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Rural women face judgement and misinformation on family planning

Women living in urban areas may take for granted their relatively easy access to family planning services that provide information and ways to freely determine the number, timing, and spacing of their…

Problems are compounded in rural areas where there might only be one doctor in a town and limited opportunity for a second opinion. Alli Polin

Women living in urban areas may take for granted their relatively easy access to family planning services that provide information and ways to freely determine the number, timing, and spacing of their children. For women in rural areas, the picture can be very different.

Recent research in rural Victoria found these women face extra hurdles and feelings of “judgement” when seeking out these services. The project I worked on with Dr Julie Kruss investigated the barriers for women seeking emergency contraception, pregnancy termination or pregnancy-related options counselling in rural western Victoria. Options counselling refers to services that explore available alternatives regarding an unplanned pregnancy.

We conducted in-depth interviews with health professionals and others whose current employment was connected to the issue of family planning, including nurses, doctors and counsellors. These frank discussions focused on issues they had witnessed for women accessing family planning services.

The study highlighted an overall lack of women’s health services in rural communities, as well as some alarming patterns in reported barriers to accessing them.

A significant issue was the feeling of being “judged” by health professionals, with some doctors refusing to make referrals based on their own moral judgement. Other doctors were suspected of deliberately delaying women’s access to abortion, for example by sending them for multiple ultrasounds, and withholding information about how to access appropriate services.

As time is of the essence in reaching decisions about an unwanted or unplanned pregnancy, delays can obviously compromise timely decision-making. The experience of being blocked produces distress and reduced self-efficacy, but can also turn women off accessing these and other health services altogether.

There were also examples of doctors who agreed to perform an abortion but then warned the patient that it wouldn’t be carried out if there was a “next time”. Threatening to withhold a health service on the basis of what is acceptable to the doctor’s moral judgement breaches medical ethics. The doctor starts to “play God” in more ways than one by assuming the power to provide or withhold a service (or information), and by imposing a moral judgement on a patient’s behaviour.

While these issues could arise anywhere, the problem is compounded in rural areas where there might only be one doctor in a town and limited opportunity for a second opinion.

There were also examples of misleading information being provided to women in rural areas. One pharmacy distributed scary pamphlets on emergency contraception that were not evidence-based.

Elsewhere, myths about abortion leaving women infertile were still being spread, despite declarations by medical bodies such as the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2005) that there’s no proof of such links if abortion is conducted by a medical professional in a medical facility.

It’s clearly a major concern if women cannot trust the information they receive from health professionals.

It also became apparent through the research that differences in cultural norms between city and country created more barriers for women in accessing the support and information they needed. Privacy, for instance, was a frequently raised issue; it’s hard to seek emergency contraception or termination in a small town where everybody knows everyone’s business.

Rural communities might also be more conservative and less likely to talk about sexual health issues in general. People can be wary of change, which makes it difficult to develop a new service, especially one such as sexual health. Young rural women may have fewer educational and employment options, and this may normalise and validate the cycle of early pregnancy.

Beyond the barriers related to judgemental attitudes and limited availability of family planning services, rural women were seen to confront a number of interconnected, practical hurdles. For example, if a woman must arrange childcare while travelling to Melbourne, she may struggle to find the money and have to reluctantly confide in friends and family, all while taking time off work. All this adds to her financial stress.

The title of our study “Country women are resilient but….” referred to one comment that, just because they do tend to deal well with adversity, women in rural towns shouldn’t have to put up with these extra burdens, and the added distress, when accessing family planning services.

More open and widely available education campaigns on the prevention of unwanted pregnancy, as well as normalising pregnancy termination within the service system, could be ways forward. Changes to service delivery, such as having family planning professionals visit rural areas and incentives for rural doctors to train to perform terminations, could be other possibilities. Whatever the solutions, these issues are real and need to be addressed.

The longer these barriers continue and are not openly discussed, the harder is it is for women to make timely decisions about pregnancy. At such a stressful time, the emphasis needs to be on timely, accurate, evidence-based and judgment-free advice and support. This is what women in the city expect and can readily seek out. Women in rural areas deserve the same choice.

Acknowledgement: The research discussed in this article was completed as part of Dr Julie Kruss' doctorate in community and health psychology. Dr Kruss also contributed to this article.

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51 Comments sorted by

  1. Karl Schaffarczyk

    Law Honours Candidate at University of Canberra

    Thanks for the great article highlighting this important problem.

    I ask: Is there a problem specifically of women not being able to access adequate, confidential and non-judgemental services in the bush?

    ... or is it indicative of a wider problem of access to appropriate, adequate, confidential and non-judgemental medical services for everybody living in rural and remote areas, no matter if young or old, woman or man?

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    1. Dianna Arthur

      Environmentalist

      In reply to Karl Schaffarczyk

      Karl, no doubt there is an issue of privacy for many people living in rural communities. However, this article is specifically concerning the types of services that are primarily about women.

      As Heather Gridley stated:

      " The longer these barriers continue and are not openly discussed, the harder is it is for women to make timely decisions about pregnancy. At such a stressful time, the emphasis needs to be on timely, accurate, evidence-based and judgment-free advice and support. This is what women in the city expect and can readily seek out. Women in rural areas deserve the same choice."

      I am sure people would be interested in a discussion regarding the issues you have raised, perhaps you would consider offering such an article to the TC editors.

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    2. Heather Gridley

      Honorary Fellow, Psychology at Victoria University

      In reply to Karl Schaffarczyk

      Thanks Karl

      Our study only focussed on rural women's access to family planning services, so I can't really answer your question; but if you join the dots between a lack of health and medical services in general in rural areas relative to most urban centres, and the related concerns about choice, privacy, confidentiality and practical access (finances, travel...), then combine that with a sensitive health issue that may carry some stigma, then chances are it would also be very difficult for, say, a gay man to access sexual health services, or for an older woman to ask a pharmacist for assistance with an incontinence problem. But gynaecology in general carries an elevated risk of litigation and it is hard enough to attract those services to the bush, let alone to ensure that services like termination come with the package; and women still carry the much greater burden in terms of family planning decisions overall, at any age.

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    3. Judith Olney

      Ms

      In reply to Karl Schaffarczyk

      Karl, as someone who lives in a remote town, (800kms from the nearest city, and 400kms from the nearest large town), I would answer yes to your question, absolutely.

      It is particularly difficult for those who are on low or fixed income, and although this article focuses on women and family planning issues, (quite rightly as this is a huge problem with many poor social and community outcomes), the problem exists in other areas of health as well. In particular mental health, and access to specialist services of any kind.

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    4. Tracy Heiss

      logged in via Facebook

      In reply to Heather Gridley

      I have lived in many isolated country towns and have found that often, the only doctors to make initial contact with, are from overseas. I am certain an Iranian Muslim may not be as forthcoming with objective advice on pregnancy options. Perhaps this will be construed as a racist observation, but I know for a fact it has had an impact on at least two women I have known. I am at a loss, really, as to how to broach this subject at all, and as I type, I'm preparing for a few harsh responses.

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  2. Julie McNeill

    Writer

    I found living in a country Victorian town a great place to bring up my daughters except when I was rushed in an ambulance from my GP to public hospital in Bendigo and when investigating cause of abdominal pain they found I was 3-4 weeks pregnant. Absolute accident and husband was booked in for a vasectomy the next week.
    As I was already admitted I asked for a termination. Well, like your article stated I had one doctor ask me, Didn't I have any morals?
    This really insulted my integrity as a responsible…

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    1. Heather Gridley

      Honorary Fellow, Psychology at Victoria University

      In reply to Julie McNeill

      Thank you for sharing this experience Julie - I understand that Bendigo does now offer accessible termination services but the situation varies widely across the state and between states. Some of our interviewees relayed stories like yours that made us question the image of the non-judgemental health professional - and in a rural town just one obstructive health service provider can have a hugely negative impact on generations of local women and their families.

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  3. Greg Byrne

    logged in via Facebook

    While Heather Gridley in "Rural women face judgement and misinformation on family planning" is critical of the judgemental attitudes of some rural doctors who are unenthusiastic about terminating the lives of unborn babies (let's be specific, Heather, and not obscure what you are writing about with euphemisms such as 'reproductive health services') she is judgemental herself about the motives of these rural doctors.
    Their moral objections to abortion may well coincide with their scientific judgement…

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    1. Olivia Hibbitt

      Medical Writer

      In reply to Greg Byrne

      Greg, you might want to get your information from credible, independent resources rather than anti-abortion websites. As the author states there is a large body of evidence demonstrating that termination is safe when performed by medical professionals in a clinic setting. You are cherry picking data and studies to push your own anti-abortion agenda.

      Whatever your stance, it is immoral and inethical for a medical professional to force a woman to go through with a pregnancy that is unwanted because of their own personal biases.

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    2. Heather Gridley

      Honorary Fellow, Psychology at Victoria University

      In reply to Olivia Hibbitt

      No doctor is forced to perform abortions against their will, but they are ethically obliged to refer patients to information and services that offer the full range of options to women facing decisions about a pregnancy. Studies that claim to show negative mental health outcomes for women who have had abortion rarely examine the mental health status or vulnerability of those women prior to or at the time of their decision to terminate. Forcing a woman to terminate a pregancy, continue a pregnancy against her will, or give a child up for adoption, is likely to cause great distress and affect her physical and mental health. As one of the participants in our study put it (referring to the decriminalisation of abortion in Victoria in 2008):
      'I think our next challenge is to support people in a variety of ways in making choices, choices to keep their baby and choices to not keep their baby now that this big elephant in the room has been done away with!'

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Greg Byrne

      I thought the name Greg Byrne sounded familiar. We met him in the thread about the colour pink in relation to breast cancer advocacy. He came in with his anti-abortion argument from another angle.

      The anti-abortionists who argue that continuing a pregnancy is protective against breast cancer neglect the fact that a huge number of pregnancies end in spontaneous miscarriage, which has the same hormonal effect.

      This article is about access, Mr Byrne.

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    4. Sue Ieraci

      Public hospital clinician

      In reply to John Phillip

      I'm not answering for Olivia, but here are some critiques of Greg Byrne's assertions:

      1. Post-abortion trauma and mental health. Many studies have failed to isolate the mental health issues that lead to women terminating a pregnancy in the first place. This 2009 paper "Is There an “Abortion Trauma Syndrome”? Critiquing the Evidence" says that "Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems…

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    5. Catherine Paull

      Communications & Research Manager

      In reply to Sue Ieraci

      Greg, and Sue please correct me if I am on the wrong track, when abortion is performed in a proper clinical environment, any negative effects (long- and short-term) as a result of an abortion are far fewer when compared to risks and complications in pregnancy and during childbirth.

      My mother's family is from a small rural town, and although it has small hospital, many of the staff were also relatives, or were friends of the family, making privacy and confidentiality very difficult. The issue here was not just about access, but the lack of privacy, and of course then having to travel very long distances to ensure that an individual's private medical treatment was not a source of local gossip.

      Even the local pharmacist was a relative. It made it impossible for many female relatives ( and male) to access any family planning services. The simple task of buying condoms was an exercise in unacceptable judgement by others.

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Catherine Paull

      Catherine - the abortifacient drug RU486 creates an induced miscarriage - so its safety is similar to a spontaneous miscarriage.

      Well-conducted surgical terminations of pregnancy - using curette or suction, do bear a small risk of infection and a much smaller risk of uterine perforation, but pregnancy and delivery also entail real risks, as you say.

      You are right about the privacy issues - especially if the pharmacist is a relative. I can't see a solution other than travel - can you?

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  4. Tim Scanlon

    Debunker

    Rural women? Could have stopped at 'Rural'.

    Rural health services in general are rubbish.

    Although, one point to add to women's health issues, there often seems to be a disconnect between services and the users. I've noticed that locally there are provisions for health nurses for pregnancy and baby care, but the people who utilise them are not the people who most need them. I don't know why the services aren't utilised, but I know that this results in later issues of child welfare (local anecdotal comments).

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  5. Isabelle Skinner

    Professor of Rural and Regional Nursing at University of Tasmania

    Hi Heather, thanks for sharing your research findings here. Your article highlights a major issue for all women who live in rural and remote areas. There is little access to appropriate, confidential, and expected health care for women's health issues. It doesn't matter if it is to access termination services, or to access birthing services. Women in rural and remote Australia are treated as second class citizens. Women are expected to relocate for normal birthing many km from home for an extended period of time, sometimes up to 4 weeks before the due date and have no access to postnatal support in many rural and remote areas. Lack of termination care is just another example of women's needs not being met by the health system we have put in place in this country.

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  6. Cait Calcutt

    Team Leader, Children by Choice

    Heather, Thank you for the aricle. Is the research going to published? The situation reflects that in Queensland. However our distances are much greater and there are very few abortion services provided in public hospitals in Brisbane or elsewhere, unlike Victoria, which has the excellent Pregnancy Advisory Service at the Royal Women's Hospital. Cait

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    1. Heather Gridley

      Honorary Fellow, Psychology at Victoria University

      In reply to Cait Calcutt

      Thank you all for your responses - taken together, your comments really reinforce the reasons we undertook the study in the first place. We hope to have the research published formally at some stage this year - peer review processes permitting!

      It is interesting that women who choose to have a pregnancy terminated are often accused of selfishness, yet we are now being presented with arguments that suggest one should proceed with a pregnancy in order to reduce one's own chances of contracting breast cancer some time in the future - hardly an unselfish motive.

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  7. Greg Byrne

    logged in via Facebook

    Several responses to my post have claimed that a rural doctor declining to perform an abortion is "coercing the patient to have a baby". Performing abortions may not only be against the doctor's professional and moral judgement, but he/she may also not be trained to perform the procedure. Many medical students decline to participate in abortion training for conscientious reasons - they find it repulsive to terminate the lives of fetuses. Even if the doctor has training, he may not be a specialist…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Greg Byrne

      Greg Byrne - of course individuals have the right to decline to perform medical procedures that are not immediately life-saving. It is highly unlikely, however, that practitioners are providing abortion procedures without any training. Are you aware of cases? IF you are, you should report them to the regulatory authorities, as no practitioner should operate outside their scope of practice or skill set.

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  8. Babette Francis

    Coordinator of Endeavour Forum

    Congratulations to Greg Byrne for precisely quoting the most recent studies showing the increased risk of breast cancer caused by induced abortion. Contrary to the claims of his critics, these are not from "anti-abortion web sites" but from reputable medical journals, and the researchers include those from the National Cancer Institute, USA, the foremost cancer organisation in the world.
    Here's another study by Janet Daling from the National Cancer Institute, which showed that every young woman…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Babette Francis

      Ms Francis, as we discussed on the other thread, induced abortion is no greater a risk factor for breast cancer than spontaneous abortion (aka miscarriage), which occurs in up to 20% of pregnancies.

      "The protective effect of breast feeding is over and above the protective effect of a full-term pregnancy, and Sue should be aware of that. "

      Ms Francis - consider two examples:

      One woman has a termination of pregnancy at age 19, then goes on to have four children, each breast fed for six months.

      A second woman has two spontaneous miscarriages, then has one child, which she breastfeeds for one month.

      All other things being equal, who has the greater breast cancer risk?

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  9. Babette Francis

    Coordinator of Endeavour Forum

    Dear Catherine,
    Sue is incorrect in asserting that the use of RU 486 is as safe as a spontaneous miscarriage. In most first-trimester miscarriages the hormonal levels of estradiol do not rise sufficiently to either maintain the pregnancy or for breast cell multiplication, so there is no increase in breast cancer risk. But RU 486 is used to abort healthy pregnancies so there will be an increase in breast cancer risk depending on the length of the pregnancy. And second-trimester miscarriages carry the same increase in breast cancer risk as an abortion at that stage of pregnancy.
    Babette Francis

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  10. Babette Francis

    Coordinator of Endeavour Forum

    Dear Sue,
    You don't seem to understand that the hormonal situation of a woman with a healthy pregnancy is different to that of a woman whose pregnancy is destined to miscarry. The hormonal differences can be identified by a simple blood test. When the woman is destined to miscarry, the estradiol levels do not rise sufficiently to maintain the pregnancy or for the breast cell multiplication (which can lead to mutations and cancer cells). When a healthy pregnancy is aborted, the woman is left with…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Babette Francis

      Ms Francis - you have your facts confused again.

      There is no specific level of hormones when either spontaneous or induced miscarriages happen - it all depends on the gestational stage.

      An induced abortion at twelve weeks occurs at a different level of hormones to a spontaneous abortion occurring at six weeks.

      No matter how you try to spin it, breast cancer is no different between spontaneous and induced abortions.

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    2. Babette Francis

      Coordinator of Endeavour Forum

      In reply to Sue Ieraci

      Dear Sue,
      You do not seem to be familiar with endocrinology. Of course the hormone level of estradiol rises with the gestational age, that is just my point, this is what causes breast cell development, but the level does not rise with a pregnancy that is going to miscarry, so there is no breast cell mitosis. As far back as 1976 a team of Swiss obstetricians could predict with 92% accuracy which pregnancies were going to miscarry because the estradiol levels did not rise above the non-pregnant…

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Babette Francis

      Ms Francis, I don't know why you keep insisting when you don't appear to understand pregnancy hormones.

      Beta hCG (human chorionic gonadotrophin is the pregnancy hormone through which foetal viability is tracked.

      Here is an extract from some basic pregnancy physiology:

      "HUMAN CORIONIC GONADOTROPIN (hCG) is produced in huge amounts by syncytiotrophoblasic cells within days of conception and can be detected within 8-10 days. They form the basis of all pregnancy tests. The function of hCG appears…

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  11. Greg Byrne

    logged in via Facebook

    Sue and Heather,
    The rural doctor may very well have no specific training in abortion procedures other than training in curettage for a miscarriage which is a far simpler procedure. Insisting a rural doctor perform an abortion or refer for one is like insisting he do a knee replacement when it is his professional judgment that the patient does not need one and that there are other alternatives. Feminists should stop trying to bully doctors into killing fetuses.
    As for Heather's comment that it…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Greg Byrne

      Mr Byrne - the "symbiotic relationship between fetus and mother" can be wonderful, but also catastrophic.

      There is nothing magical about a pregnancy that involves severe hyperemesis or pregnancy-induced hypertension (pre-eclampsia or eclampsia).

      You may learn more about the physiology of pregnancy and birth by reading the actual science, rather than populist books.

      Meanwhile, the availability of RU486 has a particular benefit for women in rural communities who would be otherwise unable to access a surgical termination of pregnancy. Their care then is just the same as a spontaneous miscarriage, which every rural doctor has helped manage.

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    2. Greg Byrne

      logged in via Facebook

      In reply to Sue Ieraci

      Dear Sue,
      The majority of pregnancies in countries where there is sufficient food and medical attention turn out to be healthy for both mother and baby - sadly about one-quarter of these are aborted for "social" reasons. Of course there are problems in pregnancy as in other areas of life, that is what doctors and hospitals are for. But focussing on these to deny the wonderful relationship between fetus and mother is gloomy and pessimistic. And have look at the latest 4D ultrasounds - you will marvel at the miracle of life - or are you too afraid to look at the beauty of the unborn babes lest it turn you against your chosen preference for abortion? How could one think of dismembering such a beautiful fetuses?
      I would not boast too much about RU486 if I were you, we have already had one death (that we know of) of a woman in Australia in 2010 - she and her fetus both died. I doubt in that region if any woman died in childbirth.
      Greg Byrne

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Greg Byrne

      What an extraordinary post, Mr Byrne - and personally offensive.

      First you say "symbiotic relationship between fetus and mother - each protects the other,...", then you admit that this "relationship" is generally successful because of the availability of medical intervention. You can't have it both ways.

      I would never "boast" about RU486 - I didn't develop it, and its use is not within the scope of my practice. Ultrasound in early pregnancy is, however.

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    4. Tracy Heiss

      logged in via Facebook

      In reply to Greg Byrne

      Greg Burn...this is about access to non-judgmental information. You are a prime example of why it is so difficult for women in the bush. Heaven help any woman who would have you as their doctor. You just tried to personally denigrate Sue Leraci for offering objective opinions and facts on this thread. Poor form.

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  12. Julie McNeill

    Writer

    Babette, I knew your daughter and family well when we lived in Kyneton - do say hello from my husband Roy and I - it's been many years since we enjoyed their company.
    I was hoping our second child would be born there but when I told the Doctor how I preferred to give birth, on the floor in a beanbag, on my knees or whatever else was comfortable he said he would be in charge! Thankfully I had my first girl at the Birth Centre at the Queen Vic in Melbourne so could return. My sister was visiting when…

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    1. Dianna Arthur

      Environmentalist

      In reply to Julie McNeill

      Well said, Julie. I am particularly impressed by your support for and understanding of other rural women who do not have the same supports that you had (I am not denigrating what must've been an adrenalin fuelled drive to the Queen Vic, salutations for standing up to your local GP) - locale should have not impact on access to medical services, but then I speak of an ideal world.

      Babette Francis & Greg Byrne

      You both should be ashamed at using this article about medical service in the vast rural sectors of our nation to, yet again, promulgate your anti-choice platform. Please do not bother replying to me I have better things to do than give you any more attention than you deserve.

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    2. Babette Francis

      Coordinator of Endeavour Forum

      In reply to Julie McNeill

      Dear Julie,
      You may be happy about your decision to have an abortion, although it is not clear whether you had one or are just talking about two experiences of childbirth, but you should be aware of the incidence of mental health problems other women experience.
      "Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased…

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    3. Babette Francis

      Coordinator of Endeavour Forum

      In reply to Dianna Arthur

      Dear Diana,
      Why is warning women about their increased risk of breast cancer if they have an induced abortion an "anti-choice platform"? Aren't women entitled to full information before they make a choice? No, I guess the abortion industry and its feminist camp followers are against full disclosure, that is why they never tell young girls that their early age pregnancy affords them substantial protection against breast cancer, a major cause of death and/or mutilation for women. And that is why…

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    4. Dianna Arthur

      Environmentalist

      In reply to Babette Francis

      You are claiming to 'help' women with a lie.

      "...These newer studies examined large numbers of women, collected data before breast cancer was found, and gathered medical history information from medical records rather than simply from self-reports, thereby generating more reliable findings. The newer studies consistently showed no association between induced and spontaneous abortions and breast cancer risk."

      http://www.cancer.gov/cancertopics/factsheet/Risk/abortion-miscarriage

      Nor have you contributed any help, analysis or even empathy for the difficulties faced by women in rural areas which is what this article is about.

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    5. Babette Francis

      Coordinator of Endeavour Forum

      In reply to Dianna Arthur

      Dear Diana,
      Well at last you are admitting there are several studies showing the increased risk of breast cancer caused by induced abortion, and that these are not myths from anti-abortion websites! There are no newer studies opposing the abortion-breast-cancer risk than the ones supporting the risk, which Greg Byrne already quoted, i.e. the ones from Turkey, Armenia, China and the USA, the last one, the Dolle study, included among the researchers Louise Brinton from the US National Cancer…

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  13. Greg Byrne

    logged in via Facebook

    Julie McNeill
    What do you want us to do Julie? Do you want us put up a post saying what a terrible person you are for having had an abortion? That isn't going to happen Julie. In this post I am going to criticize the Catholic bishops and parish priests who refused to advise parishioners of the Catholic Church's teachings on abortion and on voting for pro-abortion politicians. If they had done their duty this situation that we now face would never have arisen because no government would have dared…

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    1. Julie McNeill

      Writer

      In reply to Greg Byrne

      No - I am sharing personal experience to illustrate the article's premise of neglect of public health services for women. It's about time the RC and other religious kept out of women's business.
      It has nothing to do with you. A female learns to manage her reproductive health from the day she menstruates till the day she stops.
      Patriarchal established religions have shown they seek to control and disempower women. A truly secular solution is what the Tasmanian Government is introducing, based on Victoria's experience.
      Keep your rosaries off my ovaries brother, and re-focus your energy on those children here eg the 1000 kids in mandatory detention on the prison islands at Manus etc.

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  14. Heather Gridley

    Honorary Fellow, Psychology at Victoria University

    I don't propose to give any oxygen to people who will never change their ideological stance or values - which they have a right to - and who show no respect for the rights or values of others to hold a different stance. As Sue has said, their comments are not on the core topic of this thread - which is about the lack of access of women living in remote areas and small towns to confidential and judgement-free contraception, family planning information and termination services. If women's mental health…

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    1. Julie McNeill

      Writer

      In reply to Heather Gridley

      Thank-you Heather and others who spoke on-topic. It will be something for me to share in my policy work as QLP - ALP member.

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  15. Babette Francis

    Coordinator of Endeavour Forum

    Dear Sue,
    The info below may clarify for you why abortion is a risk factor for breast cancer:

    The physiology of the breast provides the strongest evidence of the causal link between abortion and breast cancer. The same biology that accounts for 90% of all risk factors for breast cancer accounts for the ABC link.
    Simply stated, the biology rests on two principles.
    1. The more estrogen a woman is exposed to in her lifetime, the higher her risk for breast cancer. It is well established that…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Babette Francis

      Ms Frances, I'll explain this one last time:

      The effect of pregnancy loss on the breast depends on the stage at which the gestation ends, not the reason why the gestation ended.

      Your attempt to paint beta hCG as a "pheromone" is just wrong. Beta hCG levels peak at between 8 and 11 weeks, not "within the next few days" of a child arriving.

      Pheromones are substances excreted externally that influence the behaviour of other (external) animals.

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  16. Babette Francis

    Coordinator of Endeavour Forum

    Dear Sue,
    You are quite right about the level of hormones depending on the gestational age of the pregnancy, but that applies only to healthy pregnancies. A dying pregnancy which is what a miscarriage is, does not have much if any rise in hormones.
    Perhaps you will understand this if you consider oxygen levels in people - a healthy 20year old will have a good oxygen level just before he is struck by a car and killed, but a 20-year old dying of terminal cancer will have poor oxygen levels…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Babette Francis

      Note for other readers:

      Ms Francis is incorrect about hormone levels in pregnancy and miscarriage. Spontaneous miscarriage happens for a range of reasons, at different stages of gestation. There is no single type of "dying pregnancy". Many spontaneous miscarriages happen in the first few days after fertilisation, others can occur in a fully-formed foetus of 12 to 14 weeks - or occasionally even later.

      Ms Francis and her group are trying to link termination of pregnancy with breast cancer risk…

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    2. Greg Byrne

      logged in via Facebook

      In reply to Sue Ieraci

      The overwhelming majority of professional studies on the abortion breast cancer link support the possibility of a link. Nobody is saying that there is definitely a link but that the evidence of a link is sufficiently strong for women seeking an abortion to be made aware of it. That is either true or false Sue. You seem determined to debunk the link and you are prepared to stake your professional reputation upon it. The "cancer establishment" (for want of a better term) in the US is determined to debunk the link but as time goes on the evidence of the link becomes stronger. One has to conclude that this is a case of influential people not wanting to be out of step with the political rulers and the majority of the population. It is a replay of the lung cancer - smoking debate many years previous which ended with the "cancer establishment" having to admit that there was a link. By that time millions of Americans had contracted lung cancer.

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  17. Babette Francis

    Coordinator of Endeavour Forum

    Dear Sue,

    I see why you are so obsessed with trying to prove that miscarriages are the same as induced abortions so far as hormone levels are concerned. You are probably dealing with a number of miscarriages caused not by the death of the embryo/fetus but by mechanical weakening of the cervix caused by previous abortions. I agree, in this case the hormone levels would be the same as in an induced abortion, and as I said in previous posts, miscarriages caused by a fall or a blow to the abdomen…

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