PRIORITIES
1. Take leadership in implementing the National Women’s Health Strategy to research, fund and deliver a public health system capable of recognising and responding to women’s health needs.
2. Work with state/territory health ministers to harmonize Australia’s abortion laws and regulations and initiate an Australian Human Rights Act to permanently secure women’s right to control their own bodies.
3. Work with states and territories to guarantee universal, free access to reproductive health services with contraception and abortion as the first priority.
4. Support development and implementation of a woman-centred Maternity Care Standard, as part of the current National Safety and Quality Health Service Standards, along with a Clinical Quality register.
5. Support and fund midwife led Continuity of Care through adjustment to the Medicare Benefits Schedule as recommended by the Australian College of Midwives.
6. Provide leadership and funding to ensure that women in rural and regional Australia have equal access to maternity care and choices for a safe birth, including an enhanced national roll out of Birthing on Country sites.
RATIONALE
The #EndGenderBias survey and consultation conducted in 2023 by the National Women's Health Advisory Council has uncovered shocking levels of bias and discrimination at all levels of the Australian health system. Only joint federal, state and territory action can change this. The Department of Health and Aged Care’s 2024 ‘Literature review to inform strategies to address sex and gender bias in the health system’ showed how medical research seriously neglects sex and gender differences to the detriment of women’s treatment and experiences in the health system.
The recent evaluation of the National Women’s Health Strategy indicates it is not delivering in key areas of women’s health such as reproductive health and access to maternity services. The Federal Government needs to lead the states and territories to fund and implement the Strategy.
All states and territories retain abortion related legislation specifying a range of diverse conditions, such as gestation limits, provisions for conscientious objection and in NSW monitoring and reporting on so called sex selection abortions. The ACT has the least restrictive law.
Australian women are vulnerable to covert and well-funded campaigns – particularly at the state level - to pressure wavering MPs to support restrictions on abortion, through legislative proposals or opportunistic interpretations of current legislative provisions such as conscientious objection.
The impacts of ‘pop-up’ legislation, such as the recent spate of ‘Born Alive’ bills can seem marginal but are intended to accumulate and wear down opposition over time.
Australia is the only advanced OECD country without a Human Rights Act. A legislated guarantee of the right to bodily autonomy, together with harmonisation of abortion laws across the country could secure women’s reproductive rights for the future.
There is extensive research evidence that women in regional, rural and remote Australia have restricted access to reproductive health services and that some state and territory local health districts inhibit or prevent provision of abortion through the public health system. There are opportunities for the Federal Government to work with the states and territories to ensure that state and territory health activity funding accommodates publicly provided reproductive health and abortion services
Australia lags well behind other OECD countries in the use of long-acting reversible contraceptives such as intrauterine devices (IUD) and birth control implants. Contraception is free for women in France (up to 26 years), Canada and the UK.
The ACT provides free and accessible abortion care which funds no-cost abortions to ACT residents, including to those without access to Medicare, and offers ACT residents free long-acting reversible contraceptives at the time of abortion, if wanted.
Women must be able to access integrated, holistic care of their choice, consistent with established evidence that midwifery continuity of care is best practice. Recommendation 14 of the report of the Senate Inquiry into access to reproductive healthcare recommends that the Federal Government implements outstanding recommendations made by the Participating Midwife Reference Group to the Medicare Benefits Schedule (MBS) Review Taskforce regarding midwifery services and continuity of care.
The Australia College of Midwives 2024/5 Budget submission makes specific proposals to enable states and territories to deliver continuity of care models. The ACM submission notes that funding of these will also enable expansion of Birthing on Country models of care for First Nations women and families.
Currently, Australia has national standards for stillbirth and perineal tear. However, there is no standard to achieve woman-centred pregnancy care. Without such a standard, women are subjected to unnecessary interventions leading to the maximum number of women labelled "at risk" and becoming candidates for unwanted, costly and potentially harmful interventions, with no corresponding health improvement for mother or baby.
Access to maternity and birthing services for women who live outside Australian cities has been decreasing for decades. Evidence received from the National Rural Health Commissioner during the 2022/3 Senate Inquiry into Universal Access to Reproductive Health indicated that there was a 41% reduction in the total number of maternity units in Australia between 1992 and 2011—from 623 to 368—with many of these closures impacting on small maternity services located in rural areas. This reduction was confirmed in the National Women’s Health Council’s 2023-24 Annual Report, particularly in regional and remote areas.
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