Reviewed by Norrie Sanders
Barbara Baird has published extensively on the history of abortion, and this book came about because: “..while I knew a lot about the law, the politics and how we think about the issue, I knew very little about the provision of abortion services” [p1]. She seems to be posing a question – if the majority of Australian’s support abortion and abortion is legal for medical professionals to deliver, why is having an abortion not treated as a mainstream medical service?
The book covers the period from 1990 to the present in Australia, comparing each state and territory. Facts and figures are supplemented with anecdotes from practitioners. A detailed introduction summarises much of the content, with subsequent chapters on neoliberalism, public and private health sectors, doctors, decriminalisation, and “early” and “late” abortions.
She quickly establishes that anti-abortion sentiment is in the minority: “….the percentage of Australians who reported support for abortion being readily obtainable has grown from about 60 per cent to nearly 75 per cent….” [p5] and “support for decriminalisation in the last decade has been about 80 per cent” [p6].
Of course, the “pro-life” minority continues to have an impact on government policy and service delivery. Abortion remains a moral dilemma for some, and all Australian jurisdictions prescribe limits which appear to be acceptable to the broader society, such as who can perform abortions and how late in the pregnancy should termination be permitted.
In this book, Barbara Baird moves on from the moral issues and supports “the principle that the needs of the person with an unwanted pregnancy should be at the centre of our thinking about abortion” [p1].
The picture on service delivery over 30 years is mixed – “both remarkably different….and in some respects not far from where it started” [p43]. The central pillar is consistent – the private sector continues to be the main provider in most states, partly because there is a paucity of public sector provision. Even decriminalisation in that time has not made appreciable difference. This is in complete contrast to child birth, of which the majority are in public hospitals.
For those with the means and in the right locations, “…access to high quality abortion services is good..” [p232]. But “..the system creates reproductive injustice for about one third of all people who have to have an abortion..” [p233]. Perhaps surprisingly, we learn that overall demand is declining, albeit by relatively small amounts “…in the actual number of abortions …and in the abortion rate…” [p40].
“Abortion Care is Health Care” documents many unsatisfactory features of our modern system, but the evident stasis in how abortion is provided, allied to government reluctance to engage in public debate with anti-abortionists, suggest that there is inertia in the system. The author has decided not to offer her views as to what should happen, instead noting that the book is more about “stimulated critical thinking” [about priorities for change] and “is not a vehicle for policy direction, or for activist or advocacy strategy” [p241].
The book is encyclopaedic in its content – meticulously researched and presented, with over a fifth of the content devoted to notes, bibliography and index. As a research and policy tool for specialists, it may prove to be an authoritative reference.
“Barbara Baird ……works in Women’s and Gender Studies at Flinders University and researches Australian histories of sexuality and reproduction. Since 2017 she has been the Co-Convenor of the SA Abortion Action Coalition”.
(October 2023)
by Barbara Baird
MUP
ISBN: 978 052287 840 0
$40.00 (RRP Paperback); 320pp