This week, Mona's Kat Vella shares with readers a recent experience of her own, donating money to a woman in need to cover the cost of an abortion, only to discover that she has been lied to and stolen from. Far from remaining angry, Kat says that this experience opened her eyes to the almost-impossibility of obtaining a safe, legal abortion in rural Australia.
A woman recently came to me in a desperate situation. A young woman she knew needed an urgent abortion as her family were unaware of her pregnancy. She asked for my help. She said she had done this many times before because abortion care was still so taboo and there were no local GPs that provided that care. She said she would take care of everything.
She asked me for money. She needed to cover the expensive procedure, accommodation and the hiring of a car to get to Sydney where she could ensure the young woman would receive care and anonymity.
She needed complete discretion from me, reminding me how sensitive this subject was in our town and how she, and other women helping her, would receive social backlash for enabling it.
I took a few days to gather the large sum together, and then I gave it to her. No more questions asked. A few months later I figured out that it had been an elaborate scam. And that was that. The money I gave was gone, used for no idea what.
After overcoming my initial feelings of shame and betrayal I started to unpack my motivations for wanting to help and why I gave the money to someone I barely knew in the first place. I started to wonder, how true is it that it’s difficult to access abortion care in rural communities? What exactly is the process? Why do I have no idea where to start in terms of finding out?
Firstly, what exactly are we talking about when we say ‘abortion care’?
There are two main categories of procedures available, medical and surgical abortions. Early medical abortion involves the prescription and administration of combined mifepristone and misopristol (called MS 2 Step in Australia) at up to nine weeks gestation and can be available via Telehealth consultation.
A surgical abortion, however, involves day surgery in a clinic and can be performed usually up to 20 weeks, and in some states up to 24 weeks, gestation. In both cases, only a health professional trained in providing abortion specific services is able to prescribe medications or perform the procedures. And those are hard to come by, especially in the country.
I have heard some iteration of this story of the young woman many times since moving to the country. A woman finds out she’s unintentionally pregnant and she begins the race against the clock between her pregnancy and accessing the care she needs in a timely and supportive manner. Not knowing where to go for help, small town six degrees of separation, and distrust of GPs to be discreet or even provide the care, all pile immense pressure on a woman to make decisions when she may not have the support or all the information she needs.
Coming from a big city, I’ve been horrified at just how impossible it is to receive this life-saving care in the country. On top of the overall GP shortage in towns there is an extremely limited availability of doctors trained in abortion care. Talking about abortion still prickles some people’s skin. This inevitably leads to a very real lack of public conversation around the gaping issue of abortion care access which results in a sense of isolation for women seeking it. People don’t know who to talk to, where to go for advice, or how to access the care they need.
So what on earth is really going on to cause all of this?
Researcher and PhD candidate Anna Noonan from Orange, NSW has some incredible insight into what’s going on in country communities when it comes to abortion services. She moved to the country when abortion was in the public conversation around the time NSW was debating decriminalization. This got her wondering about abortion access in her town and was horrified to discover that not only was there no one who provided abortion services, that generally, people had no idea that it was an issue.
'There’s a pretty widespread assumption, in the same way there is a taboo, people just don’t talk about it until they need it or hear about it,' Anna said. 'There is this weird situation where it’s both taboo to talk about and to do, but also people just assume that it exists without considering that it might not.'
This set her on a path of research that has been her passion for the past few years. Over an eight month period in 2021-2022 Anna interviewed 20 women who were unintentionally pregnant about their experiences seeking support and information around abortion services in Central Western and Far West NSW.
Of the 20 women who she spoke to, 10 women received an abortion and 10 didn’t. Of the 10 who didn’t however, 6 sought information and health advice about abortion as a possible option and many struggled to get the answers they were after.
Key themes that emerged from her study centred around there being no clear pathways for women to follow to seek advice, a limited number of local, willing, and trained GPs, small town culture and relationships, and the challenges of distance, travel and money.
Refreshingly however, albeit surprisingly, the women she interviewed did not carry any shame or guilt around seeking abortions, they were empowered and saw it as a normal part of basic healthcare.
'The women we spoke to didn’t talk about stigma at all! They talked about being immensely pissed off and let down by the health system, but not about stigma or shame. The only way they talked about that was anticipating having difficult conversations with GPs in community and finding a GP that was going to be able to help them and not stigmatise them. There was much more anger and frustration than shame.'
One respondent shared their experience of being turned away by their GP and not referred to someone who could help them:
So the GP that I went to – for religious reasons – said that he wasn’t able to – like all he could do was kind of send me for a pregnancy test but that if I did want to terminate the pregnancy that there wasn’t anything he could do about it. He said he wasn’t really sure what I could do about it.
Others expressed their frustration at not being provided with the information they needed. One participant said:
I didn't really get the answers I was looking for, I really, looking back now, I really just wanted to know what my options were, in terms of seeking – having an abortion, or keeping the baby. I did not know how far along you could be to access abortion, I didn't know where you could access it, I just had no idea, and I was too scared to ask the questions.
Anna and I spoke over days where we discussed our shared frustration over the reality for people in country towns seeking this care. With such glaring inequality between access in cities and country towns, I asked Anna, what is being done about it from a government level? She explained the overturning of Roe v. Wade in July 2022 opened up 'prolific and open conversation about abortion rights' in the political sphere in the USA. In contrast however, in Australia there’s been an inertia she can’t quite put her finger on: '... in Australia it’s kind of this tumbleweed situation, both in terms of services, but also in political conversation. There’s story after story in the newspapers about it but then it doesn’t convert into any hardball political conversations.'
The handing down of the 2023 Federal Budget in May this year made this alarmingly clear where there were zero allocations made for abortion care and services, despite Labor’s 2019 election promise to fund public abortion care.
Two weeks later, the report from the Senate Inquiry into Reproductive Healthcare was handed down. An inquiry that delivered 36 powerful recommendations that aimed at rapidly progressing Australia’s lagging system. However, judging by the report’s closing statements by Labor Party Senators Louise Pratt and Marielle Smith, who said that the 'issues discussed in the report remain the responsibility of the states and territories', Anna says she’s concerned federal Labor is attempting to distance itself from the debate.
Among the recommendations presented in the Inquiry there were a number that would have a powerful impact for women in rural communities. Like ensuring all public hospitals in Australia are equipped to provide surgical terminations, allowing registered midwives and nurses to administer MS-2 Step, and that abortion care training be provided for in undergraduate and postgraduate tertiary healthcare education.
Thankfully though there are some shining examples of communities taking on the responsibility of addressing the situation. In April 2023, Wagga Wagga City Council in NSW voted to advocate for improved abortion services available to their community. And in the same month the ACT government became the first jurisdiction in Australia where people can access free abortion up to 16 weeks gestation.
I’ll never know what happened with the money I gave this woman, but I don’t regret my decision to do it. Had the situation been true, I would’ve been contributing to a world where that young woman had people who were willing to go to great lengths to help her. I only wish the reality of accessing abortion in our towns were different.
Want to get informed or get involved?
Here are some links you can visit if you would like some more information about abortion care and how to access services in your state:
Follow Anna Noonan on Twitter to stay up-to-date on this issue
Consider donating money to either of these funds to support the continuation of abortion health care services:
Kat Vella is one of the founders and editors of Mona Magazine. She is an educator, activist and journalist who lives on Wiradjuri Country in Griffith, New South Wales. She is national committee member of Rural Australians for Refugees and is passionate about social justice, feminism and education. Apart from finding her work at Mona Magazine, she has been published in regional mastheads and The Guardian Rural Network.