January 17, 2020 07:41:38
The average wait time for a surgical abortion in the Northern Territory has dropped from three weeks to two — but nearly two in three women are waiting longer than clinical guidelines recommend, new data shows.
- In 2017 the NT Government decriminalised all abortion up to 24 weeks gestation
- New legislation also enabled general practitioners to provide early medical abortion
- Mean wait-time for surgical abortions in the NT has dropped sharply since the legislative changes
Research published in the Australian and New Zealand Journal of Obstetrics and Gynaecology this month analysed surgical abortion data from 2012 to 2017 in one public hospital in the NT.
It also examined six months of data after the Northern Territory decriminalised abortion in 2017.
As researcher Edwina Ali explained, the mean wait time for patients seeking a surgical abortion plummeted after the Territory introduced its new laws — dropping from a wait time of about 21 days to 15 days.
The longest wait time for patients to access a surgical abortion in the NT ranged from 40 to 45 days during 2012 to 2016 and dropped to 28 days in 2017.
Ms Ali said the decrease put the NT “more in line” with clinical guidelines from other Australian jurisdictions.
“It’s definitely a good-news story for women in the Territory,” she said.
‘The need and the want’ for services
Until 2017, Territory women were only permitted to have a surgical abortion when it was performed in a hospital with at least two doctors present.
Patients also required two doctors — one of whom needed to be an obstetrician or gynaecologist — to believe continuing the pregnancy would “cause greater risk to her mental or physical wellbeing than to terminate the pregnancy or for the child to be severely disabled”.
Now, Territory women can access an early medical abortion through their GP or Family Planning NT.
“Access to the new service and choice has meant people are choosing to use that (early medical abortion option) and the demand on hospital surgical abortion service has fallen,” Ms Ali said.
“To see such a big decrease over those months after the legislation change goes to show the need and the want for early medical abortion in our community,” she said.
Ms Ali said researchers also found the average gestation period for women seeking a surgical termination had increased, indicating more people were accessing early medical abortions through primary healthcare providers.
Dr Georgia McQueen, who co-authored the study, agreed.
“To see a change like that, it was quite significant,” she said.
“It shows that women in the Northern Territory did wait an unduly period of time for reproductive health services in the Territory prior to this legislative change.”
Challenging for remote Territory patients
Dr McQueen said despite the positive news, patients in the NT were overall still waiting too long to access medical treatment — with research showing “62 per cent of women waited longer than that in the recommended clinical guidelines”.
While the Royal Australian and New Zealand College of Obstetricians and Gynaecologists doesn’t specify an exact timeframe between referral and abortion, its UK equivalent recommends a woman should be assessed for an abortion within five days of referral and the procedure should take place within five days of the choice to have the procedure.
Queensland’s guidelines recommend the abortion is provided within 14 days of the decision to proceed, and New Zealand’s recommended time from referral to procedure is no more than two weeks.
Dr McQueen said women in the Northern Territory who lived in rural and remote locations had limited choices if they did not live near a public hospital.
“Hopefully in the future remote clinics would be able to deal with early medical abortions as well, enabling women who live in remote settings to not have to travel to have an abortion,” she said.
The NT Government funds Family Planning Welfare Association NT to provide early medical abortions at no cost to the patient.
Public provision of abortion health services is uncommon, says Dr McQueen, and only in South Australia and the NT are women offered free abortion health services.
Prior to legislation reform, the NT Government needed to fly gynaecologists from interstate to provide a surgical abortion clinic in a public hospital.
“Further cost savings and benefits of freeing hospital surgical facilities and high-level providers also are positive,” researchers concluded in their study.
“Results demonstrate potential for changes in service provision of abortion in the NT with increased choice, patient-centred care and reduced waiting times.
“This audit demonstrated the possibility to move the majority of abortion services into primary health care, leading to cost savings.”
Researchers also said demand for abortion was falling globally and in Australia, and said the collection and analysis of this type of data was important to future health system planning.
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