A jealously guarded right
The right to safe, legal abortion is now being subtly threatened by, of all groups, the Family Planning Association of NSW. An education campaign conducted under the newly devised "Family Planning Choice's Charter"aims to cut down on unplanned pregnancies and abortions — the idea is that with increased education, fewer unplanned pregnancies will occur and abortion numbers will subsequently decrease.
I find it abhorrent for a body like the Family Planning Association to have as a defined objective a reduction in numbers of abortions. This will bring us back to the bad old days of the"deserving case" concept, where women had to argue their case in order to get an abortion.
When I first began general practice medicine in Sydney in 1963, there were no clinics or legal abortion services. If a patient was pregnant and unable to cope, the only way she could get an abortion was to present as suicidally depressed to a psychiatrist, so the obstetrician would feel safe enough to perform an abortion in a public hospital.
Our time as concerned doctors was spent in the anguish and uncertainty of trying to arrange the abortion, instead of counselling about options and after-effects. Other patients were not even this lucky. One patient of mine was taken out of the bath, haemorrhaging almost to the point of death, with a hole in the top of her vagina, the diameter of a knitting needle. She had two preschool children, and she and her husband could not cope financially with another child.
Another patient was told by a gynaecologist that he would perform an abortion for her, but only if he sterilised her as well. His view was that if she didn't want this baby, she shouldn't have any more.
I do not want any move back to the days when medicine was practised like this. Try to imagine lying on a bed in the outpatients department with your knickers off trying to explain to the doctor why you should be one of the small number of people the hospital will allow to have an abortion.
From a District Court ruling came the present situation in NSW, where special clinics with skilled specialists and counsellors will see women, diagnose pregnancy and enable the woman to come to a decision about what is best for her. Very often the pregnancy will continue, but when a woman chooses a termination, it is done safely and efficiently, with her fertility left intact.
There is no question that the extremely desirable aim of increasing education and reducing unwanted pregnancies should be vigorously pursued. But once a pregnancy has occurred, there must be no suggestion that the abortion should not take place, which is what could happen once it accepted that overall abortion numbers should be reduced.
When a woman is pregnant, she is entitled to the best possible care. This means good counselling to enable her to consider all options; it means lack of pressure so that she makes her own choice.
It means referral to good antenatal services or to good abortion facilities. Unplanned pregnancy is always a serious issue. It needs to be handled with sensitivity and understanding to provide the woman with all the support she needs to make the decision which is right for her in both the short and long term.
The best education in the world won't prevent contraceptive failure. Abortion is a right which all women are entitled to, and if we are not to step back into the dark ages, it is a right we must jealously guard.
By Dr Jean Edwards