You’ll find women struggling to navigate Australia’s patchwork of legal, financial, social and geographical barriers to terminate a pregnancy in the more than 150 articles about abortion access and law reform I’ve published over the past few years.
A woman who waited days in hospital to terminate a wanted pregnancy; a woman who cancelled her surgical abortion because she couldn’t enter the clinic as her relative was protesting outside; a woman who paid more than $4000 to fly interstate for an abortion and was then fired over her online reproductive rights activism; a female politician who had to terminate a pregnancy at 21 weeks for a foetal anomaly and cried in parliament as she called out her colleagues for labelling her a murderer; a woman who explained how traumatic it can be to have a second-trimester abortion; a woman who was harassed outside a clinic as she tried to reach the door to terminate a pregnancy, which was the result of a rape.
In some cases, healthcare professionals have acted as a further barrier to access. One woman told me that her GP refused her a medical abortion because she was ‘meant to be a mother’, another said her doctor insisted abortion wasn’t possible because it was a crime and one said her doctor told her abortion wasn’t allowed after nine weeks.
But for the most part, women have emphasised the compassionate clinical care they received from doctors and nurses during what was often a complicated and upsetting time.
These are some of the stories from practitioners I’ve spoken to who described the personal risks of providing abortions and what it is like to operate within the shadow of the law in states where the procedure is still written into 100-year-old criminal legislation.
Queensland surgeon Dr David Grundmann went to work on the morning of 20 May 1985 at the Townsville clinic at which he was the medical director. He had no idea that by midday he would be holed up in a police station.
‘It came completely out of the blue when the police came into the premises and requested that everything be stopped, produced a search warrant and charged me with performing illegal abortions,’ Grundmann, 70, told me in 2017.
At 10 a.m. that morning, more than 100 police officers entered two Queensland clinics – one in Townsville and the other in Brisbane – where they seized equipment and confiscated around 47,000 patient files in what Grundmann described as a ‘military-like raid’.
Grundmann and surgeon Dr Peter Bayliss of Brisbane’s Greenslopes clinic were charged with conspiracy to perform illegal abortions.
The raids, and ensuing legal battle, would shift the parameters within which abortion could be lawful in Queensland by setting a legal precedent.
Grundmann said his main concern on the day was the fate of dozens of women who were travelling from regional and rural Queensland to terminate their pregnancies at ‘considerable cost and inconvenience’.
‘I was worried my operation would be stopped for a considerable period of time and there would be a lot of women who came to see me who would be seriously disadvantaged,’ he said.
‘Right up until 2005 we had patients who were refused contraception by their local pharmacists, who were deliberately misdiagnosed as being too late to have an abortion by a GP.’
Until Grundmann opened a second clinic in Rockhampton, patients were travelling from as far away as Bundaberg (1007 kilometres), Weipa (1140 kilometres) and Mt Isa (904 kilometres).
Grundmann escaped prosecution but the battle wasn’t over for Bayliss or anaesthetist Dawn Cullen who eventually went to trial once the then Director of Public Prosecutions Des Sturgess found a single woman ‘dissatisfied’ with her abortion.
Lawyers, doctors, anti-abortion protesters and members of women’s organisations overflowed from the public gallery of Brisbane’s District Court for the trial, during which Sturgess attempted to convince a jury that Bayliss and Cullen – who had pleaded not guilty – had performed an unlawful abortion.
The jury was not convinced.
Until October this year, abortion was a crime in Queensland and only lawful to ‘prevent serious danger to the woman’s physical or mental health’.
By 2017, when Grundmann was long retired, there was only one doctor performing surgical abortions in the 2000 kilometres north of Rockhampton.
‘It is not nice what I do, and no one talks about it over the dinner table. In fact, half the people I know don’t know what I do because I don’t talk about it,’ the doctor, who used the pseudonym Grace when I interviewed her, told me.
‘I am in a privileged position of having a skill set that allows me to actually step up and do something about something I really care about.’
Grace works at Townsville’s Marie Stopes International clinic, which can only afford to open three days a month.
‘This practice has been running at a loss for a few years, but we’ve stayed open because what we do is so important,’ she said.
‘The population of Townsville is around 230,000, and 117,000 of those people are women. The median age is 34. Do the maths.’
Half of Grace’s patients travelled a minimum of two hours to see her and almost a fifth had travelled for more than eight hours.
‘It can be an eight-hour drive to get to a regional centre, and the cost is prohibitive for a lot of women. Depending on their gestation it is about $800 [on average] just for the procedure.’
Dr Colinette Margerison works as a GP, medical educator and contraceptive and sexual health consultant across rural and regional Queensland, where she provides medical abortions.
‘Some of these rural towns, you can put a service in and all it takes is for that one doctor providing terminations to leave and you’ve got no service anymore,’ she told me. ‘If I was to leave, there would be a hole.’
Margerison has to consider the safety of her patients when taking abortion drugs, as they may be hours from medical care if they begin to haemorrhage.
‘A lot of [women’s healthcare providers] would say that if patients are living in that area and have that potential to have a natural miscarriage, then they should be just as safe, but the difference is that you’re making it happen, and you know you’re putting them at risk.’
Many patients travelled eight hours to the clinic. If they needed a surgical rather than medical abortion, they then had to drive two-and-a-half hours further to the closest surgical service.
Margerison is the only one of twenty GPs at her regular practice who provides medical terminations.
‘The barriers women might face in a clinical setting is if you have people who don’t feel comfortable with the provision [of abortion services] … I do know there are some clinicians I work with who don’t provide contraception.’
For eighteen years, until safe access zones were enacted in New South Wales this year, dealing with religious protestors was a regular part of Paul Nattrass’s job as the practice manager of The Private Clinic in Surry Hills, Sydney.
‘These protesters tend to talk to people about why they are at the clinic, which is a gross invasion of their medical history,’ Nattrass told me. ‘Many women are more concerned about protesters than the procedure itself.’
‘Even when patients are being discharged after the procedure, they nearly all ask if the protesters are still there and ask to be ushered through an alternate exit.’
When we published a story in BuzzFeed, corroborated by footage, of a protestor offering a Chinese-Australian woman entering the clinic help with ‘immigration problems, legal problems, medical problems,’ Nattrass wasn’t surprised.
He said that the protesters targeted most patients, but that it was easier for women with strong English language skills to quickly understand who was approaching them.
‘One incident that does stand out is when we had this lady protesting outside and she intercepted a patient who didn’t have English as a first language, and we saw [the protester] on the cameras taking this woman across the road to an [anti-choice crisis pregnancy counselling centre],’ he said.
‘I went across and knocked on the door but no one answered, and when we spoke to the patient later, on the phone, she was still unaware that she hadn’t been to The Private Clinic … she said she was confused as to why we would have told her about horrible dangers of abortion and shown her images of dead babies.’
A registered nurse who used the pseudonym Rosie when she talked to me worked at two clinics in Surry Hills until 2016 – The Private Clinic and Preterm, which has now closed.
‘As a staff member, I felt intimidated and threatened by the protestors out the front who eventually learned my name,’ she told me.
‘They would watch me walk up from the train, it was really predatory, there was nothing you could do.’
The protesters were there for a few hours every day and would approach patients to say, ‘You don’t have to do this,’ or hand out rosary beads, Rosie said.
‘This woman came in one day with her young son, who was about four years old, and her partner, and one of [the protestors] said: “Mummy is about to kill your baby brother”.’
‘That was a new low.’
One day Rosie discovered the protestors had slipped some of their brochures – ‘basically just the first couple of Google image results for aborted foetuses and some inaccurate medical information’ – into the stack of magazines in the clinic.
‘Can you imagine sitting there and waiting for your termination and being confronted with these flyers?’
Dr David Corbett has been an anaesthetist at Albury’s Fertility Clinic for five years and spoke at a rally for safe access zones earlier this year.
‘These protesters say they stand there in silent prayer, and no one could argue with that, but the reality is they approach [women] walking in and out and they have been known to go up to patients and tell them that she’s “murdering a baby”,’ Corbett told me.
‘As doctors we don’t like patients being harassed and we don’t like patients being lied to.’
One of the regular picketers also sprays ‘holy water’ along the footpath outside the clinic.
Corbett said that once, when his wife collected him from the clinic, she was handed a plastic foetal doll by a protester.
‘We have a security guard now who protects the women being buttonholed by the protesters, but we also need the exclusion zones.’
The anaesthetist said locals were nervous about taking on the protesters as some were considered litigious.
‘There is a lot of bluff and bluster about bringing in lawyers and … I think that scares people a little.’
It was more than bluff and blunder for retired obstetrician Pieter Mourik.
Married Albury anti-abortion picketers Roland and Anna von Marburg won $180,000 in damages from Mourik after they claimed they were defamed in 2014 by comments on the Facebook page for which he was a spokesperson.
The case dragged on for almost three years until a settlement was reached in 2017 between the von Marburgs and the Wodonga obstetrician who published an apology on the Facebook page of which he was a spokesperson.
Mourik, who practised in reproductive health in Albury for almost four decades, is staunchly pro-choice.
When I revealed in 2016 that a church-funded cafe in Albury was raising money for the anti-abortion clinic next door, Mourik told me he was concerned about the anti-choice movement in his hometown. The money was going towards a $30,000 ultrasound machine for the Women’s Life Centre – an organisation owned by the Catholic Parish of Holy Spirit Lavington – to scan women with unplanned pregnancies.
Mourik said this was an ‘appalling tactic’ used by antiabortion groups ‘around the world’.
‘It is a lovely cafe but it isn’t clear that it is backed by the Church and it is just another way of coercing a woman to continue an unwanted pregnancy by increasing her emotional distress,’ he said.
‘It is absolutely scurrilous because it is used to manipulate women to continue an unwanted pregnancy which could be far more dangerous to their lives.’
In the first legislative attempt to reform Queensland’s abortion law in 2016, abortion provider Fiona Mack said in a submission to a parliamentary inquiry into the laws that she had assisted three women in a single year who came from hospitals unwilling to provide terminations.
‘These doctors failed in their duty of care to these women,’ she wrote.
One of her patients found out she was pregnant at the same time that she was diagnosed with metastatic ovarian cancer. Her oncologist and gynaecologist would not continue with chemotherapy or surgery ‘until she was no longer pregnant’ but would not provide her with an abortion.
‘She was required to discharge herself from hospital and make her way to our clinic independently. Her sister pushed her over in a wheelchair.’
This year, senators Cory Bernardi and Barry O’Sullivan continued to proliferate their views about abortions after the first trimester in the Senate where they argued that women were terminating pregnancies at the very last minute, right before what would otherwise be a normal healthy birth.
It isn’t a new argument by anti-abortion advocates but Queensland obstetrician and maternal-foetal medicine specialist Dr Carol Portmann was furious the misinformation was being spread by not only religious lobbyists, but federal politicians.
‘I would hope that if you’d entered politics you would have an ability to separate your personal agenda from facts presented to you and it is disrespectful to women not to look at those facts before opening your mouth and giving unfounded opinions,’ she told me.
It was a ‘ludicrous fallacy’ that any doctor would support a termination in the third trimester for psychosocial reasons.
‘In my twenty years experience in Queensland, where I have never been asked by any woman to perform a termination in the third trimester for psychosocial reasons, it is always because a baby has [been] found to have such a severe heart or brain injury, or where the mother’s life is at risk,’ she said. ‘Even in a very late pregnancy diagnosis, or if someone turned up thinking they were at fourteen weeks gestation and found themselves at 30 weeks, they would just have to go on to have the baby.’
Portmann said it was usually severe medical complications that weren’t visible in the patient’s first or second ultrasound.
‘It is mostly brain problems which weren’t visible earlier on, and parents know their child will survive for a period of time with no quality of life, whether that is a matter of days or up to a year, and pass away, and parents feel they simply can’t watch their child in suffering,’ she said. ‘These are conditions which are ultimately always lethal.’
I was in Queensland’s parliament house on 17 October last year when politicians voted for abortion to be decriminalised. In the public gallery sat Caroline de Costa who had campaigned for this since 1971.
She was the first doctor in Australia to gain permission to prescribe medical abortion drugs RU486. In 2009, when a Cairns couple were charged for procuring a medical abortion, de Costa was forced to withdraw her service due to possible legal repercussions.
When one of the only doctors providing surgical abortions in Cairns retired and women were being flown interstate for terminations at huge cost, de Costa was on the frontline calling on the state government to fix the situation for months on end.
She has spent decades as a specialist obstetrician and gynaecologist but has always dedicated time and energy to campaign for abortion law reform and increased access to services, particularly for vulnerable women.
Like many women’s health professionals, de Costa has had to straddle clinical practice and activism in order to advocate the best care for her patients.
A few days later I spotted her across the room in Melbourne at the headquarters for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. We chatted about the highs and lows of the two-day parliamentary debate over the legislation in Queensland.
‘How did it feel when the bill eventually passed?’ I asked.
‘Oh, we were sitting there and when it happened we just …’ she took an exaggerated breath in and exhaled loudly, using her whole body.
She then stood shaking her head, wordless with weary happiness for a moment until snapping herself out of it: ‘But of course there’s still more to be done.’