City/rural parity

January 9th, 2006

Currently there are four individual doctors and two separate applications with the Therapeutic Goods Administration (TGA) to become an authorised prescriber of the drug RU 486.

Professor Caroline de Costa an Obstetrician based in Cairns, was the first doctor to use the authorised prescriber route, which is available for medical practitioners in Australia if they want to use a drug for a particular patient or a group of patients which isn’t normally available in Australia.  Late last year Professor de Costa had her application (to prescribe RU 486) endorsed by the ethics committee of her hospital and now awaits a decision from the Health Minister.

The other three doctors are based in and around Mildura, Victoria. They argue that rural (and remote) women are disadvantaged by their geographical isolation when it comes to accessing an abortion.  The disadvantage is two-fold:

  1. Lack of local surgical resources
  2. Difficulty in controlling privacy 

A conscience vote is expected next month amoungst MP’s when parliament returns.

With paternalistic, infantilising rhetoric such as this, MP’s will hopefully show Australian women (and the men who support them) their sophistication and vote for the end of the current veto, the resumption of the TGA’s role and the widening of choice.

Image from here  

Risk assessment choice.

January 3rd, 2006

A study conducted in New Zealand and published in the Journal of Child Psychology and Psychiatry and Allied Disciplines has findings suggesting that abortion in young women may be associated with increased risks of mental health problems.

Does this mean that young women should not have access to abortions – no, these findings should inform choice and clinical practice not dictate it.

"No-one’s denying the fact that there will be psychological problems in some women after this procedure (abortion) in the same way as there are after a hysterectomy. But we also know that having an unwanted pregnancy to term or having to give a child up for adoption because you can’t manage also is related to mental health problems."

"There’s lots of complex reasons why people might feel distressed and disturbed after abortions.  Most of the research shows that transient and short-lived feelings of anxiety or depression are probably quite common." – Director NSW Institute of Psychiatry, Dr. Louise Newman.

Consider mental health incidence figures for continuing with a pregnancy.

"The incidence of depression in women postpartum is similar to depression in women generally. However, the incidence of depression in the first month after childbirth is three times the average monthly incidence in non-childbearing women. Studies across different cultures have shown consistent incidence of postnatal depression (10 to 15 percent), with higher rates in teenage mothers. A meta-analysis of studies, mainly based in developed countries, found the incidence of postnatal depression to be 12 to 13 percent.

Four systematic reviews have identified the following risk factors for postnatal depression:

  1. Past history of psychopathology, including postnatal depression;
  2. Low social support;
  3. Poor marital relationships;
  4. Recent life events.

Recent studies from India and China also suggest that spousal disappointment with the sex of the newborn child, particularly if the child is a girl, is associated with postnatal depression. The mother’s reaction to the sex of the baby also may be a risk factor within some cultural groups."

Just as a woman can choose pregnancy to birth (advised of known risks) so a woman can choose pregnancy to end (advised of known risks).

Update: A succinct piece by Julia Baird.

creating a balanced choice

Image from here