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Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia
  1. L A Keogh1,
  2. D Newton2,
  3. C Bayly3,
  4. K McNamee4,
  5. A Hardiman5,
  6. A Webster6,
  7. M Bismark7
  1. 1Associate Professor, Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2Research Fellow, Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3Senior Clinical Adviser, Women's Health, The Royal Women's Hospital, Melbourne, Victoria, Australia
  4. 4Medical Director, Family Planning Victoria, Melbourne, Victoria, Australia
  5. 5Manager, Pregnancy Advisory Service, The Royal Women's Hospital, Melbourne, Victoria, Australia
  6. 6Senior Policy and Health Promotion Officer, Women's Health Victoria, Melbourne, Victoria, Australia
  7. 7Associate Professor of Law and Public Health, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Louise Keogh, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; l.keogh{at}unimelb.edu.au

Abstract

Introduction In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform.

Methods Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached. Nineteen experts from a range of health care settings and geographic locations were interviewed in 2014/2015. Thematic analysis was conducted to summarise participants' views.

Results Abortion law reform, while a positive event, was perceived to have changed little about the provision of abortion. The views of participants can be categorised into: (1) goals that law reform was intended to address and that have been achieved; (2) intent or hopes of law reform that have not been achieved; (3) unintended consequences; (4) coincidences; and (5) unfinished business. All agreed that law reform had repositioned abortion as a health rather than legal issue, had shifted the power in decision making from doctors to women, and had increased clarity and safety for doctors. However, all described outstanding concerns; limited public provision of surgical abortion; reduced access to abortion after 20 weeks; ongoing stigma; lack of a state-wide strategy for equitable abortion provision; and an unsustainable workforce.

Conclusion Law reform, while positive, has failed to address a number of significant issues in abortion service provision, and may have even resulted in a ‘lull’ in action.

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Footnotes

  • Funding The research was funded by the Brenda Jean Brown Trust.

  • Competing interests None declared.

  • Ethics approval The University of Melbourne.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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