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Experts unveil roadmap to close abortion care equity gap
A GP-chaired coalition has delivered a raft of recommendations to help women facing the highest barriers in accessing abortion care.
‘GPs are the best advocates for their patients and already help patients to navigate the system.’
A coalition of medical experts has called on governments to remove significant cost barriers that prevent women from having affordable access to abortion services.
Led by Monash University, the SPHERE Coalition is a multidisciplinary alliance of expert clinicians, consumers, peak body representatives and other stakeholders advocating for equitable and improved sexual and reproductive health care in Australia.
To tackle access inequity faced by many Australian women, including those living in rural and remote areas, the group has laid out a raft of ‘practical steps’ for governments to urgently address.
The Sphere Coalition has released a roadmap of nine recommendations to reduce out-of-pocket costs and improve equitable access to abortion care. These include:
- a targeted bulk-billing incentive for sexual and reproductive health consultations, available to all abortion providers
- funding no-cost ultrasound services for abortion care
- improving Medicare rebates for surgical abortion
- subsidising abortion medications and consumables
- reforming health insurance arrangements for temporary visa holders.
SPHERE Coalition Chair and Head of General Practice at Monash University Professor Danielle Mazza said despite significant reforms in recent years, too many women are still facing substantial out-of-pocket costs for what is essential healthcare.
‘For patients, these can be unexpected costs, and GPs might not consider necessarily all of these costs involved,’ she told
newsGP.
‘You’re billing in your consultation, but there are also additional costs for the patient, particularly around when an ultrasound is required, and also when you undergo a medical abortion – the MS-2 Step (the medical abortion medication) is on the PBS but you also need to purchase analgesia, and you also need an antiemetic potentially.
‘There are costs in terms of follow up, time off work, childcare, travel if you live in the country and are travelling to a service, and that’s for a medical abortion. Most GPs are doing this with two or three consultations, so it’s the potential out-of-pocket costs for each one of those, and it soon adds up.’
While not all women will be impacted in the same way by these costs, there were some at a clear disadvantage including women who live in rural areas, Professor Mazza explained.
‘It may not be less of an issue for educated, middle-class, metropolitan women but a great number of abortions are done in women under 25 who are not in regular employment, rural women, or those without Medicare, international students, temporary visa holders – the affordability issue is critical,’ she said.
‘And if they need or want a surgical abortion, it’s really hard still to get those in the public system. It’s one of the few kinds of essential healthcare procedures for women that’s almost entirely done in the private sector, where you’ve got all of these out-of-pocket costs.’
Other measures in the roadmap include establishing state and territory based navigation services to help people access appropriate abortion care more easily, and funding intrauterine contraception device insertion at the time of surgical abortion.
The recommendations were developed in response to the
2023 Senate Inquiry into Universal Access to Reproductive Healthcare, building on further discussions at the National Abortion Affordability Roundtable held in Melbourne earlier this year.
Professor Mazza described the recommendations as practical reforms which will particularly benefit those who face the highest barriers.
‘There has not been a political appetite to really address abortion accessibility in a proactive way, and this statement really sets out some very concrete suggestions and recommendations by key stakeholders and experts in the country about how abortion affordability, and therefore access, can be improved,’ she said.
‘It’s not rocket science – they’re all very practical steps, which could easily be addressed, and don’t necessarily need huge legislative change. They just need policy.
‘GPs are the best advocates for their patients and already help patients to navigate the system, and we want them to be aware of this statement and the issues, and hopefully pressure for support of them at a policy level.’
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