Public hospital systems would need to provide abortion services to qualify for federal funding under a wide-ranging new Labor plan, which will also look at improving access to some contraceptives.
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As the Coalition battles perceptions it has a "woman problem," Labor is also pledging to "progress" the decriminalisation of abortion in New South Wales under its national sexual health strategy released on Wednesday.
Opposition spokesperson for women Tanya Plibersek said that if Labor is elected the Commonwealth-state hospital funding agreements "will expect termination services to be provided consistently in public hospitals".
"Women have been turned away from public hospitals for termination services and have not been able to access or afford to go to a private clinic," Ms Plibersek said.
"Choosing to terminate a pregnancy is difficult enough. Forcing a woman to travel long distances or interstate to access surgical services can dramatically increase the emotional and financial burden."
The next Commonwealth-state hospital funding agreement is due to begin in mid-2020 and run until 2025.
About one quarter of Australian women will access an abortion service across their reproductive lives, says family planning organisation Marie Stopes Australia. It also estimates between 0 and 10 per cent of abortion services are provided by public hospitals, depending on the state.
"Provision [of terminations] in hospitals in quite sporadic," Marie Stopes acting chief executive Jamal Hakim said.
Under its National Sexual and Reproductive Health Strategy, Labor says it would review the Medicare rebate associated with medical terminations "to address access and affordability issues". Labor says while the drug RU486 itself can cost as little as $6.40, associated scans, appointments and blood tests put the average out of pocket cost for a medical termination at close to $600.
As part of its plan, Labor would also push for abortions to be decriminalised in NSW. It is the only state in Australia where abortion is a criminal offence, although women can still be charged for "unlawful" abortions in South Australia.
"This causes uncertainty and hampers the provision of essential healthcare," Ms Plibersek said.
A spokesman for NSW Labor leader Michael Daley has previously said he would speak with the important women in his life before voting on the issue in Parliament. Premier Gladys Berejiklian has said she is "open-minded" on decriminalisation.
Labor's plan, which has set aside an initial $9.3 million over five years, will also set up a "reproductive health hub" in Tasmania as part of the state's public hospital system. Access to low-cost terminations has been an ongoing concern in Tasmania, with reports of women paying thousands of dollars to travel to Melbourne for procedures.
The plan also includes a review of the Medicare rebate for long acting reversible contraceptives (LARCs), such as intrauterine devices and contraceptive implants, which have relatively high upfront costs. According to the Royal Australian College of General Practitioners, Australia has very low uptake rates of LARCs, even though they are accepted as a successful way to prevent unintended pregnancies.
Labor also says it would also ask the Therapeutic Goods Administration for advice on whether Australia should follow New Zealand's lead and allow three-year prescriptions for the contraceptive pill. Currently Australian women must visit the doctor each year to renew a prescription for the pill.
Welcoming Labor's strategy, Mr Hakim said it was important to have a national approach for abortion and reproductive services.
"It should not be a postcode lottery."
