Talk choice, no time to waste

Late-term abortions are sought for many reasons - rarely ones that are trivial, despite what the pro-life lobby says.

A WOMAN was taken to Box Hill Hospital last week after complications while having an abortion at a clinic in Croydon. She suffered organ failure. Whatever the connection between the abortion procedure and the woman's current condition - and there is no evidence that there is one - any incident at a clinic that provides ''late-term'' abortions raises questions in the community.

One is why women have abortions later in pregnancy. It's a question that is rarely answered. Academic experts and activists decline because they don't like the assumption that's usually behind it, which is that we must turn to the foetus, not the woman, to discover the morality of abortion. Victorian women who terminate after 24 weeks and the few providers who help them are silenced by uncertain laws, threats of violence - a security guard was murdered several years ago at a Melbourne clinic - and the relentless shame our society heaps on anyone who has anything to do with abortion.

But I think the time has come to discuss the reasons women's presentation for abortion, or their access to the service, can be delayed; the reasons that the medical profession tends to approve of, and those that it does not.

Advertisement: Story continues below The statistics on women in Victoria having terminations from 24 weeks into pregnancy are incomplete, badly presented and out of date - but they still allow us to estimate the number at slightly fewer than 138 women a year.

Some hospitals won't provide any terminations, some not at later stages. Others restrict access, granting a woman's request only where she or the foetus have a serious medical condition. And I mean serious.

Committees are nearly always convened for such cases, to decide whether the risk to the woman's life or health is certain enough, or the conditions affecting the foetus are catastrophic enough, for the answer to be ''yes''. Women are barred from speaking to these committees, though it is they, their partners and existing children who will wear the consequences of the judgment made. If they pass muster, they'll be offered a safe, lawful abortion. If it's ''no'', they'll be shown the door.

Some women will have an unwanted child, a risky endeavour because unwanted children are at increased risk of mental illness and poor psychosocial development. Others will push on in search of an abortion and perhaps find their way to Croydon.

There they'll meet women seeking abortions for ''psychosocial'' reasons. Indeed, in the official statistics, abortions done to save the life and health of the mother are categorised as psychosocial. This is despite the fact that hospital access restrictions imply, and pro-life advocates argue, that psychosocial reasons are silly and trivial. As pro-life campaigner Margaret Tighe put it when news of the Croydon case broke last week, ''psychosocial reasons are just an excuse''.

But are they? In Victoria, the reasons women seek abortions after 24 weeks include the women not being a woman at all but a girl aged 11 to 15. They include the fact that the pregnancy was the result of rape or incest. Psychosocial indicators take in women who are victims of domestic violence and women with intellectual disabilities or psychiatric conditions such as paranoid schizophrenia and suicidal depression. Heroin and alcohol addiction also fall under the psychosocial heading, as do cases of women from religious migrant families that might, upon learning of the pregnancy, set them alight. Women who had planned to continue the pregnancy until they learnt an existing child or their husband had cancer fell into this category, as do women who have been delayed by medical incompetence (like failures to diagnose pregnancy) or obstructed by ignorant or pro-life doctors who wrongly advise that abortion is illegal or that they are too far gone.

Silly and trivial? I don't think so. Nor, apparently, do the obstetricians who told ABC News that the Croydon clinic ''performs a valuable service to women in need'', though it would have been nicer if they had added their names and faces to the testimonial.

If we want a clinic like the one in Croydon, if we want there to be somewhere for desperate women - including ourselves, our daughters, sisters and friends - to go when everyone else turns them away, then we must stand up and be counted.

Governments must insist all public hospitals provide safe abortion services. Medical professionals who think the work matters must push their institutions to help women whose presentation for an abortion is delayed, rather than judge by committee and send them packing.

And women who have had abortions at later stages must stop skulking in the shadows of shame. They must tell their friends and family their story, and speak to the media so the word gets out, so that everyone understands how later terminations happen and how it happened to them - and what it would have been like if they hadn't had the choice.

Leslie Cannold is a novelist and ethicist, and the president of Pro Choice Victoria.

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