Mridula Shankar1, Kirsten I Black2, Philip Goldstone3, Safeera Hussainy4, Danielle Mazza5, Kerry Petersen6, Jayne Lucke7, Angela Taft1. 1. Judith Lumley Centre, School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Victoria. 2. Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medicine School, University of Sydney, New South Wales. 3. Marie Stopes International, Victoria. 4. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Victoria. 5. Department of General Practice, Monash University, Victoria. 6. Law School, La Trobe University, Victoria. 7. Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria.
Abstract
OBJECTIVES: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation. METHODS: Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression. RESULTS: Over a third of eligible women opted for a medical abortion. More than one in 10 (11.2%) stayed overnight. The median Medicare rebated upfront cost of a medical abortion was $560, compared to $470 for a surgical abortion at ≤9 weeks. Beyond 12 weeks, costs rose considerably. More than two-thirds (68.1%) received financial assistance from one or more sources. Women who travelled ≥4 hours (AdjOR: 3.0, 95%CI 1.2-7.3), had no prior knowledge of the medical option (AdjOR: 2.1, 95%CI 1.4-3.1), had difficulty paying (AdjOR: 1.5, 95%CI 1.2-1.9) and identified as Aboriginal and/or Torres Strait Islander (AdjOR: 2.1, 95%CI 1.2-3.4) were more likely to present ≥9 weeks. CONCLUSIONS: Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice. Implications for public health: Policy reform should focus on reducing costs and enhancing early access.
OBJECTIVES: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation. METHODS: Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression. RESULTS: Over a third of eligible women opted for a medical abortion. More than one in 10 (11.2%) stayed overnight. The median Medicare rebated upfront cost of a medical abortion was $560, compared to $470 for a surgical abortion at ≤9 weeks. Beyond 12 weeks, costs rose considerably. More than two-thirds (68.1%) received financial assistance from one or more sources. Women who travelled ≥4 hours (AdjOR: 3.0, 95%CI 1.2-7.3), had no prior knowledge of the medical option (AdjOR: 2.1, 95%CI 1.4-3.1), had difficulty paying (AdjOR: 1.5, 95%CI 1.2-1.9) and identified as Aboriginal and/or Torres Strait Islander (AdjOR: 2.1, 95%CI 1.2-3.4) were more likely to present ≥9 weeks. CONCLUSIONS: Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice. Implications for public health: Policy reform should focus on reducing costs and enhancing early access.
Authors: Courtney Devane; Regina M Renner; Sarah Munro; Édith Guilbert; Sheila Dunn; Marie-Soleil Wagner; Wendy V Norman Journal: Pilot Feasibility Stud Date: 2019-11-08
Authors: Ernestina Coast; Samantha R Lattof; Yana van der Meulen Rodgers; Brittany Moore; Cheri Poss Journal: PLoS One Date: 2021-06-09 Impact factor: 3.240