Supporting women’s right to choose

womens-right-to-choose

MCWH is one of forty organisations that has signed on to an open letter to the Premier regarding abortion laws. Immigrant and refugee already face significant barriers to accessing sexual and reproductive health services and MCWH welcomes the government’s commitment to reject any changes to the Abortion Law Reform Act that would reduce women’s access

to appropriate, safe and legal abortion. MCWH also supports the government’s commitment to create safe access zones for women, as it will further ensure that immigrant and refugee receive timely and safe health care.

Read the letter here

Why myths can be dangerous to your health

Alex Danko: Songs of Australia

Alex Danko: Songs of Australia

Every culture has them.  Stories, slogans and words that help to explain the often difficult, complex and challenging aspects of the world we live in.  Our language is peppered with imagined explanations—‘jumping the queue’, ‘she was asking for it’ or ‘too clever for her own good’—that are far removed from the messy realities of seeking asylum, violence against women or gender inequality.  The complex reality of abortion is one issue that has long been subjected to the type of shorthand thinking underpinning cultural myths.

Today (the 28th of September) is the Global Day of Action for Access to Safe and Legal Abortion, and this year’s Call for Action focuses on busting cultural myths. We’ve mentioned before that access to safe and legal abortion in Australia is generally thought about as a ‘third world’ problem, yet feelings of silence, shame, guilt and fear are still very real barriers to accessing abortion services whether you’re an immigrant and refugee woman living in Frankston or a woman living in the Philippines.

In some ways we have good reason to call ourselves the Lucky Country, where abortion is less legally restricted than many other countries around the world (it is, however,still in the Crimes Act in NSW).  Yet, safe access to abortion is far more complex than making it legal.  In Australia, physical access to the premises of an abortion service has been an ongoing issue because of the constant presence of anti-abortion protestors.  In addition to blocking entry and making unwanted comments to women, protestors have been known to hand women anti-abortion information.  Immigrant and refugee women already face many barriers when accessing health services and this type of harassment would further prevent them from accessing safe and timely treatment.

The Victorian Government has recently announced its intention to introduce a safe access Bill to ensure women (and clinic staff) can safely and privately access abortion services without fear of being harassed and intimidated.  The proposed bill could not be more welcome.  It sends a clear message that harassment, intimidation and any other form of violence directed at women will not be tolerated under any circumstance.  People shouldn’t be prevented from expressing their opinion but not at the expense of women’s privacy and security.

The proposed bill also conveys an implicit message that the propagation of myths such as ‘the right to life’ can lead to misinformation. Myths spread when access to evidence-based, comprehensive information is limited.  Today is the day to help bust a few of those mythical balloons.

Further information about abortion can be found on the Women’s Health Victoriawebsite, the Reproductive Choice Australia website and the Marie Stopes website

Abortion stigma: shame on you

Safe and legal access to abortion, like clean drinking water and poverty, is often thought about in ‘third world’ terms. Australia is, after all, the ‘lucky country’, with a not-perfect, but nevertheless top class public health system, right? As we often highlight in our WRAP articles, ensuring access in all of its forms (legal, financial, physical and cultural), is key to improving immigrant and refugee women’s health. Access to choice free from judgement is an equally important factor and can seriously impact on a woman’s health and wellbeing, wherever she happens to live.

The 28th of September is the Global Day of Action for Access to Safe and Legal Abortion, and this year’s Call for Action focuses on addressing abortion stigma. Abortion stigma is one of the main obstacles towards ensuring the availability and accessibility of comprehensive abortion services. Silence, shame, guilt and fear are all very real barriers, not only to accessing safe abortion but to speaking openly about it. And while it’s true that every year, almost all of the 21 million women (approximately) who undergo unsafe abortion are in developing countries (WHO 2011), abortion stigma can be and is experienced by women in the ‘developed’ world.

Although there are clear actions we can take, both in Australia and internationally, to make abortion legal and safe, it will not guarantee that all women have ready access to it. Even in countries such as Australia where abortion is less legally restricted, women can resort to unsafe abortion because of abortion stigma. A case in point: if you’re a non-English speaking immigrant woman on a temporary visa living in a small, rural town with only one health service, it’s doubtful you would have access to culturally appropriate health service or be able to retain medical privacy. (Albury, for example, has about 100,000 residents and one abortion clinic.)

Stigma can manifest itself in many ways. Secrecy, shame or feelings of regret, guilt and fear associated with seeking a termination can impact on a woman’s ability to make an independent and autonomous choice. As Anuradha Kumar and others have highlighted, abortion stigma is in effect ‘compound stigma’ because ‘it builds on other forms of discrimination and structural injustice’. The stigma around abortion is tightly interwoven with other social expectations and stereotypes around gender roles in relation to motherhood, sexuality and family responsibility.

Prevailing social, cultural and religious attitudes within different communities can create and reinforce negative attitudes towards women seeking abortion. These potential pressures are often magnified in rural and regional areas where gossip in one community can mean dishonour for a woman in another. But abortion stigma can also be created and perpetuated through organisations and institutions, as is the case of insurance companies who limit the extent of pregnancy-related cover to international students.

In reality, safe access to abortion is far more complex than making it legal, opening more clinics and making medication available (although obviously this is essential). Without social support, abortion stigma will continue to impact on women’s physical and mental health and well-being long after the decision ‘to abort’ or ‘not to abort’ has been made.

Safe and legal abortion free from stigma and discrimination is a women’s health and human right issue. On Sunday, we call for action for the 26% of world citizens where abortion is prohibited. But we also call for action to develop our thinking on the ways that Australian society, including media representations and government policy, can take the stigma out of the decision-making process for all women who seek an abortion.

Media Release: International seminar highlights invisibility of abortion as a federal election issue

Variation in abortion law among the states is not the only issue at stake for women in Australia.

Today MCWH will host a visit by Dr Anu Kumar, Executive Vice-President of Ipas, a global nongovernment organisation dedicated to ending preventable death and disability from unsafe abortion.

Dr Kumar’s visit marks the beginning of MCWH’s partnership with researchers from the Social Sciences and Health Research Unit, Monash University on a research project investigating the contraceptive and reproductive choices of immigrant and refugee women.

Executive Director of MCWH, Dr Adele Murdolo said that while abortion law continues to be a matter for the states, both state and federal governments need to ensure that abortion is accessible and available to all women.

Twenty six per cent of the world’s population still live in countries where abortion is generally prohibited, so in that regard Australian women are in the fortunate position of living in a country where induced abortion is legally available. However, access to abortion is still restricted to different groups of women in various ways. It is already well-known that immigrant and refugee women have limited to access to sexual and reproductive health for a range of reasons including visa status, economic reasons and lack of access to culturally sensitive programs.

A recent report has found that living in a rural or regional area can also severely restrict your access to abortion because of the lack of services in certain regions. There’s a triple disadvantage then if you’re an immigrant or refugee woman living in one of these regions.

In many respects there are overlaps with the human rights work being done at an international level. In Australia, immigrant and refugee women’s access to abortion is still determined by such things as visa status and other policies, which can indirectly impact on women’s right to free choice.

Women’s rights aren’t just a matter for the law, although legal reforms are crucial – we’d like to see government make the necessary policy changes, and fund appropriate services, to improve women’s access to abortion.

RU486: where to from here?

The government’s decision to list mifepristone and misoprostol (RU486) on the Pharmaceutical Benefits Scheme (PBS) should be seen as victory in the battle for women’s right to choose.  Women now have the option, during the seven weeks’ gestation period, of choosing a safe, less-invasive medical termination. But as with all things that have been long-awaited and hard-fought, we shouldn’t feel complacent. A victory for all women? It should be. So, in the interest of ensuring RU486’s availability lives up to its potential we take a good hard look at the fine print accompanying such a milestone achievement.

Its listing on the PBS means the cost of the drug will drop down from $300 to $36, which is reasonably affordable for most women. But what about the women who are not eligible for Medicare and are therefore not eligible to claim for PBS-listed items? Immigrant women on temporary migrant visas such as international students and temporary 457 workers will continue to pay the full cost for RU486 for the first twelve months after their arrival, unless they are paying for a level of private health insurance which includes pregnancy related health care with no waiting period. So if you don’t have plans to get pregnant immediately (in which case you probably wouldn’t need it) chances are you won’t have the cover needed to make RU486 affordable. In our work advocating for international students’ access to pregnancy-related care, we’ve learned that over 70% of insurance claims in the first twelve months are ‘pregnancy-related’. Whether the claims are related to contraception; termination; or child-birth is anyone’s guess because this data is not publicly available.

Which brings us to another critical factor in RU486 being made available and accessible to all: the need for comprehensive and systematic collection of abortion statistics. If we don’t know the extent of what is happening to whom and why, then it makes it difficult to monitor the safety, quality and equity of access to abortion. Some groups of immigrant and refugee women, for example, are more at risk of adverse sexual and reproductive health outcomes than Australian-born women. A national abortion register would assist in designing and evaluating targeted health promotion programs.

The availability of RU486 spans complex territory and no doubt, it will continue to attract controversy and debate (for starters, how might we regulate conscientious objection?). But now that we’ve come this far our efforts should continue to sit squarely with the health and wellbeing of all women. Addressing barriers to access for women who are marginalised or disadvantaged by ethnicity, visa status, disability and/or socio-economic factors is a good place to start.

We’ve just released a Position Paper about International Students’ Access to Pregnancy-Related Care and why the laws around Overseas Students’ Health Coverage need to be amended.