• It is estimated that almost half of all pregnancies in Australia are unplanned.

    Unplanned pregnancies occur for a wide variety of individual, social and political reasons. Some of these include:

    • misinformation such as 'you can’t get pregnant the first time you have sex' or 'you can’t get pregnant during your period';
    • embarrassment of buying contraception;
    • self esteem issues;
    • having sex while using drugs or alcohol (reduced judgement and capacity to make safe decisions);
    • parents not talking to their children about contraception;
    • lack of communication or support within the relationship;
    • sexual or intimate partner violence;
    • lack of government funding to increase education and access to contraception; and
    • lack of access to contraception due to insufficient sexual and reproductive health education, high cost, unsupportive doctors, religious beliefs and limited and inaccurate explanations around contraception.

    It is also important to remember that no contraception method is 100% effective. While some methods may technically be 98-99% effective, the effectiveness of any method is reduced when allowing for human error. Even when used correctly and consistently, contraceptive methods can fail: the World Health Organisation estimates that even if every couple used contraception perfectly every single time they had sex, there would still be six million unplanned pregnancies each year worldwide [1]. Abstinence is usually not a realistic contraception option for most people across their entire reproductive lifespan.

    To ensure that women cope effectively with an unplanned pregnancy, it is important that women have access to correct information and non-directive support about their three options - parenting, abortion and adoption.

     

    Women's experience of unexpected pregnancy

    Women respond in a number of ways to an unplanned pregnancy. Some women have chosen to share their stories here.

    For many women it is a shock, as more often than not, they were using some form of contraception and did not expect to fall pregnant: studies of Australian and New Zealand women considering abortion have shown that up to 80 per cent had been using contraception at the time they became pregnant. While not every unplanned pregnancy is unwanted, many women will be faced with a decision about what the best option is for them and their family in this situation.

    Some women experiencing unplanned pregnancy contact agencies such as Children by Choice and Family Planning to find out more information about their options. Most women talk to their partner or the man involved in the pregnancy, or confide in a good friend or close relative - three quarters of women told a national survey about unplanned pregnancy options that they felt no need to speak to a counsellor in order to make their decision [2].

    Women may experience an unplanned pregnancy as a major life event which forces them to consider their values and beliefs, or even challenge the values they hold about abortion, parenthood and adoption. They may confront issues such as support for parenting, illness, relationship concerns, financial difficulties, not having accurate and up-to-date information about their options, and sexual assault.

    When trying to make a decision about an unplanned pregnancy, women usually try to identify which option they will cope with best. This usually ensures that women will cope with whichever option they choose. In order to identify which option is best it is important that women have accurate information on all their options.

     

    Abortion

    "Given the complex and compelling nature of human sexuality, it is inevitable that unplanned and unwanted pregnancies will continue to occur. And despite the availability of contraceptive agents, a percentage of Australian women will continue to seek safe, legal abortion."

    -Karen Struthers MP, speaking at the Abortion in Queensland conference in 2008.

    Almost half of all unplanned pregnancies in Australia end in a termination of pregnancy (abortion), and, using what little data is available on abortion rates in Australia, it is estimated that almost one in three Australian women will choose abortion in their lifetime [3]. Medicare claims for abortive procedures in the years 1995- 2004 averaged about 75,700 annually, with numbers decreasing over this period [4]; however it should be noted that the same Medicare item numbers are used to denote procedures which are not terminations, including miscarriage, fetal death, or other gynaecological conditions.

    The suction curettage method is the most widely used in Australian clinics. When performed in registered clinics, this method of pregnancy termination is a very safe procedure, with an estimated complication rate of less than 2% in Australia [5]. Medication termination is available in some locations, but providers are still limited.

    All Australian states have some abortion services however the availability varies, with some states allowing abortion up to 24 weeks gestation. Western Australia and South Australia are the only two states routinely collect data on pregnancy termination, and they both report that over 90% of pregnancy terminations in Australia occur in the first 14 weeks [6], [7].

    In most states, services are provided in private clinics only, so patients will pay some out-of-pocket expenses. In Queensland, the cost of a termination has risen steeply in the last few years, and increasing numbers of women are struggling to pay for a procedure. Some clinics may offer a reduced cost for health care cardholders and pensioners. Costs are higher in clinics based in regional and northern areas of Queensland, and women from rural and remote town and communities often face additional costs and barriers due to travel and accommodation - only three clinics operate north of the Sunshine Coast.

    Following a court case in 1986, abortion is legal in Queensland when there is serious risk to the woman’s physical and mental health if the pregnancy continues. Abortion remains the only medical procedure included within the Queensland Criminal Code.

    For more information on abortion in Queensland, read our paper 'Abortion in Queensland: a summary of the issues'

     

    Adoption

    The number of adoptions in Australia has declined steeply since the 1970s [8] due to a rise in the acceptance of, and government financial support for, single and unmarried parents, and improved access to contraceptives and abortion services. The 1970s also saw the beginning of the end of the forced adoption practices that created long-lasting harm for pregnant unmarried women and their children [9].

    Now, between 8 to 12 local adoptions of infants occur in Queensland every year. In Queensland, the Adoption Services Queensland unit, within the Department of Communities,arranges all legal adoptions. The unit will not consider an application for adoption until after the baby is born. However, if adoption is being considered during the pregnancy, there are a number of organisations that can provide information, support and counselling.

    Birth parents can sign an adoption consent form from 30 days after the birth. The Department will make every effort to obtain the consent of both parents, however, the birth father's consent is not required in cases where there is a risk of violence to the woman or child, he cannot be identified, or incest is involved. After providing consent, either birth parent has 30 days to revoke this consent (like a cooling off period). Following the revocation period, the adoption is legal and the child will be placed with adoptive parents.

    Once the adoption order has been made, the birth parents are unable to regain the right to parent the child. Since February 1 2010, the adopted child and the birth parents have the right to access identifying information once the adopted child turns 18 for all previous adoptions.

     

    Parenting

    Parenting is the option chosen in around half, or just over half, of all unplanned pregnancies [2]. Australia's overall fertility rate steadily declined for 40 years after the baby boom of 1961, to a low of 1.73 babies per woman in 2001. The last ten years have seen a rise in the fertility rate, and it is now close to 2.0 [10]. The rise in fertility has mostly been seen in women older than 30, with an increasing age at first birth amongst Australian women.

    The teenage pregnancy rate is relatively high in Australia compared to other developed countries: 17.3 of every 1000 women in 2003. As with women of any age, young women who experience higher socio-economic disadvantage also experience a higher birth rate. See the Australian Bureau of Statistics website for more information. Young pregnant or parenting women can also face further disadvantage in trying to continue their education.

    A woman's decision to become a parent is often embedded in a range of cultural and society constructs; however, the face of parenting and of families has changed significantly in Australia over recent decades and there is now a diversity of arrangements that people choose to embark on in order to raise their children, including single parenting. This is partly due to the rise in acceptance of single parenting and diverse family arrangements.

    Whether in a 'traditional' family unit or not, some women will face many challenges in raising their children. It is important that women and their children are supported through these challenges; Children by Choice can provide referrals to many pregnancy and parenting support groups for women and their children.

    An unplanned pregnancy presents a woman or couple with three options: abortion, adoption or parenting. There are no definitive rules for how to reach a decision regarding a pregnancy. However it is essential for the pregnant woman to own the decision, whether it is to parent, have an abortion, or to place the child for adoption. It is therefore important that the options are carefully considered before following through with the decision. Having accurate and current information on all of these options and being able to access unbiased, non-judgmental support during decision-making contributes to making a well-informed decision.

     

    References

    1. 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.

    2. 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.

    3. 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.sahealth.sa.gov.au/wps/wcm/connect/349eb60047edf25c9d6a9df22c7c1033/Pregnancy+Outcome+SA+2009-Operations-POU-20110815.pdf?MOD=AJPERES&;;CACHEID=349eb60047edf25c9d6a9df22c7c1033.

    4. 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.

    5. 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

    6. 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.

    7. 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.

    8. Australian Institute of Family Studies Adoptions and adoptive families. Available online at http://www.aifs.gov.au/institute/pubs/diversity/08adoption.pdf.

    9. Commonwealth Contribution to Former Forced Adoption Practices and Policies Report by the Commonwealth Senate Standing Committee on Community Affairs, tabled on 29 February 2012. Available online at http://www.aph.gov.au/Parliamentary_Business/Committees/Senate_Committees?url=clac_ctte/comm_contrib_former_forced_adoption/report/index.htm.

    10. 'Recent increases in Australia's fertility' 1301.0 Australian Year Book 2008, Australian Bureau of Statistics. Available online at http://www.abs.gov.au/ausstats/abs@.nsf/7d12b0f6763c78caca257061001cc588/21b3a6d10ca1b6fcca2573d20010ffc8!OpenDocument.     

    Page last modified on: Thursday, 21 November 2013

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