Sarah Smith* fell pregnant unexpectedly when she was 20 years-old.
For her, it was a difficult but necessary decision to have an abortion but it was one made even harder by the costs involved.
Marie Stopes Australia, one of the country’s biggest reproductive and sexual health service providers, is hoping to take at least one problem out of the equation for women by setting up a $3 million fund to help those struggling to afford abortion and contraception.
The company is on the hunt for “brave philanthropists” to start up the fund, which would be distributed through Marie Stopes’ and partner company’s clinics in the form of extra subsidies or full cost cover.
“We want to tackle it. We think that there are some innovative and brave philanthropists out there that will provide funding, because they can see the direct impact it’s going to have on women’s lives,” said Marie Stopes’ spokesperson, Eleonore Bridier.
“We want to run it like a sustainable endowment fund, where the funds are put into something that gets interest, so we can build the capacity to always have that support there.”
Ms Bridier says that while $1 million is going directly to abortion services, $2 million from the fund will be used to help women queuing on often lengthy public hospital waiting lists for long-acting reversible contraception (LARCs).
They also intend to help women in regional areas have better access to abortion and contraception, by using the fund to cover associated costs such as travel.
Ms Smith said she didn’t have a planned pregnancy, and to add to this, she had an illness called hyperemesis gravidarum which stopped her from eating or taking liquids.
"I was vomiting every waking 10 minutes,” Ms Smith said.
“At the time, I was trying to hold down three jobs, but I couldn't do it anymore and had to quit all of these jobs as the illness took over.
“I started receiving some [government] benefits, but I was still struggling financially and I had to make a decision on whether to keep going with the pregnancy, and with my illness, or get a procedure done.”
When Ms Smith did decide to get an abortion, she says it was relatively easy to organise the procedure, despite it still being a criminal offence under NSW law.
Doctors are required to take into account a woman’s circumstances and physical and mental health before they can rule against the procedure, so being below the 12-week mark and at serious risk of health implications meant that Ms Smith could go ahead without fearing she would end up in court.
But the out-of-pocket costs involved proved to be a huge burden on Ms Smith, who struggled to come up with the funds.
“It was hard enough to make this decision as it was, but the added stress of coming up with the money for a procedure that I had to have made it that much more difficult for me,” Ms Smith said.
“I ended up having to borrow the money, because I had hardly any income to pay for this. It left me feeling desperate and guilty.”
Medical professionals say stories like Ms Smith’s are ones they hear regularly from patients, with procedural costs being one of the biggest barriers to abortion access in Australia.
Despite medical and surgical abortion procedures being subsidised by Medicare on a national scale, women still face average out-of-pocket costs of about $500.
There are no provisions for publicly funded procedures for those in NSW, the ACT, Tasmania or Queensland unless a woman is at serious risk of medical complications.
Even then, it’s left up to doctors to determine whether they think a woman is at legitimate risk.
Dr Sascha Callaghan, a lawyer and ethicist from the University of Sydney, warns that some might prioritise their fear of prosecution over a patient’s well being.
“The fact of the matter is that, even though this [abortion procedures] tends not to be prosecuted, [doctors] can be, and it remains risky in NSW for doctors to vouch for the reasons why they give women abortions,” Dr Callaghan said.
“...not wanting to have a baby is not enough but that’s up to the individual doctors to determine. They determine that not on the basis of what the woman wants, but on their fear of being prosecuted.”
Marie Stopes is aiming to reach their $3 million goal by 2020, and distribute the funds nationally despite abortion legislation being state-based in Australia.
*Name changed to protect privacy.