Developments in the detection of fetal abnormalities have outstripped Australia's patchworked abortion laws, creating barriers to access for women, according to the authors of an editorial published online by the Medical Journal of Australia.
"Medicare-funded diagnosis of fetal abnormality is now routinely offered to all pregnant Australian women - with the implication that a woman may choose to terminate the pregnancy if a serious abnormality is detected", Professor Caroline de Costa, from James Cook University, and Professor Heather Douglas, from the University of Queensland, wrote.
"Abortion laws, however, have not kept pace with these developments."
In 2002, the Australian Capital Territory removed all criminal sanctions for abortion, in 2008 it was decriminalized in Victoria (where a doctor can now terminate a pregnancy with the woman's consent at up to 24 weeks, and after 24 weeks with the agreement of a second doctor); Tasmania followed suit in 2013 (with the timeframe restricted to 16 weeks).
"Fetal abnormality is specifically discussed in the legislation in Western Australia, South Australia, Tasmania and the Northern Territory, and covered by the decriminalisation of abortion in Victoria and the ACT; in practice, however, late abortion is restricted by health regulations in WA, SA and the NT", de Costa and Douglas wrote. "In Queensland and New South Wales, the law does not refer to fetal abnormality at all.
"The result of these differences is continuing and extensive abortion 'tourism' from all Australian states to Victoria and overseas in the face of barriers to access to abortion."
Although mifepristone is being used in accredited hospitals throughout Australia for second trimester abortions, access to the drug is very difficult for rural women, especially in SA and the NT, where abortion can only be performed in designated hospitals. Other barriers to abortion services include verbal and sometimes physical harassment outside clinics; except in Victoria, doctors who have a conscientious objection to performing abortions are not obliged to refer their patients to another doctor; and a lack of national data collection of abortion statistics.
"In 2015, there is an urgent need for legislative uniformity across Australia so that the law is in step with modern medical practice, and so that women, regardless of where they live, have equal access to abortion services", de Costa and Douglas concluded.