The following is excerpted from Women's Health Tasmania Submission to the Federal Inquiry into universal access to reproductive healthcare.
Women’s Health Tasmania has been a leading voice in the development of better sexual and reproductive health systems and practices in Tasmania for over 30 years. Our recent work in this space includes the establishment of the Pregnancy Choices website, the delivery of state-wide training workshops on pregnancy options and reproductive coercion, and the preparation of a new report into termination experiences titled Talking to people about terminations of pregnancy in Tasmania.
From this vantage point, Women’s Health Tasmania is well placed to respond to the Inquiry into universal access to reproductive healthcare (the Inquiry).
We welcome this opportunity to contribute to the Australian Government’s understanding of and response to “barriers to achieving priorities under the National Women’s Health Strategy for universal access to sexual and reproductive health information, treatment and services that offer options to women to empower choice and control in decision-making about their bodies.”
The scope of this submission is limited to the Tasmanian context in which Women’s Health Tasmania operates and is informed by the experience of our service users and staff. While some features of the local context will likely be relevant to other regional and rural areas of Australia – for example, the requirement to travel long distances to access healthcare services and the scarcity of specialist services – other characteristics are unique to the Tasmanian socioeconomic landscape.
Importantly in relation to healthcare access, Tasmania’s population health outcomes are inseparable from the state’s overall experience of complex and sustained disadvantage. Tasmania has the unenviable title of being the country’s “poorest state” with “among the worst education and health outcomes in the nation.” In fact, we are the state with the highest population of people with a disability, the highest levels of smoking and obesity, the highest pre-term birth rate, and the lowest levels of literacy, educational attainment, and income.
Despite this, Tasmania has fared relatively well in terms of systemic progress on reproductive healthcare, at least at the regulatory level. Termination of pregnancy was decriminalised in Tasmania in 2013, ahead of New South Wales, Queensland, South Australia and the Northern Territory.
Financial support for people in financial distress, including people who are not eligible for Medicare, to access surgical and medical terminations has been provided in Tasmania since 2018. Financial support for people on low incomes, including people who are not eligible for Medicare, to access long-acting reversible contraceptives (LARCs) has been provided in Tasmania since 2019. Free public provision of surgical terminations was guaranteed through regional hospitals in 2021.
While on paper these provisions have placed Tasmania ahead of all other Australian jurisdictions, in practical terms they have not always translated to the provision of safe and accessible reproductive healthcare for all Tasmanians.