Bills

Termination of Pregnancy (Termination and Live Births) Amendment Bill

Introduction and First Reading

The Hon. B.R. HOOD (11:49): Obtained leave and introduced a bill for an act to amend the Termination of Pregnancy Act 2021. Read a first time.

Second Reading

The Hon. B.R. HOOD (11:50): I move:

That this bill be now read a second time.

When we stand in this chamber we are often confronted with difficult decisions, decisions that force us to examine not just the laws we make but the values that we hold. In introducing this bill we are touching on one of the most profound human rights issues of our time. The Termination of Pregnancy (Terminations and Live Births) Amendment Bill 2024 is about drawing a line, one that ensures we uphold our duty to protect the most vulnerable among us without infringing on the rights of those facing immensely difficult situations.

Since the enactment of the Termination of Pregnancy Act 2021, we have witnessed an outcome that should give every single one of us pause, an unintended but deeply troubling consequence, one that I do not believe the people of South Australia realise is happening in our state. We have seen 45 healthy, viable babies, babies capable of life outside the womb, lost to feticide. These were not emergencies where the mother's life hung in balance, nor were they cases of severe—or indeed any—fetal anomaly.

Let us be clear: we are not speaking about a mere statistic, we are speaking about 45 individual, unrepeatable human lives, about children capable of living outside the womb. What we do not know, from the South Australian Abortion Reporting Committee data, about these 45 terminated babies is exactly what age they were when their life was terminated. All we know is that they occurred after the age of viability which, according to the act, is defined after 22 weeks and six days. On such an important, indeed a life-and-death issue, we are not afforded any more detailed data than that.

I understand, as we all do, the complexity of this issue. These 45 cases are but a small fraction of the nearly 5,000 abortions that take place in South Australia every year, and no-one in this chamber doubts the extremely heavy burdens and difficult decisions faced by women who make these choices. However, there comes a point when we must confront a simple and profound question: when does the life of a child begin to matter?

This is not an abstract question. My wife, Elle, witnesses the miracle of life unfold in her role as a senior midwife. She has been present at the birth of children at 28 weeks of gestation. Elle has given them their immunisations; Elle has seen them walk down the street, enjoying their lives. These children are now happy, healthy and thriving. These are not hypothetical beings: they are real, they are here and they are alive. So I ask again: when does their life matter? When do we, as a society, begin to recognise the humanity in the slightest and most vulnerable among us?

This is not about ideology. It is about the fundamental value of life itself. This bill is not about denying women the right to end their pregnancies; in fact, the innovation of this bill is that it allows a mother to end her pregnancy throughout all nine months and, indeed, right up to birth. This bill proposes a compromise to protect both the mother's choice and the child's life.

After 28 weeks, in the third trimester, we are talking about a fully formed and viable baby, one who, if delivered early, has a 96 per cent chance of survival. In these cases, why should we end a human life when we have the option to deliver it early and care for that child? A true measure of any society can be found in how it treats its most vulnerable members.

At 28 weeks, a child in utero is in its third trimester and capable of surviving without the mother's body. I believe that the measure of our society will be found in how we choose to treat these lives. A medical procedure known as feticide, where a lethal injection of potassium chloride is administered to stop the baby's heart, is not medically necessary to save the life of the mother. It is done solely to ensure the baby does not survive.

The process of feticide is a harrowing one. An ultrasound is used to obtain a four-chamber view of the baby's heart and the baby's heart rate is recorded. A long needle is inserted through the mother's abdomen into the uterus. It is guided by ultrasound and the clinician injects a needle of potassium chloride into the left ventricle of the heart. This causes the baby's heart to stop. This is done without any sedation or pain relief for the child, the child who can feel pain. We do not even do this in euthanising animals, who must be heavily sedated before being euthanised by potassium chloride. Following feticide, the mother takes labour-inducing drugs. The mother then goes through labour prematurely, usually 12 to 24 hours later, and delivers her baby but stillborn.

In South Australia, this procedure is recommended after 22 weeks so that the child is killed in utero and then early labour is induced and the child is delivered stillborn. The reason it is recommended is that, without feticide, it is more likely than not that the child will be born alive. This underscores the central premise of the bill. Feticide is unnecessary to safeguarding the mother's life, as its only intention is to kill the baby.

Normal obstetrics practice in emergencies is to deliver the baby, not kill her first. When faced with a medical emergency, the priority is to act swiftly. An emergency delivery, typically through an emergency caesarean, can be completed in a matter of hours, allowing both the mother and child to receive the care they need. In contrast, feticide-induced labour is a long and drawn-out process, taking anywhere between 12 and 24 hours to complete as the procedure stops the baby's heart before inducing labour, prolonging the time the mother must endure the emotional and physical burden of termination.

The mother will still go through the arduous process of labour as she delivers a stillborn baby. Not only does this add unnecessary complexity, it also delays critical care, making it a less effective and humane option in non-emergency scenarios. In response to those who say this bill is forced induction of labour, let me be clear: the only way to abort a child in non-emergency situations, a child who is healthy during late-term pregnancy, is to deliver that baby either stillborn or alive.

Only yesterday, a senior midwife from the Flinders Medical Centre contacted me. They wish to remain anonymous but could no longer stay silent. They told me what they had seen firsthand, and the incredible burden that late-term feticide places on mothers and the toll it has on midwives. I wish to read for the record some of what they told me. I will need to leave out some expletives but these are their words:

It breaks your heart to look after stillbirths and neonatal deaths. It's completely devastating. And uses up all of your energy and compassion.

But this is next level and NOT what I signed up for as a midwife.

We have all of SA's late term feticides at Flinders. It's far more common than we ever expected when the law changed.

I could go on and on for hours about the stuff we have seen.

35 weeker showed up thinking it was a small procedure and she [thought she could go] by the afternoon…didn't even seem to realise she had to birth a baby.

The Pregnancy Advisory Centre just call it a pregnancy, not a baby so it confuses the mum.

But by the time they came to us, [the] baby is already dead. So any concerns we have about their understanding of what's happening, it's all too late.

I really struggle with feticide, it's a whole perfect baby. None of these babies have shown any genetic abnormalities whatsoever.

This is not midwifery. I hate it so much.

This midwife told me that in the past three to four months two healthy babies over 28 weeks have been killed by feticide. This midwife told me that they and their colleagues mistrust the information the Pregnancy Advisory Centre passes on to women regarding how far they are along in their pregnancy. They are concerned that the gestational age of the baby is being underestimated when feticide is performed.

By requiring early delivery we are not only protecting the life of the child but also sparing the mother from the trauma of a prolonged and avoidable medical process. As we have seen in the data from the South Australian Abortion Reporting Committee, late-term abortions are not performed in emergencies. They are not performed because the mother's physical life is at risk. Indeed, they are performed because continuing the pregnancy is considered too difficult, either emotionally, physically or mentally. I do not want to diminish the severity of those challenges, but I must ask: is ending a viable human life the only solution we have?

This bill does not take away a woman's right to end her pregnancy, it acknowledges that sometimes continuing a pregnancy is not possible or desired. However, it sets a clear line: after 27 weeks and six days, after 28 weeks, in the third trimester, when a woman is beginning her seventh month of pregnancy, when the baby is clearly viable, if a pregnancy must be ended it requires that the baby be delivered alive.

In the vast majority of cases that baby will survive, and if the mother does not wish to raise the baby there are loving families ready and eager to adopt. The child would receive immediate care in the neonatal intensive care unit, ensuring the best chance at a healthy life. This is not about forcing anyone into motherhood. It is about recognising that once a child has reached viability and is in its third trimester we are responsible for protecting that life. The bill ensures that the mother's decision to end her pregnancy is respected, but it is also that the child has an opportunity to live.

I understand this is a sensitive issue and some will argue that the state should not interfere in personal choices as these are between a woman and her doctor, but in this place we are charged with making laws and there is a community expectation that our laws should protect the vulnerable.

From 20 weeks in utero South Australians can report a child at risk to child protection authorities. At 20 weeks in utero a wanted child who is delivered stillborn still receives a birth certificate and a death certificate. Yet some opponents of this bill are arguing that at 28 weeks the decision as to whether to kill the baby should solely rest with the mother and her doctor. I think that is out of step with community expectations and with current practice, where we do have laws and policies to protect children in utero from being harmed and we recognise their existence. When a child can survive outside the womb our responsibility extends to protecting that life.

This bill is about offering both compassion to the mother and the chance for the child to live. The medical advancements of the last 10 years make this bill not only morally right but medically sound. According to the Australian and New Zealand Neonatal Network, babies born at 28 weeks have a 96 per cent chance of survival. Seventy-six per cent of those children will go on to have normal motor development and 89 per cent will live free of moderate or severe disability. These are not small numbers. These are lives, lives that can be saved through early delivery rather than feticide.

We cannot forget the risks of feticide to the mother. While very rare, there have been cases of maternal infection, including one case of sepsis and another where a lethal injection was inadvertently administered to the mother, requiring her to be resuscitated. Early delivery is safer, quicker and a more ethical option.

This bill is not about eliminating choice. It is about ensuring that when the choice is made after 28 weeks it respects the life of the child as well as the needs of the mother. This bill does not compel women to continue pregnancies. It provides for early delivery and ensures that if a child is born alive they are given the care they need. It does not require a mother to form a maternal relationship with a child. After early delivery the mother has the right to relinquish that child for adoption.

This is not about forcing anyone into motherhood but giving a child the chance to live. The Adoption Act 1988 in South Australia provides a clear pathway for mothers who do not wish to keep their children. The adoption process is thorough, and mandatory counselling and a period of reflection to ensure that the mother's decision is fully informed are provided for.

We must acknowledge that this is a matter of balance—balancing the mother's choice with the undeniable right of a child to live. This bill does not seek to undermine a woman's autonomy or force her to carry a pregnancy to term against her will. Instead, it recognises that at 28 weeks we are no longer dealing with a potential life but a viable human being capable of surviving outside the womb.

This bill has been drafted with the assistance of eight women, experts from medical and legal professions, neonatologists, midwives and obstetricians who care for the women and children. I thank Dr Joanna Howe for her work in this bill. This bill is not about ending abortion. It is about ending the unnecessary loss of children who could survive. We have the medical knowledge. We have the resources and the compassion to offer these children a chance at life.

This bill presents us with a crucial decision, and what we decide in this place will determine whether we choose to safeguard life or allow viable children to die needlessly. Let us have the courage to protect life and the compassion to support those in difficult circumstances. I urge all in this chamber to support the bill, not as an act of opposition to choice but as a stand for life, for humanity and for the future of our South Australian children who deserve a chance to live.

Debate adjourned on motion of Hon. I.K. Hunter.