Women's health experts have called for school-based contraceptive education, a nationally consistent approach to abortions and an "urgent" royal commission into the impact of detention centres on the health of female refugees in a statement released on Mother's Day.
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The Royal College of Obstetricians and Gynaecologists' Priorities Document has acknowledged women as "the single most important influence on the health of their children and wider family network".
Its examination of six at-risk populations - including migrant and refugee women, rural and remote women, women with disability and Aboriginal and Torres Strait Islander women - has called for urgent action.
Among priorities was:
- Applying a "gender lens" to health strategies and policies;
- A whole-of-community approach to addressing embedded racism, and;
- Strengthening collaborations between healthcare providers.
The report's section on rural and remote women noted a high rate of teen pregnancies among that population, citing 2012 data that showed very remote regions recorded a teen birth rate 7.4 times higher than that of major urban areas.
The experts recommended that all schools mandate contraception as a compulsory part of their curricula. Further, they said, rebates for long-acting reversible contraception should be revisited and barriers to accessing "appropriate" pregnancy termination services should be addressed.
"The federal minister could show leadership at the Council of Australian Governments by raising [the] possibility of aligning termination legislation in each jurisdiction to make it consistent," the document said.
Racism affected the health and access to care of Aboriginal and Torres Strait Islander women and migrant and refugee women, the priorities document said.
Each population suffered worse health outcomes than the broader population. Indigenous women were more likely to have more babies younger, more likely to experience chronic disease younger and at a higher risk of experiencing domestic violence, the document said.
"The experience of racism inhibits access to societal resources, such as education and employment, and has a profound effect on health," it said.
And the health of both migrant and refugee groups actually deteriorated once in Australia, the experts agreed.
The statement noted the impact of "prison-like" immigration detention on the health of asylum seekers: "These risks are particularly high for children and women during pregnancy or in the postpartum period."
The Guardian last year reported that 50 refugees and asylum seekers on Nauru, including at least three women seeking to terminate a pregnancy, had been refused or not considered for overseas medical treatment.
"The psychological and physical damage that detention centres inflict on migrant and refugee women is undeniable and, furthermore, counterproductive for integration effects," the RANZCOG statement said.
"A royal commission should address this urgent issue."
Further, gender inequalities were "particularly evident" for women with disability, the experts said.
Ninety per cent of women with intellectual disabilities had been sexually assaulted and rates of forced sterilisation were "excessive", the document said.
Experts called for recognition of the differing health needs and social circumstances of people with disability, greater access to healthcare and information about healthcare, and better access to funding for women with disability.
The Priorities Document summarised topics of consensus from RANZCOG's March National Women's Health Summit.
RANZCOG president Steve Robson said: "It is RANZCOG’s hope that this document moves the conversation forward to shape future policies with regard to women’s health and, by extension, the health of Australia."