A local women's health clinic is fielding three times its usual calls for help with abortions and says many women are being forced to pay up exorbitant private fees and travel to Sydney to undergo the medical procedure.
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The Illawarra Women's Health Centre (IWHC) normally sees about three women a week seeking help with an abortion.
However, it got 10 enquires the week of December 12 and seven by the middle of the week leading up to Christmas - a number its CEO Sally Stevenson says is driven by rising living costs, a lack of availability for GPs and other medical appointments, and a severe lack of services for the medical procedure.
Abortion was decriminalised in NSW in 2019, however Ms Stevenson said this has made little difference to services in the Illawarra and said women needing to terminate a pregnancy still faced major barriers.
These included cost, availability of service providers, geographical access, as well as ongoing judgement and stigma from some medical professionals despite the law change.
"It's almost as though the decriminalisation has made no difference because access remains impossible for some women and extremely difficult for many others," she said.
"There doesn't seem to be any planning of pathways for this to improve.
"And right now, over the holiday period so many people are on holidays or places are closed, and this is a medical procedure that is absolutely time critical.
"And it has life-long consequences, so it's not something that can be delayed, and it not something that's of minor importance, even though the procedure itself is pretty straightforward and should be readily available without judgement or cost."
She said a quality private service GCA Wollongong, which offers abortions at a cost of about $500 or $600 was currently closed for renovations, exacerbating the access problems.
Other women were having to travel to Sydney, and having to just accept the cost of wherever they can get in, as some clinics in Sydney are also booked out or not taking appointments until mid-January.
"The hospital says they offer them, but there are significant barriers to accessing those - and actually we don't know how many they are offering," Ms Stevenson said.
"To get to access to the public hospital service, you have to get into a GP, so you have to be able to afford the gap fee, and you need all that to happen in time.
"Over the holidays there are a lot of GPs away, so that's more difficult right now."
Asked how many public abortions were being performed, the Illawarra Shoalhaven Local Health District did not answer, but said access to abortion was "a whole of sector response shared by the public health system, private providers, primary care and accredited nongovernment organisations".
"In most cases, medical or surgical terminations can be provided in the community or non-admitted settings by an accredited health practitioner up to 22 weeks," a statement said.
"This includes services provided by the Local Health District, with priority given to patients from socially disadvantaged and vulnerable communities with limited access to other options.
"Women with more complex health needs or those requiring a termination beyond 22 weeks are referred to hospital for care. In Illawarra Shoalhaven Local Health District, this occurs in Wollongong and Shoalhaven Hospitals through the obstetric service."
Ms Stevenson said the women who recently sought help from the women's health centre were from a range of locations and backgrounds.
"We see a range of women, and that's what is important - this affects women across the reproductive age from all socioeconomic circumstances and with different life situations," she said.
"We might get young women falling pregnant for the first time and don't want the child, or we get women who have got three kids and are happily married but don't want t fourth one - at least 30 per cent of women seeking abortions in Australia already have children and are older women who don't want any more kids."
"We also have women who have been sexually assaulted or who are experiencing reproductive coercion. Even women from high socioeconomic category may be seeking our support if they are in a domestic and family violence relationship where financial abuse is present, they can't access the money for an abortion."
Ms Stevenson noted there was a "predictable increase in domestic and family violence rates over the holiday season, so we expect this will be a crisis for many more women."
This week, the IWHC made a submission to the federal Senate Standing Committees on Community Affairs, inquiry on universal access to reproductive healthcare.
Ms Stevenson said improving access to abortion would require major changes in the public health system.
"It will take a straight political commitment to provide free access to abortion through the public health system, in the first instance in the hospitals, so women can come in and self refer," she said.
"The most that that just happens, the more it becomes normalised."
The centre's submission also advocates for one or more free clinics that provide medical and surgical abortions, contraception and support and information to be set up in the region, allowing women to bypass the requirement to see a GP for a publicly funded abortion.
It also says strategies are needed to "change structural and cultural barriers in public hospitals where there is a high level of reluctance, refusal and conscientious objection by staff that prevents effective service delivery and compromises duty of care to women requesting abortion".
The submission recommends amending the Pharmaceutical Benefits Scheme to provide free access to long acting contraception, and a greater uptake of training by GPs to be able to provide medical abortions.
"At the moment there are only between five to 10 GPs in the whole Illawarra who perform a medical abortion and this is only a two to three day training - but if we had more people doing that and who could bulk bill, that would be much better," Ms Stevenson said.
"And we would also advocate for nurse practitioners being able to provide medical abortions."
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Kate McIlwain
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
