LATE TERM ABORTION IN AUSTRALIA
When abortion was legalised in Western Australia in May 1998, the amendments to the Health Act 1911 provided that:
If at least 20 weeks of the womanís pregnancy have been completed when the abortion is performed, the performance of the abortion is not justified unless
medical practitioners who are members of a panel of at least 6 medical
practitioners appointed by the Minister for the purposes of this section have
agreed that the mother, or the unborn child, has a severe medical condition
that, in the clinical judgment of those 2 medical practitioners, justifies the
(b) the abortion is performed in a facility approved by the Minister for the purposes of this section.
King Edward Memorial Hospital is the only facility which has been approved under this provision. The names of the medical practitioners on the panel have never been officially released but it is known that Drs Jack Goldblatt, Jonathon Rampono, Harry Cohen and Jan Dickinson are on the panel.
Dr Dickinson, without disclosing her membership of the panel, has authored an article "Late pregnancy termination within a legislated medical environment" which was published in the Australian and New Zealand Journal of Obstetrics and Gynaecology (2004: 44:337-341). From this article we learn something of the otherwise secret work of this panel.
From June 1998 to December 2003 there were 219 abortions at 20 weeks or more carried out at King Edward. (Although Dickinson ignores this in her article the first six of these were in clear contravention of the law as they were performed before the Minister appointed the panel.)
Dickinson reveals that when a woman wants an abortion at 20 weeks or more she is first referred for counselling which "includes information on the conduct of the termination in addition to the alternative management options available". If she wants to proceed with an abortion her obstetrician will refer the case to the chairman of the panel which will consider the case, usually at a single meeting.
"Feticide using intracardiac potassium is used for all non-lethal anomalies beyond 24 weeks gestation, prior to the commencement of the abortion process. Misoprostol is the principal abortifacient used for medical pregnancy termination.... all women undelivered after 48h of misoprostol therapy received ... extra-amniotic prostaglandin or intravenous oxytocin."
The killing of the unborn child in his motherís womb by stabbing poison in his heart is no doubt done to avoid the occurrence of live born babies such as Jessica Jane, who in 1998 survived for 80 minutes after an induced abortion in Darwin, and the aborted baby found alive in the bin at Sydneyís Westmead hospital the same year.
Reasons for abortion
All abortions approved by the panel were for "a severe medical condition"in the child. These "severe conditions" that the panel believe warrant the killing of the child include Downís Syndrome and spina bifida.
The panel did refuse 11 applications for approval of post-20 week abortions. These included 7 for "psychosocial reasons" and 4 for minor or correctable disabilities.
Given that the law explicitly provides for post-20 week abortion on the grounds that the mother has a "severe medical condition ... that in the clinical judgement of those medical practitioners justifies the procedure" it is revealing that there was not even a single application, let alone an approval, for a post-20 week abortion on these grounds. This indicates that in approximately 145,000 pregnancies there has not been a single case where the pregnancy, post-20 weeks, has proved a severe threat to the motherís health.
There were 377 late-term (post-20 weeks) abortions performed in South Australia from 1998 to 2002. Of these 171 were for fetal abnormalities, 10 for a medical problem with the mother and 196 (52%) on "mental health"grounds. The "mental health" ground, provided for in South Australiaís abortion law which dates from 1969, is generally accepted to cover any psychosocial reason that is to allow effectively for abortion on request.
Other states in Australia do not require the notification of abortions so there are no comprehensive statistics on late term abortions.
In Melbourne in 2000 a 32 week old baby girl was aborted after her mother threatened to kill herself because her baby may have been a dwarf. Hospital notes indicate that "On delivery the baby doesnít look small."
PARTIAL BIRTH ABORTION
Dr. David Grundmann, the medical director for Planned Parenthood of Australia, has written a paper in which he explicitly states that he uses the partial-birth abortion procedure (he calls it "dilatation and extraction") as his "method of choice" for abortions done after 20 weeks (4 1/2 months), and that he performs such abortions for a broad variety of social reasons. ["Abortion After Twenty Weeks in Clinical Practice: Practical, Ethical and Legal Issues," ]
Dr. Grundmann himself described the procedure in a television interview as "essentially a breech delivery where the fetus is delivered feet first and then when the head of the fetus is brought down into the top of the cervical canal, it is decompressed with a puncturing instrument so that it fits through the cervical opening."
In the 1994 paper, Dr. Grundmann listed several "advantages" of this method, such as that it "can be performed under local and/or twi-light anesthetic" with "no need for narcotic analgesics," "can be performed as an ambulatory out-patient procedure," and there is "no chance of delivering a live fetus." Among the "disadvantages," Dr. Grundmann wrote, is "the aesthetics of the procedure are difficult for some people; and therefore it may be difficult to get staff." Dr. Grundmann also wrote that "abortion is an integral part of family planning. Theoretically this means abortions at any stage of gestation. Therefore I favor the availability of abortion beyond 20 weeks."
Dr. Grundmann wrote that in Australia, late-second-trimester abortion is available "in many major hospitals, in most capital cities and large provincial centres" in cases of "lethal fetal abnormalities" or "gross fetal abnormalities," or "risk to maternal life," including "psychotic/suicidal behaviour."
However, Dr. Grundmann said, his Planned Parenthood clinic also offers the procedure after 20 weeks for women who fall into five additional "categories": (1) "minor or doubtful fetal abnormalities," (2) "extreme maternal immaturity i.e. girls in the 11 to 14 year age group," (3) women "who do not know they are pregnant," for example because of amenorrhea [irregular menstruation] "in women who are very active such as athletes or those under extreme forms of stress i.e. exam stress, relationship breakup...," (4) "intellectually impaired women, who are unaware of basic biology...," (5) "major life crises or major changes in socio-economic circumstances. The most common example of this is a planned or wanted pregnancy followed by the sudden death or desertion of the partner who is in all probability the bread winner."
Items covering abortions were added to the Medicare schedule from 10 April 1974 without any public announcement or parliamentary debate or vote.
On March 22nd 1979 a motion introduced by National Party MHR Stephen Lusher to curtail Medicare funding of abortion was defeated 62 votes to 52.
The Abortion Funding Abolition Bill introduced by Liberal MHR Alasdair Webster as a private memberís bill in 1989, 1990 and 1992 was given a total of 2.5 hours of debate and never came to a vote.
Australian taxpayers have been funding abortions through Medicare for over 30 years.
On the 2004 Medicare General Medical Services Table there are two items under which abortions are funded.
Item 35643 is defined as "Evacuation of the contents of the gravid uterus by curettage or suction curettage". This abortion method can generally only be used in the first trimester (up to 13 weeks) of pregnancy. Note that the Table includes a note that this item is not to be used when Item 35640 applies. This is the item covering a curette after an incomplete miscarriage. A "gravid" uterus means a uterus that is pregnant or "with child". In the 2003/04 financial year taxpayers paid abortionists $10,428,730 to perform 72, 554 abortions by curettage or suction curettage.
Item 16525 is defined as "Management of second trimester labour, with or without induction, for intrauterine fetal death, gross fetal abnormality or life threatening maternal disease". This item would cover abortions by misoprostol or prostanglandin induction as well as the partial birth abortions performed by Dr David Grundmann. The second trimester is defined as weeks 14-26 of pregnancy. While there may be a small number of non-abortion procedures included under this item (intrauterine fetal death in the second trimester is rare) the majority of the 637 "services" funded at a cost of $116,031 are likely to be abortions at 14-26 weeks.
Medicare funding does not apply to procedures carried out on public patients in public hospitals. Abortions in public hospitals, including late term abortions, are funded through the general block grants given by the Federal Government to each state or territory under the regular 5 year duration Australian Health Care Agreements. The current agreements last from 2003-2008.
WHAT IS TO BE DONE?
In March 2004 the Hon Tony Abbott, Minister for Health first raised publicly his strong discomfort at presiding over a Medicare system which funded 73,000 abortions annually. Since then, and particularly since the return of the Howard Government to a fourth term of office, there has been an escalating debate on abortion among Federal MPs and other commentators.
As well as Tony Abbott a number of Coalition MPs have expressed their concern at the high rate of abortion in Australia, continued Medicare funding of abortion and particularly the performing of late term abortions. Those who have spoken out include: The Hon John Anderson, Deputy Prime Minister; the Hon De-Anne Kelly, Minister for Veteransí Affairs; the Hon Eric Abetz, Special Minister for State; Alan Cadman, Member for Mitchell; Christopher Pyne, Parliamentary Secretary for Health; newly elected Member for Hasluck, Stuart Henry and Senator-Elect Barnaby Joyce.
THE PRIME MINISTER
The following doorstop interview with the Hon John Howard, Prime Minister of Australia, took place on November 10.
Well you ask me about the abortion discussion, well look the position is as I stated before and after the election. There will be no Government-sponsored change at a federal level to current arrangements.
It is always open, if somebody wishes to on an issue like this, to bring forward a Private Memberís Bill and the Liberal Party for its part, and Iím sure also the National Party, would allow all of its members a free or open vote as we have in the past.
These are not issues that can be determined in accordance with political philosophy. There are strong views on both sides and I respect those views.
There are a few absurd propositions floating around in the whole debate. One of them is the vague suggestion of trade offs between support for legislation in one area provided there is change in relation to the governmentís attitude to abortion. Let me make it clear, thereíll be no trading off in relation to this issue of any kind.
The other rather odd proposition is that in some way it canít be talked about because there was a debate 20 or 30 years ago. That is self-evidently a negation of a free and open society, people are entitled to raise these issues.
But I stress there will not be any Government-sponsored change because we have a situation and inherently it is matter of a free vote and a matter of conscience. But if people wish to bring forward a Private Memberís Bill, well people are free to do so but they will obviously have to assess the views of people individually within the parties that are represented in the Parliament.
But itís not an easy issue and I would encourage those who hold strong views on both sides of it to recognise the strength of feeling of those who support in its entirety the present arrangements, that it is ultimately a matter for a woman to decide and equally I ask those who hold that view to respect the fact that people on the other side of the argument believe that they are dealing with issues relating to the termination of a life and that those views are held with equal strength.
Are you personally comfortableÖ
Well I have personally expressed a view about late term abortions in the past. If you have a look at an interview I gave on the Neil Mitchell programme only a couple of weeks ago.
So you may supportÖ
Look I have stated the broad framework in which the debate will take place, Iím not going to add to it. Next subject.
The Prime Ministerís remarks here suggest that the way forward in this debate would be for a Coalition MP to bring forward a private memberís bill dealing with Medicare funding of abortion. Of course, if such a bill is treated in the normal way private memberís bills are dealt with it would receive very limited debating time and never come to a vote.
However, there is the important precedent of the Euthanasia Laws Bill 1996 which was introduced as a private memberís bill by the Hon Kevin Andrews to deal with the problem of legalised euthanasia in the Northern Territory. The Prime Minister, while allowing a conscience vote to all Liberal MPs and making clear that this was not a Government bill, nonetheless ensured that parliamentary business in both the House of Representatives and the Senate was managed so as to allow adequate debating time on the bill. This resulted in its successful passage in both houses.
1. Write to:
The Hon John Howard
Prime Minister of Australia
Canberra ACT 2600
In your own words thank him for encouraging a full and open debate on abortion. Express your opposition to abortion, especially to the use of taxpayers money through Medicare to pay for abortions. You may wish to congratulate him for his own opposition to late term abortion. Finally, ask him to allow time in Parliament for a full debate and vote on this issue.
2. Write to any of the Coalition MPs named above (all at Parliament House, Canberra ACT 2600) and congratulate them for their public comments against abortion. Encourage them to pursue this matter in Parliament.
3. Write to your local MHR congratulating him or her on their recent success in the Federal election. Ask where he or she stands on abortion. Questions you could ask include: "Do you think there are too many abortions in Australia?"; "Do you think taxpayers should fund abortions through Medicare?" "Are you concerned that babies are being aborted at 20 weeks or more when premature babies born at the same age can survive if given proper care?""What are you going to do about this important problem?"