Protect compassionate abortion care in SA: harmful amendments explainer

Right now MPs are preparing to debate and vote on a series of harmful amendments that would undermine compassionate and accessible abortion care for those who need it. 

These amendments could be brought to a vote as soon as today or Thursday, so please contact your MP now to urge them to oppose all amendments.

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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 harmfulThe 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.