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.