Abortion provision in Australian public hospitals

Abstract

Introduction: Increasing the proportion of abortions performed in Australian hospitals would reduce abortion stigma, increase training opportunities for health care workers, and expand access to no cost abortions and in rural and regional areas. Method: This article uses a descriptive-interpretive method to map hospital-based abortion provision across Australia, drawing on four data sources: grey and scholarly literature, government and referral websites, materials from a 2023 Senate Inquiry, and interviews with 51 health professionals and advocates. Results: There are three main approaches to hospital-based abortion provision in Australia: universal hospital provision of procedural abortion (Northern Territory, South Australia and Tasmania); the outsourcing of public provision to private clinics (the Australian Capital Territory, Queensland and, to a very minor degree, Western Australia); and systems that leave decision-making about abortion provision to individual hospitals (New South Wales and Victoria). Discussion: Hospital-based abortion provision in Australia is uneven and inequitable and underpinned by problematic criteria of moral deservedness that determine who receives care. Quality care is further compromised by a lack of method choice in the second trimester of pregnancy.