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Legislative Council - Fifty-Fourth Parliament, Second Session (54-2)
2021-03-02 Daily Xml
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Bills

Termination of Pregnancy Bill

Final Stages

The House of Assembly agreed to the bill with the amendments indicated by the following schedule, to which amendments the House of Assembly desires the concurrence of the Legislative Council:

No 1 Clause 3, page 3, after line 18—Insert:

prescribed hospital means a hospital, or hospital of a class, prescribed by the regulations;

No 2 Clause 6, page 4, lines 22 to 25 [clause 6(1)(a) and (b)]—Delete paragraphs (a) and (b) and substitute:

(a) the medical practitioner considers that, in all the circumstances—

(i) the termination is necessary to save the life of the pregnant person or save another foetus; or

(ii) the continuance of the pregnancy would involve significant risk of injury to the physical or mental health of the pregnant person; or

(iii) there is a case, or significant risk, of serious foetal anomalies associated with the pregnancy; and

(b) a second medical practitioner is consulted and that practitioner considers that, in all the circumstances—

(i) the termination is necessary to save the life of the pregnant person or save another foetus; or

(ii) the continuance of the pregnancy would involve significant risk of injury to the physical or mental health of the pregnant person; or

(iii) there is a case, or significant risk, of serious foetal anomalies associated with the pregnancy; and

(c) the termination is performed at a prescribed hospital.

No 3 Clause 6, page 4, lines 31 to 37 [clause 6(3)]—Delete subclause (3) and substitute:

(3) Without limiting section 13 of the Consent to Medical Treatment and Palliative Care Act 1995, a medical practitioner may, in an emergency, perform a termination on a person who is more than 22 weeks and 6 days pregnant, without complying with paragraphs (b) and (c) of subsection (1).

No 4 New clause, page 4, after line 37—After clause 6 insert:

6A—Care of person born after termination

(1) This section applies if a termination results in a person being born.

(2) Nothing in this Act prevents the medical practitioner who performed the termination, or any other registered health practitioner present at the time the person is born, from exercising any duty to provide the person with medical care and treatment that is—

(a) clinically safe, and

(b) appropriate to the person's medical condition.

(3) To avoid doubt, the duty owed by a registered health practitioner to provide medical care and treatment to a person born as a result of a termination is no different than the duty owed to provide medical care and treatment to a person born other than as a result of a termination.

No 5 New clause, page 4, after line 37—After clause 6 insert:

6A—Requirement for information about counselling

(1) Before performing a termination on a person, a registered health practitioner must provide all necessary information to the person about access to counselling, including publicly-funded counselling.

(2) A registered health practitioner may, in an emergency, perform a termination on a person without complying with subsection (1).

No 6 New clause, page 4, after line 37—After clause 6 insert:

6A—Mandatory considerations for medical practitioners performing terminations after 22 weeks and 6 days

In assessing matters for the purposes of section 6(1), a medical practitioner must, when determining whether to perform a termination, have regard to the following:

(a) whether it is essential to perform a termination of an affected foetus in a multiple pregnancy at a gestation that does not risk severe prematurity and its attendant consequences for the surviving foetus;

(b) whether there are serious foetal abnormalities that were not identifiable, diagnosed or fully evaluated before the pregnancy reached 22 weeks and 6 days, including but not limited to abnormalities involving the brain, heart, renal and skeletal systems, or whether the foetus has been exposed to infective agents which may damage or limit the gestation and development of the foetus;

(c) whether the patient has had difficulty accessing timely and necessary specialist services before the pregnancy reached 22 weeks and 6 days, including but not limited to patients experiencing significant socio-economic disadvantage, cultural or language barriers and those who reside in remote locations;

(d) whether a patient has been denied agency over the decision to continue a pregnancy or not, including (but not limited to) the abuse of minors and vulnerable adults to sexual and physical violence including rape, incest and sexual slavery;

(e) whether the abuse outlined in paragraph (d) includes circumstances in which such abuse is not apparent, or the pregnancy is not diagnosed until an advanced gestational age;

(f) whether medical or psychiatric conditions may become apparent or deteriorate during the pregnancy to the point where they are a threat to the patient's life;

(g) whether the patient has a deteriorating maternal medical condition, or late diagnosis of a disease requiring treatment incompatible with an ongoing pregnancy (such as malignancies).

No 7 Clause 8, page 5, lines 5 to 28—Delete clause 8 and substitute:

8—Registered health practitioner with conscientious objection

(1) This section applies if—

(a) a person (the first person) asks a registered health practitioner to—

(i) perform a termination on another person, or

(ii) assist in the performance of a termination on another person, or

(iii) make a decision under this Act whether a termination on another person should be performed, or

(iv) advise the first person about the performance of a termination on another person, and

(b) the practitioner has a conscientious objection to the performance of the termination.

(2) The registered health practitioner must, as soon as practicable after the first person makes the request, disclose the practitioner's conscientious objection to the first person.

(3) If the request by a person is for the registered health practitioner (the first practitioner) to perform a termination on the person, or to advise the person about the performance of a termination on the person, the practitioner must, without delay—

(a) give information to the person on how to locate or contact a medical practitioner who, in the first practitioner's reasonable belief, does not have a conscientious objection to the performance of the termination, or

(b) transfer the person's care to—

(i) another registered health practitioner who, in the first practitioner's reasonable belief, can provide the requested service and does not have a conscientious objection to the performance of the termination, or

(ii) a health service provider at which, in the first practitioner's reasonable belief, the requested service can be provided by another registered health practitioner who does not have a conscientious objection to the performance of the termination.

(4) For the purposes of subsection (3)(a), the first practitioner is taken to have complied with the practitioner's obligations under that paragraph if the practitioner gives the person information approved by the Minister for the purposes of that paragraph.

Note—

The information to be approved by the Minister is to consist of contact details for a SA Government service that provides information about a range of health services and resources, including information about medical practitioners who do not have a conscientious objection to the performance of terminations.

(5) This section does not limit any duty owed by a registered health practitioner to provide a service in an emergency.

No 8 New clause, page 5, after line 28—Insert:

8A—Health practitioner must not terminate pregnancy for sex selection

(1) Subject to subsection (2), a registered health practitioner must not perform a termination of a pregnancy for the purposes of sex-selection.

(2) Subsection (1) does not apply to the performance of a termination if the registered health practitioner is satisfied that there is a substantial risk that the person born after the pregnancy (but for the termination) would suffer a sex-linked medical condition that would result in serious disability to that person.

No 9 Clause 13, page 6, line 31 [clause 13(1)(a)]—Delete 'section 5 or 6' and substitute:

section 5, 6 or 6A

No 10 Clause 13, page 6, after line 34 [clause 13(1)]—After inserted paragraph (c) insert:

or

(d) contravenes section 8A.

No 11 Clause 13, page 6, after line 34 [clause 13(1)]—After inserted paragraph (c) insert:

or

(d) contravenes section 6A.

No 12 New clause, page 8, after line 32—Insert:

15A—Annual report

(1) The Minister must, on or before 30 April in each year, ensure that a report relating to services provided in connection with the performance of terminations for the last calendar year is prepared and provided to the Minister.

(2) The report must contain—

(a) information in relation to each termination performed in the calendar year which must include the age of the pregnant person and the gestational age of the foetus at the time of the termination; and

(b) other information (including data and statistics) of a kind prescribed by regulation or determined by the Minister.

(3) The Minister must, within 12 sitting days after receiving a report under this section, cause copies of the report to be laid before both Houses of Parliament.

No 13 Clause 16 Delete this clause

Consideration in committee.

The Hon. J.M.A. LENSINK: I move:

That the House of Assembly's amendments be agreed to.

I just want to make a few brief remarks in relation to this bill. I also want to emphasise, once again—and I have no desire to re-prosecute any of the arguments that we have debated at length in both of the chambers—that this bill does not allow terminations up to birth. I think it is really important to reassure people in the community who have been given that false message. Can I assure them that if that was the case, I would not support the bill, and while I cannot speak for others I am assuming they would be of the same view.

We know that there has been considerable and lengthy debate on this piece of legislation, and I just wish to make some acknowledgements about the work that has gone into it, because there have been many stakeholders. I really do not like that word sometimes, because they are all people after all, but a range of organisations, individuals and the like have reached this place at this historic time.

First and foremost, I acknowledge the SA Abortion Action Coalition, a number of whom are here today. I always get more nervous when I have an audience. If we had COVID times, I probably would not have quite so much pressure, but there you have it. They have been on the case for decriminalising South Australia's laws for many years now.

The Hon. Tammy Franks brought in a bill in 2018, which reminded us that terminations remained in the criminal code and that was not appropriate. The South Australian Law Reform Institute undertook a comprehensive review of existing laws and other models, and consulted with a very large range of stakeholders to come up with a report that was incredibly informative and which has formed the backdrop of the debate.

The Deputy Premier and Attorney-General, Vickie Chapman, referred the matter to SALRI and took the concept of removing terminations from our criminal laws into a piece of legislation that has received the consensus of members in both houses, without wanting to pre-empt what happens today. Her Herculean performance in the 22 hours or so of debate has cemented her reputation as a fierce and practical advocate for South Australian women.

I also need to acknowledge the Minister for Health and Wellbeing in this place for his extensive work in the committee stage, as well as for providing a lot of advice. While I have the glory of having introduced the bill, he did all the work in the committee stage in this place. Many others through the parliament have been strong advocates, including the Hon. Irene Pnevmatikos; the Hon. Connie Bonaros; the member for Hurtle Vale, Nat Cook, who has some experience which has been very beneficial and who described her work when she worked in the health system; the member for Reynell, Katrine Hildyard; and the member for Port Adelaide, Dr Susan Close.

We also need to acknowledge all the staff who have been engaged in this, including departmental officers for SA Health; the Women's and Children's Health Network; the Pregnancy Advisory Service; of course the Attorney-General's Department, which put this bill together; parliamentary counsel; the ministerial advisers; the Australian Medical Association; and the Royal Australian and New Zealand College of General Practitioners.

As I have outlined, I will not be proposing to not agree to any of the amendments from the House of Assembly. I have no doubt that many of the amendments were well intentioned. I have just a word about that tweet, which got quite a lot of publicity. I put that out on the Wednesday night. Given the exhaustively thorough work of the SALRI report, it seems that some of the most active members that night either had not read it or had not understood it, including several former ministers. That should be enough to be able to identify who exactly I was referring to as auditioning for an intervarsity competition. However, others may choose to identify with that description if that is their choice.

I certainly was not the only person watching that night who was frustrated by some of the debate. I received much more supportive feedback than negative by about 10 to one and also, I note, from people who do not feel that they are in a position to make public comments. Hopefully, I have voiced some of that frustration. It is something that I have seen before, and it is frustrating. However, there was no match for the Deputy Premier, who has demonstrated her depth of knowledge of the subject, patience and tenacity. I understand the Minister for Health and Wellbeing may have some additional comments.

The Hon. S.G. WADE: The passage of the Termination of Pregnancy Bill 2020 through this parliament, half a century after this state led the nation in abortion reform, has decriminalised what is a health service and removed key barriers to access to services for women in South Australia. As the Minister for Health and Wellbeing, I would like to take this opportunity to recognise the work and commitment of some of the many individuals who have collectively made this bill possible.

Firstly, I would like to acknowledge the courage, leadership and hard work of the Attorney-General and the Minister for Human Services, the sponsors of this bill in their respective houses. I would like to thank the dedicated staff of SA Health, including those of the Pregnancy Advisory Centre and the Women's and Children's Health Network, who have continued to provide high-quality abortion care in South Australia for many years, all the while having to operate under the criminal code.

I would also like to extend my appreciation to those who have worked tirelessly to support this parliament in the consideration of this bill by providing information that supported us to have an informed debate. Among this group are, from Wellbeing SA, Professor Katina D'Onise, Helen Thomas, Brigitte Drinkwater and Brenda Muturi.

I would also like to thank those who provided briefings to members of parliament, such as Professor Jodie Dodd, Associate Professor Rosalie Grivell, Brooke Calo, Helen Smith, Bree Van Der Kolk, Associate Professor Christopher Barnett, Anne Baxendale, Dr Jane Baird, Dr Aimee Woods, Dr Brian Peat, Noel Savage, Helen Gibbons and Dr Sarah Cash. My sincere thanks also to Anna Tree from my office for her diligent work in support of this bill. I would also like to thank Dr Chris Moy from the Australian Medical Association, along with Associate Professor Rosalie Grivell, Chair of the Royal Australian College of Obstetricians and Gynaecologists, for their expert advice and advocacy for this bill.

As I expressed in my second reading speech on this bill, as a Christian I know that many Christians and people of other faiths consider abortion to be the taking of a human life and a grave moral offence. However, other citizens, including other Christians, hold dramatically different moral perspectives. We live in a pluralist society, and in 1969 our state decided that, despite the diversity of moral perspectives, abortion would be legally available in this state.

This debate has demonstrated that the consensus in support of abortion retains broad support in the community and in the parliament. By way of preface, I would like to agree with my ministerial colleague. I do not propose to reprosecute the arguments that have been had in both houses, but I did think it was appropriate, as the first Minister for Health in South Australia to have responsibility for abortion law as the Attorney-General hands it over from the criminal law into health law, to make some comments in relation to implementation and in the context of the changes that have been made to the bill through the parliamentary process.

As we are all aware, some amendments were made to the bill in the lower house and I would like to take this opportunity to provide some context and clarifications on the more substantive of these. The amendments that were made to the criteria under which a termination of pregnancy can occur after 22 weeks and six days expound upon the meaning of the term 'medically appropriate' as was provided for in the original bill and the components of which already govern the practice of termination.

The language in clause 6A on mandatory considerations for medical practitioners performing terminations after 22 weeks and six days is almost in whole lifted from the latest guideline on late-term abortion published by the Royal Australian College of Obstetricians and Gynaecologists. I would like to reiterate at this juncture that, with regard to issue of later term abortion, the circumstances that would necessitate later term abortions are often extraordinary and simply cannot be predicted or managed in advance of the 22 weeks and six days cut-off period.

Clause 6(2)(b) of the bill relates to adherence of medical practitioners to appropriate professional standards and guidelines. This provision is a restatement of current accepted best practice. Indeed, part of the obligation and duty of care of the medical profession is to be aware of and practice in accordance with applicable guidelines for clinical practice from all relevant key bodies, such as the colleges. These guidelines will continue to be updated in line with best practice.

Clause 6(1)(a) outlines further applicable criteria to allow for lawful termination of pregnancy beyond 22 weeks and six days. Although clause (6)(1)(a)(ii) provides that the continuance of the pregnancy would involve significant risk to the physical or mental health of the pregnant person, I would like to provide some other insight as to what this clause may entail. There is a range of pre-existing diseases that women may have that can be exacerbated or complicated by pregnancy.

These conditions can pose a serious risk to the health of the pregnant person but can potentially be treated. Examples include kidney disease, liver disease, heart disease or diabetes. In these cases, pregnancy can lead to disease progression. Therefore, consideration may need to be made for termination, where the pregnancy is not advanced, in order to protect the health of the mother. There are also myriad diseases that can arise as a result of pregnancy that can mean considerable risk of physical harm, such as pre-eclampsia.

Serious mental illness can also be brought about by pregnancy, including psychotic disorders or severe depression, or even serious addiction to substances that are toxic to a foetus. These and many others are among the range of factors, in addition to foetal viability, that two doctors will need to consider under the legislation to determine if the termination is appropriate and can proceed.

Clause 6A is a new provision of the bill that relates to care of a person born after termination, which is in itself a rare occurrence. The clause also articulates existing best practice in medicine whereby, in consultation with the parents and in the later term pregnancy, generally from 20 weeks, appropriate care is provided to the baby. This can include palliative care after careful discussion and in accordance with the wishes of the parent or parents.

For the sake of the record, I would like to clarify some key facts about abortion in South Australia. Around 0.5 per cent of terminations are undertaken at private facilities. The proportion of terminations done medically—that is, via tablet—I am advised was in the order of 40.2 per cent in 2018. The number of late-term abortions in a private facility in 2020 was nil, but I am advised that this data has not yet been released. The proportion of late-term abortions performed for mental health reasons is 0.9 per cent, as per the 2018 annual report.

I understand the Hon. David Ridgway has had questions raised with him relating to a proposed amendment by a member in the other place, the member for West Torrens. This amendment was labelled 10B to the Termination of Pregnancy Bill and discussed prohibiting the sale of foetal tissue obtained as a result of termination.

While the amendment was not passed by the House of Assembly, I have sought advice from my department for the sake of clarity and transparency and have been advised that a foetus has no distinct 'personhood' at law and hence is legally part of the mother, that is, the foetus is the tissue of the mother. As such, any sale of foetal tissue or other body parts is governed by the Transplantation and Anatomy Act 1983; that is, foetal tissue and body parts cannot be sold, as outlined in the act. Only with consent of the mother, section 35(3) of the Transplantation and Anatomy Act provides:

(3) Subsection (1) does not apply to or in relation to the sale or supply of tissue (not being tissue obtained under a contract or arrangement that is by subsection (1) void) if the tissue has been subjected to processing or treatment and the sale or supply is made for use, in accordance with the directions of a medical practitioner, for therapeutic, medical or scientific purposes.

That is the end of the advice I have been given. Further, this amendment does not allow for the reality of medical ethics and practice as it exists in Australia. Not only is the notion of sale of foetal tissue, or indeed any other body part, anathema to medical practice and abhorrent to members of the medical profession in Australia, there is no evidence of this issue in the Australian context.

In addition, it is important to recognise that there is a host of robust clinical practice policies and guidelines, as well as codes of conduct and ethics, that govern medical practitioners in Australia in their delivery of medical services. The Australian Health Practitioner Regulation Agency also rigorously implements and oversees the National Registration and Accreditation Scheme to ensure that only practitioners who meet required standards are able to practise medicine in Australia.

Going forward, as I said, the Department for Health and Wellbeing will assume responsibility for supporting the minister to whom this bill is allocated. This parliament has decided that it should no longer be in the criminal law but should be in the health law. SA Health is tasked with considering a range of factors in the development of policies and guidelines to reflect the new legislative framework. This will include deliberation on how services may need to change and the provision of counselling services in order to comply with the new legislation, as well as the development of a new registry to record data on terminations and report to parliament.

Should the council endorse this motion today and the bill pass, this process will begin in earnest to ready the health system and the broader community for the changes that parliament has authorised, thereby responding to our shared responsibility to ensure the wellbeing of all South Australians by, on this occasion, optimising our health care in a manner that is caring, sustainable and responsive to the reproductive healthcare needs of the women of South Australia.

The Hon. T.A. FRANKS: I rise to associate myself with the remarks made by the Minister for Human Services, Michelle Lensink, and the Minister for Health and Wellbeing, the Hon. Stephen Wade. Currently, in March 2021, abortion remains a crime in South Australia, punishable by up to life imprisonment. We once led; we now lag.

Today, it is time to move forward. Today, I hope we will see that step forward that ensures every person's experience of abortion will mean they no longer encounter laws that constrain possibilities for their medical practitioners and health services to provide them the best possible health care. I hope from the time this act comes into force that pregnant people will be treated with the respect that they have not necessarily been treated with in some parts of this debate.

There is, of course, abortion stigma in the community and there has been abortion stigma in the parliament. It has been why our archaic laws—over 50 years old—have not been touched by this parliament and have not been reformed as they should but also why the extraordinary work of the South Australian Abortion Action Coalition, which formed some six or so years ago, is to be commended. They have mounted the case for law reform, which was a compelling case, and they are to be congratulated on ensuring that those who seek abortion in this state will be treated with respect for their decisions and that their medical professionals will not be impaired by 50-plus year old laws that are in fact a barrier to that health care.

Indeed, it is why in 2018 I moved a bill in this place to decriminalise abortion in this state. Certainly, the debate sparked by that bill saw the SALRI review and I commend SALRI for their fine work. The extraordinary efforts that went into that work I think ensured that the debate in this place and in the other was able to be based on fact and not on stigma.

I commend, in the other place, Minister Chapman, the Attorney, for her stewardship but also the shadow ministers Hildyard, Cook and Close, as well as the member for Cheltenham, Joe Szakacs. In this place, the leadership of the Hon. Irene Pnevmatikos and the Hon. Connie Bonaros must be noted and, indeed, the expert whipping abilities of the Hon. Ian Hunter, which, whilst not to the forefront, were invaluable.

I also thank the staff and advisers, not just my own, who have been subjected to personal abuse and unacceptable behaviours, but those who have across party lines rallied together. In particular, Madeleine Church, Ingo Block and Anna Tree have done an extraordinary amount of work to get us to this place.

Today, we bring our abortion laws into the 21st century, some 21 years into this 21st century. Make no mistake, you can ban abortion, but it will not stop abortion—it will simply stop safe abortion. I hope this law goes some way to ensuring that we stop the stigma around abortion. Abortion is health care and it should be provided in a way that is accessible, that is available publicly and that is safe and preferably without the stigma that we have seen. Quite often in our society, we trust people to be mothers but we do not trust them to make a choice whether to be a mother.

I have been struck that we have actually demonised those people in the most difficult and distressing situations, those who do require a termination of their pregnancy in the later stages of that pregnancy. Previously in debates I have quoted from an open letter that was written by these very people to Donald Trump, the then President of the United States. They, in their open letter, responded that they knew what late abortion meant because they were the families who had gotten them. That quote was:

We are later abortion patients and their partners who are concerned with the politicization of this issue at the expense of both truth and compassion. While we do not speak for every later abortion patient and do not pretend to represent everyone who seeks this care, we can speak for ourselves and our families.

The stories we hear being told about later abortion…are not our stories. They do not reflect our choices or experiences. These hypothetical patients don't sound like us or the other patients we know.

The barbarous, unethical doctors in these scenarios don't sound like the people who gave us compassionate care.

Our cases, the ones that would be affected by [banning later abortions] constitute a relatively small number of abortions.

So while these cases are incredibly rare and specific to each patient's unique circumstances, they are being broadly misrepresented and are playing an outsized role on the [American] national stage.

The decision to terminate a pregnancy is never a political one, it is a personal one.

They conclude with the words that have rung in my ears many a time as I have heard mischaracterisations of these people who are in the most difficult situation that we will ever see a person face:

We are not monsters. We are your family, your neighbours, someone you love. We are you, just in different circumstances.

None of us here would want to be them, but all of us here, I would hope, will now support them. This decision is a personal one and the parliament, of course, is a political institution, but in passing this legislation we trust these people and we trust their medical professionals and that is something I wholeheartedly welcome today.

The Hon. I. PNEVMATIKOS: I just want to make a few comments. I have made previous comments and thanked people in this chamber, so I will not do that again, but what I will do is make some comments and observations about what I saw in the other place and in particular following the debate that occurred in the other place. It was certainly an interesting experience, to say the least.

From the outset, it was clear that there was a group of members who supported the bill without amendments, those who wanted to provide constructive amendments and debate and a group of members who were diametrically opposed to all aspects of the bill other than the notion of decriminalisation. I would like to acknowledge the Attorney-General (the member for Bragg), the member for Port Adelaide, the member for Hurtle Vale and the member for Cheltenham for their contribution in the debate. There were others who contributed as well.

The disparity in quality and level of debate in both houses was enlightening. At best, the debate in the other place was spreading misinformation and at its worst, it was misguided and verging on ignorant. Members blatantly provided the chamber with unfounded facts and ignored the medical and scientific expert opinion. They also moved the debate away from the health and rights of women to a debate about the rights of the unborn. Most of the members' comments on issues such as sex selection, counselling, alternative options to abortions, the term 'medically appropriate' and foetal tissue being used on the black market were fanciful to say the least.

Also, a majority of those members were men. Strangely enough, it is women who give birth. It is predominantly women who care for and educate their children, and it is women who become further disadvantaged without proper and adequate health care. I do not see those members standing up for the unborn, actively progressing any of those interrelated issues.

This debate has proved that women are being listened to but not heard—ignoring both the community and social mores calling for the bill to be passed, as well as the science and health experts' advice on abortion. If babies and children are those members' main focus in this debate, I look forward to them fearlessly advocating and standing up for youth unemployment; youth homelessness; the gender pay gap; drug and alcohol issues; youth mental health; underage gambling; education, training and job opportunities for young people; child protection; childcare; period poverty; domestic violence against women and children; and the list goes on.

The supporters of this bill were pushed to compromise in order to ensure the legislative outcome for women and healthcare practitioners. I would again like to thank the Attorney for her resilience in at times facing unrelenting nonsense from opponents and her endeavours to maintain the integrity of the bill. Even though there were some compromises made, a fair outcome was reached that did not denigrate from the intent of the bill.

I also extend thanks to the Attorney's staff and other staff who have been involved in supporting this endeavour, professionals assisting in the making of this bill, parliamentary counsel, SA Health and professors. Your tireless work has been incredible, and as a consequence we have achieved a great outcome for South Australians. I would also like to acknowledge the South Australian Abortion Action Coalition—I note that some of them join us in this chamber today—for their tireless work, providing research, sharing personal experiences and constantly inspiring us to keep going and fight the good fight. This would not have been possible without you.

The Hon. M.C. PARNELL: I will be very brief. I was somewhat concerned at the amendments that were passed in the other place. I was not sure how this bill would progress today when it came back to us, but I took great comfort from the letter that was written to me, and I expect to other members, from the South Australian Abortion Action Coalition. I want to put their position on the record. Others have summarised it. It is only a few paragraphs. They say:

We write to ask that you vote in support of the Termination of Pregnancy Bill 2020 as amended by the House.

We ask that you vote to pass the Bill in its current form so that abortion is decriminalised and regulated as health care.

They then go on to describe some of the improvements that the bill will make to South Australians. It concludes:

While the Bill was amended in the House of Assembly in ways which the South Australian Abortion Action Coalition did not support, the significant and historic changes and improvements which this Bill will create lead us to ask you to vote for it in its current form.

Further delay of the decriminalisation of abortion and continuation of our outdated and restrictive current laws would mean that abortion is not treated as the health care procedure it is. This is critical and life changing reform.

That is under the hand of Ms Brigid Coombe and Dr Barbara Baird, the co-conveners of the South Australian Abortion Action Coalition. I thought I would put that on the record. That was very helpful to me, so that we had some advice and assistance from those who have been working on this issue for so many years. They were prepared to accept the compromises, and I think we should too.

The Hon. D.G.E. HOOD: I will be relatively brief; I made a reasonably substantial contribution at the second reading of this matter when we dealt with it the first time. I will summarise very quickly my feelings and my decision on this bill, which members will not be surprised to hear: I will not be supporting it, even in the amended form. The Book of Jeremiah, chapter 1, verse 5, reads:

Before I formed you in the womb I knew you...

As a Christian it is not just this verse but many others that help form my views on these matters. I would point out—and I think it is important for members to know—that it is not just the church, the scripture or any of these religious teachings or texts that form the basis for my opinion on these matters. I also believe that, aside from what you might call spiritual or philosophical reasons for one's position, there are good practical reasons to try to at least reduce abortion numbers in our community. I think it was Bill Clinton who said that abortion should be safe, legal and rare, and most of us, if not all of us, would agree with that.

One of those practical reasons that I have always thought requires further investigation or consideration on this issue is that we have an ageing population in South Australia; indeed, the Western world has an ageing population, by and large. One of the reasons for that of course is that medical advancements have enabled people to live longer, and as a result you get an ageing population.

Also, in South Australia, using our specific numbers, another contribution to that ageing population is that we have over 4,000 abortions a year, and that is 4,000 babies who do not make it to living, if you like. If they did, over a 50-year period they would grow into adults, some of them would have children and the average age of our population would therefore decline. That is good for everyone: it is good for our economy, it is good for our health system, it is good for our society, you would argue. That is one practical thing that bears consideration in this issue.

Another is the declining fertility rates we experience that are also prevalent in our community. Members may recall that I gave an account of the experience that my wife and I had with IVF when trying to conceive our daughter some years ago now. It was difficult. My wife was diagnosed with a certain condition, which meant that falling pregnant was going to be almost impossible. In fact, two doctors said to us that we should give up on it and that it was not going to happen, but we pursued the IVF path and in the end our little miracle, Madeline, was there.

We have declining fertility rates, and the point is that, when we were going through that process, like many other South Australian couples we would literally have cut off our arm to have access to a newborn baby, ideally a locally born baby. We looked into the potential for adoption overseas and, frankly, it was bureaucratically almost impossible.

They are two practical considerations that members may wish to ponder in reaching their final position, if they have not already, on this issue. We do have an ageing population and we do have declining fertility rates, and those things seem to run contrary to at least not wanting to reduce abortion numbers.

In the other place a number of amendments were passed, of which members would be aware—they have been given to us in this list of amendments that we all received today as part of the message. In very general terms, they seek to outlaw sex selection abortions. Members will remember that I moved an amendment to that effect in this place when we had the debate and, whilst the amendment was lost 11 votes to 10, I am pleased it passed the other place.

Another amendment ensures a duty of care to any babies born alive after an attempted abortion. Another group incorporates detailed guidelines as to matters to be considered by doctors in assessing whether late-term abortion should occur at all—I certainly agree with that. Another amendment requires the provision of information about counselling to the woman considering the abortion—I certainly agree with that. Another makes changes to the conscientious objection provisions, which a number of doctors contacted me about. Whilst it does not go far enough, clearly it is an improvement to the bill, from their perspective and also from mine.

I support all of those amendments. If they had all been tabled in this place (and most of them were, but not at all), I would have supported them, and in fact did, in the case of the ones that were tabled, and if I were in the other place I would have supported them all. I am pleased to see they have made their way into the bill.

Just couple of final comments: this bill has been framed as a central attempt to remove abortion from the criminal code and place it into the health code. I support that. I think that that is not at all unreasonable in this day and age, and I suspect every single member of parliament would have supported that if that is all the bill had done, and this would have been a very simple passage of a bill that had unanimous support. But it goes so much further, and I guess there will be speakers who will outline some of the reasons they cannot support it.

Fundamentally, from my perspective, in this bill there is no clear upper limit on gestation at which an abortion can occur, and I simply cannot bring myself to support the bill because of that. Neither could 99 per cent of the correspondence I received. I do not have the exact numbers here, but I literally did a tally and it was 98.6 or 98.7, or something close to that. Let's say 98.6 per cent of correspondence that I received was against the bill. I think it is important that people acknowledge that was probably similar across the parliament. There may be slight variations on those numbers, but I suspect everyone would have received at least 90 per cent against the bill or thereabouts. For the reasons I have outlined, I simply cannot support this bill.

The Hon. N.J. CENTOFANTI: Like many of my colleagues, I will be very brief with my comments on the amended Termination of Pregnancy Bill 2020. I am grateful that my colleagues in the other place were somewhat more successful in the passing of several amendments. As the Hon. Dennis Hood has just spoken about in this chamber, these amendments sought to outlaw sex selection abortions, ensure protection for babies born live resulting from a failed abortion procedure, make changes to conscientious objection provisions, require doctors to provide information on counselling prior to late-term abortions and incorporate detailed guidelines as to the matters to be considered by doctors in the assessment of late-term abortions.

More specifically, there was an amendment to clause 6 by the member for Lee requiring mandatory considerations for medical practitioners performing terminations after 22 weeks and six days. I am heartened by this amendment in particular, as it provides guidelines to practitioners around the circumstances for late-term abortions. I am also appreciative of the rest of the amendments, including those of the member for Davenport regarding conscientious objection and care for persons born after a failed termination. It is also pleasing to see an amendment from the Attorney-General on sex selection.

However, in saying this, I still cannot support this bill, as whilst these amendments improve the bill significantly from its original form, it still allows for a wide variety of situations in which late termination can occur—too wide in my view. For that reason, although I support decriminalisation of abortion laws, I cannot support this bill.

My only other concern is that according to these amendments we inherit three clauses 6A; however, I am sure that the good people of parliamentary counsel will attend to this when the bill is finalised to avoid any future confusion.

The Hon. C.M. SCRIVEN: Certainly the bill that we have before us is something of an improvement over the previous bill. However, throughout much of this debate the human rights of the unborn child have been downplayed or ignored altogether. In seeking to show compassion for women, this bill instead allows for entirely healthy unborn babies who are capable of being delivered early with a strong likelihood of a healthy life to instead be aborted. I acknowledge there are members here who sincerely believe that will not occur, but a belief is not the law, and it is the law that does nevertheless allow it, if this bill passes today.

Proponents of abortion often characterise it as the rights of a woman against the rights of a foetus, as they will call the unborn baby. This ignores the fact that, while a pregnancy significantly affects a woman's life, an abortion ends the life of the unborn child. What has been particularly tragic in this debate is that in late-term abortions there need be no conflict between the woman and the unborn child. A healthy baby can be delivered early, have a high chance of survival and continued health and the woman will still be no longer pregnant.

The Hon. Ms Lensink described the abortion to birth aspect as a false message, but this has ignored the message from Victoria, which showed abortion at 36 weeks occurring for psychosocial reasons, and the evidence of medical practitioners who say that they know of it occurring interstate and they know of people who will do it here without what I think most of the community would consider to be appropriate reasons at that late-term stage.

In existing law—that is, without this change which we are expecting to pass today—no-one is guilty of a felony if they have an abortion. No woman in South Australia has been prosecuted in over 50 years for procuring an abortion. However, that is the basis on which this bill was presented.

I would like to thank the many people who worked to oppose this bill and who sought to amend the bill. I point out that supporters of the various amendments in the other place were from a variety of backgrounds, many of whom have worked over many years to improve workplace conditions, to improve social conditions and to improve our society. It is inaccurate to imply otherwise.

I would like to especially thank the brave doctors, midwives and other health practitioners who spoke out about the deficiencies in this bill. They were willing to point out that bodies such as the AMA and the ANMF had not surveyed their members to gauge their support or to get feedback. They were willing to risk the pressure from their peers and, indeed, sometimes those higher up in the hierarchy to nevertheless stand up for what they thought was right for our state.

I would like to thank the over 5,000 people who joined the Walk for Life, in contrast to the roughly 200 who rallied in support of the bill. I would like to especially thank those women who have had abortions—those women who have had abortions and who spoke out against this bill because they knew that, whatever the intent of abortion legislation, their experience with reality was a betrayal of women and their babies. You were brave and you were inspirational. I am very sad that your voices were ignored, and I am sorry that this parliament has failed you.

The Hon. C. BONAROS: I rise to very briefly associate myself with the contributions of my colleagues the Minister for Human Services, the Minister for Health and Wellbeing, the Hon. Tammy Franks, the Hon. Irene Pnevmatikos and the Hon. Mark Parnell, and to formally thank all the amazing people who worked so tirelessly behind the scenes to get us here today. Never underestimate the contribution you have made in this debate, particularly in terms of the votes that have taken place on the floor of these chambers.

This has been an exceptionally difficult debate for all of us for myriad reasons, and I am exceptionally grateful for all the support that we have received both personally and professionally throughout the course of the debate. Once again, thank you to all those amazing people for all their tireless work.

The Hon. F. PANGALLO: I just want to read some emails from the people of South Australia, emails that were passed on to me by FIVEaa announcer Andrew Reimer. Andrew told his listeners that he would give them to me either to be tabled or to be read out. In doing this I am making no judgement of the members on either side, and I hope they give me the same courtesy because all I am doing here is giving a voice to South Australians in their parliament, to have their say about what they think about this legislation.

I concur with the words of the Hon. Dennis Hood and the Hon. Nicola Centofanti and I would have supported those amendments but I, too, agree that perhaps they do not go far. I want to give you an example, and these are the words of the people of South Australia, the people who vote for us. I think it is only fair that we at least hear what they have to say about this legislation. This one is from Sandy George:

I sent letters to every MP and got 3 responses…only of receipt of my correspondence.

Even my own local MP in Norwood seat of Dunstan-Premier Stephen Marshall, didn't even acknowledge receiving my correspondence let alone a reply to ask him to vote against this Bill.

Every MP who votes in favour of this Bill…their names will go down in the history books as contributing to the next 'stolen generation' will have blood on their hands, allowing mothers and doctors to 'murder' viable babies.

Sandy goes on to say that she does not support abortion to birth for any reason:

I believe that all babies capable of being born alive should be allowed to live. I do not believe it should be made legal to take a viable human being's life. I also oppose the introduction of private providers for abortions. This opens the gates to profiting from abortions and therefore those providing abortions pressuring women into having them so the provider can make money…There is a lot of loving support out in the community to help women considering abortion so close to term of the baby being born, to help them not terminate their pregnancy. There are so many couples also who can't have children willing to adopt.

That was Sandy George. Geraldine Whiting wrote:

The following is my opinion, if people don't agree don't have a go at me, give their opinion. How many women have had an abortion and have not told their husband/partner. It does happen. It is a woman's choice if she has an abortion, after all she is the one carrying the baby. If men could have babies all reproduction would stop. It is a woman's choice not to continue the pregnancy not the man.

Anonymous wrote:

I've only just started listening [to the debate] so don't know if this has been brought up. I am sadly in the position to know a few close friends who have had to have late term terminations due to medical reasons not picked up until the pregnancy is considered viable. The babies had complex medical issues and whilst they may have been born alive medical advice was to terminate as the quality of life would have been very low. A life full of surgeries hospital admissions and constant hardships on both the baby and the family. The process to get a late term abortion is not a nice one to go through, parents need to get multiple medical opinions then explain themselves to a board of directors at hospital. To do this usually just days after learning that your much loved much wanted baby won't be coming home won't be having 1st smiles 1st words 1st steps is a horrible thing for parents to have to go through and just another cruel blow to parents who are already at their lowest point. To hear them being called murderers breaks my heart. 95% of the population won't make this decision easily or irresponsibly. So as long as there are appropriate protections put in place, I think to make the process less traumatic for parents already going through what is undoubtedly the worst time in their life isn't necessarily a bad thing.

These are the words of the people of South Australia. Neil Cox writes:

I am appalled at the proposed abortion bill and implore our members of state parliament to maintain the status quo regarding the abortion laws.

Why…

Proponents of the bill say they want the abortion limit permitted well beyond 6 months to almost full term. However, lawyers interpret the bill to mean up to full term. Full term is the moment of birth. Does the wider community really want to abort babies at the moment of birth? I do not think so. That any bill could be put to parliament as law and be worded so loosely that it can be interpreted so differently is itself a great concern.

In the late 1960s, when abortion became legally available, medical science was far less advanced than today. Many pre-term babies were not viable, and the gestation limits on abortion were set appropriately.

However, to legalise abortion from 6 months onwards denies some basic realities of 21st century medical care in 1st world countries such as ours. The realities are:

66% of babies born at 6 months and admitted into Natal Intensive Care Units (NICUs) live to go home, and

98% of babies born at 7½ months gestation survive.

To be clear, what this means is, at 6 months 66% of these babies are viable human beings, because we now have the medical science and medical facilities available to provide the majority of the pre-terms a viable future.

The ethical issues with the 98% of babies who would be viable at 7½ months should be even more clear cut and obvious to everyone.

The intent of this bill would take society far beyond what the existing laws permit.

I believe the majority of South Australians would consider the existing laws to be acceptable and reasonable, and not requiring change. Since the 1980s and to this day Australians have taken an essentially non-partisan approach to abortion laws. Understand this well, this means the majority of the voting public have been non-partisan, and a minority have been partisan. This bill will satisfy only a minority of the voting public.

I implore you to maintain the status quo regarding the abortion laws, and not to vote for the proposed bill for abortion that is being considered in Parliament.

Any member of our state parliament who votes in favour of this bill does not deserve any support at the next election.

Yours Sincerely,

Neil Cox

Libby Mills talks about Mr Reimer, who shared his own story at the grief of losing his own child. Libby goes on to say:

I would like to say that I have been involved with Genesis pregnancy support and Love Adelaide and would like to emphasise there is help for women and men who are faced with unplanned pregnancies.

The proposed new law only seeks to get rid of a so-called problem and does not offer real help or choice for women. 95% of women undergo abortion for mental health reasons and yet the mental health problems often get worse post abortion. What about real solutions. With late term abortion it seems the humanity of the child is also ignored. To pass this law will open the flood gates to more abortions, sex selections abortions, private providers with a profit motive and offer no real help or choices for women and totally ignores the humanity of unborn children.

Thanks for the opportunity to express our views.

Libby Mills

Again, the voice of South Australians who wish to be heard—

The CHAIR: The Hon. Mr Pangallo, I recognise that you are raising the voices of South Australians. I should remind you and the committee that the question we are dealing with is that the amendments from the House of Assembly be agreed to, not about whether the bill—

The Hon. F. PANGALLO: Okay.

The CHAIR: A number of these are about the status quo.

The Hon. F. PANGALLO: I will cut it short, Mr Chair.

The CHAIR: If you can.

The Hon. F. PANGALLO: I will not read any more of these, but I seek leave to table them, so at least these people who wanted to be heard are able to be heard.

Leave granted.

The Hon. F. PANGALLO: I will leave it at that, and as I said I pass no judgement. It is only because I, along with every other member in this place, have been contacted by thousands of South Australians wishing to have their voice heard. I think it is only appropriate that we have allowed that to happen today and I thank the chamber for actually being able to listen and not pass any judgement on any of the emails that I have read.

The CHAIR: I am going to proceed to put the question, and I remind members, as I just said, that the question we are dealing with is that the amendments be agreed to, because the bill has already passed this chamber and the bill has passed the lower house and the question is about whether the amendments be agreed to.

Motion carried.

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