Briefing paper: Abortion in Queensland - a summary of the issues
Last updated February 2013
What is the issue?
Abortion is the only medical procedure that is contained in the Queensland Criminal Code. The current Queensland law on abortion dates back to 1899. Since then community attitudes, safe medical practice and women’s status in Australian society have been transformed. Criminal law is an inappropriate vehicle to regulate the provision of medical treatment. Current abortion laws create barriers to doctors providing quality reproductive health care for women and restrict women’s capacity to make decisions about their own reproductive health and fertility.
Queensland’s abortion law is antiquated and must be modernised so that it is clear, widely understood, and reflective of community attitudes and clinical practice.
Abortion is one part of a spectrum of sexual and reproductive health care. Providing good abortion care to Queensland women must form part of a larger strategy to increase sexual and reproductive health knowledge, improve access to contraception and sexuality education programs, ensure all women can access non-directive and all-options pregnancy counselling, and provide accessible sexual and reproductive health care to all Queenslanders. A sexual and reproductive health strategy would contribute to lowering the incidence of unplanned and unwanted pregnancy and thereby reduce the need for abortion services.
Unplanned pregnancy and abortion
It is estimated that half of all pregnancies in Australia are unplanned, and that around one quarter of all pregnancies are terminated .
Unplanned pregnancy is a reality for Australian women. Women will experience between 30 and 45 fertile years on average, or between 370 and 530 menstrual cycles . The reality is that no contraception is 100% effective and contraception can fail even when used correctly and consistently. The World Health Organisation estimates that even if all contraceptive users used contraception perfectly in every sexual encounter, there would still be six million unintended pregnancies every year .
Studies of Australian and New Zealand women seeking abortion have shown that over half of women presenting for abortion had been using contraception prior to becoming pregnant ,.
Unplanned pregnancy can occur for a variety of reasons, including contraceptive failure, lack of knowledge or information about fertility and pregnancy, lack of communication or support within the relationship, sexual violence, lack of access to contraception due to insufficient sexual and reproductive health education, high cost, unsupportive doctors, religious beliefs around use of contraception and limited knowledge around contraception.
What is the legal status of abortion in Queensland?
Abortion remains in the Criminal Code in Queensland, contained in sections 224,225 and 226 which make it a crime to perform an abortion, access an abortion, or supply drugs or instruments to be used in an abortion .
Under this law, which dates from 1899, a woman does not even have to be pregnant for charges to be laid.
Section 224. Any person who, with intent to procure the miscarriage of a woman, whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, is guilty of a crime, and is liable to imprisonment for 14 years.
Section 225. Any woman who, with intent to procure her own miscarriage, whether she is or is not with child, unlawfully administers to herself any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, or permits any such thing or means to be administered or used to her, is guilty of a crime, and is liable to imprisonment for 7 years.
Section 226. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman, whether she is or is not with child, is guilty of a misdemeanour, and is liable to imprisonment for 3 years.
In 1986, Doctors Bayliss and Cullen were prosecuted for performing an unlawful termination.
Section 282 of the Criminal Code provides a defence to doctors for the provision of surgical (and now medical) treatment where the doctor believes is it necessary to save the woman’s life. Case law from 1986 deems abortion lawful under this section if it is performed to prevent serious harm to a woman’s mental or physical health, or to save her life.
Rape, incest and the diagnosis of severe fetal anomaly are not grounds for a legal abortion in Queensland .
How does the law in Queensland compare to other states and territories?
Most states in Australia were originally subject to abortion laws similar to Queensland’s, generally adapted from the 1861 Offences Against the Person Act from the United Kingdom (which was itself reformed in the UK in 1967).
However, most states and territories have re-examined and reformed their laws to varying degrees, starting with South Australia in 1969, leaving Queensland with some of the most restrictive abortion legislation in the country.
Laws in other states vary from a close mirror of Queensland’s law to complete legalisation. On one end of the spectrum is New South Wales, where abortion laws are very similar to Queensland and deem abortion unlawful unless a woman’s physical or mental health is at risk – however, in New South Wales, a woman’s social and economic factors may also be taken into account, considerably broadening the availability of lawful abortion.
Victoria and the ACT abortion law have completely removed all reference to abortion from their Crimes Acts. In the ACT, abortion is legal as long as it is provided by a medical doctor, with all abortion laws fully repealed in 2000; in Victoria, abortion is legal to 24 weeks with the woman’s consent and after 24 weeks with two doctors’ approval, under decriminalisation legislation introduced in 2008.
Victorian abortion law
Misinformation is rife about the implications of the abortion law reform introduced in Victoria in 2008.
The Victorian legislation provides a two-tiered system for access to abortion. Prior to 24 weeks gestation, abortion is legal with the woman’s consent – ie, there are no grounds which have to be satisfied for her to access a legal abortion. After 24 weeks, a woman must have the approval of two doctors in order to obtain an abortion.
Conscientious objection for doctors
Contrary to claims from the anti-choice lobby, doctors in Victoria are not forced to refer for abortion. What they are obligated to do if they have a conscientious objection to abortion, is make that objection known to their patient and then refer that patient to a doctor they know does not hold the same objection – in line with the Australian Medical Association’s code of ethics for health professionals:
Claims that doctors are forced to provide abortion under Victorian legislation are grossly misleading. According to the law in Victoria, doctors who have a conscientious objection are not obliged in any way to participate in the provision of abortion services unless a woman’s life is in immediate danger, in which case the conscientious objection provision does not apply.
Reproductive health advocate and president of Pro Choice Vic, Dr Leslie Cannold, summarises the conscientious objection issue as follows:
"They [the anti-choice lobby] declaim with high dugeon the "extraordinary attempt by pro-abortion legislators" to threaten the livelihoods health practitioners who "are unwilling to ... perform an abortion," but never mention that the only compulsion to provide abortion in the Victorian legislation is in an emergency where it is necessary to preserve a woman's life.
The conscience clause in Victoria's new abortion law requires just two things from doctors…
The first is that they don't exercise this freedom at the cost of a woman's life. The second is that they ensure their refusal to provide timely medical care doesn't translate into her inability to get timely medical care by providing an effective referral." 
Counselling for women considering abortion
Anti-choice lobby groups often push for mandatory counselling to be provided to women considering abortion. The inference in the claim that Victorian women are not provided with ‘independent counselling’ is that a) all women need counselling prior to an abortion (something that pregnant women themselves disagree with ), and that b) the law should enforce this. The Victorian Law Reform Commission examined the issue of mandatory counselling in their inquiry into the state’s abortion laws in 2007, concluding that:
"In arguing for compulsory counselling, people generally came from the position that abortion is such a traumatic event, with long-term consequences, that women need counselling regardless of whether they request it. This suggests that women are not fully capable of making their own decisions and require protection.
Compelling a person who has already determined a course of action to attend counselling is unlikely to do much good, but has the potential to do harm. Mandating counselling may result in women having to travel long distances for multiple medical assessments and counselling sessions before they can proceed. This would exacerbate existing inequities.
But isn't abortion readily available in Queensland?
Abortion is provided through private clinics and day surgeries in Queensland.
In addition to the high cost barriers for Queensland women, only three of the private abortion providers in Queensland are situated outside the southeast corner of the state, in Rockhampton, Townsville and Cairns. Women in rural and remote areas often face extreme costs and travel distances to get to a provider.
Children by Choice provides financial assistance for over 350 women a year in order to facilitate their access to a pregnancy termination procedure. Some women still report being unable to pay for the procedure or travel to a clinic, and so are faced with the prospect of continuing with an unplanned and unwanted pregnancy. Young women, Aboriginal women, women with disabilities or from non-English-speaking backgrounds, and women who are financially disadvantaged or on low fixed incomes, are among those which find abortion services hardest to access.
Lack of clear information also impacts on Queensland women’s ability to access a pregnancy termination.
A 2004 study found that Queensland GPs were more likely to identify as anti-abortion than the national average (26% Queensland v 20% nationally) and are less likely to be confident of the legal status of abortion (54% Queensland v 63% nationally) .
GPs and health workers are under no obligation to provide information on pregnancy termination services, or where to find that information, to their patients. Many women each month contact Children by Choice after having a negative experience with a GP, health worker or anti-choice pregnancy counsellor, looking for information about abortion from an unbiased source.
Who supports legal abortion?
The 2003 Australian Survey of Social Attitudes (AuSSA) found that 81% of those surveyed believed a woman should have the right to choose whether or not she has an abortion .
The 2003 AuSSA also found that religious belief and support for legal abortion are not mutually exclusive, with 77% of those who identify as religious also supporting a woman’s right to choose .
A survey conducted by Auspoll in 2009 of over 1000 Queenslanders found that almost 4 out of 5 voters wanted the law changed so abortion is no longer a crime .
A review of over 20 years of data on attitudes to abortion published in October 2009 found that “more than half the electorate in Australia and in Queensland support freedom of choice, and a further third support the availability of abortion in special circumstances… As far as attitudes are concerned, Queensland is no different from the rest of Australia.” 
On average, between only 5% - 9% of the Australian community are opposed to abortion in every circumstance. .
The Royal Australian College of Obstetricians and Gynaecologists , the Public Health Association of Australia , and Sexual Health and Family Planning Australia  all advocate for the decriminalisation of abortion and equity of access to abortion services.
85% of practicing obstetricians and gynaecologists are not opposed to abortion, and 90% of these doctors agree that abortion should be available through the public health system in all states and territories .
The Australian Medical Association Queensland says current abortion laws are unclear and do not provide certainty for doctors or for women. The AMAQ stated that Queensland’s “abortion laws are a barrier to a doctor's first duty - best patient care” .
Do people vote for pro-choice politicians?
The Queensland experience
When pro-choice ALP member for Aspley Bonny Barry lost her seat at the 2009 Queensland election, it was claimed by the anti-choice lobby that it was due to the electorate being informed of her intention to introduce a bill to decriminalise abortion. A group who later emerged calling themselves Voters for Life claimed that their “humble education campaign” consisting of leafleting the Aspley electorate “had contributed to her defeat”. 
In reality, the swing against Bonny Barry in Aspley was due to a campaign against the State Government’s plan to close a nearby children’s hospital, and surrounding seats also suffered similar swings due to the same issue. Election analyst Antony Green, in his examination of Aspley in the lead up to the election stated that
“The Bligh government is planning to close the Royal Children's Hospital at Herston on the northern edge of the Brisbane CBD and replace with a new facility in South Brisbane. This has been raising ire on Brisbane's northside, anger not placated by a promise to upgrade pediatric facilites at Prince Charles Hospital just outside the electorate in Chermside. The LNP is promising to upgrade both the southside facility and the Royal Children's Hospital...A part of Brisbane that was Liberal held until the 2001 debacle and on past election results, [Aspley is] one of the first seats that should return to the non-Labor fold if there is any swing against the Bligh government.” 
Statewide, the ALP suffered a 4.7% swing against them on polling day.
While the swing against Barry was larger, at 7%, it was not disproportionate to the swings suffered by other sitting Labor MPs on Brisbane’s northside, and indeed was smaller than many whose electorates were also affected by the Children’s Hospital debate.
Ferny Grove (-7.1%), Brisbane Central (-7.7%), and Everton (-8.4%) all suffered bigger negative swings than Aspley, while Stafford (-5.9%) and Nudgee (-5.4%) also experienced negative swings larger than the statewide average .
Women’s Health Victoria recently analysed over 25 years of Australian election data to ascertain the effect on voting patterns when candidate’s views on abortion were known to the electorate. They found that
“Despite anti-choice activity, the last 25+ years demonstrate that pro-choice candidates do not suffer at the ballot box. In fact, their stance on a woman’s right to choose is rewarded by the electorate.” 
In the Australian Capital Territory
Following a 1994 NSW court decision regarding common law rulings on abortion, ACT MLA Wayne Berry drafted a Bill to decriminalise abortion in the ACT. He was heavily targeted by anti-choice campaigners, which intensified during the 1995 election campaign, including an anti-choice aerial banner on election day. Wayne Berry retained his seat and increased his margin. Wayne Berry successfully led a Bill in 2001/02 to fully decriminalise abortion in the ACT and held his seat until retirement in 2008, saying later that
"While anti-abortion campaigners are loud and well organised, they are out of step with the rest of the community. It is a mistake to view their loudness and organisational ability as a reflection of how the rest of the community will vote on the issue of abortion." 
How many abortions take place in Queensland every year?
There is no standard data collection in Queensland regarding the numbers of terminations carried out each year, nor is there routinely-collected national data that give accurate figures for elective abortions in Australia .
Estimates are made using private health insurance claims and Medicare records, which are problematic for several reasons. .
The same Medicare item numbers are used to denote procedures which are not terminations, including miscarriage, fetal death, or other gynaecological conditions – which some experts say could account for up to half of all these procedures .
These records also exclude overseas visitors who may not have access to Medicare, as well as outpatient services or some provided in private health facilities.
Medicare records for Queensland for the year of 2009 show that around 15,500 procedures took place .
If abortion was legalised, would the abortion rate rise?
International studies have shown there is no correlation between the legality or otherwise of abortion and the numbers of women who will seek abortion .
This holds true for states within Australia as well, where laws which vary from state to state seem to have little impact on the rates of abortion – while the estimated national abortion rate in 2003 was 19.7, South Australia’s abortion rate in that year was 16.7 . South Australia reformed their abortion laws in 1969 and their pregnancy termination services are relatively easy to access compared with many other states.
Australia has a higher abortion rate than European countries that have more liberal abortion laws and greater access to contraception and pregnancy termination services .
What about abortion after 20 weeks gestation?
Only some states routinely collect and analyse data on pregnancy terminations.
Figures from Western Australia, one of the only states to do so, state that in 2005, over 90% of abortions were performed at 13 weeks gestation or under, or within the first trimester. Only 0.6% of all abortions were performed at 20 weeks or later. 
The report on pregnancy outcomes from South Australia’s Department of Health in 2009 reports similar figures, with 92% of abortions performed within the first 14 weeks of pregnancy .
The small numbers of women who will choose to terminate a pregnancy after 20 weeks gestation do so in severe circumstances, such as severe maternal illness, diagnosis of a severe fetal anomaly, sexual assault or other exacerbating circumstances.
What are the health risks for women choosing abortion?
In Australia, where abortions are performed by highly qualified health care professionals in very sanitary conditions, a pregnancy termination is one of the safest medical procedures, and complications are rare .
The anti-choice lobby use the supposed 'risks' of abortion in an attempt to scare women out of having a termination – the three most often used in misinformation campaigns are that an abortion will affect a woman's future fertility, that it causes breast cancer, and that there are long-lasting psychological impacts of abortion .
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, or RANZCOG, states that serious complications after abortions are rare, and that mortality and serious morbidity occur less commonly with abortions than with pregnancies carried to term . While minor surgery or the administration of medication does carry some risks, both surgical and medical methods of abortion should not have any adverse effect on future fertility.
The Royal College of Obstetricians and Gynaecologists in the UK identifies that there are no proven associations between induced abortion and subsequent ectopic pregnancy, placenta praevia or infertility, a view supported by RANZCOG, who state that
Around the world, reproductive health and anti-cancer organisations have rejected any association between abortion and an increased risk of breast cancer. This rejection is based on reliable scientific investigation, documented in reputable medical publications, and has been endorsed by the World Health Organisation .
One study published in the Lancet medical journal in 2004 was an analysis of 53 studies, involving 83,000 women with breast cancer from 16 countries, which found that ‘pregnancies that end as a spontaneous or induced abortion do not increase a woman’s risk of developing breast cancer’ .
The National Cancer Institute in the United States examined in depth the research on abortion and breast cancer in 2003, finding that “having an abortion or miscarriage does not increase a woman’s subsequent risk of developing breast cancer” . The Australian Cancer Council does not recognise induced or spontaneous abortion as a risk for breast cancer , nor does the National Breast and Ovarian Cancer Centre .
Emotional trauma or mental ill health
Every woman experiences the termination of a pregnancy differently, but there is no evidence to suggest that it can cause permanent emotional strain.
The American Psychological Association's Taskforce on Mental Health and Abortion reviewed 20 years of research and studies into the psychological effects of abortion and released its final report in 2008. It found no difference in the psychological effect of terminating an unplanned pregnancy and carrying that pregnancy to term .
Reviews of studies into the issue have found a number of consistent trends:
- The legal and voluntary termination of a pregnancy rarely causes immediate or long-lasting negative psychological consequences in healthy women; 
- Greater partner or parental support improves the psychological outcomes for the woman and that having an abortion results in few negative outcomes to the relationship; 
- Some studies have reported positive outcomes, such as feelings of relief, for women .
In 2005, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) reviewed the evidence on the psychological impact of abortion and concluded that
“Psychological studies suggest that there is mainly improvement in psychological wellbeing in the short term after termination of pregnancy [and that] there are rarely immediate or lasting negative consequences” .
Risk factors for adverse psychological effects are consistently identified as
- Perceptions of stigma, need for secrecy, and low or anticipated social support for the abortion decision;
- A prior history of mental health problems; and
- Characteristics of the particular pregnancy, including the extent to which the woman wanted and felt committed to it .
 C Rissel, J Richters, AE Grulich, RO de Visser, & A Smith, ‘Sex in Australia: attitudes towards sex in a representative sample of adults’, Australian and New Zealand Journal of Public Health, vol. 27, no. 2, April 2003, pp.118–123.
 Understanding your menstrual cycle Fact sheet, Women’s Health Queensland Wide. Accessed January 2011. Available online at http://www.womhealth.org.au/factsheets/menstruation.htm.
 Safe Abortion: Technical and Policy Guidance for Health Systems World Health Organisation, Geneva 2003 p12. Available online at http://www.who.int/reproductivehealth/publications/unsafe_abortion/en/ Accessed 21 April 2010.
 F Amin Shokravi, P Howden Chapman, N Peyman ‘A Comparison Study: Risk Factors of Unplanned Pregnancies in a Group of Iranian and New Zealand Women’ European Journal of Scientific Research Vol.26 No.1 (2009), pp.108-121
 W Abigail, C Power, I Belan ‘Changing patterns in women seeking terminations of pregnancy: A trend analysis of data from one service provider 1996-2006’ Australia and New Zealand Journal of Public Health Volume 32, Number 3, June 2008 , pp. 230-237(8)
 C de Costa ‘Abortion, Queensland, and a law unchanged since 1861’ Crikey, 17 February 2010. Available online at http://www.crikey.com.au/2010/02/17/abortion-queensland-and-a-law-unchanged-since-1861/.
 Code of Ethics 2004 (Revised 2006), Australian Medical Association. Available online at http://ama.com.au/codeofethics.
 What women want when faced with an unplanned pregnancy Research by WebSurvey, commissioned by Marie Stopes International Australia. November 2006. Available online at http://www.mariestopes.org.au/research/australia/australia-what-women-want-when-faced-with-an-unplanned-pregnancy-key-findings.
 Law of Abortion: Final Report Victorian Law Reform Commission, March 2008, pp125-126. Available online at http://www.lawreform.vic.gov.au/.
 Dr Tony O’Connell, the Chief Executive of Queensland Health’s Centre for Healthcare Improvement, in response to media enquiry from Wendy Carlisle from the ABC. Cited in ‘Abortion on Trial’, broadcast on ABC Radio National on 7 November 2010. Full response is available online at http://www.abc.net.au/rn/backgroundbriefing/documents/bbg_20101114_termination.pdf.
 For clinic locations and a summary of costs, see the Children by Choice website at http://www.childrenbychoice.org.au/nwww/termination.htm.
 Australian Reproductive Health Alliance What Do Australians Think About Abortion 2005. Available online at http://www.arha.org.au.
 Public Health Association of Australia Women’s Health Special Interest Group Abortion in Australia: Public Health Perspectives 3rd edition, 2005. Available online at http://www.phaa.net.au/documents/phaa_abortion_kit.pdf.
 Sexual Health and Family Planning Australia (Inc) Position Statement: Abortion. Version 2, published 24 August 2004. Available online at http://www.shfpa.org.au.
 CM de Costa, DB Russell and M Carrette ‘Views and practices of induced abortion among Australian Fellows and specialist trainees of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists’ Medical Journal of Australia (2010; 193 (1): 13-16). (Available online at mja.com.au)
 ABC Elections Queensland 2009, analysis available online at http://www.abc.net.au/elections/qld/2009/guide/aspl.htm.
 Seat by seat analysis by Antony Green available on the ABC Elections website, at http://www.abc.net.au/elections/qld/2009/guide/electorateindex.htm.
 The Myth: Politicians suffer at the ballot box if they are pro-choice in relation to women’s access to termination of pregnancy services Information compiled by Victorian Women’s Health Services, September 2010. Available online at http://whv.org.au/publications-resources.
 Quoted in H Wiseman ‘Law and Disorder’ Australian Doctor, 10 November 2006, pg 21-25. Accessible via:http://www.abortionhelp.com.au/news/media_coverage/law_and_order
 N Grayson, J Hargreaves, & E Sullivan. Use of routinely collected national data sets for reporting on induced abortion in Australia. AIHW Perinatal Statistics Unit Sydney, 2005. Perinatal Statistics Series Number 17(AIHW Cat. No. PER 30).
 A Pratt, A Biggs, L Buckmaster ‘How many abortions are there in Australia? A discussion of abortion statistics, their limitations and options for improved statistical collection’ Parliament of Australia Library, Research Brief no 9, 2004-2005.
 Statistics available through the Medicare website at https://www.medicareaustralia.gov.au/statistics. Figure cited is generated by adding the numbers of procedures under item numbers 35643 and 16525.
 A Chan, W Scheil, J Scott, A-M Nguyen, L Sage Pregnancy Outcome in South Australia 2009 Pregnancy Outcome Unit, SA Health, Government of South Australia. Adelaide, 2011 p55. Available online at http://www.health.sa.gov.au/pehs/pregnancyoutcome.htm.
 F Hudson ‘Thousands of young women had abortions in Victoria last year’ The Herald Sun, 21 November 2009. Available online at http://www.heraldsun.com.au/news/thousands-of-young-women-had-abortions-in-victoria-last-year/story-e6frf7jo-1225800664147.
 Straton J, Godman K, Gee V, & Hu Q. (2006). Induced abortion in Western Australia 1999-2005.Report of the WA Abortion Notification System. Department of Health. Perth, Western Australia. Available online at http://www.health.wa.gov.au/publications/documents/AbortionReport1999-2005FINAL(4).pdf.
 Royal College of Obstetricians and Gynaecologists The care of women requesting induced abortion London 2004. Available online at http://www.rcog.org.uk/womens-health/clinical-guidance/care-women-requesting-induced-abortion.
 See for example the Victorian Law Reform Commission’s Law of Abortion: Final Report Melbourne 2008, Chapter 8, p117, at http://www.lawreform.vic.gov.au. See also ‘Abortion: Did you know?’ on the website of Cherish Life (formerly known as Queensland Right To Life Association) at http://www.cherishlife.org.au/Resource-Areas/Abortion/85
 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Termination of Pregnancy: A resource for health professionals November 2005. Available online at http://www.ranzcog.edu.au/publications/womens-health-publications/termination-of-pregnancy-booklet.html
 World Health Organisation Induced abortion does not increase the risk of breast cancer Fact Sheet 240, June 2000. Reproduced on the Australian Women’s Health Network website at http://www.awhn.org.au/content/view/27/76/#_edn1.
 V Beral, D Bull, R Doll, R Peto, G Reeves “Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries” Lancet 2004; 363: 1007-16.
 National Cancer Institute Fact Sheet Abortion, Miscarriage and Breast Cancer Risk. Available online at http://www.cancer.gov/cancertopics/factsheet/risk/abortion-miscarriage.
 Cancer Council Australia Fact Sheet Breast cancer. Available online at http://www.cancer.org.au/aboutcancer/cancertypes/breastcancer.htm.
 National Breast and Ovarian Cancer Centre. Breast cancer risk factors: a review of the evidence. National Breast and Ovarian Cancer Centre, Surry Hills, NSW, 2009. Available online at http://www.nbocc.org.au/.
 American Psychological Association, Task Force on Mental Health and Abortion. Report of the Task Force onMental Health and Abortion. Washington, 2008. Available online at http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf.