'NSW abortion law needs to change'

Josephine de Costa speaking at the launch of #end12. Photo: Mehreen Faruqi
September 29, 2015

I was asked to speak today about my perspective on abortion law reform in NSW as a medical student.

I realised that my perspective on this — even though it’s fairly well informed — actually can’t be separated at all from my perspective as a young woman in NSW, especially a young woman who, dare I say it, has sex.

So, for me, this debate really has two major impacts on my life: first, on restricting a service that I may need, and that 1 in 3 Australian women will need in their lifetime; and secondly, in limiting the services that I will be able to advise on or perform as a doctor.

It’s confusing, both for the people who want them and the people who perform them, that abortion is a crime, because in practice abortions are regularly performed in NSW.

The problem is that really, this law is unenforced with only a handful of prosecutions in the last few decades.

Unfortunately, though, lack of enforcement doesn’t mean the law has magically disappeared.

It actually seems likely many of the abortions that are performed in NSW may not stand up to a rigorous application of the current law, which only allows for physicians to perform an abortion if they deem that the pregnancy presents a serious threat to the woman’s physical or mental health.

But let’s just use me for a hypothetical example. I’m 23, physically and mentally healthy and I have a very supportive family. If I were to become unexpectedly pregnant, economically — with the support of my family — there is every chance that a jury would find that I probably could support a child.

The thing is, I don’t want to. I’ve just begun a demanding career and at this point it doesn’t make sense for me to have a child.

I don’t think that makes me a bad person, though. I think it makes me someone who is in control of my body and my future.

The problem is that, in NSW, that puts me at risk of being found guilty of a crime.

Hold that thought, and let’s just fast forward a decade or so to a time where I am a fully qualified doctor being asked to provide an abortion.

Even now, I am taught constantly about the importance of providing non-judgmental healthcare, and ensuring that patients have both the best information about their health possible and the best access to the healthcare that they need and want.

Those two things – appropriate information and equal access – are the fundamental tenets upon which the trust between doctors and patients rests.

However, if this law doesn’t change, future me and my practice as a doctor will be limited because my patients simply won’t have the access that they need to adequate termination services.

If I and other doctors want to comply with the letter of the law, I probably wouldn’t be able to perform abortions for women who may be able to support children but simply don’t want to.

This has a negative impact on all women but it is especially the case for women in rural areas or who are socio-economically disadvantaged.

Contrast the law though with the statistics. One third of women will have an abortion in their lifetime, and 80% of GPs support abortion provision.

Seventy three percent of people in NSW do support the removal of abortion from the Crimes Act — a view that’s certainly in line with how I’ve been raised. I’ve always been taught that my body and my life are my own, and that’s how I will always treat my patients, regardless of their health issues.

I wanted to finish on this note. I can see myself as becoming both someone who needs an abortion and as someone who might provide an abortion, but in neither case should I be seen as a criminal.

NSW abortion law needs to change to be in line with how people understand abortion: as a key aspect of non-judgmental health care that allows women the independence to decide what they do with their bodies and their lives, and that allows their doctors to provide them with the support that they need.

[Josephine de Costa gave this speech on September 28 at the NSW Greens launch of the #End12 campaign to take abortion out of the Crimes Act and for protection zones around clinics.]

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