International students are being denied pregnancy care, leading to them dropping out of university, having “reluctant abortions”, and or undertaking sex work to pay for antenatal care, advocates say.
Those on student visas are not eligible for Medicare and instead must take out overseas student health cover (OSHC). The terms of that cover – agreed via a deed between the federal government and insurers – exclude any pregnancy care for the first year.
Alison Coelho, a public health and inclusion expert consultant and the co-chair of the International Students Sexual Health Network (ISSHN), said international students can have low sexual health literacy, difficulty accessing contraception, more stigma around unintended pregnancy and a distrust of university health services.
She said if they become pregnant, they might have to choose to go home “in shame”, or to stay in Australia but with insufficient or no antenatal care, including basic screening.
This will get worse when the hours they are allowed to work is capped at 48 a fortnight from July 1, she said.
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“When you cap their hours, what are they [going to] do? It’s going to be dealing in sex work,” she said. “We’re affecting their future, their lives, their careers.”
Coelho said education is one of Australia’s biggest exports, so the country had an obligation to those students. The sector added almost $30bn to the economy last year, according to Universities Australia.
ISSHN and others have spoken out in a Senate inquiry into universal access to reproductive healthcare, which is due to report on Tuesday. They want a better deal for students when the government renegotiates the deed with health insurers in July.
In its submission, ISSHN said the wait for pregnancy-related services led to “access and equity challenges, resulting in university dropouts, reluctant abortions, sex work to pay for unplanned children and severe mental health issues compounded by multiple terminations”.
International students work in low-paid jobs, and their course fees are often far more than what domestic students have to pay. They may also be repaying student loans from their country of origin while being hit by the cost of living crisis as well, it said.
The Multicultural Centre for Women’s Health (MCWH) said if an international student or their partner had an unintended pregnancy they “may be faced with limited reproductive choices and feel coerced into making a decision, whilst experiencing financial and settlement difficulties at the same time”.
MCWH’s executive director, Dr Adele Murdolo, told the inquiry that a lot of young people coming to Australia are alone for the first time, making it their first opportunity to explore their sexuality. “So we did find that there were a lot – or there was a higher rate … of unintended pregnancies,” she told the inquiry.
“[They] weren’t necessarily coming to Australia with a really good knowledge of how pregnancy happens and how you might avoid a pregnancy.
“Even if they did have the information that they needed, they weren’t able to access contraception freely … so there are low rates of contraceptive usage and not a lot of information about reproductive health, and … even if they were able to access an abortion, they’d have to pay for that out of pocket.
“If they do go ahead with the pregnancy … they then are in debt for many thousands of dollars for the birth.”
Murdolo said it “might be a good time” to think about excluding the clause in the OSHC that allowed a 12-month waiting period.
Sexual Health and Family Planning ACT’s chief executive, Tim Bavinton, said international students faced significant barriers to accessing care and were often isolated and alone when they arrived.
“They may be coming from countries of origin where even discussion of these topics is suppressed or highly stigmatised,” he said.
The assistant health minister, Ged Kearney, said she supports the inquiry and looks forward to its findings.
