Tasmanian women could be forced to travel interstate to get an abortion if new regulations governing medical clinics cause doctors to abandon their practices in the state or increase their fees.
Abortions are notoriously difficult to obtain in Tasmania.
Two Victorian doctors who fly in one day a week carry the surgical load for the state.
And now Fertility Control Clinic's Kathy Lewis has said regulations introduced in 2011 mean she will have to upgrade her Hobart clinic and register it as a day hospital.
``I'm at the point where I'm debating whether it's worth going ahead and doing that or not,'' Dr Lewis said.
She said any increased costs would have to be passed on to her patients.
At the moment the Medicare rebate covers about half of the procedure costs.
A fee hike could mean it was cheaper for women to fly to Melbourne and have an abortion there.
``It's a fairly precarious situation,'' Dr Lewis said.
Abortion is a crime in Tasmania and illegal without a written referral from two doctors that continuing with the pregnancy would cause more harm to the woman's physical or mental health than termination.
No one has ever been prosecuted for abortion in Tasmania.
Dr Lewis said she was able to provide abortions at up to 12 weeks gestation in Tasmania - any longer and the procedure required an overnight stay.
She said that allowed most women four weeks after they discovered their pregnancy to see a doctor, get a referral, make a booking to see her or another clinic and get to the front of a two-week waiting list.
``It's a wonder anyone gets themselves organised in time at all, but they do,'' she said.
Women who miss this window can travel to Victoria, where abortion is decriminalised up to 24 weeks.
Family Planning Tasmania chief executive Glenn Campbell said access to abortion in Tasmania would not improve until it was decriminalised.
Mr Campbell said the service provided counselling and referral to one to three women a week in Launceston and two to five a week in Hobart.
He said elective abortions were not performed in Tasmania's public hospital system, and its ``confused'' legal status and the conscientious objection of some doctors had locked out much of private practice.
``I don't think anyone encourages abortion - no one is particularly fond of the idea - but women have the right to decide when they have children and whether they have children at all,'' Mr Campbell said.
Dr Lewis said decriminalisation was less of an issue than the availability of doctors willing to take up the specialisation.
Health Minister Michelle O'Byrne said Tasmanian women were concerned about their right to access safe and legal abortion.
``It has become an issue for women who can't afford to pay private clinics for the service and we've been working with women's organisations and health organisations to see what's necessary to ensure that women can access safe and legal terminations at an affordable price,'' Ms O'Byrne said.
The manager of Specialist Gynaecology Centres, which runs abortion clinics in Hobart and Launceston one day a week, could not be contacted.