Queensland will become Australia’s first jurisdiction to introduce a law to allow nurses and midwives to dispense pregnancy termination medication in a move expected to improve access in the state’s “huge abortion deserts”.
In August the Therapeutic Goods Administration scrapped restrictions on the prescription of medical abortion pills, known as MS-2 Step, to be used in the early stages of pregnancy. But it is up to individual jurisdictions to determine the specific healthcare practitioner and the appropriate qualifications for prescribing.
In Queensland – where abortion access has been described as “a postcode lottery” – legislation must be introduced to allow the changes to take place.
A Labor bill introduced on Thursday will allow Queensland nurses and midwives to prescribe, administer or supply MS-2 Step in the early stages of pregnancy. It is expected to pass, given that the Palaszczuk government holds a parliamentary majority.
A prescription for MS-2 Step in Queensland can now only be obtained from a doctor.
Daile Kelleher, the chief executive of Children by Choice, said Queensland contained “huge abortion deserts” where access to pregnancy termination healthcare was severely limited.
Guardian Australia has revealed how a number of publicly funded Catholic hospitals including the Mater in Brisbane are opting out of providing reproductive care.
“There are areas where there’s not a single prescriber or any type of medication and there’s no surgical or hospital options for people,” Kelleher said. “People from regional and remote areas travel on average 200km to access a termination of pregnancy and we just don’t think that’s suitable.”
Kelleher said she was excited about the new laws which would reduce barriers for those accessing healthcare.
“We know that people being able to manage a termination of pregnancy, in their own homes with their own communities and their own support networks, and not having to go into hospitals or clinics, is really important,” she said.
Katrice Bulgarelli, the senior counsellor at Children By Choice, said she had spoken to one Queensland woman who had to drive two-and-a-half-hours each way to see a prescribing doctor.
“If you have to see the doctor … for appropriate follow-up care that’s a two-and-a-half-hour drive six times,” she said. “It’s a completely unnecessary step for women, in my opinion.
“It just wouldn’t be accessible for someone [who has experienced domestic violence] who might be trying to access care discreetly and safely.”
Bulgarelli said transport costs could make termination services unaffordable, while telehealth services were not always appropriate for those who lacked trust in the medical system.
“It will be such a welcome change for nurses and midwives to be able to support women and pregnant persons with this choice,” she said.
“The Queensland government’s not only made the commitment to the legislation but to also operationalising it and making sure that in practice, it does actually open up more health practitioners to be able to provide this care.
“So … Queensland will be the first state in Australia that will actually allow nurses and midwives to prescribe MS-2 Step.”
MSI Australia’s director of clinical excellence, Catriona Melville, said she was “delighted” to see the laws introduced.
“We support this progressive move, and we believe it will contribute to better health outcomes for Queenslanders and set a positive example for the rest of the country,” she said.
The state’s health minister, Shannon Fentiman, said the law would bolster equitable access to terminations across the state. “Access to safe termination of pregnancy care is a basic human right that remains a significant health issue for Queenslanders,” she said.
“Nurses and midwives have the necessary skills, experience, qualifications and training to be able to undertake this important role and provide greater access to reproductive healthcare, particularly in rural and remote communities.”
Under the proposed changes, doctors will remain the only health practitioners allowed to perform surgical abortions, as well as medical terminations for gestations nine weeks and above.
The amendments will also change references from “woman” to “person” to ensure all pregnant people can access medical terminations – including those who are transgender or gender-diverse.
The new laws come as the government announced on Thursday it would also introduce midwife-to-patient ratios in Queensland’s public hospitals.
The proposed changes would make the minimum ratio one midwife to every six patients or fewer.
It would be the first time nationally that a baby would be counted as separate patient to their parent.
• In Australia, the national family violence counselling service is on 1800 737 732. In the UK, call the national domestic abuse helpline on 0808 2000 247, or visit Women’s Aid. In the US, the domestic violence hotline is 1-800-799-SAFE (7233). Other international helplines may be found via www.befrienders.org.
