by Suzanne Belton, Adjunct Associate Professor, Menzies School of Health Research, Darwin, Northern Territory, Australia
Top photo: NT Minister for Health Natasha Fyles
The report from Australia’s 8th Periodic Review by the Committee on the Elimination of Discrimination against Women (CEDAW) recommended that Australia harmonise abortion-related legislation across Australian jurisdictions to increase health access and equity. In Australia this is done at state level in our federal system. It seems that sometimes politicians listen and do the right thing.
After a five-hour debate on 29 November 2021, amendments that had been proposed by Minister for Health Natasha Fyles to reduce barriers to abortion health care in the Northern Territory, were passed into legislation by the House of Assembly in the Termination of Pregnancy Law Reform Legislation Amendment Bill 2021. There were no changes to the bill and no division was called to record the vote. This is unprecedented in Australia and perhaps internationally where abortion is often hotly contested.
The amendments to the existing law tabled by the Minister for Health were to reduce the number of doctors from two to one who need to approve an abortion in the first half of pregnancy, remove any gestational age limit on having an abortion, remove the need for any extra credentialing for doctors who provide abortion care, and keep anonymous data for health system review.
Perhaps the most controversial change was to change the upper time limit of 24 weeks to no upper limit. This always gets people jittery. Dreadful slurs are directed at women and doctors by anti-abortion groups on this topic. Around 2,500 emails were directed against this Bill from one website alone. Nevertheless, we know in Australia that abortions in the second half of pregnancy are often due to potentially lethal maternal or foetal health conditions, diagnosed foetal abnormality or catastrophic social circumstances. Women from the Northern Territory who required an abortion after 24 weeks previously had to fly hours interstate to obtain it – a logistical difficulty in Covid-19 times and disruptive.
The Termination of Pregnancy Law Reform Legislation Amendment Bill 2021, now states:
Termination of pregnancy by a medical practitioner at more than 24 weeks
A medical practitioner may perform a termination on a woman who is more than 24 weeks pregnant if:
(a) the medical practitioner has consulted with at least one other medical practitioner who has assessed the woman; and
(b) each medical practitioner considers the termination is appropriate in all the circumstances, having regard to each of the matters mentioned in Section 7.
(Section 7 deals with relevant medical circumstances, the woman’s current and future health, social and psychological condition, and professional standards.)
These types of abortions regularly involve complex medical and social issues and seeking support from an experienced obstetrician/gynaecologist, geneticist, paediatrician, or psychiatrist would not necessarily be any different from standard care. In this legislation it is stipulated in law, which is probably not needed but it keeps the voters calm.
The Northern Territory reformed its abortion law in 2017 and one of the major reforms at that time enabled Territorian women to use medical abortion pills up to nine weeks gestation in their homes. This was something that they had been denied due to the law not keeping up with current medical advances. The NT data on this showed that this has been highly successful and safe, with 73% ending their pregnancy before nine weeks gestation. This is a geographically large territory with a small population, a large Indigenous presence, and a small number of abortions. Each year about 740 abortions take place, using the public health system, with very few in the private health system.
NT Minister for Health Natasha Fyles said the changes had been proposed by health professionals and would impact about six women each year. “For those women and their families, it is hugely important,” she said.
The parliamentary debate took the normal route. Introduced by the Minister for Health, a few silly letters to the editor, interventions of varied quality by politicians and then – surprisingly – it passed unanimously without dissent. It was a conscience vote and the debate indicated that several politicians did not fully agree with what was being proposed. However, it was passed unanimously.
I believe this has never occurred before in Australian history. A contentious topic, abortion, with a provocative suggestion to allow women to access abortion services in the second half of pregnancy was passed without a vote cast against it, except some muttered no’s that were not recorded in the parliamentary record. Although several members of the Legislative Assembly stated that they would not vote for it or had misgivings, they did not call for division to count votes. Usually in Australia, politicians take a free vote or conscience vote on legislation like this, and it is possible for the electorate to know how their member of parliament voted on abortion issues. The 2017 Termination of Pregnancy Bill had four votes cast against it.
No amendments by those who may have had misgivings were offered. Sources inside parliament suggested possible reasons. Those against knew they did not hold the majority, or those against were not able to formulate alternative amendments. Or another possibility was that those who spoke against the Bill did not really want to scuttle it – rather they wanted their electorate to hear they were ‘concerned’ but not worried enough to vote against. It is most likely that those against the Bill simply were not organised enough to call for a division to vote and made a tactical error, as some of them seemed confused at the end of the proceedings.
Strong female leadership from Natasha Fyles (Minister for Health), Nicole Manison (Deputy Chief Minister), Selena Uibo (Attorney General), Lauren Moss (Minister for Women), Kezia Purick (Assembly Member) and supportive male colleagues assisted the Bill. Minister Moss stated:
I acknowledge that this debate will be challenging for many members of this Assembly, but I can guarantee that it is always more challenging for the women and their families who either have faced or may be facing this incredibly painful decision right now, not only in the Territory but across the country. I am acutely aware that their grief and pain is often co-opted in this debate, with women almost always painted as incapacitated, incompetent, coerced victims or, at worst, immoral.
In reality, these are women in our community who are daughters, sisters, colleagues, mothers, volunteers and trusted others. They are us. Women and their families who have navigated through complex situations in regard to pregnancy are incredibly strong and deserve all the support and care that we can give them.
We must utterly reject those who seek to mould other people’s pain, grief and legitimate loss for their own arguments or to maintain structural discrimination and policing of women’s bodies. Instead, we need to focus on what is actually at stake here; that is, providing high-quality, accessible healthcare for people who need it when they need it, and enabling our health practitioners to provide that care without judgement or false moral arguments.
The Assembly contains 12 women out of the 24 members, the highest rate of female participation in any jurisdiction in Australia. This tends to change the tone of the abortion debate here. The Northern Territory now has a very good abortion law that considers the complex and difficult circumstances of a handful of women. It aligns with similar legislation in other Australian jurisdictions. Australian laws on abortion are evolving and unhelpful legal barriers are being removed.
If the Northern Territory can vote unanimously for sensible abortion law reform, maybe it’s time for a plebiscite for the rest of Australia.
MEDIA REPORTS: SBS. 6 December 2021 ; MSN News, 1 December 2021. PHOTO: Natasha Fyles, NT Minister for Health: abc.net.au, by Che Chorley, 27 October 2021