Feeling shamed and judged, travelling hundreds of kilometres and ending up significantly out of pocket: these are some of the issues raised by women in their own words with abortion access in Australia.
The stories were gathered by Monash University as part of an ongoing research project into what barriers, or enablers, there are for people seeking abortions.
The team shared some of those in a submission to a current Senate inquiry that's looking more broadly at the state of access to sexual and reproductive healthcare nationally.
Even though many of the services that fall under that umbrella are run by states, the federal inquiry will look at ways the government can make sure the quality of care is the same, regardless of where you live.
And, according to the women Monash University spoke to, there are some clear areas that could be improved.
Access
One of the issues touched on by a range of participants was the difficulty they had finding information or a service in the first place, followed by long wait times once they did:
"The only ones who do surgical abortions in the area had a month wait," one woman in regional NSW said. The submission said the woman travelled more than 2 hours each way to access timely services and spent another 10 hours at the clinic itself.
"I had to ring a few different places and was told it would be a six-to-eight-week wait. I was really shocked, because I was expecting it to be an easier process," another woman, also from regional NSW, said.
"I didn't really have much of a sexual health education, and I grew up in a religious family. I didn't know anyone who'd had an abortion before. I just had no idea where to go. I didn't know that a GP could do it," someone from urban Victoria said.
"It’s an abortion clinic so there's no children allowed. We didn't want anyone to watch our kids because we didn't want anyone to know what we were doing," said a woman in urban WA.
"I jumped on Google, but there wasn't any sort of direction on facilities or where you could go. I found a lot of religious websites saying you can adopt. Nothing really about services that are available," a woman from regional NSW said.
Of the 24 women aged between 20 and 40 years old interviewed by Monash, two-thirds lived in metropolitan or urban areas and a third in rural and remote areas.
The participants were from six Australian states and territories and experienced medical and surgical abortions, with gestational ages between 6 to 28 weeks and use a variety of different care methods including GPs, clinics and hospitals.
As part of its submission, Monash University recommended the government reduce the cost and distance to abortion services.
Stigma
Another of its recommendations was to create and implement strategies to reduce abortion stigma in the community, but did not identify how or what that would look like.
"He was hesitant to give it to me. He said, 'I'd rather you think about it and come back Monday.' I said, 'no, I’m running out of time, I do not want to delay this any further.' He then said, 'I will prescribe this for you if you promise to go on contraception afterwards. You're not allowed to do this again,'" someone in regional Queensland said.
“The doctor said, 'I don't recommend [an abortion] because you'll regret it if you're 30.' The GP should have had more information and less opinions and steered me in the right direction, like they would with any other procedure," another woman said.
"It was the receptionist that told me the GP couldn't help me. It was a complete [compounding] experience of not having the right information or the right people to speak to. I actually couldn't get in to see my GP. She passed me on, sort of judgemental," another woman in urban Victoria said.
"I didn't need to feel so alone, and I think, ultimately, it is because of the stigma around abortion. One in four women has an abortion, so it is crazy that no one really talks about it. I think that's the biggest barrier that doesn't need to be there," a 20-year-old woman from regional NSW said.
Negative experiences weren't just limited to GPs or others working in the space; one woman from urban WA reported feeling a sense of stigma even at an abortion clinic.
“I found the nurse in the abortion clinic horrible. She had zero understanding, zero tolerance, was really judgemental. I was thinking, 'these women who are here in a very volatile, vulnerable state'. Anyone working in this field needs to be incredibly sympathetic to the people that they're serving."
But not all the women reported bad experiences, with the submission pointing out that supportive interactions with the health system had lasting impacts too.
"The GP was amazing. Really supportive and understanding. She didn't ask any questions that would imply judgement. She explained everything in great detail. That emotional support. Everyone should get access to a GP as lovely as mine," a woman in urban Victoria said.
Cost
One of the other major barriers identified in Monash University's submission was the out-of-pocket expenses involved.
"I had a heart attack, because it was $500. And with a health care card too. It's so much money, I just think it's crazy … It's $1,200 without a Medicare card … someone paid that when I was in there … I nearly fell over," a woman from regional Victoria said.
"I had to borrow from my partner to be able to afford it outright. Maybe the up-front fee was $500 plus, and then I did get the Medicare rebate, but my doctor's clinic is a private billing clinic and then the ultrasound was obviously an extra few hundred dollars," said another woman from urban Victoria.
"I was really lucky that my partner could financially help me. He paid half and I paid half, but it would have been really quite difficult otherwise," a woman from regional NSW said.
But, much like a lack of stigma around abortion, the submission highlighted how big a difference offering free care could be to people who found themselves needing services.
"It's free here. I feel like it's so inclusive. Distance is a barrier, but you know you can access it if you can get there," a woman from a regional part of the Northern Territory said.
"We're very lucky here in South Australia in that the services actually don't charge. The only thing that I had to pay for with the medication," said someone from urban South Australia.
"The doctor asked, 'Do you want to travel to the sexual clinic for a low-cost service or do you want to be seen locally in a private practice?' So, I went with the sexual health clinic," a woman from regional Queensland said.
The inquiry will hold its next public hearings at the end of the month in Canberra.
