Planned parenthood and reproductive rights

An evaluation of access and equity in the provision of medical abortion following the introduction of mifepristone on the Australian Pharmaceutical Benefits Scheme

Angela Taft and Mridula Shankar; in collaboration with Jayne Lucke, Kerry Petersen and Julia Shelley, Deakin University; Danielle Mazza, Monash University; Kirsten Black, University of Sydney; Philip Goldstone, MSH; Safeera Hussainy, Monash University

Mifepristone, a safe and effective abortifacient, was included in the pharmaceutical benefits scheme in 2013, providing women in Australia with a non-surgical option for pregnancy termination. In the absence of national data on abortion, little is known about issues of accessibility to this service, and whether and how the availability of medical abortion impacts access. This baseline collaborative study (with Marie Stopes International Australia) explores:

  • The geographical distribution of medical abortion services.
  • Women's experiences of abortion, including direct and indirect costs, the barriers to seeking and receiving care, preferences for type of procedure, and the information and advice available in assisting women to make informed choices about continuing or terminating an unintended pregnancy
  • The prevalence of unwanted pregnancy in Australia

Data collection for this study is currently underway and includes:

  • A completed survey of providers registered with Marie Stopes Health
  • A computer-assisted telephone interview (CATI) survey of a random sample of 2000 Australian women aged 18-45, and
  • A self-administered survey of ≈ 3000 abortion clients in all 14 Dr Marie clinics across Australia.

In addition to providing national data on the status of abortion services in Australia, this study will serve as a baseline, against which we will compare changes in measures of access and equity over time through a follow-up study in 2016.

FUNDING: TCPP, MS Health, Women's Health Association of Victoria

STATUS: Data collection

Collaborative Work

The Australian Contraceptive Choice Project (ACCORD)

Angela Taft; in collaboration with Danielle Mazza, Monash University; Kirsten Black and Kevin McGeechan, University of Sydney; Jayne Lucke, La Trobe University; Marion Haas, University of Technology Sydney; Jeffrey Peipert, Washington University, USA

The primary aim of this study is to increase the uptake of long-acting reversible contraceptives (LARCs) amongst Australian women by trialling a complex intervention that involves training GPs to provide "LARC First" structured contraceptive counselling and implementing rapid referral pathways to LARC insertion.

FUNDING: NHMRC 2015-2018

STATUS: awarded in 2014, commencing in 2015

Accessing contraception for emergency supply study (ACCESS)

Angela Taft; in collaboration with Safeera Hussainy, Danielle Mazza Kevin McNamara, Ayesha Ghosh and John Jackson, Monash University; Kirsten Black, University of Sydney; Rhonda Clifford and Sajni Gudka, Unversity of Western Australia; Kath Ryan, La Trobe University

Access to emergency contraception is essential as it helps prevent unwanted pregnancies – an important public health goal. The levonorgestrel containing emergency contraceptive pill (ECP) has been available in Australia since 2004 through community pharmacies without prescription. In 2012 the Pharmaceutical Society of Australia (PSA) released a new guideline for levonorgestrel provision that contains the latest scientific evidence regarding its use.

While the ECP is extraordinarily safe and has no medical contraindications (International Consortium for Emergency Contraception and International Federation of Gynecology & Obstetrics 2012), there are significant barriers to pharmacy access in Australia and overseas. Pharmacists' practices in Australia are variable, commonly not meeting evidence-based recommendations in the PSA guideline and resulting in women being unnecessarily declined ECP supply (Hussainy et al. 2011, 2014). Women's experiences of obtaining the ECP from pharmacies are both positive and negative (Hobbs et al. 2011).

This research project involves conducting a comprehensive barriers analysis to confirm findings from earlier studies. Evidence-based interventions will subsequently be designed and piloted in community pharmacy, to promote increased adherence with the PSA guideline and therefore increased supply of, and enhanced access to, the ECP by women.

FUNDING: Monash University, Bayer and Marie Stopes

STATUS: awarded in 2014, commencing in 2015