Democratic Labor Senator John Madigan’s bid to ban Medicare funding for abortions which are conducted due to the gender of the foetus is a “symbolic declaration” that would have next to no real-world impact, according to former Australian Medical Association president Andrew Pesce.
Pesce, an obstetrician and gynaecologist, says there is no credible data on the number of gender-based abortions in Australia but he believes the number would be extremely small.
Senator Madigan will introduce a private member’s bill in the Senate today aimed at stopping the public funding of abortions ”procured on the basis of gender selection”.
“I know of a couple of isolated cases where women have indicated they are interested in a termination based on gender, but they are usually based on s-x-linked chromosome abnormality,” Pesce told Crikey. “Most doctors, instinctively, are very reluctant to perform terminations if they feel the only reason is because of the s-x of the baby. I don’t believe it’s a big problem but I can’t say it never happens. I think it’s a symbolic declaration from the senator.”
Madigan is quoted in Fairfax papers today saying he is introducing the bill because he has ”seen data that abortion on the basis of gender selection is happening overseas and that means it is likely to be happening here”.
Pesce says the use of s-x-selective abortion in countries such as China and India — where cultural norms can favour male over female children — is borne out by population data showing a major imbalance in the ratio of males to females. “There is no evidence of any altering of the s-x ratio in this country,” he said.
As for Madigan’s threat to strip Medicare funding for abortions based on whether a foetus is male or female, Pesce said: “It’s not likely to make any material difference to access for these women, if they exist.”
Medicare does not have definitive data on how many abortions are performed each year — nor why they are performed. The relevant Medicare Benefits Schedule items (16525 and 35643) include both terminations and the removal of foetuses that have died naturally. This means Medicare is not aware whether a woman has terminated a pregnancy because of the s-x of the foetus or not, Pesce said.
The creation of a separate Medicare item number for abortions has been opposed in the past because it is seen as a possible precursor to legislation aimed at reducing the number of abortions. Before the last election Tony Abbott committed not to introduce a separate Medicare item number.
Pesce said women desperate to avoid having a baby of a particular s-x would simply opt to bypass Medicare altogether because the cost of terminations (from around $400) would not be prohibitive for most of them.
Abortion in Australia is legislated by state governments. In NSW, for example, common law holds abortion is legal if a doctor has found “any economic, social or medical ground or reason” it is needed to avoid danger to a woman’s life or physical or emotional health. In Victoria, there is no restriction on abortion before 24 weeks under the Abortion Law Reform Act 2008. After that time, doctors must consult another medical practitioner and consider the “current and future physical,psychological and social circumstances” of the patient.
In making the case for his bill, Madigan has cited the case of a Victorian couple who aborted twin boys conceived through IVF because they already had three sons and wanted a daughter.
National Health and Medical Research Council guidelines on assisted reproductive technology state that s-x selection should not be undertaken for non-medical purposes as admission to life should not be conditional on whether a foetus is male or female.
“The Australian Health Ethics Committee advises against s-x selection (by whatever means) except to reduce the risk of transmission of a serious genetic condition,” an NHMRC spokesperson told Crikey.
In 2010, a University of Melbourne study found 80% of Australians disapproved of s-x-selective abortions and 69% of respondents disapproved the use of IVF for s-x selection.