The medical definition of ‘abortion’ is the expulsion or removal of a fetus from the uterus.5 Abortion can be spontaneous, or it may be induced. The former is more commonly referred to as ‘miscarriage’, and it is the latter—that is, medically induced abortion—and the circumstances in which it takes place, which is the focus of public debate (and of this brief). Medically induced abortion is also referred to as ‘termination of pregnancy’. The terms ‘abortion’ and ‘termination of pregnancy’ will be used interchangeably throughout this brief.
The most common type of induced abortion is a surgical procedure known as a suction curette. This procedure—which usually takes about 15 minutes—involves the removal of the lining and the contents of the uterus (the fetus and placental tissue) by applying suction to the inside of the uterus with a small plastic tube.6 Abortions performed later in pregnancy involve different kinds of procedures, depending on the stage of gestation and the reason for which the abortion is being performed.7
As with all surgical procedures, pregnancy termination is not without risk. However, suction curettage is a simple and low risk procedure for women to undergo when performed between 7 and 12 weeks of pregnancy.8 The available data suggest that it is also overwhelmingly safe: in South Australia—which, as we discuss below, is the only Australian jurisdiction where comprehensive data on abortions are published—over the last decade, on average less than 1 per cent of women who had abortions experienced complications (and in fact, the proportion of reported complications has decreased steadily: from 1 per cent in 1994, to 0.4 per cent in 2002).
The total numbers of Medicare claims processed for the two MBS items which may result in an abortive outcome in each year over the last decade (1995–2004) are shown in Figure 1. The average number of Medicare-funded abortive procedures in the years 1995 to 2004 was approximately 75 700. As Figure 1 shows, in six out of the last ten years, the number of Medicare claims processed for procedures which may have resulted in an abortive outcome has decreased.
The South Australian data is sometimes used to calculate estimates of national abortion rates. For example, in 2002 there were 5417 abortions notified in South Australia, which equals approximately 17.2 pregnancy terminations for every 1000 women aged between 15 and 44 years.42 If this rate were replicated in the total Australian population of women aged 15–44 years (the so-called ‘fertile age range’) for the same time period, there would have been approximately 73 300 abortions in Australia in 2002.
In the light of current debate on ‘late-term’ abortions,47 the South Australian data on the gestational age at which pregnancies are terminated is particularly useful. It shows that in the years 1994–2002, the vast majority of abortions performed in South Australia took place before 14 weeks gestation, and that only a very small proportion (less than 2 per cent) took place at or after 20 weeks.
