Ministers for women will meet this week to discuss the future of abortion access in Australia.
Australia fortified abortion rights five years ago.
At a bipartisan Women's Health Summit in Sydney in 2018, politicians met with community and sector leaders to co-design a long term vision.
It had been a tumultuous road for national women's health. The National Women's Health Strategy (2010-2020) had been scrapped following a change in government in 2013.
That day in 2018, we sat in the dimly lit function room, mini escargot pastries in hand, watching the women's health landscape change before our eyes.
The then-health minister, Greg Hunt, addressed the elephant in the room. He acknowledged that the previous women's health strategy had been abandoned, and announced a new one.
The Summit marked the initial stages of a liberal framework to progress the health rights of all women, the National Women's Health Strategy (2020-2030).
"Equitable access to pregnancy termination services" was listed as a "key measure of success".
From 2018 until today, abortion law reforms have taken place in Queensland, the ACT, NSW, the Northern Territory, Western Australia and South Australia.
Celebrating the "decriminalisation of abortion" has been misleading.
When abortion moved into health law, layers of regulation ensued. While patients were given the green light, caregivers, nurses and doctors hovered in the amber.
Decriminalisation was a mirage.
We were only removing parts of the code that referred to patients being criminalised. Why?
Politicians are not doctors.
Ideally, medical colleges would regulate abortion so that they can continually update clinical guidelines based on current medical evidence. Instead, state and territory governments overregulate abortion.
Abortion stigma is political.
During parliamentary debates on abortion law, against expert advice, politicians table obscure abortion law amendments. These last minute changes restrict, who, where and why an abortion can be provided.
States and territories have created abortion deserts.
Across Australia, people seeking abortion access work hard to trump the postcode lottery.
For those with a Medicare card that is registered in a lucky postcode, they win.
For specific people, in specific parts of Australia, abortion can be free. Others lose. They face the wrath of abortion deserts.
Abortion deserts have little to no activity funds allocated to sexual and reproductive health their region.
Every region receives federal health dollars. Some regions use those dollars to fund abortion equity. Others don't.
Instead, community-based health services and other non-profit organisations fill the gaps in abortion funding. They include support groups, women's health services, refuges and safe houses.
Women's safety funds are frequently reallocated to women's health.
Abortion has become a matter of safety.
Safety is relevant given the anti-choice hate mail that my colleagues and I receive.
But abortion is healthcare.
I work for the only national abortion provider in Australia. There's good reason why there is only one.
The complexities and inconsistencies of state and territory abortion law means that the health service is costly to provide.
No jurisdiction fully funds abortion access throughout their state or territory.
That results in constant contact with distressed people who can't afford essential healthcare.
Those of us working in abortion clinics sit surrounded by paperwork, deciphering the contradictions and nuances across a patchwork of legislation and regulation.
Each week, people in Australia fly thousands of kilometres to access abortion across jurisdictions. It may be the only option for their gestation, it may work better for their childcare or recovery support needs, or it may simply be more affordable.
These intersectional barriers to abortion are more nuanced for First Nations women, migrant and refugee women, disabled women, LGBTIQ+ people and survivors of violence.
Meanwhile, our federal government has one of the most progressive abortion policies in our region.
The National Women's Health Strategy, founded on that landmark day in 2018, has a vision for universal access to abortion in Australia by 2030.
Abortion rights are solid. Abortion access is not.
We have a national framework for universal abortion access this decade. Now state and territory governments are coming to the table.
It's the ministers for women who are leading the conversation. They will share their next moves towards the 2030 vision.
They have an opportunity discuss why abortion is more accessible in places like Perth, Darwin, Adelaide and Tasmania. These are places where for some, abortion care can be low or no cost.
Abortion is not just an issue of women's rights or safety.
Abortion is healthcare.
National cabinet must prioritise a women's health working group to action universal access to abortion by 2030.
Bipartisan state and territory collaboration can end the postcode lottery.
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