Calls for greater access to abortions in Tasmania continue, with a recent study highlighting the support of general practitioners that vulnerable women should be provided with termination of pregnancy in the public health system.
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Published in the Australian Journal of Primary Health in May, "Termination of pregnancy in Tasmania: access and service provision from the perspective of GPs" explored the issues facing GPs in regards to aiding access to terminations and early medical abortion services for Tasmanian women.
Based on the results of a survey, with responses from 211 GPs across the state, the study found accessing pregnancy terminations remains an issue for Tasmanian women, with almost half of GPs - excluding conscientious objectors - indicating they would be interested in providing early medical abortion services, "but perceived barriers were significant".
There are two safe ways for a woman to terminate a pregnancy - by surgical abortion, or by medical abortion. Both methods are available and legal in Tasmania.
However, medical terminations are only an option for women up to nine weeks of pregnancy. While, surgical terminations are legal up to 16 weeks of pregnancy.
Of the questions asked in the study, the greatest level of agreement among GPs was in response to the statements that vulnerable patients should be provided with abortions in the public system, that greater leadership by decisionmakers was needed to improve termination access, and that access was more difficult for women in rural areas.
"The present study provides evidence that with the correct support and training there is a potential workforce for providing EMA [early medical abortion] in rural Tasmania," it reads.
There was also support among GPs for providing pregnancy terminations in the public healthcare system. However, the report noted that at the time of research (October and November 2018), significant changes were being made to the landscape of abortions in Tasmania.
In December 2017, the last dedicated provider of surgical terminations in Tasmania closed, requiring many women to travel outside their region to access surgical termination with private providers, and with limited accessibility to lowcost services.
Since November 2018, women have been able to access surgical abortions through undisclosed private providers operating out of Hobart.
However, women must be referred by their GP. There are also four prescribed health service providers chartered with the responsibility of supporting access to surgical abortions, in accordance with the Reproductive Health (Access to Terminations) Act 2013.
This includes Family Planning Tasmania, who championed the report in partnership with the University of Tasmania, and who recently renewed calls for abortions to be offered in Tasmania's public hospitals.
The report also identified a delay in referral to a service provider as a common barrier reported by women trying to access abortion services, and a contributing factor for psychological distress.
"The present study supports previous studies that identified affordability as a major barrier to accessing TOP [termination of pregnancy] services and supports more publicly funded TOP services being available to address this barrier," it reads.
"One in 10 GPs identified as conscientious objectors; of those who did not, almost half were willing to provide EMA, with the number greater among rural doctors. Training opportunities, after-hours care and the availability of other support were seen as the most significant barriers by all GPs."
The study concluded that there was an interest and a willingness to provide early medical abortion services among Tasmanian GPs, including those in rural and remote areas. However, poor knowledge remains a major barrier to provision.
"By addressing these concerns, there is potential to improve equitable access to services for Tasmanian women seeking TOP," the report reads.
"Responses to this survey indicate that the GPs' experiences on the ground are informative and that they should be part of the political conversation, at both a state and federal level, in advocating for improved access to TOP services, including EMAs, for all women."
Earlier this month Health Minister Jeremy Rockliff confirmed the Health Department was working to finalise a referral pathway for GPs and prescribed health providers to refer vulnerable women seeking a surgical termination in the north to the Launceston General Hospital, "as occurs in the south of the state with the RHH to ensure that the principle of equity is maintained".
A Health Department spokesman said it had met with prescribed health services, Primary Health Tasmania and other stakeholders in recent days to finalise details.
"The department expects the pathways to be finalised next week and information provided to general practitioners," the spokesman said.
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