There are many myths in relation to how abortion can impact someone’s mental health. One persistent myth is that having an abortion is something that will harm the pregnant person mentally, and cause them trauma.
“Large longitudinal and international studies have found that obtaining a wanted abortion does not increase risk for depression, anxiety, or suicidal thoughts.”
This research was predominantly based on a ground-breaking longitudinal study with abortion seekers, known as ‘The Turnaway Study.’ In short, the findings reflected the reality that for most women, an abortion is not inherently traumatic, nor does it cause ongoing mental health crises. In fact, it reflected that the opposite is true – that the mental health of abortion seekers who were denied an abortion is most negatively affected.
Women and pregnant people often report a variety of mixed feelings after an abortion, including relief as a dominant emotion. However, this does not mean that everyone experiences abortion in the same way, nor does it mean that everyone experiences exactly the same emotions or trajectories post-abortion. Some abortion-seekers report challenging feelings post-abortion in relation to their individual circumstances.
Personal, familial, cultural and social factors will all impact on an individual’s decisions regarding abortion. It may be helpful to explore this with a non-judgmental friend, family member, community member or counsellor. It is extremely important that people can exercise their autonomy and are free from coercion in relation to this decision. The best mental health outcomes are seen in people who receive the support they need, to make a decision in a timely, autonomous manner.
You can find some accredited non-directive pregnancy options counsellors by contacting 1800 My Options or searching online.
The Abortion Project offers some post-abortion peer-support groups in some states of Australia.
The Royal Women’s Hospital and Children By Choice havesome great activities to help you explore your pregnancy options in relation to an unintended, unwanted, or unplanned pregnancy:
Medication abortion can be a convenient option to end an early pregnancy as it allows you to have the abortion in the privacy of your own home. However, the process for accessing the medication (MS2STEP) is not quite as simple as many people believe it to be – there are a few steps to the process.
Steps for a medication abortion
Most doctors will require you to have both a blood test and an ultrasound dating scan before they will prescribe the medication needed for a home abortion. These tests are needed to confirm how many weeks pregnant you are (gestation) and to check for an ectopic pregnancy (this is when the pregnancy is developing outside the uterus).
Where can I go for a medication abortion in Victoria?
If you live in the Melbourne metropolitan area you can attend a private abortion clinic where they can do the blood test, ultrasound and give you the medication all in the one visit.
Alternatively, you could see a GP that prescribes the medication. In Victoria only 10% of GPs provide medication abortion so they can be tricky to find. This is where 1800 My Options comes in. We can help you find your nearest medication abortion provider that best suits your needs.
If you are going through a GP, it will require two separate visits – first visit to request referrals for a blood test and ultrasound dating scan and second visit (after you’ve got your test results back) to receive the prescription for the medication.
Some public hospitals also provide medication abortion, but as with GPs, you would need to have the blood test and ultrasound done beforehand.
How long does this all take?
Having a medication abortion generally takes a lot longer than most people expect. Firstly, you need to take into consideration the time it may take to get appointments with services. Availability for appointments is often more limited in rural areas where there are less health services.
How long it takes, can also depend on the gestation of the pregnancy (how many weeks you are). While blood tests can be done from anytime you return a positive pregnancy test, ultrasounds are not normally done until at least 6 weeks of pregnancy (as they cannot get a clear enough image before 6 weeks).
Once you have the medication, the actual abortion process takes several days as it involves taking two separate lots of medication, taken 36-48 hours apart.
So, with all these factors, a medication abortion can take some time.
For more information about medication abortion and services please call us or talk to us over webchat. We’re here Monday – Friday, 9am-5pm – call1800 696 784, email [email protected] or message us on web chat!
Sex and international travel: What you need to know
When travelling overseas, it is useful to research your destination to take care of your health and potential needs.
Some things to consider include:
Research the laws at the destination you are travelling to:
Is premarital sex legal? Can you access contraception services if you aren’t married?
Are same-sex relationships and sexual acts legal?
Are abortion services legal?
Where and how to access contraception, including emergency contraception
Can you access emergency contraception at pharmacies without a script?
Do you have to be a certain age to buy contraception?
Do most pharmacies stock the type of contraception you use?
Where and how you can access STI checks and treatments
Is your destination a high risk country for certain STIs, like HIV?
Where and how you can access abortions
Can you get an abortion for any reason?
Are abortions performed in clinics or hospitals?
Are there abortion services where you are staying? Would you need to travel to another city or country?
Are medication and surgical options available?
How far along can you access an abortion?
How much healthcare and medications might cost
Could you afford to pay for medicines or a procedure?
Before your trip overseas, it’s a good idea to have the following organised:
An STI check to confirm your STI status before you travel.
Get any relevant vaccines for your destination.
Purchase condoms, dams and lube to take with you.
If you are taking the oral contraceptive pill or medications to manage STIs, ensure you have enough of your medication for the duration of your trip and make sure it is in its original packaging. It’s a good idea to pack some of your medication in your carry-on luggage in the case your check-in luggage is lost or stolen. It may also be handy to carry any prescriptions with you along with a letter from your doctor to confirm what medication you are carrying.
Get travel insurance and make sure it covers you for any sexual and reproductive healthcare, in case you need it.
We wish you safe travels on your next holiday!
Is Emergency Contraception the same as Abortion Pills?
Emergency contraception and medical (medication) abortion are often confused, with many people thinking that emergency contraception is the same as an early medical abortion. But there’s a big difference between the emergency contraception pill and medication abortion pills.
Essentially, emergency contraception pills are used to prevent a pregnancy whilst the medication abortion pills are used to end a pregnancy.
Emergency contraception pills
The emergency contraceptive pill works by stopping or delaying when your ovaries release an egg. It is up to 85% effective. They are most effective if taken within 24 hours after unprotected sex. Emergency contraception pills may not work if you:
take them too late after unprotected sex and have already ovulated
are taking certain medications (check with a doctor, nurse or pharmacist)
vomit within 3 hours of taking them.
In Australia, there are two options available:
Levonorgestrel, which can be taken up to 3 days after unprotected sex.
Ulipristal acetate (sold as EllaOne), which can be taken up to 5 days after unprotected sex.
Ulipristal acetate is more effective than Levonorgestrel, but only Levonorgestrel is safe to take when breast or chest feeding.
Emergency contraception pills are directly available from pharmacists. You do not need a prescription.
Medication abortion pills
Medical (medication) abortion is a safe and legal non-surgical method to end a pregnancy. Before you can have a medication abortion, you will need to have a blood test and ultrasound scan to confirm the pregnancy.
Medication abortion is a two-stage process. The first stage involves taking a tablet (mifepristone) which blocks the hormone that is needed for the pregnancy to continue. This is followed by a second medication (misoprostol) which expels the pregnancy from the body.
The medication abortion pills have a high success rate of working – up to 98% effective in ending an early pregnancy. Medication abortion is only available up until 9 weeks of pregnancy. In Australia, surgical abortion is required after 9 weeks.
Medication abortion pills are available from (some) GPs, private abortion clinics, (some) public hospitals and (some) community health and sexual health clinics. A prescription is required for this medication.
If you’re worried about an unplanned pregnancy, or if you need support finding Emergency Contraception or Medication Abortion services, please call us on 1800 696 784 (weekdays, 9am – 5pm) or search for services online.
Nothing about us, without us.
Writing by guest contributor, Felix Saturn
Sexual and reproductive health services, and adjacent healthcare providers, love to publicly declare their support for us when it is convenient from a marketing perspective. Think IDAHOBIT, TDOV and other hallmark LGBTQIA+ calendar days that promote awareness and imply support – while simultaneously reducing our unique, ongoing needs and struggles to issues worth recognising for only a few days of the year via social media. This is especially true within our local abortion sector, where actual processes and pathways for TGD specific care are virtually non-existent. While this is obviously most harmful to affected consumers, it also sets a depressing precedent for providers seeking to improve their inclusivity practices – without an accurate blueprint for service reform, how can we expect them to impactfully integrate our needs into their service models?
Put simply, we can’t – not without our community’s active involvement and consultation. As it stands, there are no Australian-based, publicly available resources outlining trans-inclusive abortion practices. Similarly, there are no Australian-based, publicly available studies that specifically target our TGD population who utilise or have utilised abortion services. While international resources are useful, local resources and data are crucial in understanding how trans-inclusivity within this space can look, beyond LGBTQIA+ representation aesthetics. Without this baseline, it is up to our community to collaborate with each other, and with committed providers, to map the way forward. Nothing about us, without us!
Trans-inclusivity within a clinical setting can look like trans-101-basics – such as pronouns on intake forms; separate “known as” name and Medicare name options on forms and patient management software; multiple options for gender selection alongside assigned sex at birth on forms; inclusive language on booking/information sites e.g. “women and pregnant people”; pride and trans paraphernalia in-clinic or online e.g. flags on counter or email signatures; and of course targeted LGBTQIA+ social media marketing. While these inclusivity measures serve an important purpose, they can feel performative and contradictory to consumers when they are not paired with further, consistent service reform.
Service reform and implementations we can strive for include:
Internal procedures review – What trans-inclusivity measures are we currently implementing into our service models? Is there anything further we could be doing that we could start right away?
Access and collate local TGD resources – What services are available locally that could benefit our TGD consumers? Are these resources readily available to our consumers on our website or verbally offered, or would they need to ask?
Warm referrals – Are the care requirements for our client out of our scope? Can they afford our services, can we subsidise them? Could another service be more suitable? Would it be appropriate to connect them directly rather than advising the client to organise this on their terms?
Request stakeholder feedback – Do we have an anonymous feedback/complaints/suggestions system, in-clinic or online? Are we acting on this information when it is received?
Staff/workplace training – Are all staff members adequately trained in LGBTQIA+ inclusivity, right through from reception to doctors? Is this training recurring and up to date?
TGD-specific peer navigation roles – Do we have capacity to hire a TGD peer navigator? How could that benefit consumers?
Hire more TGD employees – Is our intention to commit to trans-inclusivity practices for our consumers reflected in the way our workplace is structured? Would it be a safe workplace for TGD people?
TGD working groups – how are we involving our local TGD community within our work, beyond our consumers? Do we welcome community consultation?
Build relationships between services – do adjacent LGBTQIA+ healthcare providers know that we are improving our services? Could they assist us in this pursuit? Have we reached out to them?
Long term action planning – How do we plan to include trans-inclusivity into our long term diversity goals?
Advocate for local research, justice and structural changes – How can we use our power as an organisation to advocate for this community? What industry connections could we utilise to assist?
As community members, providers and advocates, we are capable of impactful collaboration to move towards these attainable goals. Language and visibility are just the tip of the iceberg – providers need to be more ambitious about their capability to support us.
What Does It Mean to be Pro-Choice?
Pro-choice is a term used widely in debates around abortion care, but what does it actually mean?
Being pro-choice means supporting the notion that people are able to have agency over their lives, bodies, and choices.
Having a child is a significant life event – and it is in everyone’s best interests that a potential parent is emotionally, financially, and physically prepared to do so.
To be forced to have a child is to completely alter someone’s life. Access to education, career progression, and even family support is often limited, if not blocked completely, if someone were to bear a child they do not want to have. When someone is not ready for parenthood, an unplanned pregnancy often results in devastatingly poor outcomes for everyone involved, parents and child included. This is in addition to horrendous circumstances involving rape, incest, family violence, and minors.
However, abortion care is not only for victims of horrific situations. No one should be forced into an unwanted pregnancy, under any circumstances. Abortion care is also for those who aren’t ready for parenthood, whether it is due to study, career, or inter-personal instability, or don’t want to become a parent at all!
It is also not enough to just make abortion legal – abortion care must also be accessible. To be pro-choice does not only mean to be supportive of someone’s choice to get an abortion but also of the systems in place to provide it. In Victoria, the cost of an abortion can vary, from under $100 to the thousands of dollars. There are many reasons for this discrepancy, but the core issue remains that there are many barriers to safe abortion care in Australia – from cost, wait times, geographic distances to doctors refusing to provide abortions.
When we say we’re pro-choice, what we mean is, we support your right to…
have an abortion, and be supported in doing so
have a child, to parent, and be supported in doing so
continue a pregnancy, and access adoption or kinship care arrangements
legal, safe and accessible healthcare
unbiased pregnancy options counselling
medical privacy and confidentiality
accurate, evidence-based information
make choices free from judgement
Safe access to abortion, free from harassment, judgement, and other barriers is a core human right that needs to be protected.
Explainer: The abortion “post-code” lottery
What is the abortion “post-code” lottery, and what can we do about it?
The term “post-code lottery” refers to the fact that where someone lives can often determine the availability and quality of healthcare services they can access. Simply living in the “wrong” city, town, or even street can make a difference in what healthcare services you can access, or whether you can access it publicly or privately.
When it comes to abortion and other sexual and reproductive health services, this post-code lottery can be even more obvious. In some countries such as the US, the abortion post-code lottery is dramatically visible, as abortion is criminalised in certain states.
In Victoria however, there is still an abortion post-code lottery. This is for a combination of reasons:
Not all public hospitals provide surgical abortion services.
For the hospitals that do, there is often criteria around who they can provide an abortion to – such as a catchment area for nearby suburbs, or priority criteria.
Not all GP clinics, community health services and pharmacies provide medication abortions. Staff need to have done special training in order to prescribe medication abortions. Unfortunately, this could mean that unless your local services have done this training, you may need to travel to access a medication abortion.
In some areas, there may also may be a significant amount of conscientious objectors who refuse to provide abortion services. For example, one study conducted in rural western Victoria found that nearly 40% of GPs and Practice Nurses working in the region were conscientious objectors who did not provide information on abortion.
There are often limited services available in rural and regional areas.
Most surgical abortion providers outside of Melbourne only perform surgical terminations up until 12 weeks gestation.
Some rural towns may have limited GP, pharmacy or ultrasound services.
Fees at private clinics all vary. This can mean that finding an abortion service within your budget could involve some travel.
People seeking essential healthcare services such as abortion should not need the luck of the post-code lottery on their side. Some ways that we can address the abortion post-code lottery can include:
Providing surgical abortions at all public hospitals
Encouraging GPs and pharmacists to undergo training to provide medication abortions
Keep telehealth appointments for sexual and reproductive healthcare subsidised
While abortions are safe and legal in Victoria, there is clearly still work to be done to ensure that abortion access is equitable for everyone, regardless of where they live.
If you need help finding an abortion service, contact 1800 My Options – weekdays, 9am – 5pm, on 1800 696 784.
How does a medication abortion work?
Medication abortions (also called Medical Terminations of Pregnancy – MTOP) are a popular and safe method of abortion.
This week, our guest contributor Dr Madeleine explains how exactly a medication abortion works, and addresses some common questions people have about them.
There are two main methods available in Australia to induce an abortion (also known as a termination of pregnancy (TOP)). These can be surgical (STOP) or medical (MTOP). Your medical professional may recommend one over the other, due to factors including your gestation, your previous medical history, and your own desires for your healthcare experience. If you are considering a medical termination of pregnancy, and would like to learn more about how it works and what to expect, read on below.
MTOP is usually performed as a two-step process, either at home with the MS2Step medications prescribed by an accredited medical professional (available up to 9 weeks’ gestation)1, or as an inpatient in a hospital. Prior to being prescribed the medications required for an MTOP, you will need to have an ultrasound to confirm the pregnancy is inside the uterus, and a blood test to measure your pregnancy hormone and to determine your blood group2.
The first step of the termination itself is a medication named mifepristone, which acts to block the action of the hormone progesterone. Progesterone is important in maintaining the lining of the uterus in pregnancy, so mifepristone acts to stop the pregnancy from progressing. It also starts to soften the cervix to help allow passage of the products of the pregnancy through at the second step3. Some women may have a degree of vaginal bleeding and some nausea and vomiting after taking mifepristone, and a few women (approximately 3 in 100) will have a complete abortion after taking this drug4.
The second step, taken 36-48 hours later, is a medication called misoprostol. This further softens the cervix, as well as induces contractions of the uterus to help expel the products of the pregnancy4. The first dose of misoprostol is usually given orally if undertaking MS2Step at home, or can be inserted vaginally if given as an inpatient in hospital. Women undergoing MTOP can anticipate heavier vaginal bleeding and some painful abdominal cramping after taking the misoprostol step; most people will pass the products of pregnancy within 3-4 hours2. Use pads and simple pain relief as you need. However, if pain is severe and you are worried, or if you find your bleeding is very heavy (for example, you have fully saturated a pad every hour for a couple of hours), you should present to your nearest Emergency Department for assessment. There is also a 24-hour MS2Step hotline you can call for advice.
You should see your GP within a few weeks after the procedure for a follow-up; if you have concerns about ongoing heavy bleeding, smelly vaginal discharge, or fevers and chills, see your GP sooner. Around 95% of women up to 9 weeks’ gestation will have a complete abortion using MTOP3. However, in a small minority of cases (approximately <5%), further intervention may be required due to ongoing heavy bleeding or ongoing pregnancy3.
Overall, a medication abortion when compared to a surgical approach can make abortion “earlier, more accessible, safer, less traumatic, less medicalised and less expensive”5, and fulfils an important demand in Australian healthcare.
Mazza, D., Burton, G., Wilson, S., Boulton, E., Fairweather, J., Black, K. (2020). Medical abortion. Australian Journal of General Practice, 49(6). doi: 10.31128/AJGP-02-20-5223
Berer, M. (2005). Medical abortion: issues of choice and acceptability. Reproductive Health Matters, 13(26). doi: 10.1016/S0968-8080(05)26204-3
Abortion in Victoria – A Historical Overview
Abortion laws have changed drastically since Victoria was founded.
This Women’s History Month, let’s take a look at some of the major milestones in bringing about accessible and safe abortions for Victorians.
The consequences of criminalisation
1865
The state’s initial founding laws include the criminalisation of abortion. In the years to come, many voices will call for law reform to adapt to changing values and technology.
1958
Abortion criminalisation was further solidified in The Crimes Act 1958 (Vic). As stated in the Act, it was a criminal offence to “bring about, attempt to bring about, or to assist a person to bring about, an unlawful termination of pregnancy”.
The criminalistion of abortion meant that people seeking abortions had to pursue unregulated services, often with dangerous outcomes. So-called “backyard abortions” commonly happened in suburban homes in secrecy, and were performed by both compassionate and unscrupulous, qualified and unqualified abortionists. There is also evidence of police corruption in state responses to “backyard abortion” rings at the time. Unsurprisingly, while some women experienced life-threatening medical complications as a result of such procedures, many hesitated to seek help due to the possibility of criminal charges. Read more here.
The road to legalisation
1969 – The ‘Menhennit Ruling’
The late 1960s saw a challenging period of social change relating to gender, class and political inequalities, both at home and internationally. However, even with substantial support from local communities, abortion laws were a controversial topic for politicians.
In a landmark legal case, a doctor – Dr Charles Davidson – was charged with multiple counts of causing miscarriage. However, Justice Clifford Menhennit ruled that abortion was lawful under circumstances where the medical practitioner believed that it was a necessity for the patient and “adequate response to protect an individual’s life, physical or psychological wellbeing.” This was the first legal ruling on abortion in Australia, and the principles put forward by Justice Menhennitt were then utilised across the country to provide safer abortions.
1970s – The rise of surgical abortion practices
Following the Menhennit Ruling, private abortion specialists begin to openly practice from the early 1970s. Dr Bertram Wainer opened the Fertility Control Clinic in East Melbourne in 1972. This was Australia’s first private abortion clinic, with no upfront fees at the time, helping to increase access to professional pregnancy termination and contraception.
2008 – Decriminalisation
Following decades of advocacy, abortion was decriminalised through the Abortion Law Reform Act, 2008. The Abortion Law Reform Act states that “termination of pregnancy by registered medical practitioner at not more than 24 weeks” was now legal and available on demand.
Ensuring safety
2001 – Anti-Abortion Violence
In July 2001, a violent incident at the aforementioned East Melbourne Fertility Control Clinic heightened discussions around the necessity for safe access zones in Victoria. A man entered the clinic carrying weapons and arson items, and held clinic staff hostage. Though staff and clients regained control of the clinic, thwarting the attacker’s plan to kill workers and patients, a 44 year old security guard was fatally shot. You can find out more about this event here.
2016 – Safe Access Zones
Safe Access Zones were legislated in 2016, restricting protests within 150 metres of an abortion provider. These zones help protect patients to access essential healthcare with privacy, safety and dignity, as well as ensuring safety for healthcare workers and local residents.
Ensuring further accessibility
1974 – Medicare coverage
Under the Whitlam government, women who had termination procedures were able to access Medicare benefits for the first time.
2015 – Medical termination
Medical Termination of Pregnancy (MTOP) was listed on the PBS for the first time in 2015. MTOP consists of two medications – mifepristone and misoprostol – sold as “MS-2 Step”. These medications work to induce an abortion up to 9 weeks (63 days) of pregnancy. Medical abortions were reviewed by the Pharmaceutical Benefits Advisory Committee to have “similar clinical efficacy to that of surgical termination, and comparable safety”. Medication abortions have made abortions more accessible to many people, as they are often cheaper than surgical abortions, and can be provided by trained GPs.
2018 – 1800 My Options
The 1800 My Options phoneline and online information service was launched in March 2018, as part of the Victorian State Government’s Women’s Sexual and Reproductive Health Strategy. The strategy focused on reducing barriers for women to access SRH services. 1800 My Options has supported nearly 18000 Victorians to date, answering questions about contraception, pregnancy options, abortion and sexual health, and linking them to appropriate services.
2020 – Telehealth
COVID-19 pandemic restrictions resulted in the increased availability of telehealth within the sexual and reproductive health sector – meaning phone and video consults could be provided to patients. Telehealth has offered more flexibility, convenience and comfort to many, including workers, parents, students, those experiencing family violence and those living in rural and regional areas. GP sexual and reproductive health services and non-directive pregnancy support counselling will now continue until 30 June 2023.
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