What is an abortion?
Abortion is a safe and common medical procedure used to intentionally end a pregnancy. Sometimes, abortion is called a termination of pregnancy (TOP).
It is estimated that up to 1 in 3 women* in Australia have at least one abortion in their lifetime. Most of these abortions occur in early pregnancy and over 92% occur in the first 14 weeks of pregnancy.
There a lots of reasons someone might want to end a pregnancy. A pregnancy may be planned, unplanned, or wanted or unwanted. Whatever the circumstances, having an abortion is a difficult but valid choice and is a human right. It is legal to have an abortion at any gestation in the ACT. Gestation means the number of weeks a woman or person with a uterus has been pregnant.
There are different types of abortion: Abortions can involve a surgical procedure, or taking medication that causes the contents of the uterus to be expelled. The type of abortion someone has will depend on factors including their preference, cost, the gestation of their pregnancy and the service or practice they access an abortion from.
Whether or not you’re in need of an abortion, everyone has the right to know about options and be enabled to access safe and effective abortion in the ACT.
Types of abortion
In the ACT, women and people with uteruses can access up to two types of abortion depending on the gestation of their pregnancy : these are medication abortion and surgical abortion.
Medication abortion
Medication abortion is a safe and effective method for pregnancies up to 9 weeks (63 days) gestation. This is a non-surgical method of terminating a pregnancy using two medications (mifepristone and misoprostol) to induce an abortion. Sometimes, it is also referred to as a medical abortion.
Some people prefer medication abortion because it means they can have their abortion in the privacy and comfort of their home. For more information on the medication see NPS Medicinewise.
In the ACT, medication abortion is available at the MSI Australia clinic and through some GPs who have received training in providing medication abortion.
There is no publicly available list of GPs who provide this service in NSW or the ACT so you will need to ask your GP if they do this, or call the unplanned pregnancy counselling service at Sexual health and Family Planning ACT (SHFPACT) on 02 6247 3077. GPs at some community health services, like the Women’s Health Service and Winnunga Nimmityjah Aboriginal Health and Community Services may also provide medication abortion if you are eligible for their services.
MSI Australia provides a medication abortion by telehealth option, where you can have consultations with a doctor over the phone, and the medication mailed to you (call 1300 323 197).
Typically, a medication abortion will involve:
- A consultation with doctor (with a GP, at a clinic or over the phone) to discuss medical history, provide time to ask questions and provide informed consent.
- Ultrasound and blood tests to confirm gestation and intrauterine pregnancy to make sure its safe for you to have a medication abortion. If you go to an abortion clinic, these scans and tests may be done at the clinic.
- If you see a GP for an abortion, you will need to go to a pharmacy to fill your prescription for the medication. It is useful to know that not all pharmacies stock abortion medication, or will have it in stock.
- You may take your first medication in the clinic under the supervision of a doctor, or at home after receiving it in the mail. This medication blocks the hormone progesterone which is maintaining the pregnancy.
- You take the second medication at home roughly 24-48 hours after the first medication. This medication causes the uterus to expel the pregnancy. This process usually takes 4 hours but can take up to a few days. You may have significant cramping and bleeding which is more than your normal period. The bleeding should ease within the first week, but lighter bleeding can continue for up to a month afterwards.
- You will need to take a day off work and have child care at the time the second medication is taken.
- Follow up care with the doctor to check that the abortion is complete and confirm whether additional follow up is required. This is also the opportunity to discuss about effective and appropriate contraception with the doctor.
Medication abortion is low risk and success rates are up to 98%. While still very low, the complication rate is slightly higher than for surgical abortion.
For more information visit the MSI Australia website.
Surgical abortion
Surgical abortion is a safe and effective method available in an approved medical facility. In the ACT, surgical abortion is available up to 14 weeks gestation through Gynaecology Centres Australia, and up to 16 weeks gestation through MSI Australia. Generally, a person will have to travel to a clinic interstate for an abortion after 16 weeks. Canberra Hospital can provide late abortions in specific and restricted cases.
Most surgical abortions are performed using a procedure called “suction (vacuum curettage) aspiration” up to 14 weeks gestation. The procedure itself takes less than ten minutes and is carried out as a day procedure. While surgical abortion can be done under local anaesthetic (which is injected into the cervix) or general anaesthetic, it is most often performed under twilight sedation, where you are effectively asleep during the procedure. Twilight sedation has few health risks and is considered safer than a general anaesthetic.
The process involves:
- Visiting a clinic where there will be free counselling.
- While procedures vary with individual clinics this will usually include admission, consultations with a nurse, an anaesthetist, and the doctor to discuss medical history, the opportunity to ask questions and to provide informed consent
- Confirmation of gestation via ultrasound and/or blood test.
- Preparation for surgery at an appointed time includes fasting beforehand. You will also be told what things you need to bring with you.
- You will then be taken to the theatre where the procedure is performed. The actual surgery itself takes only 10 to 15 minutes to perform and is done by putting a small tube through the cervix and gently removing the pregnancy tissue from the uterus using suction.
- You will then spend some time in recovery and may spend from two hours to half a day at the clinic.
- Most clinics require that you have someone to drive you home because you have had sedation.
- Post-operation you may experience some cramping and bleeding.
- Follow up care with the doctor or your regular doctor.
Surgical abortions after 12 to 14 weeks (or from the beginning of the second trimester) usually require a different procedure, sometimes involving two separate visits to the clinic, one for the cervix to be prepared and one for the procedure itself, altogether called “dilation and evacuation”. Second trimester abortions are more expensive, with cost increasing with the gestation of the pregnancy.
For more information visit the MSI Australia website.
How safe is abortion?
Abortion in Australia is performed by highly trained medical professionals, and in the case of surgical abortions are performed in accredited health facilities. They are one of the safest procedures available.
The complication rate for early surgical abortion is very low at around 1%. This rate rises to around 5% after 15 weeks gestation. The complication rate for medication abortion is between 2% and 5%.
If complications do occur the most common are retained products (where a small bit of pregnancy tissue remains in the uterus after the abortion, usually requiring a second procedure) and infection, which is dealt with using antibiotics. Your doctor will tell you more about the possible risks and complications in your consultation.
How much does an abortion cost?
The cost of an abortion depends on whether you access it from a GP or a clinic, the type of abortion (medication or surgical abortion), the gestation of the pregnancy and whether you have a Medicare Card and a Health Care Card. Prices start to rise at most clinics once the pregnancy reaches 11 weeks gestation, with steep increases from 14 weeks onwards. It is important to remember that abortion is a time sensitive procedure.
If you access medication abortion through a GP, it is important to remember that you will need to pay for appointments, scans and tests, as well as the medication. This can add up to as much as $200 for someone with a Medicare Card. The medication itself will cost $42.50 with a Medicare Card. If you go to a private abortion clinic, these costs may be included in the total price, starting from $590 for a medication abortion for someone with a Medicare Card.
How might you feel following an abortion
The most common feeling women and people with uteruses express following an abortion is relief.
How you feel afterwards will depend on many factors, including your individual circumstances, how you felt about the decision, your individual beliefs and values, if you had good support and someone to talk to, and importantly if the decision was yours. Studies show that the vast majority of people who have abortions (around 98 per cent) feel that they made the right decision.
The very small number of women and people with uteruses who do experience emotional problems tend to be those who were very ambivalent at the time of the abortion or were persuaded or coerced into having abortion by someone else.
Some women and people with uteruses are pressured by partners, family or others to have an abortion. If a person wants to continue the pregnancy, a coerced abortion can result in emotional problems for her afterwards.
If a woman or person with a uterus has had problems with anxiety or depression in the past and has found the decision to have an abortion a very difficult one then she may have more difficulty and need more support during this time. This support may be from family or friends or through professional counselling.
Other useful information
Freedom from harassment
In the ACT there are laws to keep you safe and protect you from being harassed or having your privacy invaded when accessing an abortion from a clinic. These laws create a 50m zone around an abortion clinic where no protest activity can take place.
In NSW (including Queanbeyan), there are different laws but they have a similar impact.
Myths about abortion
As with a lot of issues, there are many myths about abortion. These are often put forward by individuals or groups who are anti-choice and run scare campaigns about abortion, or by people who are simply misinformed. As a result there is a lot of biased and inaccurate information out there, particularly online.
In reality we know that legal, safe abortion has very low complication rate and is a common procedure in Australia that forms part of women and people with uteruses’s reproductive health care.
Research has shown that there is no link between safe, legal abortion and future problems such as infertility, breast cancer, or long-term mental health problems.
In fact, we know from the Turnaway Study undertaken in the US that denying women an abortion can have significant negative economic, health and social impacts on their lives.
Abortion laws in the ACT
Accessing a safe abortion has been legal in the ACT since 2002, as long as it is provided by a registered medical practitioner.
- Abortion in the ACT is governed by the Health Act 1993, which requires that:
- Only a registered medical practitioner may carry out abortion (maximum penalty: 5 years imprisonment)
- As of July 2019 the Health (Improving Abortion Access) Amendment Act 2018 allows women in ACT to access abortion medication from registered general practitioners in Canberra.
- For the safety of people accessing abortion services and the staff working in abortion services, the Health (Patient Privacy) Amendment 2015 put exclusion zones in place 50 meters around clinics that provide abortion services. This means those seeking medical advice and treatment can do so in privacy without harassing, obstructing, threatening, humiliating or intimidating behaviour.
What to do next if you decide to have an abortion?
You can call one of the abortion clinics MSI Australia or Gynaecology Centres Australia directly to make an appointment, you do not need a doctor’s referral for this. You can call MSI Australia for medication abortion or surgical abortion until 16 weeks on 1300 323 617, or Gynaecology Centres Australia for surgical abortion until 14 weeks on 02 9585 9599.
If you would like further information before booking then make an appointment with SHFPACT ’s free unplanned pregnancy counselling service for more information or call 02 6247 3077.
*In this resource, we use the inclusive terms women and people with uteruses, unless referring to specific research where the category women has been used.
