‘We must be alert to complacency': inside Victoria's push to extend abortion access

The Guardian

03-05-2025

On a grey Monday morning outside the State Library in Melbourne's CBD, there's little to suggest anything out of the ordinary – no protests, no placards, no media. But stream of women – and a few men – are making their way inside for what is, in fact, a landmark event.
'How extraordinary it is,' says former Victorian health minister and MC Jill Hennessy, 'to come to a symposium about abortion as healthcare in the state of Victoria, [and] that this isn't some secret meeting held down in an underground tunnel where women plot to ensure our health rights are recognised.'
The plotting, many in the room would argue, is happening elsewhere – and increasingly in plain sight, as highlighted by the symposium's opening video: a montage of US vice-president JD Vance denouncing abortion rights, a news clip from a recent failed bid in South Australia to wind back the state's laws and a scene from The Handmaid's Tale.
Sign up for Guardian Australia's Afternoon Update email newsletter
It's dramatic, but the message is clear: even in Victoria, where abortion laws are considered among the most progressive in the country, nothing is guaranteed.
'We must be alert to complacency,' the state's health minister, Mary-Anne Thomas, tells the room of health professionals. 'The laws are just the beginning. Unless they lead to action, they're worth nothing.'
A report by the not-for-profit Women's Health Victoria, published last year, found 53 out of Victoria's 79 local government areas in 2023 had no surgical abortion provider, and 15 had no medical abortion provider.
At the time, only 17% of Victorian GPs provided access to medical abortions and 19% of pharmacies in the state dispensed the medication.
Those figures have increased significantly since national restrictions on MS-2 Step, the medication used for medical abortion, were relaxed, says Prof Danielle Mazza, head of Monash University's department of general practice and the SPHERE Centre for Research Excellence in women's sexual and reproductive health.
'Since deregulation of medical abortion happened in 2023 we've had almost three times as many GPS and twice as many pharmacists [across Australia] provide medical abortion for the first time,' she says.
Mazza says in 2019, almost a third of Australian women – and half of those in remote areas – lived in regions where MS-2 Step was not available because it hadn't been prescribed by a local GP.
In Victoria, medical abortions can be administered up to nine weeks' gestation, while surgical abortions can be performed up to 24 weeks, though they typically occur by 12.
Now, Mazza is advocating to extend access to medical abortion from nine to 10 weeks' gestation. A submission to the Therapeutic Goods Administration by Marie Stopes International is now under way, she says.
Since taking on the health portfolio, Thomas has introduced a suite of reforms including 20 sexual and reproductive health hubs across Victoria, scholarships for women's health specialists and a mobile clinic that now delivers medical abortion services to women in remote and regional parts of the state.
During her regular visits to public hospitals, Thomas has also taken the direct approach of asking whether they provide abortion care. 'I've been pleasantly surprised by how many have said yes,' she says.
It's a contrast with New South Wales, where just three of the state's 220 public hospitals are routinely providing abortions, according to research by the University of Sydney.
But while these changes mark progress, speakers at the symposium are clear that change on the ground is often slower and uneven.
Sign up to Afternoon Update: Election 2025
Our Australian afternoon update breaks down the key election campaign stories of the day, telling you what's happening and why it matters
after newsletter promotion
Carolyn Mogharbel, manager of 1800 My Options – a free, anonymous phone line run by Women's Health Victoria that has fielded over 40,000 calls since launching in 2018 – says affordability remains one of the biggest barriers.
'In the past year, 35 to 40% of people of our callers don't have the means to pay for their sexual and reproductive health services,' she says, up from previous figures of 20 to 30%.
Many callers can't afford to attend a private clinic, pay for a dating scan – typically about $200 – or even for a GP consultation to get a prescription. The total cost, she says, can exceed $1,000, not including time off work, travel costs or childcare.
Then there are the structural barriers.
Mogharbel shared the story of a caller who, at 11 weeks pregnant, had been referred to five different metropolitan hospitals. Only the fifth hospital said they provided abortions, but told her they wouldn't be able to see her before she passed their 12-week gestational limit.
Another caller, a 19-year-old, was told by her family GP she would 'regret' her decision and should consider 'the joys of parenthood'.
'The doctor, who had watched her grow up, said they were really looking forward to watching this next generation grow up too,' Mogharbel says. A second GP referred her to a clinic that said it would cost $600 for a termination.
Catherine Bateman, a nurse practitioner with Latrobe Community Health, says Victoria should be 'the shining light of the whole world' for abortion access. 'But it's not. Why is that? And not to be too controversial, but doctors.'
Of the 40,000 GPs in Australia, Bateman says only a 'minuscule percentage of them' offer abortion care. 'That's appalling.'
Bateman says some delay patients with ultrasounds – despite clinical guidelines stating that they are not always required. Others invoke the state's conscientious objection laws – which require doctors with moral objections to refer patients elsewhere. Bateman says the laws are 'not working' and are 'being used as a cover'.
Lily McAuliffe, co-founder of peer support network The Abortion Project, says the need for care after an abortion procedure is often overlooked. Even as someone who is firmly pro-choice, she felt isolated and overwhelmed after her own abortion.
'It was a really messy grey area,' she says.
For Mazza, the path forward is clear. She points to the UK, where abortion is publicly funded via the NHS, with centralised data collection and a target of a one-week wait time between initial consultation and procedure. In Ireland, GPs are paid €450 to provide medical abortion, and ultrasounds are free through private radiology clinics when required.
Her vision, she says, is of 'a future with fewer unplanned pregnancies, every child a wanted child' and equitable access to abortion at no cost.