding commitments are distributed, services still won’t be resourced to assist everyone who needs it. Experts have expressed particular concern about: 

• There will still be a significant number of women who will not be able to access safe at home programs. This means they’re left to make the impossible choice between fleeing and hoping they can access homelessness services, or staying trapped at home with their abuser. Without safe at home programs which assist survivors with security for the home, protection orders and support; many women and children will remain trapped in abusive situations in perpetuity.  
• Crisis accommodation services will still be beyond their capacity to provide physical shelter to those fleeing unsafe homes; and without the specialist staff who are needed to provide the immediate safety management assistance to those facing such significant safety risks
• Services that intervene with men at risk of using violence to change their behaviour expect a huge surge in demand for behaviour change programs as isolation measures lift, and warn that without additional investment in capacity, the waiting lists for intervention with men at risk of using violence will be unacceptably long, and won’t be available everywhere it’s needed.
• Family Violence Prevention Legal Services - the key specialist and culturally safe service for Aboriginal and Torres Strait Islander victim/survivors of family violence - particularly women and their children - are already unable to meet demand, and bracing for a massive increase in demand as restrictions start to lift. 
• Community legal services warn that they’re still unable to meet existing unmet need; far less the further surge in demand expected as the next wave impacts are felt. These are the kinds of services women affected by domestic violence rely on to help them protect their children, to navigate the family law system, and to deal with financial abuse.

Ensuring the legal system prioritises safety

Even before the COVID19 pandemic, systemic failures in the justice system meant that many women and children facing violence were not getting adequate protection; and dealing with a legal system that sometimes increases risks to their safety.  

Police and courts need to have women’s and children’s safety at the top of their agenda during this time of increased risk. 

Governments need to improve AVO standards to hold perpetrators accountable and interrupt escalating violence. Too often those orders are not enforced, or don’t account for the dynamics and patterns of abuse being used, and so don’t provide the protection that’s needed for a woman or child’s safety. 

While progress has been made with the urgent COVID-19 family law list enabling faster resolution of high risk parenting cases, the family law system  still operates to force children into care arrangements with parents who are violent and abusive. The legislated requirement that the starting point for decisions about parenting arrangements is a presumption of shared parental responsibility must be removed so that courts can more freely consider what is in the best interests of the child in each individual circumstance with a focus on safety first.  

Ensure every woman subject to violence is able to access the support she needs to be safe

Economic insecurity can be an insurmountable barrier to escaping escalating violence, and loss of income due to COVID-19 will increase the barriers faced by many women trying to escape a  violent perpetrator. As costs rise and access to many services becomes more difficult, experts have urged the Government to ensure that people with a disability and those on temporary visas aren’t left behind and in danger.

This crisis is making everything harder for all victim-survivors to access support, and to be safe. Unlike those relying on most other forms of income support, people living with a disability haven’t received an increase in their payment. And those on temporary visas face existing barriers to accessing services, income and basic healthcare due to strict eligibility criteria. The risks they face are likely to be compounded by perpetrators withholding and blocking access to healthcare and finances; and they face increased uncertainty about their migration status if they are to reach out for help. Women in these situations urgently need access to income support available to others - as well as housing, health services, interpreters and legal assistance.

Maintaining access to contraception and abortion care 

The increase in abuse and violence is expected to include sexual violence and reproductive coercion. It’s known that forced pregnancy is often used by abusers in an attempt to tie their partner to them, and make it more difficult for them to escape and re-establish a separate life.

Experts are highlighting the importance of ensuring those who need contraception and abortion care are still able to access it. That means ensuring clinics and delivery avenues for medical abortion care remain operational, and that clients can access care.

Add your support to the campaign: https://www.fairagenda.org/familyviolence_pandemic