RU486

This is a guest post by Dr Suzanne Belton. Dr Belton is a medical anthropologist and midwife with clinical experience in community health, women’s health, family planning and refugee health.

Advocacy group WHAT RU4 NT? gathered in virtuous indignation on the 20th of April to hear the third and ongoing debate in the Northern Territory Legislative Assembly on reform to the Northern Territory’s Medical Services Act, the 1982 law which regulates access to abortion in the NT, a reform process which began in 2012.

Since that time the minority Country Liberal Government has leaked members faster than a Indonesian fishing boat full of refugees. One renegade ex-member–Speaker of the Legislative Assembly and now Independent Member for Goyder, Ms Kezia Purick–a veritable Amazon, announced her private member’s bill to reform abortion law after she left the CLP in 2015.

This soap opera is due to a conservative stagnation in the parliament. Minister for Health John Elferink confirmed that during the debate this week, stating, ‘Clearly the government of the day made a determination that nothing should change in relation to the use of RU486 in the Northern Territory.  That is the position of government; it is a board decision, to which I am bound.’

In our over-governed, unicameral legislative assembly we have 25 members of parliament, nine of whom are women. For a far flung frontier, the Territory is leading the way for women in politics. We make Malcolm Turnbull look like he fell out of Mad Men. Truly ladies, the Northern Territory is a hotbed of feminist advocacy!

Abortion–is a touchy subject–one in four women in Australia has had or will have one and everyone has their own opinion.

My opinion is that the Northern Territory law needs a makeover not simply a bit of Botox. Currently the law says that only a specialist gynaecologist can perform a termination of pregnancy and there must be two doctors agreeing to the procedure as one would not be able to do the job alone. This in a place where it is difficult to find health services. The law says doctors and women can be criminalised and that abortions must occur in a hospital.

This has been interpreted by some lawyers to mean that early medical termination of pregnancy provided by a GP before nine weeks gestation with tablets taken at home is not legal in the Northern Territory. The tablets were invented and used 25 years ago in Europe: RU486 has been available for a decade in the rest of Australia and is on the Pharmaceutical Benefits Scheme. The Northern Territory is the only jurisdiction that does not allow early medical abortion.

In the Northern Territory medical and scientific progress is fossilised in a time warp, when Kylie Minogue (aka Charlene in Neighbours) still had the mullet perm and the home pregnancy test was not available.

The debate has been riveting.  So far, there are the cowboys, the missionaries and the modern madams.

One “cowboy”, the Member for Fong Lim, Mr Dave Tollner a former CLP Minister of Health felt the need to explain women’s reproductive physiology by saying, ‘I am concerned about people having abortions in the toilet.’

However the “missionaries”–including lapsed and practising Catholics–are not concerned with plumbing so much as women’s psychological hygiene. The Labor Member for Barkly, Gerry McCarthy stated, ‘…This became my thinking – psychosocial support networks for Territory women who undergo this process [of medical abortion].  If you live in the greater Darwin region you have access to those supports; if you live in Tennant Creek or Borroloola you do not.’  He did not mention the lack of psychological support that a woman may experience with a forced pregnancy and unwanted childcare that tend to last two decades.

Another “missionary”, the Independent Member for Nelson, Mr Gerry Wood used a road trauma analogy.  ‘If you do not support abortion in the first place, under the existing process of abortion, then just because a different method is developed to achieve the same goal of destroying a human life does not mean that it can be supported.  To do so, for me, would be hypocritical.  It is a bit like asking me if I would like to be hit by a bus or a car.’

In the Territory it seems that men often get confused and think they can get pregnant and go on to muse about their abortion choices being like road-train accidents. It’s hard being a man in the NT. The missionary types forget that even Pope Francis has said the Church needs to get out of people’s bedrooms and focus on the tough stuff like poverty. Hell, there’s plenty of that here to keep the righteous busy.

The “modern ladies” are more measured. Labor Member for Nightcliff, Ms Natasha Fyles told the Assembly, ‘This is very important debate for the women of the Territory because we face that tyranny of distance and locational factors.  This is about giving Territory women equal rights that women all over Australia are afforded, except for those in the Northern Territory who probably need it the most – access to a medical termination in their communities close to home with support when they need it most.  Access to a medical termination is something that is safer and less invasive for women.’

There are only three hospitals that provide surgical abortions in Darwin and Alice Springs and they are 1,500 km apart  The service is fragile. Many Territorian women travel interstate at their own cost to get the reproductive health services they need–if they can afford it.

Would you go to a lawyer for an appendectomy? We don’t write laws telling doctors how to manage health problems because lawyers probably shouldn’t be doing medicine.  CLP Member for Drysdale, Ms Lia Finnochiaro recognised this, ‘I have confidence in the profession, the AMA and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists to determine the appropriate administration of RU486 and the guidelines associated with it.’

Many parliamentarians have mentioned safety. They want to do the right thing by women. Perhaps letting women decide would be a start?

And here’s the news – women make decisions all the time about pregnancy and childbirth. They risk their health and wellbeing every day by simply managing their fertility though contraceptive, pregnancy, birth and menopause options.

All are risky.

It is women who experience teenage pregnancies, hormonal related illnesses and cancers, maternal sickness and death so please give us some credit.

Each year around 20 Australian women die due to childbirth not abortion. We talk with our friends and family, we talk with our partners, we read, we visit our health providers and ultimately we decide and take the risks that inevitably are a part of motherhood (or not).

Territorians are getting tetchy with political dinosaurs who treat women like empty beer stubbies. We are ripping White Ribbons off Attorney-General’s breasts faster than you can paddle down the Todd River and are working towards abortion law reform to simply bring the Northern Territory in line with other parts of Australia that have reformed laws and health service choices.

The next debate on the Medical Services Amendment Bill in the NT Legislative Assembly is scheduled for May 25th.

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Dr Belton is a medical anthropologist and midwife with clinical experience in community health, women’s health, family planning and refugee health.

She is a senior researcher at Charles Darwin University (CDU) and has worked in remote Australia, Thailand, Indonesia, East Timor and China.

Dr Belton’s research interests include the anthropology of health, the social and cultural context of sexual and reproductive health, gender and violence against women, cross-cultural studies, traditional birth attendants, community ethnography, models of maternal health care, and human rights. She uses mixed methods and teaches qualitative research methods, global health, sexual and reproductive health and community and public health.

Dr Belton is the Chairperson of Family Planning Association NT and a past representative for Australia in International Planned Parenthood Federation.