Bills

Termination of Pregnancy Bill

Second Reading

Adjourned debate on second reading (resumed on motion).

The Hon. C.M. SCRIVEN (15:21): I rise today to speak on the Termination of Pregnancy Bill, and I thank those who have made contributions so far. I acknowledge that many have a sincere concern for women and are doing what they think is right to assist them. This is a conscience vote for Labor Party members.

I have many issues with this bill. Moving provisions in regard to abortion from the Criminal Law Consolidation Act to the Health Care Act is minor. The decriminalisation of women is a symbol only, as no-one has been prosecuted for 50 years for procuring an abortion. I will come to some specific aspects of the bill shortly, particularly the aspect of abortions up to full term. But this bill also presents an opportunity to rethink the accepted narrative on abortion.

I am told that votes are not changed by speeches in the chamber, and quite possibly that is true; however, it is still worth placing on the record and including in public discourse alternative points of view. We are told that to be feminist one must be pro-choice, and pro-choice of course is to support abortion. I believe we need to challenge this view of feminism. We need to look at whether abortion is limiting women's real choices. I will quote one feminist writer who spoke first about the pressures on women to abort, often for other people's convenience, and then went on to say:

The lack of choice is reflected not only in pressure applied by others, but also…through social and cultural factors. The decision to have an abortion is often made under conditions of reduced freedom. Inequitable workplace treatment, struggles to receive appropriate welfare and child support payments, class and cultural biases in family size, attitudes to 'older' women who are pregnant and to disabled women and disabled unborn babies, along with the social subordination of women in general, all conspire to direct certain women in a certain direction.

A feminist writer wrote, as far back as 1992:

The fiction of the right to 'choice' masked women's real vulnerability in the matter of reproduction…When they availed themselves of their…right to abortion, they often, perhaps even usually, went with grief and humiliation to carry out a painful duty that was presented to them as a privilege…Abortion is the last in a long line of non-choices.

What women 'won' was the 'right' to undergo invasive procedures in order to terminate unwanted pregnancies…unwanted by their parents, their sexual partners, the governments who would not support mothers, the employers who would not support mothers, the landlords who would not accept tenants with children, and the schools that would not accept students with children…If a child is unwanted, whether by her, her partner or her parents, it will be her duty to undergo an invasive procedure and an emotional trauma and so sort the situation out.

The crowning insult is that this ordeal is represented to her as some kind of privilege. Her sad and onerous duty is garbed in the rhetoric of a civil right. Where other people decide that a woman's baby should not be born she will be pressured to carry out her duty…by undergoing abortion.

Women have been abandoned to their autonomy in the abortion decision. It is your choice, therefore you are on your own. The same attitude carries over to the woman who chooses to continue a pregnancy. She finds she is on her own in that as well. There should be a greater focus on measures to ensure an end to discrimination against women in benefits, housing, work or education. One writer asked why should a 17 year old be denied the chance of completing their education at the whim of an anti-abortion zealot?

Apart from name calling, why should that 17 year old be denied the chance of completing their education because they do not choose abortion? We need to be willing to flip the questions if we are really going to look at institutionalised vulnerability of women and the options we are presenting to them.

Some have argued, as do I, that women are exploited by abortion itself. Open access to abortion makes it hard for women to continue accidental pregnancies. A man can avoid the responsibility for his sexual activity by insisting that the woman terminate the pregnancy as a condition of continuing the relationship. This statement should ring through the solid feminist thought. Catharine MacKinnon, for example, has drawn attention to the unequal conditions under which women become pregnant.

Abortion, she argues, was legalised to serve a man's requirements for sexual access to women and to enable him to be free of the inconvenient results of that access, that is, children.

She writes:

When convenient to do away with the consequences of sexual intercourse (meaning children), women get abortion rights. Women can have abortions so men can have sex [without consequence].

Women often do not control the conditions under which they become pregnant. Systematically denied meaningful control over the reproductive uses of their bodies through sex, it is exceptional when they do. Women are socially disadvantaged in controlling sexual access to their bodies through socialisation to customs that define a woman's body as being for sexual use by men.

Sexual access is regularly forced or pressured or routinised by denial. Poverty and enforced economic dependence undermine women's physical integrity and sexual self-determination. In MacKinnon's view, abortion actually demonstrates the reality and scope of women's oppression. Because abortion is borne of a woman's inequality, MacKinnon urges action to reverse that inequality:

'Those who think that fetuses should not have to pay with their lives for their mothers' inequality might direct themselves to changing the conditions of sex inequality that make abortions necessary,' she states.

Many of us who do subscribe to that view do indeed work to reduce the conditions of sexual inequality.

I refer now to a woman called Laurel who was a former abortion clinic nurse. She left her job in a Melbourne clinic partly because of the pressures she saw being applied to women who were judged unsuitable for motherhood, and I quote her:

Women who were poor, unemployed, too young, too old, working in the sex industry, not married, had no steady partner or suffered any mental instability were reassured by the clinic staff and society that it was best they have an abortion. It is clear that society fears a certain type of woman having a baby and I found that many of the doctors and nurses I met in the abortion clinic were not any different despite their supposed commitment to feminist principles.

The popular narrative says that abortion is a free choice, that abortion frees women, and yet I refer again to the example of the young woman told that she will be unable to complete her education unless she has an abortion. The problem that needs to be addressed is that students with babies are not given support for their education, and they will never be given that support while abortion is presented as their solution.

Abortion is easier for everyone else around her, because then they do not need to address the actual problem: support for women or girls with babies in the educational institution. The implicit message in abortion as an option is: 'Don't bother us with your problems.'

Continuing with regard to the issues around the pressures, the same former abortion clinic nurse said:

What if they said 'no' when entering the operating room? In this instance I felt compelled to reassure them they didn't have to go through with it and walked them back to the change room. This was not welcomed by my colleagues at the clinic. I was reminded that this is a business and any slowing the production-line costs money. Constant threats were made that the anaesthetist had another list at another hospital and any more discussion with the uncertain woman was wasting precious time. Their patronising remarks that some women will never be 100 per cent sure, and that I should encourage them to go on and get the abortion over quickly, were not comforting. I could no longer participate.

A second issue is that abortion is offered as the first option quite often, and not the last. Women are pressured to have abortions if their circumstances are difficult, and particularly if their baby is thought to have a disability. Those who attended a meeting at lunchtime today heard from Jordan, who at 22 weeks had an ultrasound and was told that her unborn child had Dandy-Walker syndrome, would be blind, have a mental disability and never walk or talk, and she was pressured.

Every two weeks after that, up to 38 weeks, 10 ultrasounds altogether, the diagnosis was confirmed. When he was born, there was another surprise: he did not have that level of disability. In fact, he is now a thriving six year old, who was there today at the meeting, able to walk, able to talk considered very intelligent by his school, and developing very well.

She said she felt pressured 100 per cent. At every appointment, they would keep reiterating all the negatives: he would be blind and he would have all these intellectual disabilities. Worst of all, she was told that she would be making a selfish decision if she kept him. That was in a South Australian hospital, a South Australian woman.

I have spoken before in this place about a close relative of mine. She had one daughter with a profound disability and then she was pregnant with her second child. The second child was diagnosed in utero with spina bifida. She did not want to have an abortion, but she was told by a nurse, 'Don't you think your family is costing the health system enough?'—'Don't you think your family is costing the health system enough?'

She was pressured, to the extent that one of the health professionals actually visited her at home, uninvited, to again pressure her to have an abortion. She did not do so, and that child is now thriving. She is a young adult. She has very low-level spina bifida. She has completed high school and is living a healthy and fulfilled life; not without any health issues, but with very minor ones.

I draw attention to these cases because they are the reality of what happens. Many people talking about this bill are talking about, if you like, the theory or the intent, and I acknowledge that many of them consider that this bill will make a positive difference in women's lives, but we cannot separate the intent or the theory from what actually happens to women, what actually happens in terms of pressures, and what actually happens in reducing their choices.

I can even reiterate how that is in other circumstances. After I had my first child, I had quite serious postnatal depression. I then became pregnant. I went to the GP and had a pregnancy test after I had done my own at home. His first response was, 'Do you really think this is a good time to be having a baby?'

He did not address the issue of postnatal depression; he did not address what supports I might need or could avail myself of. His first option was to offer me an abortion. This is essentially offering what is a quick fix to other people instead of real care for the woman. I assume that the GP was totally unaware of post-abortion grief and how badly that would have contributed to my mental health had I proceeded.

Some people have said that they are not concerned that the legislation allows abortion to birth because they are confident that the doctors will do the right thing. However, we are told, and this has been mentioned by a number of speakers today, that this bill does not greatly change current practice. What that means is that the current laws are being circumvented.

We are told that abortions up to 22 weeks and six days will be able to be done by one medical practitioner in contrast with the current law, which says there must be two. However, we are told that this is basically current practice, so clearly there are already methods to circumvent the laws. If they are currently circumventing, it is to be expected that the laws will be further circumvented in the future if they are expanded. It would be naive to think otherwise.

Similarly, we find it hard to imagine that there might be medical practitioners who will not do the right thing, but this fails to learn the lessons of history. There are many periods and events that we look back on today and ask, 'How could it have been allowed to happen? How could people, no different from ourselves, have been involved? How could they have stood by and tolerated such atrocious treatment of a whole group of people?' Those circumstances include entire segments of humanity being dehumanised. Dehumanisation is defined as:

…a psychological process whereby opponents view each other as less than human and thus not deserving of moral consideration [nor humane treatment].

The definitions goes on:

This can lead to increased violence, human rights violations, war crimes and genocide.

International non-governmental organisations consider dehumanising speech one of the precursors to genocide. An article in The Conversation stated:

Once someone is dehumanized, we usually deny them the consideration, compassion and empathy that we typically give other people. It can relax our instinctive aversion to aggression and violence.

Yet this is what has happened to unborn babies in our society. I refer members to statistics taken from trends in maternal and infant characteristics in perinatal deaths from termination of pregnancy for Victoria 2008 to 2017. These are the figures that relate to late-term abortions, as defined as 20-plus weeks, that are undertaken for psychosocial reasons, so not because there is any abnormality with the baby and not because of any physical health of the mother.

In the 23 to 27-week range from 2008, the figures are 87, 93, 85, 77, 53, 49, 58, 29, 35 and 52. They are the number of abortions done in that year between 23 and 27 weeks for psychosocial reasons. In the post 28 weeks, remembering that our current legislation prohibits abortion after 28 weeks unless to save the life of the mother, in 2009, after the legislative changes came in in Victoria, there were 11 post 28-week babies aborted for psychosocial reasons. That was babies who could have been born alive and been entirely healthy. It was the same figure in 2011.

I am very glad to note that they have gone down since that year and that in some years there have been zero. I bring members' attention to those figures because clearly they do happen, and they do happen when they have nothing to do with the physical health of the mother or any abnormality in the baby, so if this law passes in its current form they will happen.

Another aspect of the bill that is very concerning to me is that it will allow abortion centres with a profit motive to be established. They will no longer need to be prescribed hospitals. I think that is a retrograde step. Whatever one thinks of abortion, having a profit motive means that women will not necessarily get the full range of options. We know that does not happen now and that women do not get that full range of options and they are often pressured. When there is a profit motive for a centre, that will be even more pronounced.

Some speakers have claimed that we all know exactly month by month the development of a foetus and we do not need to be told. This reflects a consistent theme: that women already know all of the information and they are making free choices without pressure. Yet the stories of many women, some of whom I have recounted today, tell a different tale and the result is extreme grief.

I was told at a briefing last week by the Pregnancy Advisory Centre that there are no situations where babies are born alive following an attempted abortion procedure; however, today a healthcare worker talked about her own experience of that and also the experience of a friend of hers just two or three weeks ago in a public hospital here in Adelaide, so healthcare workers are having to deal with the grief and the tragedy of having babies there and having to leave them to die—having to leave them to die.

I also move to the issue of disability and how it is viewed through our abortion legislation, including our current legislation. There seems to me an inherent contradiction between what we are rightfully trying to do with people who are born with a disability—making sure we have things like the NDIS so people have access to the supports they need and having disability access plans within various organisations—yet saying that babies with disability are somehow lesser and should not be born. We heard of Jordan's story of pressure when a diagnosis came—a diagnosis that was wrong.

We also hear about this simply being a matter of health care. As I mentioned, I do not have a big problem with abortion being moved into the Health Care Act instead of the Criminal Law Consolidation Act because, after all, we have had no women prosecuted for having an abortion. But abortion is not health care like any other. It is obvious it is not because it involves another life as well as the pregnant woman. People may give different value to the lives of those who are unborn, but it is nevertheless a biological fact that there is a second life involved. In the preamble for the Convention on the Rights of the Child, 2 September 1990, it clearly states:

Bearing in mind that, as indicated in the Declaration of the Rights of the Child, 'the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth',

That convention says that babies should have legal protection before as well as after birth. Abortion denies those babies their human rights. With modern technology, we now know, and this bill acknowledges, that a baby is viable at 22 weeks and six days. A baby who can live independently of its mother is nonetheless not being afforded the protection of human rights.

This whole issue is sometimes presented as pitting the rights of the woman against the rights of the child. They do not need to be in opposition to each other and, in fact, their being portrayed as though they are opposition is symptomatic of the kind of discrimination against women that we referred to earlier. They can be complementary rights. Indeed, I would argue that if as a society we actually valued the giving of life much more greatly than we do, it would be far more easy for women to continue their pregnancies, to have it seen as a viable option, to have it seen as something positive that they were able to do what, in fact, a man is not.

We are told that this is health care and therefore abortion is no-one's business but that of the woman. This is eerily similar to comments that we used to hear many years ago with regard to family violence. We would be told, usually by the male in the family, the perpetrator of violence, 'It's not your business. It's my child. Don't interfere.' As a society we rightly reject those sorts of views, yet we are told the concern about an unborn child is not anyone else's business. I see an inherent contradiction in that.

I accept that many people will not accept that. Be that as it may, it may be useful for members to consider that point of view so it may assist them to understand why there are still concerns with the conscientious objection provision in this bill. This bill requires a medical practitioner who has a conscientious objection to abortion to refer a woman to someone else who will provide an abortion or provide information; I will go on about that in a moment.

To someone who has a conscientious objection to abortion, that person considers that abortion is the taking of a life. We know it is the taking of a life but, of course, the value put on that life varies between people. To refer to someone else to take that child's life means that that medical practitioner sees themselves as being complicit in that abortion. The bill before us says that the provision to refer will be fulfilled by providing information in a prescribed form but, of course, the prescribed form is to be set by regulation. We cannot see it now, so we cannot tell to what extent this will actually infringe on the doctor's rights to not be involved in an abortion.

The Hon. Dr Centofanti mentioned one of the issues around rural GPs and conscientious objection. If, because of their location, they are the only doctor in the region who would be able to provide an abortion service, they may have a duty of care to do so despite their personal conscientious objection. What this means in reality is that doctors with a conscientious objection may well be deterred from taking up positions in regional areas because it will place them in that position. A metropolitan doctor would rarely if ever be placed in that position but a rural doctor could well be.

As a regional woman myself, I am well aware of the difficulty of attracting and retaining health staff in regional and rural areas, and it would be a retrograde step if this bill results in that becoming even more difficult and it being even more difficult to attract GPs and other health staff to regional areas.

I note that some amendments have been filed, I have filed two myself, and I will speak more to those at the committee stage. I would like to put on the record my disappointment regarding the rush of this bill. The SALRI report was received by the Attorney-General over a year ago and yet we received this bill only in the last sitting week. We are told that this is a historic bill, yet we have been forced to have all second readings in the sitting week following the bill's introduction and we are told that it will go to the committee stage for a final vote on the next available sitting Wednesday.

This is a regrettable rush for such an important and serious bill. It has meant that briefings have had to be crammed into that time, given the relatively short notice. I note that this has particularly disadvantaged regional members such as the Hon. Dr Centofanti and myself in terms of being able to attend those briefings. Perhaps the irony will not be lost on members that this bill supposedly is partly to help rural and remote women, and yet the regional women in this place were unable to attend some of the briefings because of where they live.

I note that today a staff member from the Minister for Health's office has indicated that they will run further briefings before the vote in the lower house. While I do appreciate that, it is disappointing that we were unable to attend those briefings before the second reading vote in this house and, as I understand it, probably before the third reading vote in this house. I think that is unfortunate. If the bill had been introduced sooner, given that it was received over a year ago by the Attorney, those problems would have been overcome. However, I have attended every briefing that has been offered, if I have been able to do so.

As I mentioned, I will speak further to amendments and other problems in the bill as we go through to the committee stage. I appreciate that there is a single view sometimes of abortion. One thing that I consider is often missed is the post-abortion grief. The public health significance of the effects of abortion do not have sufficient attention. I will quote another feminist writer:

Abortion has for too long been a loss negated by society. Speckhard and Rue have observed that: 'Post traumatic stress is more damaging and more difficult to treat if those around the affected person tend to deny the existence and/or significance of the stressor.'

A presumption exists that those who did not return to the abortion clinic or hospital afterwards must have experienced no after-effects; an assumption that women who don't complain about their experience must have benefited from abortion.

It is also irresponsible to assume that abortion will solve some problems, without causing additional ones.

I quote one young woman who had an abortion:

Looking back now, if I had known then what emotional torment I would go through as a result of having the abortion, I would never have gone through with it. I told her that I still didn't know whether I could go ahead with the abortion, but she just fobbed it off by convincing me that this was the best thing for everyone.

But those who raise questions about the effect of abortion on a women's wellbeing are labelled as traitors to the cause. A further quote:

In the rush to be right and dominate public opinion, we lose the chance for greater insight and an opportunity to improve pre and postoperative care for women wanting abortions. Women who may question the blob theory, who may experience grief after an abortion, are silenced by the fear of losing their membership in the club.

This relates also to other women who have raised questions or concerns or opposition to abortion. We are somehow labelled as traitors to the cause, not standing up for women. There is no opportunity to question without being labelled. This is not a positive thing for women, and this is not a positive thing for society. We need to be able to question when there is a single narrative.

One thing that I have been particularly encouraged by is that, since this issue has come up in this parliament, I have been contacted by many people, many women, who have said, 'At last I know I'm not alone. I'm not the only one who questions,' either the abortion that the woman had or questions about whether abortion is actually this wonderful civil right that we are told it should be. So I am very pleased that by speaking this place and in public forums I have been able to give other women the courage to speak out as well.

There are other impacts on women that are denied through our current abortion processes. Sometimes people will attack the experiences that are told of women's abortions and say, 'Well, that doesn't happen to everyone.' I think that is quite possibly true. I would hope that not every woman experiences the terrible difficulties, the terrible grief and often the negative physical and emotional experiences that many women experience with abortion.

However, we need to ensure that we are not suppressing the voices of those women, that we are not dismissing them. Their experiences are real, and their experiences are enabled or permitted through the approach that we have to abortion. They will not be rectified or improved through the bill that is in front of us. Opening up abortion further means that more than likely many more women will experience those negative impacts because the issues around full information, the issues around pressure to abort, the issues around not providing true options to women will all continue because the narrative will say, 'Abortion fixes your problem. Now go away.'

We need to not dismiss women's experiences, and many times this is expressed in terms of the meaning of 'the baby'. Many women told this particular interviewer that they had tried to do this during pre-termination counselling—that is, refer to 'the baby'—but received curt and dismissive answers: 'A scrap of paper. A 10 cent piece. Just cells. Nothing there.' The doctor said, 'Don't worry, it's not formed until after 12 weeks.'

This woman said, 'Then I saw TheHuman Body program on the ABC. I would not have gone ahead if I'd been told the truth about the formation of the baby.' The woman I referred to earlier who worked at an abortion clinic and then left said:

When the women woke up in recovery they often whispered to me 'was it a girl or a boy?' I was instructed to tell them it was too small to know for sure. But occasionally a woman would ask 'Can I see the foetus?' The standard line in an abortion setting was 'a pregnancy is a bunch of cells, too early to differentiate'…

This contrasts with IVF where the women having miscarriages at earlier stages are told that they have lost the baby. This sense of not being able to identify that there is a baby that they have lost, not being able to grieve, being told by society, particularly for earlier abortions that, 'Your problem is over. You chose it. Why are you complaining?' This is not a positive thing for women and this is the result of that single narrative that we hear around abortion today.

As I said, I acknowledge that many if not all people who are advocating on this, are doing so thinking that it is in the interests of women. I hope that we can all continue this debate in a respectful manner, sensitive to each other, to our experiences and those who are close to us, but this bill as it currently stands should not be supported.

The Hon. R.I. LUCAS (Treasurer) (15:58): I rise to speak relatively briefly but to indicate my opposition to the second reading of the bill, and to the bill. I think, as my colleague the Hon. Mr Hood outlined in his contribution earlier, if the bill was to do what has been, I guess, most publicised about the legislation—that is, to remove from the criminal law jurisdiction the issue of terminations and to place it into health law and practice—then I, too, would be inclined to support that. However, the legislation, I think as the supporters would acknowledge, does not only that but does much more in relation to the legislation.

A number of members have coloured their contributions with a little bit of personal reflection. I recall, as someone who is much older than most, other than the Hon. Mr Darley, in this particular chamber, that with our own children we looked at those grainy photos of the ultrasounds. As I looked at those photos of the baby in my wife's womb it was very hard to distinguish features. The doctor would point out to us, 'Well, there's this and there's that,' and whatever it was.

Many years later now, as I look at the similar but massively upgraded technology photos of our grandchildren, they are quite clear and you can make out the detail and the outline, as we never could, in terms of ultrasounds or X-rays, whatever they are—the photos that our children proudly show us of our grandchildren through pregnancy.

I accept people have a different view, but to me it is just unarguable that at some stage as we look at those photos these are real little people in their mother's womb. That is my guiding view. It has always been my view, and I guess it has been reinforced as I see the clarity of the images of those real little people in their mother's womb, our grandchildren awaiting birth some months later.

I know there are many others in the chamber, probably in a majority, who do not accept that particular view, but nevertheless it is the view that I have, that I have held dearly for my adult life and will continue to hold dearly for so long as I am in this chamber, indeed after I leave this chamber as well.

The second reflection I wanted to make, I guess, is in relation to the intentions of we legislators when we move legislation. I think a number of members have referred to the person who was claimed by many to be the great reformer of the Liberal Party in relation to abortion legislation, that is, Robin Millhouse; his reflections on what he had intended, what had happened as a result of his legislation and his reflection, as someone, as I said, who was portrayed as the great reformer that in the end he never intended to have abortion on demand but in his view believed that was what had eventuated.

When you go back and look at section 82A—Medical termination of pregnancy, and the way the legislation was drafted—if I can read it:

(a) if the pregnancy of a woman is terminated by a legally qualified medical practitioner in a case where he and one other legally qualified medical practitioner are of the opinion, formed in good faith after both have personally examined the woman—

(i) that the continuance of the pregnancy would involve greater risk to the life of the pregnant woman, or greater risk of injury to the physical or mental health of the pregnant woman, than if the pregnancy were terminated; or

(ii) that there is a substantial risk that, if the pregnancy were not terminated and the child were born to the pregnant woman, the child would suffer from such physical or mental abnormalities as to be seriously handicapped…

The provision that Robin Millhouse and the others who supported the law at the time that was interpreted by medical practitioners and others more broadly than was intended by the original legislators was the provision in relation to the mental health of the pregnant woman.

I recall in my very first years in this parliament—I could not find the actual debate in preparation—that a member of the Legislative Council I think in a piece of legislation sought to tighten up slightly the provisions in relation to the mental health provisions by saying, 'Well, perhaps one of the two medical practitioners should have some training in mental health; that is, some psychiatric background.' That particular amendment was defeated at the time, I recall.

But that was the provision through which the number I think the Hon. Ms Scriven gave, if I am not misquoting—I think it is 4,300 or so abortions per year—occur. Clearly, as I said, the so-described great reformer of abortion reform, Robin Millhouse, described that as completely unintended, but nevertheless that is what had occurred as a result of the legislation that had been drafted.

Again, I accept the intentions of those who have drafted this legislation. Various assurances at briefings have been given that the term 'medically appropriate' would not encompass situations where a mother who was almost six months pregnant simply changes her mind. I accept that that is the intention of those who draft the legislation, as it was the intention, I am sure, of the Hon. Robin Millhouse in terms of drafting the legislation.

Those who support the legislation as well seek to give comfort to those who have concerns about the legislation, to say that a medical practitioner has to consider all relevant medical circumstances and the professional standards and guidelines that apply to the medical practitioner in relation to the performance of the termination, and that medical practitioners are subject to stringent professional and ethical obligations and protocols, which will be developed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

As someone who has had long experience in this parliament in terms of legislative reform and how it is interpreted by professionals, I only refer to the area of workers compensation legislation where the concept of doctor shopping or forum shopping is quite common. It is well known that various doctors are prepared to interpret in certain ways the legislation in relation to workers compensation, and equally on the other hand doctors who might interpret the legislation in other ways in terms of the legislation. People become well known over the years as, if you want to increase your likelihood of getting a medical opinion that will support your particular view of a workers compensation case, you go to a particular individual or doctor in relation to it.

I accept, as I am sure the legislators when Robin Millhouse moved legislation accepted, that it would not open it up, as Robin Millhouse described it, as abortion on demand, but in the end the words are the words, doctors are doctors, medical practice is as it will be, despite the best intentions of medical standards, stringent professional and ethical obligations, and the like.

It is for all those reasons that I think the intentions of those who have drafted the legislation—I am sure that if the legislation passes both houses of parliament—will not be as described to those who might have some concerns in relation to the legislation. For whatever it is worth, we are where we are with the legislation. If it was to be merely a fact of moving something from the criminal law to be placed in health law and practice, which is publicly one of the major claims as the need for the legislation, then I am sure, as the Hon. Mr Hood indicated, that there would be a strong majority in both houses of parliament who were likely to support it.

My final comment is in relation to a particular comment made by the Hon. Ms Pnevmatikos, where she said it was highly offensive that certain members who were going to oppose the legislation had not turned up to various briefings that she had attended. I think the inference behind that attack on those who oppose the legislation, those who either chose not to or could not attend those briefings, and the assumption that is made is that in some way it is only the supporters of legislation who therefore are rightly placed to be able to judge the scientific merits, the medical arguments and the competence or otherwise of the legislation.

As someone who opposes the legislation, I reject completely that attack from the Hon. Ms Pnevmatikos, because I was one of those who was unable to attend the particular briefings. The Hon. Ms Pnevmatikos is entitled to say that it is highly offensive that some of us did not attend those briefings, but there are many of us who are quite capable of looking at legislation, informing ourselves of the scientific, the medical and legal aspects, and making our own conscience and moral judgements in relation to a conscience vote issue.

We can seek the wise counsel of the Minister for Health, the Attorney-General or other experts on both sides of the debate should we so choose, but the mere fact that we did not or chose not to attend the briefings the honourable member attended is not a reason, in my view, for it to be described as 'highly offensive' that we had not turned up to those particular briefings.

As I said, I reject completely the inference in that that in some way there is some intellectual superiority in the hands of those who support the legislation and that those who choose to oppose it for a variety of reasons are in some way intellectually inferior in terms of the competence of their arguments. With that, I indicate my position in relation to the legislation and look forward to the debate on the 25^th when the debate and the committee stage resumes.

The Hon. J.M.A. LENSINK (Minister for Human Services) (16:10): I thank all honourable members who have made contributions today. I would also like to echo the thanks of many members today who thanked people who have gone before. I would further like to thank all those people who have been involved in framing the clauses of the bill, from all of the many people who participated in a range of consultations, including through the South Australian Law Reform Institute, otherwise known as SALRI.

I am personally grateful to the AMA SA, Royal Australian and New Zealand College of Obstetrics and Gynaecologists (RANZCOG) and the Law Society for being available to answer my many questions. I should also acknowledge the Hon. Tammy Franks for bringing a bill into this place in 2018. The medical fraternity in particular have voiced to me, as they would have to a number of members, that they do not wish to continue to be the legal gatekeepers for procedures in this difficult situation that people find themselves in.

There have been many things that have been said about this bill in recent months. There has been a lot of misinterpretation of what is in the bill, and I would particularly urge those community leaders who have been advocating in certain regards to get the best information they can so that they do not alarm those who would take their lead on a number of these issues. Many of the claims are grossly incorrect.

This bill brings South Australia's laws into line with the rest of Australia's. This bill is more conservative than laws that have been passed in other jurisdictions. This bill is also more conservative than the recommendations in the SALRI report. It is also more conservative than the Franks' bill of 2018. The Attorney-General has included specific provisions regarding coercion which I would like to refer to, and this is in the context of intervention orders:

While SALRI report did not recommend creating a specific anti-coercion offence, it was acknowledged that reproductive coercion is a form of domestic violence and, as such, should be recognised as such within the meaning of the Intervention Orders (Prevention of Abuse) Act 2009.

Part 3 of the Termination of Pregnancy Bill 2020 amends section 8 of the Intervention Orders (Prevention of Abuse) Act 2009 to specifically include 'coercing a person to terminate a pregnancy' and 'coercing a person to not terminate a pregnancy' as acts of abuse within the meaning of the Act.

Where the act of abuse is committed by a defendant against a person with whom the defendant is or was formerly in a relationship, the abuse is expressly recognised as a form of domestic abuse (section 8(8)) and the court may endorse the intervention order to reflect the fact that the order intended to address a domestic violence concern.

I would also like to address the matter that has been in the community and I thank honourable members for being respectful in their second reading contributions. Some of the correspondence that I have received from members of the community has portrayed that these decisions are frivolous, and it is one that I reject.

The Australian Medical Association states that they support this bill because it merely reflects what takes place as part of contemporary health practice, which is that within all of the training, the skills and the ethics exercised by the medical fraternity, the pregnant woman needs to be given access to the best available information to make informed choices, and that is consistent with all of health practice.

It is worth remembering that doctors undertake the Hippocratic oath. It will be easier for women in some circumstances to obtain a termination earlier, specifically those who need to satisfy the two-month residency clause and regional and remote women who face obstacles to utilising medical terminations because they need to take place in a hospital.

The most common form of terminations are medical terminations, which are undertaken early—up until nine weeks. At all decision points, women are supported by a team of professionals, and if a pregnancy has reached 17 weeks, the pregnant woman would always consult with a dedicated and skilled multidisciplinary team, who provide support, advice and information to women who are navigating a path that is always difficult.

While medical advances have improved early detection of foetal and genetic abnormalities, the severity of the impact on individual cases cannot always be determined prior to the 18 to 20-week stage. For an example of the challenges that women have to face, I urge everyone to consult with the personal stories in the SALRI report. The advice from obstetricians who work in this field is that women need to be given time to consider the information from the multidisciplinary team.

Late-term abortions are rare. Approximately 90 per cent of terminations take place in the first trimester. As documented in the RANZCOG statement regarding late abortion:

The College strongly supports the availability of legal abortion for those women facing circumstances where the decision regarding terminating the pregnancy is being considered at a late gestational age (i.e. after 20 weeks) because of clinical necessity or because of delayed fetal diagnosis or presentation. While such circumstances are not common, they merit an acknowledgement of their validity and the complexity of clinical and supportive care.

The college then lists the circumstances as:

1. multiple pregnancy discordant for severe foetal abnormality;

2. delay in diagnosis, or determining prognosis, in the setting of foetal abnormality, for instance, hydrocephalus;

3. psychosocial circumstances, which may include the abuse of minors and vulnerable adults to sexual and physical violence including rape, incest and sexual slavery; and

4. maternal medical conditions, such as pre-eclampsia, which put the mother's life at risk.

This bill does not make it easier to obtain a late-term abortion. This is because the clinical decision-making and practices of doctors and other health professionals are governed by incredibly strong safeguards and regulations, which are sometimes called health law. These include codes of conduct under the medical board and AHPRA; professional standards under professional bodies, such as the AMA and colleges; health service policies, procedures and credentialling requirements; and the overriding principles enshrined in medical and health ethics, which they must comply with.

Doctors must act ethically, and if they do not they lose their right to practice. The advice that I have received is that obstetricians will not terminate a healthy foetus which is capable of being viable—which is generally considered at 24 weeks—unless there is a risk to the mother's life. These circumstances are rare and extreme and would already, in existing practice, involve a multidisciplinary team providing advice to the woman and her family.

I believe we can be confident that in Australia the ethics and practices of the medical profession are of the highest order. We see in fields such as assisted reproductive technology or IVF that sex selection does not occur and multiple embryo implantations do not occur. All of these things are governed by the highest level of ethics.

The Minister for Health and I will make some more contributions at clause 1, which will address a number of issues that have been raised today that we think will assist with the further debate. I look forward to the committee stage.

The council divided on the second reading:

Ayes 13

Noes 8

Majority 5

Second reading thus carried; bill read a second time.