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The town without abortion

Mar 2, 2020 • 13m 45s

A consortium of powerful religious doctors has made it impossible to choose a surgical abortion in one of Australia’s largest regional towns – even in the public hospital there.

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The town without abortion

173 • Mar 2, 2020

The town without abortion

RUBY:

From Schwartz Media, I’m Ruby Jones, this is 7am.

Religion and a culture of fear have made it impossible to choose a surgical abortion in one of the country’s largest regional towns – even in the public hospital.

Today, Justine Landis-Hanley on how faith and fear can control access to reproductive rights.

Justine, why did you start investigating this story?

JUSTINE:

The whole way that this story came about was because I had a friend of a friend who worked at Wagga Base Hospital and mentioned to their friend casually, Oh, it's so strange. I have women coming into the emergency department here who can't have an abortion.

RUBY:

Justine Landis-Hanley wrote about this for The Saturday Paper.

JUSTINE:

They clearly wanted one, but they weren't able to access one. And that's how I got onto the story.

Archival Tape -- Justine

“So we've just landed in Wagga. We're here for the next three days to meet with as many people in town, particularly medical professionals…”

JUSTINE:

Wagga is a town of 64,000 people in New South Wales. So Wagga is a very religious town, comparatively, to the rest of Australia.

Archival Tape -- Justine

It’s taken months to get to this point of finding people who are willing to meet with us and talk to us, so we thought it was really important to come to the town itself and meet them face to face.

JUSTINE:

Driving through Wagga on a Sunday morning, you can see at St Michael's Church there that it's just packed. The streets are lined with cars. There are groups of people walking in in their Sunday best. And not only is it a religious town, but it's religiously conservative, meaning that a lot of the senior specialists there identify with churches that strongly condemn abortion. And because the law doesn't require doctors to provide abortions if they morally disagree with it. They don't have to.

RUBY:

So Wagga Wagga is a religious, conservative place. But how is it possible that there can just be no access to these health services?

JUSTINE:

So I spoke to Dr. Jane Goddard...

Archival Tape -- Jane Goddard

“I’m Dr. Jane Goddard, General Practitioner...living in the area for about 23 years.”

JUSTINE:

She explained to me some of the reasons why doctors are so hesitant to provide abortions in town. And it really comes down to fear from the medical community. There are doctors who recognise that there is a demand in Wagga for local abortion services that are pro-choice. But a lot of doctors are afraid of backlash from Wagga's very conservative religious community.

Archival Tape -- Jane Goddard

“Really, it's just the attitudes of the medical fraternity. I think that work against us and it does need to change.”

JUSTINE:

Firstly, doctors may be afraid that providing medical abortions could damage their future prospects of working at any of Wagga’s hospitals that currently don't provide abortion for moral and religious reasons, and could potentially bar them from working at clinics that are run by very conservative doctors who morally oppose abortion.

Archival Tape -- Jane Goddard

“There is a fear of retribution because there are some very strong medical powers that can people don't quite know if they stir the pot, what will happen”

JUSTINE:

Junior doctors in particular are concerned about the professional ramifications this could have on their career. They really rely on references from senior specialists in town to help them get jobs in the future.

Archival Tape -- Jane Goddard

“I think we need to move with the rest of Australia and understand that terminations are part of general quality women's health care.”

RUBY:

So is there any way to get access to an abortion if you’re a woman living in Wagga Wagga right now?

JUSTINE:

I spoke to several doctors and health professionals in the area, some of whom provide a medical termination. So that means that they prescribe a pill called the MS-2 Step. It's two pills that a woman can take if she is within nine weeks of the pregnancy.

And they were the only two doctors that I could find after months of looking into the matter who were, one willing to talk to me and two provided medical terminations to women for abortions by choice as opposed to abortions that are a matter of life and death.

It is likely that there are one or two other doctors who are willing to provide, and accredited to provide medical abortions. But the problem is that none of these doctors are willing to publicly advertise the fact that they do so. So if it's hard for me to find these doctors, then you can imagine it would be really difficult for a woman in town to find out within that nine week gestation period where they can go to have a medical abortion, if not through word of mouth.

Dr. Jane Goddard said that when she first came to town, she asked one of the gynaecologists why the town doesn't have any local abortion services. And he told her that when he first moved there, he was providing surgical terminations to any woman who needed them. But shortly after he started receiving hate mail in his letterbox and as the father of young children, he thought that the risk that providing these services could impose on his family outweighed his ability to provide them.

Archival Tape -- Jane Goddard

It is rather extraordinary that Wagga seems to be little conclave where this isn't available and we do have a high teenage pregnancy rate, we do have a lot of social issues, and we can't hide behind religious biases and things.

RUBY:

We’ll be back in a moment.

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RUBY:

Justine, we’re talking about the fact that abortion is essentially not an option in Wagga Wagga. There are three major medical centres in the town - how is it that none of them offer this service?

JUSTINE:

So there are two big hospitals in town and a private day surgery. The public hospital has a gynaecology and obstetrics department, but this department does not provide abortions for women as a matter of choice. The Catholic hospital has it in its charter that they do not agree morally with terminations and so they won't provide this unless it's a matter of life or death. They also told the Saturday paper that usually if a patient who comes to them wants to have an abortion, they will usually refer them on to someone who will provide it or refer them back to their GP. And I just want to emphasise the word “usually”.

RUBY:

Okay, so that’s the two hospitals - what about the day surgery?

JUSTINE:

The day surgery is interesting. It provides a number of procedures that are religiously controversial, like IVF, vasectomies and tubal ligations. But interestingly, they don't provide abortion. And when I asked them why, they said it's because no doctor has approached them willing to provide this service, and so they have to wait until someone will to do so.

RUBY:

What happens if you're a pregnant woman there who needs an abortion?

JUSTINE:

There are two kinds of abortions that you can have under the law. You can have a medical abortion where medication is prescribed by a GP. But if you're past the nine week cut off, then you have to have a surgical abortion. And this has to be done in an operating theatre or some sort of suitable operating space. And there is nowhere in Wagga that will provide a surgical termination.

So women are having to drive to other regional centres like Sydney, Canberra, Melbourne, Queanbeyan, in order to have a surgical termination. They used to be able to drive to Albury Wodonga, but because of the high number of women who were travelling there, the Albury Wodonga Health Network said that they can't have women from out of their catchment area having surgical terminations in their public hospitals anymore. The demand is just too great and they need to service their local communities.

RUBY:

So how many women who are from Wagga are having to travel like this?

JUSTINE:

It's really hard to know because South Australia is the only state that collects and publishes data about women accessing abortion. But we can put it together from a number of providers, both locally and out of town who spoke to us. So if we add all that up on average, we can say roughly 20 women a month in Wagga are trying to access an abortion. And that's only the ones who we know have successfully contacted some of these services. We don't know how many women are perhaps going to a doctor who is saying, no, you can't have that here or for financial reasons is just unable to try and access the service at all.

Surgical terminations are not cheap. They're around $500 just for the procedure alone. But if you're having to travel, the costs start to add up. You've got travel costs. You need to spend a night close to the clinic who provided it in case there are any complications. That's accommodation you may need to pay for childcare. But on top of that, you've also got to find someone, a support person who's willing to travel with you. And for many women, particularly in a town where this is so secretive and so shamed, they may not have someone who they can take with them.

I spoke to one doctor who said that she has women coming to her sometimes at 18 weeks into the pregnancy. And while the surgical termination is still available, then until 22 weeks under the law, they just can't afford it. She's had women come to her who have had to continue with the pregnancy. And it is frustrating and heartbreaking to see someone forced into that situation because there are no local services that are affordable.

RUBY:

And Justine, we're talking about Wagga, but is this a problem that exists across regional Australia?

JUSTINE:

It's likely, very likely that there are many towns, not only in New South Wales, but across Australia, where women are essentially cut off from these legal medical services.

We know that there are huge disparities in medical equality in Australia. But when you add things like religion and moral objection to it, that inequality just grows bigger.

RUBY:

In that case - with the government planning this religious discrimination bill - is the situation likely to change?

JUSTINE:

So any doctor currently has the right to refuse certain procedures on moral or religious grounds. We have only seen draft legislation that basically a religious discrimination bill is not going to make it easier to access reproductive health care. In fact, it's the opposite. It will entrench the right of hospitals and doctors to refuse to provide procedures like abortions. It will also allow pharmacists or GPs to refuse access to reproductive health care, including contraceptives.
So things aren't getting better. They're potentially going to get a lot worse.

RUBY:

Justine, thanks for your reporting on this.

JUSTINE:

No problem at all. Thank you so much.

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RUBY:

Also in the news.... the US government has signed a historic peace deal with the Taliban, designed to bring an end to the two-decades long war in Afghanistan.

Under the terms of the agreement the US and its allies will withdraw troops within 14 months. The Taliban have agreed to prevent extremist groups like Al Qaeda from using Afghanistan as a launching pad for future terror attacks.

There have been more than 100,000 casualties in the war since 2009.

And Australia has announced a travel ban on visitors coming from Iran, following the escalating outbreak of coronavirus in the country. 43 Iranians have died from the virus and a number of Australians have tested positive since returning from Iran.

The total number of coronavirus cases in Australia is now at 26.

I’m Ruby Jones, this is 7am. See you tomorrow.

A consortium of powerful religious doctors has made it impossible to choose a surgical abortion in one of NSW’s largest regional towns – even in the public hospital there. Justine Landis-Hanley on how faith and fear can control access to reproductive rights.

Guest: Freelance journalist Justine Landis-Hanley.

Background reading:

Doctors crippled by religious backlash in The Saturday Paper
The Saturday Paper
The Monthly

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7am is hosted by Ruby Jones. The show is produced by Ruby Schwartz, Atticus Bastow, Elle Marsh and Michelle Macklem. Brian Campeau mixes the show. Our editor is Osman Faruqi. Erik Jensen is our editor-in-chief. Our theme music is by Ned Beckley and Josh Hogan of Envelope Audio.

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auspol health abortion womenshealth regional nsw




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173: The town without abortion