How to Get an Abortion in South Australia
WORDS BY TAHLIA DILBEROVIC.
One year ago in March 2021, South Australia decided to join their more civilised counterparts and finally decriminalise abortion. This change meant that for the first time in decades people would not be treated like criminals for accessing vital healthcare.
Decriminalisation brought about many logistical changes as well – abortion shall now be allowed on demand until 23 weeks and 6 days without the approval of two doctors; patients would be able to access medical abortions via telehealth; abortions would be provided outside of hospitals; and patients would no longer need to be residents of SA for more than two months in order to access healthcare. Doctors who conscientiously objected to abortion would also finally be required to actually do their jobs and provide referrals if they did not wish to provide the procedure themselves.
Or at least, these changes were meant to happen.
As of March 2022, these changes have still not been enacted. South Australian health services are still waiting for new government regulations to be established, and in the meantime, people seeking these services are still subject to an archaic system; one that requires the approval of two doctors and is only technically legal if these doctors decide an abortion is necessary to a) protect the life, b) mental health of the patient or c) the fetus is detected to have serious abnormalities. No abortions on demand for us.
Perhaps something worse than the backwardness of South Australia’s laws is the inaccessibility of these procedures. Even if fully decriminalised, there are still significant barriers to access – the distance of providers (especially for those living rurally), the cost of procedures (nope, it isn’t free!) and, of course, the underlying stigma involved. However, there is another barrier that is rarely ever talked about; knowledge – how the hell do you actually get an abortion in SA?
Always the researcher, I asked around my friend group to see if this secret of womanhood had simply been kept from me (I went to a catholic school after all) – but nope. Hardly anyone in my pro-choice, politically (and sexually) active friendship group knew the particulars about actually accessing an abortion. So, while bitching about a problem is always fun (and, I would argue, a prerequisite for creating social change), this is a question I can actually answer.
So, here it is – a guide on how to the best of my understanding (gained by excessive googling and bugging of healthcare professionals) you get an abortion in South Australia. Mileage may vary and this is N O T medical advice
STEP 1
If you think you are pregnant, take a test.
Generic brands are essentially as accurate as expensive ones, so no need to splash out. Pregnancy tests are the most accurate after you’ve already missed your period (so 5 weeks from your last cycle) as it takes a while for enough HCG to build up in your urine. Let’s assume the test is positive.
STEP 2
Contact your closest service provider to schedule an appointment (https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/services/health+services+for/womens+health+services/unplanned+pregnancy+services/unplanned+pregnancy+services)
This conversation for those who like having a script can simply start with ‘Hello, I think I may be pregnant and I want to discuss my options, can I please book an appointment?’.
When contacting the provider, it is best to give them an estimate of how far along in the pregnancy you may be (calculate this by counting the weeks since your last period). If it is possible you are more than 12 weeks pregnant, mention this when booking the appointment. The waiting time for an appointment will generally be less than 2 weeks.
STEP 3
Bring your Medicare card (if you have one) with you to your first appointment.
This appointment will be a clinic consultation and may take up to two hours. You will be assessed by a healthcare worker and a doctor who will confirm the pregnancy (either through a blood test, ultrasound, or both) and explain to you your options going forward.
OPTION A: A MEDICAL ABORTION
A medical abortion is available to you up until 9 weeks gestation and involves a fee (which can be up to $250, with the average cost for a Medicare card holder being $42). It involves taking 2 pills, 24-48 hours apart, and can take place in the privacy of your own home. The first pill is mifepristone and is taken at the end of either your clinic consultation or a secondary appointment (this will depend on the provider).
Mifepristone blocks the hormone progesterone, which causes the breaking down of the uterus lining. After taking this pill, you may be able to resume normal activities.
24-48 hours after the first pill, you will take the second pill, Misoprostol. Misoprostol softens the cervix and causes the uterus to contract and expel the pregnancy. This will generally cause cramping and bleeding. It is recommended you have a support person with you during this time.
OPTION B: A SURGICAL ABORTION
A surgical abortion is available up to 22 weeks (28 weeks under exceptional circumstances) under current regulations. Surgical abortions after 14 weeks require more extensive medical intervention (such as higher dosages of medication or slightly modified procedures).
A surgical abortion involves 2 appointments, which can last up to two hours each. The first appointment will follow the clinic consultation process outlined above, where the pregnancy is confirmed, and options discussed. The second appointment will be allocated to you and scheduled for the nearest appropriate date. You will also be given a date and time from which you need to fast from (cease intake of food and water).
The second appointment involves the surgery. A surgical abortion is preformed in hospital, under general anesthetic (you will not be awake for the procedure) and generally takes around 15 minutes.
What occurs during this surgery varies depending on how far along you are in your pregnancy. For most, it will mainly consist of the doctor using a gentle suction tool to remove the pregnancy (a suction aspiration abortion).
Prior to the surgery you will be given misoprostol to soften the cervix and reduce bleeding. You will take this once more after the surgery for the same effect.
After the surgery, you will need someone else to pick you up, as is the case with most surgeries. Alternatively, you may be able to make arrangements to stay at the hospital overnight but this conversation should take place before the procedure.
STEP 4
2 weeks after either procedure, you should schedule a follow up appointment to confirm the success of the procedure and address any concerns. This can be done through your GP, SHINE SA, the Pregnancy Advisory Centre, or the hospital the procedure was performed at.
EDITORIAL NOTE: This article has been reuploaded and was originally published in 2022.