Each week, about 10 women call the Illawarra Women's Health Centre seeking the same medical procedure.
Often, the centre is unable to refer them to the care they need - it costs too much, and only a small number of GPs in the Illawarra provide the service.
The result has lifelong consequences for them, and the child they may give birth to as a result.
Tracey Lumb, manager of the Shoalhaven Women's Health Service, says they help about 100 women a year in the region access abortions, and the number is steadily growing.
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Almost all of those women have to leave the area to access the service, adding to the cost as they negotiate time off work and take transport and accommodation costs into account.
"There are a very limited number of GPs in the area that support abortion - some bulk-bill and some don't," Ms Lumb said.
"We know we're miles from anything.
"Transport is costly, you have to find childcare, it's difficult.
"If you need a surgical abortion you need to go to Canberra or Wollongong, and all of that builds to a very expensive experience.
"Because of the cost women put it off.
"As time goes by the cost increases because of the complexities, and so do the mental health impacts because of the length of time they have been carrying that foetus."
The reason women seek abortions are varied.
Illawarra Women's Health Centre general manager Sally Stevenson said many people would be surprised if they knew who sought the procedure.
"It's a myth that young women view it as an alternative to birth control," Ms Stevenson said.
"That's very unusual.
"Often it's women who already have children, and for whatever reason, whether it be emotional or financial, know their family can't support any more.
"It's a medical procedure that shouldn't require justification.
"Reproductive coercion in domestic violence relationships is also an issue. Forcing women to have children is a way of controlling them."
One Illawarra woman, who cannot be identified for safety reasons, found herself in just that position.
"I was in a domestic abuse relationship, and I didn't want to bring a child into that environment," she said.
"If we had a child, I know I wouldn't have been able to leave. He would still be part of my life."
But when she sought an abortion, she was faced with one obstacle after another.
"I was given four different numbers to call - they were all disconnected or rang out," she said.
"They wanted me to do counselling and get a referral from a doctor. It was really hard, you have to find a specialist counsellor.
"It took about four weeks to get to speak to someone, with the help of a support worker. I was getting depressed."
Finally, at 11 weeks she was able to get the intervention she needed through Wollongong Hospital.
She has since left the relationship she was in, and said it wouldn't have been possible if she and her ex had shared a child.
But it didn't come cheap, and added to the financial strain of leaving the relationship.
NSW Health offer publicly funded terminations, but Illawarra women say it is difficult to access the service through a public hospital.
A NSW Health spokesperson said this was because GPs usually referred to private practices rather than hospitals, but could not say why.
The procedure can cost between about $400 and $1500 at a private clinic, depending on the stage of the pregnancy and complications. This gap is not covered by Medicare, and means women who cannot afford the procedure instead must afford to raise a child.
Research by the Australian Institute of Family Studies in 2018 found each child costs low-paid families about $170 per week or $159,000 over 18 years.
The Illawarra Mercury asked the Illawarra Shoalhaven Local Health District detailed questions about the accessibility of abortions through Wollongong Hospital earlier this week; the health district had not provided a response at the time of publication.
The average cost per standard birth at a NSW public hospital in 2020-21 was $4652, a NSW Health spokesperson confirmed. This is entirely covered by Medicare.
Abortion was decriminalised in NSW in 2019, more than a century after it was included in the state's criminal code. The Abortion Law Reform Act 2019 was first presented to parliament by Independent MP Alex Greenwich.
In addition to taking abortion out of the criminal code it allows terminations up to 22 weeks as well as later abortions if two doctors agree.
Despite the success of the bill, women's health advocates in the Illawarra-Shoalhaven say the procedure is still practically inaccessible for many women, who by default are forced to have children they don't want, or are unable to care for.
This story was first published by the Illawarra Mercury in February.
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