AMY* was left close to tears when she found out she was pregnant late last year.
The Bendigo woman, in her 20s, had taken all precautions with her partner to avoid an unplanned pregnancy.
Struggling to find long-term employment and a stable income, the imminent possibility of bringing a child into the world could not have come at a worse time.
Amy decided to have an abortion.
“I wouldn't want a child to be come into the world with its caregiver not being 100 per cent there for them and their needs,” she said.
“When I'm ready emotionally and financially, maybe I will, but I'm just not sure at this point and that's okay for me.”
At 10 weeks, she knew that in order to guarantee going through with the process, she would need to start right away.
But the roadblocks were apparent from the very beginning.
A Bendigo GP refused to refer her to abortion services, citing religious beliefs, despite Amy informing the clinic of the purpose of her visit. She needed to make another appointment and – given she had one day off from work per week – it added more time.
The GP referred Amy for an ultrasound, which she described as the “easiest part of the process”, and returned to the GP.
The doctor referred her to the women’s clinic at Bendigo Health – and gave her a warning.
“He warned me to call right on 9am, or sometimes they won’t answer after that,” Amy said.
“I took the warning to hand and made my first attempt to call at 9am the next morning.
“When the call was answered, they explained that the woman who makes those bookings was unavailable and I would have to call back later.”
Amy called later that day, and got the same response.
The next day, she called at 9am and was told the same thing.
Amy tried three times per day and could not get hold of anyone to book the appointment at Bendigo Health, even with the correct contact information and using the advice from the GP.
“At this point, I already felt guilty about the position I had gotten myself into. I was trying to do my best to move forward and deal with this in the way I wanted to,” she said.
“I was trying to get everything organised as best I could, but I was getting nothing back from them.
“It made me feel upset, and even more out of control of everything going on. I just honestly thought it would of been much easier to do than it actually was.
“I felt embarrassed having to call over and over, and telling them again and again why I was calling.”
After five days, and a total of 15 calls to the clinic, she finally got hold of the woman.
“They then told me my blood test was done incorrectly, and I would have to get them done again,” Amy said.
After weeks of stress and worry, Amy received an appointment.
On the day, she went to the front desk at Bendigo Health at 8am and was pointed in the direction of the women’s clinic.
She sat with three other women for almost six hours in the waiting room, before they were each taken through.
For the struggle she went through to get to that point, the procedure itself was quick and trouble-free.
She went to a six-week check up, and the process was over.
When reflecting on her experience, Amy became aware that she was not the only one going through the process. Others in more vulnerable situations would also face the same delays.
They might not have had the same support from their partner as Amy received.
“I’m sure it would be hard for anyone to make that choice, and it wasn’t made any easier when the services that are meant to be there to help you, are instead brushing you off,” she said.
“If there were any other circumstances, like domestic violence issues, people who are in a difficult relationship, people who are uncertain about what they want to do, then it would make coming to the decision to have an abortion even harder.
“That’s made worse by the lack of response from services that are put in place to support women.”
An abortion clinic opened at Bendigo Health in 2008 – the last major public hospital in Victoria to offer the service.
Bendigo Health director of obstetrics and gynaecology Nicola Yuen said the health service was apologetic for the delays in Amy’s procedure.
“Bendigo Health wishes to apologise for the stress caused to the woman over her booking,” Dr Yuen said.
“All GP referrals for termination services to Bendigo Health are treated as ‘urgent’ with staff available to take bookings every week day.
“At present all women who are referred to the service are contacted by the hospital within days of the referral.
“Information on how to access this service is available on the Women’s Clinic Referral Triaging Guideline.
“Ongoing collaboration between the hospital and the referring GPs will ensure that the availability of the service and the process of referral of a patient is communicated to ensure women receive timely and quality care.”
Amy appreciated the response from the hospital, but remained concerned that others would be put through the same process in the future.
*name has been changed to protect privacy
Rural women face increased barriers to health services
A women’s support advocate says Bendigo is falling behind the rest of Victoria when it comes to access to abortion and contraceptive services for women.
Centre for Non-Violence chief executive Margaret Augerinos has seen women in Bendigo in all levels of distress, some of which can be heightened by a lack of information about what services are available locally.
She said information about services was far more readily available in other regional centres, like Mildura, compared with Bendigo.
“Bendigo is big enough to have an easily accessible information point within the hospital,” Ms Augerinos said.
“I know it has been a big concern for some women who access these services in Bendigo.
“If you’re a young person trying to find out what services exist, and it’s extremely difficult to do so, what message does that send to women?”
Women who are subject to domestic violence or under extreme financial stress would find it even more difficult to access abortion or contraceptive services in Bendigo, she believes.
“I believe it’s a right that women deserve to have,” Ms Augerinos said.
“It is just a health rights issue. This should be available for women.”
In 2012, rural women’s health services completed a large-scale survey of rural women to determine the difficulties in accessing family planning services in country Victoria.
The Victorian Rural Women’s Access to Family Planning Services report found availability, travel, cost, privacy, information and community attitudes as the main issues facing women in rural areas.
The report recommended having contraception services available out-of-hours, establishing clearer referral pathways and making information as available as possible.
Women’s Health Loddon-Mallee executive officer Tricia Currie said an updated report was in the pipeline, in an effort to further add to the picture.
She said it was clear women in rural areas faced a range of difficulties.
“Rural women do not have good access to sexual and reproductive health services compared with those in the cities,” Ms Currie said.
“We know that access is variable, it relies very much on the service providers.
“From our perspective, we’re looking for a strategic plan in the Loddon-Mallee region to form a better view.”
Statistics on the number of medical and surgical terminations in the Bendigo region was almost impossible to establish, given women can access services in Melbourne or use the morning after pill.
Women’s Health Loddon-Mallee has a nurse available to provide information to women about what services are available.
Country women face unique challenges
The Victorian Rural Women’s Access to Family Planning Services report included survey responses from 225 women in rural Victoria about their access to contraception, abortion and other services.
Loddon-Mallee had the highest response rate of the five regions in the study, which also included Goulburn North East, Gippsland, Barwon South West and Grampians.
The report recommended increasing access to contraceptive services in rural areas, establishing clearer referral pathways and improving available information.
The survey found:
- 72.1 per cent of women believe anonymity is an issue in their area
- 61.9 per cent of these women attributed it to “small town syndrome”
- 33.3 per cent believe better education in the public would address small town syndrome
- 47.5 per cent said privacy impacted their access to condoms
- 62 per cent believe privacy and availability impact their access to emergency contraception
- 23.5 per cent were unaware that abortions are legal in Victoria up to 24 weeks, and require two doctors’ approval after 24 weeks
- 42 per cent were either unsure of, or had no access to, abortion services up to 12 weeks in their area
- 32 per cent required a referral to Melbourne for an abortion between 12 and 24 weeks
- 35.1 per cent said travel impacted their access to surgical abortion
- 48.2 per cent did not know if medication abortion was available in their area
- 23.2 per cent said medication abortion was not available in their area
- 26 per cent said sexual health clinics were the main priority for improvements in their area
- 21.5 per cent said better access to contraception was the main priority