A Year in Review
From Daile Kelleher, CEO and Dr Nicola Sheeran, President
The 2021/22 financial year for Children by Choice was one of realignment and repurpose as we reviewed the organisational strategic plan for 2021 – 2026 and moved into our new office in Toowong, after 40 years in the purple house. As we entered our 50th year in 2022, we took the time to ask ourselves – what does life after law reform look like for Children by Choice? As you can see below, there is still so much work for us to do.
Our vision is that people can freely and safely make their own reproductive and sexual health choices without barriers and it was a stark reminder to all how fragile these rights are when Roe v Wade was overturned in the US in June 2022. While abortion has mostly been decriminalised across Australia, reproductive rights need to be protected and access to compassionate abortion embedded within our health systems in Australia.
Over the past 12 months we have continued our core work of non-judgemental, all options pregnancy decision making counselling, information and referral as well as post abortion support. Our counselling team has implemented a number of changes to streamline our service and offer client centred, trauma informed counselling. There continues to be a high demand on our Queensland wide service and the team works incredibly hard to ensure calls are answered and all clients are supported.
The education team have been busy planning for the Reproductive Rights and Abortion Conference in August 2022 as well as finding ways to celebrate Children by Choice’s 50 years in 2022. We have painted a traffic box in Windsor, held fundraising activities, been featured in several magazines and organised a 50th anniversary gala dinner at Queensland Parliament House.
We have strategic goals to ensure that our clients can make their own reproductive and sexual health choices without barriers and that the sector is informed about sexual and reproductive health and strives to create an effective service system that supports reproductive choice and rights. In line with these goals, we have delivered on several projects in 2021/22 including a multicultural project to co-design digital, video and print resources for language groups on pregnancy options, contraception and reproductive coercion. We have a similar project due to finish in the later part of 2022 co-designing resources for health professionals working with women with intellectual disabilities. We have also partnered with Women’s Health Tasmania to deliver our education and professional development in a Tasmanian context.
The Queensland Abortion and Contraception Services online map was launched in 2021 in a move to increase transparency and accessibility of abortion and contraception services to the general public and those supporting people seeking services. We hope to continue to add more providers to this online resource and empower abortion and contraception seekers to manage their care in an informed way.
We round out the year with optimism that Children by Choice’s advocacy and service continues to advance access to compassionate abortion in Queensland and across Australia and that reproductive justice can be a reality for more people.
Access to compassionate abortion and the reduction of barriers to reproductive autonomy are at the heart of all our advocacy work.
2021/22 saw some challenging moments in reproductive rights including the closure of several surgical abortion clinics in Australia, and the overturning of Roe v Wade and subsequent restriction or removal of abortion access in the United States.
Children by Choice has continued to advocate for access to legal, safe, timely, compassionate healthcare and protections for reproductive rights in conjunction with supporting bodily autonomy and reproductive justice.
We developed an Australian position statement after Roe v Wade with over 700 individuals and organisations signing on to voice their support for reproductive rights. We called upon state and territory Health Ministers to embed essential reproductive healthcare into our public health services.
Children by Choice is a member of the Queensland Sexual Health Clinical Network termination of pregnancy working group and is involved in the development of an action plan for Queensland Health provision of abortion in public and primary health settings.
7 Committees and Working Groups
We are representatives on many committees and working groups, ensuring that reproductive health and rights are part of submissions and consultation with government and other stakeholders, such as:
- Women’s Health Services Alliance of Queensland
- Ending Violence Against Women Queensland
- SPHERE Coalition for sexual and reproductive health
- QCOSS Women’s Equality Network
- Equality Rights Alliance
- Queensland Abortion and Contraception Community of Practice
- QCOSS CEO Network
4 Parliamentary submissions
We have made parliamentary submissions
- Health and Other Legislation Amendment Bill 2021 – Proposed changes to the Termination of Pregnancy Act 2018 and Criminal Code
- Submission to the Queensland Law Reform Commission. Sex Work Industry review in Queensland
- Women’s Safety and Justice Taskforce – Options for legislating against coercive control and the creation of a standalone domestic violence offence
- Religious Discrimination Bill 2022
Pregnancy Options Counselling Service
During the 2021/2022 year, the Counselling Team introduced the role of an Intake Officer. This role has supported the service to meet an increase in demand. The service saw a 10.4% increase in the number of clients from quarter 1 to quarter 4 of this year and an increase of 44.4% in the number of times our counsellors interacted with a client.
The introduction of the Intake Officer role has also ensured:
- Improved responsiveness to live calls – warm welcome – fewer calls needing to go to voicemail
- Improved access for clients who require additional support to access services,
- Inclusive of clients from diverse background
- Routine safety screening with women and pregnant people who are experiencing domestic and family violence
- Trauma informed engagement with clients
- Triaging our callers according to the urgency of their needs
The number of people supported by our Counselling Team in the 2021/2022 financial year.
People who contact our service are often dealing with multiple challenges and their complex cases take multiple interactions to resolve.
7 Counselling sessions
7 sessions per client on average
76.6% First presentation
Percentage of clients who contacted us within their first trimester of pregnancy
Most women and pregnant people present to our service and are able to access abortion care earlier on in their gestation under 9 weeks (54%).
These percentages reflect the barriers to accessing timely abortion care and the results of system delays, obstruction, conscientious objection and other reasons for care being provided after 13 weeks’ gestation, not necessarily delays in first presentation.
Our team developed a Language Guide with an overview of key recommended terms we believe are best practice in the sector to date.
Children by Choice uses these preferred terms in our work to talk about our services, clients and associated concepts.
We recognise that language is key to progressing the destigmatisation of abortion and ensuring inclusive and trauma informed care. It is not an exhaustive list of terms, however it reflects our current learnings within this space and we look forward to reviewing it ad hoc.
For counsellors and other health practitioners, it is not anticipated or intended to change the way they practice, which generally involves mirroring language used by clients themselves.
Moreover, we included gender-neutral/inclusive language, terms both recommended and not recommended, and its explanation to support practitioners and professionals on how to describe clients, types of abortions offered in Australia, pregnancy options, and other key terms that might be useful and beneficial.
You can access the language guide on our website.
Queensland Hospital and Health Services
The counselling team works with women and pregnant people across the state in rates as shown in this graph. When you consider the different Hospital and Health Services data side by side, the team is able to paint a picture of how supporting abortion services are delivered across the state.
In the metropolitan areas, while the number of clients who access our services are roughly the same, there is a clear difference in what women and pregnant people are seeking from our service. In Metro North HHS, there are a higher number of clients seeking post abortion support, as a referral from the hospital for holistic wrap around ongoing care, whereas other HHS’s closer to Metropolitan Brisbane are more likely to be calling for financial assistance for privately funded abortions and/or support navigating the public pathways, particularly when accessing private abortion care is not affordable or there are other health/psychosocial reasons why private care is not a safe option for them.
*Under 2% of clients were from Central West, North West, South West and, Torres and Cape combined.
48% Metro North
46% Metro South
23% Gold Coast
14% West Moreton
8% Central QLD
8% Sunshine Coast
6% Wide Bay
5% Cairns and Hinterland
4% Darling Downs
Barriers to access
Most common barriers to access the difficult pathways in Queensland
24.8% Abortion Cost
20% Abortion Info/support
10% Unsupportive Professional
7.9% Abortion Misinformation
6.8% Advanced Gestation
6.2% No Medicare
5.3% Public Hospital
3.1% No Surgical Abortion Support
3.1% Unsupportive Friend/family
1.5% Disclosure Difficulties
1% Child Care
Most Commonly Requested Information
General abortion information
“How do I get an abortion?”
Types of abortion procedures
“What does the process involve?”
“How much does an abortion cost?”
General information on adoption
“How does adoption work in QLD?”
Financial Assistance Program
Since the removal of abortion from the criminal code in 2018, Children by Choice has been winding down our Financial Assistance Program as we have been able to support more clients to access publicly funded abortion care.
Although, for some of our clients’ abortion care in the public system is not an option. This includes international students and people on working or partner visas as they do not qualify for Medicare support.
$33,700 Abortion Access
We pledged financial support to 46 clients to access abortions with an average of $732 provided for each client needing financial assistance, not including peripheral costs such as loss of income, travel costs, childcare, etc.
$5,300 LARC and Travel Costs
We provided 38 clients with an average of $140 each to access Long Acting Reversible Contraception and travel cost assistance.
Who Are We Financially Supporting To Access Abortion Care
Most of these clients identify with 2 or more of the intersections below plus: Mental health issues, suicidality, financial distress, homelessness, physical health issues, single parenting, caring responsibilities.
56% Culturally and Linguistically Diverse
23% Overseas Student
21% Backpacker and/or Fruit Picker
21% Have Experienced Violence
7% Aboriginal and/or Torres Strait Islander
Education and Training
Our Education Team provide training and information to professionals and tertiary students across Australia. They also deliver relationships and sexuality education for young people in schools and youth services.
We also undertake broader community education work online through our social media channels and website.
1,900 Professionals and Tertiary Students trained
1,540 Young people educated
447,431 Visits to our website
5,000 Connected to an engaged following of over 5000 across Facebook and Twitter
900,000 Reached over 900,000 people on social media
In December 2020 Children by Choice hired a Senior Research Assistant, our only research dedicated role.
This role will design and implement a range of research projects it will also support the evaluation of key Children by Choice projects. Embedding research within our work supports evidence-based practice, and further enables us to progress a research agenda that is driven by and informs organisational, client and sector-wide needs and priorities.
Along with a range of staff and organisational support, the Senior Research Assistant has:
- Worked with staff team and working groups, as well as with client records and local and global literature, to develop a research plan that will support the organisation’s strategic vision and priorities over the next 5 years.
- Supported a range of research collaborations and activities focused on reproductive coercion and abuse, including a multi-organisational collaboration to identify the prevalence and trends of reproductive coercion and abuse in Australia.
- Designed and received ethical approval to conduct a process and impact evaluation of the Abortion and Contraception Services Map.
- Supervised a student to conduct a systematic literature review on ‘supporting reproductive autonomy among pregnant people with intellectual disability living with violence and/or reproductive coercion’.
- Developed processes to support improved quality of organisational data collection.
- 3 conference abstracts accepted.
- Supported grant applications and submissions to government.
The Regional Rural and Remote Abortion Access Program
The Regional Rural and Remote Abortion Access Program (RRRAAP) is a three year project funded by the Lionel and Yvonne Spencer trust which commenced in August 2018. RRRAAP aims to improve equitable access to abortion care in regional, rural and remote Queensland by focusing on three core elements, referral, access and support.
This financial year the Regional Rural and Remote Abortion Access Program has supported and conducted the following key activities.
Abortion Doula Program
The Regional, Rural and Remote Abortion Access Program (RRRAAP) was tasked with establishing an abortion doula initiative to ensure effective support mechanisms were in place for women and pregnant people seeking abortion care in Queensland.
A doula is a non-medical support person who can provide emotional, physical and informational support through any of life’s transitions. This includes support across the full spectrum of pregnancy, including abortion. A doula specialises in non-judgemental and compassionate care, and is respectful and client-centred in the way they provide support.
In 2020, Children by Choice (CbyC) delivered Australia’s first abortion doula training program, in partnership with the Australian Doula College (ADC). This partnership was established between CbyC and ADC to deliver the abortion doula training as a Masterclass, initially available to Queensland students and graduates of ADC’s birth and end of life doula training programs. In 2022, the Masterclass will be available to ADC (and other) trained doulas nationwide via an online self-paced course accessed via ADC’s online learning platform, Canvas.
The abortion doula training workshops were initially offered at no cost to participants during the pilot period, however the online training and future face to face workshops will be offered as fee-for-service to ensure CbyC can continue to deliver the training in a sustainable way after the RRRAAP has ended.
Mapping Access Pathways Project
The Mapping Access Pathways Project (MAPP) is a key project outcome of the Regional, Rural and Remote Abortion Access Program, aiming to increase access to abortion and contraception services for all Queenslanders.
Children by Choice received consistent feedback from clients, referring organisations and the wider sector that the services needed to enable access to abortion in Queensland are hard to find. Addressing barriers to abortion provision, and minimising social and practical barriers for abortion seekers, are both vital to improving equitable sexual and reproductive health outcomes.
The MAPP has established a publicly accessible interactive online map of abortion and contraception providers, pharmacies that dispense MS-2 Step and ultrasound clinics across the state. It is searchable by postcode, provider type and fee information, and is based on a similar map funded by the Department of Health in Victoria as part of the 1800 My Options service. More detailed search criteria is also be available for services, including gestation, availability of a female doctor, LGBTIQ+ sensitivity and wheelchair accessibility.
Prior to this project, there was no publicly available comprehensive list of abortion or contraception providers in Queensland.
Resources for People Supporting Abortion Seekers
In May 2021 Children by Choice collaborated with the team from I Had One Too. Together we developed a suite of video resources around how to best support someone who’s having an abortion.
This video resource featured individuals with lived experience sharing their stories of being a support person. These videos will be used across our website, social media and training materials.
Kitchen Table Discussions with Aboriginal and Torres Strait Islander Health Consumers
In late 2020 and early 2021, we engaged Health Consumers Queensland to run a series of 5 ‘Kitchen Table Discussions’ to hear from Aboriginal and Torres Strait Islander women about their experiences of pregnancy decision making, contraception and abortion. This consumer feedback will allow Children by Choice to consider the role we play in Aboriginal and Torres Strait Islander reproductive health care, and how we can better support these clients.
View the final report here (LINK IN HERE)
208 Healthcare professionals trained from regional, rural or remote areas
6 Hospital and Health Service districts received training
Mackay, Wide Bay, Darling Downs, Central Queensland, Cairns and Hinterland, and Townsville
11 Nurses and doctors sponsored to complete portable ultrasound machine training to support the provision of medication termination in regional rural or remote areas
6 Portable ultrasound machines were donated to regional rural or remote clinics providing abortion care
7 Abortion doulas trained
3 MToP in General Practice info sessions held across Queensland
Pathways Support Sessions held in Rockhampton and Emerald
The Culture and Language Inclusive Practice Studio
The Culture and Language Inclusive Practice Studio (CLIPS) is a one year project which commenced February 2021 and will conclude in February 2022.
The project is funded by WorkUP Queensland. CLIPS will utilise a three-step collaborative process to co-create culturally appropriate resources on reproductive health, abortion and reproductive coercion that are in language and relevant to the community.
More about the Practice Studio
Kurdish Kurmanji, Swahili, Spanish and Arabic were the languages identified by the reference group of healthcare and resettlement organisations. These languages were determined by level of need and vulnerability of clients in the community.
In collaboration with each community group appropriate resources across varying mediums will be developed. A final focus group with each of the participant groups will be held to obtain feedback before the print and launch of each of the language resources.
At the completion of this project each language group and their community members will have an opportunity to meet and receive the resources created from this project, resources will also be launched and disseminated via our website, social media and shared with resettlement organisations and health care providers to share with their clients.
Knowledge sharing workshops will be delivered between resettlement services, interpreters and healthcare professionals where they will hear from people with lived experience and share information about how to best support clients from migrant and refugee backgrounds around topics of abortion access and care, reproductive health and reproductive coercion.
With over half of the Australian population identifying as culturally and linguistically diverse, providing resources that are culturally appropriate and available in language is essential to reducing the systemic barriers migrant and refugee communities face when accessing services.
WWILD and Children by Choice Collaboration
Children by Choice and WWILD (working with people with intellectual and learning disabilities) began a collaboration in 2020.
More about the Practice Studio
The partnership funded by WorkUp Queensland aims to; understand why people with intellectual and learning disabilities are under-reported in Children by Choice counselling client data but over-represented in their reporting of reproductive coercion and sexual violence, understand how to improve pregnancy decision making support for people with intellectual and learning disabilities; support consumer needs and the needs of the domestic and family violence and sexual assault support sector in Queensland.
This collaboration is ongoing, funding has been sought to develop resources for consumers and training for professionals based on gaps identified by people with intellectual and/or learning disabilities.
International Safe Abortion Day Event
What Is Your Vision: The Future of Abortion Care In Australia a panel discussion facilitated by Gina Rushton
28th of September is International Safe Abortion Day, the herstory of this day begins in Latin America and the Caribbean where women’s groups have been mobilizing around September 28 for the last two decades to demand their governments decriminalize abortions, provide access to safe and affordable abortion services and to end stigma and discrimination towards people who choose to have abortions.
In 2020 Children by Choice with support from Family Planning NT, I Had One Too, 1800 My Options, Our Bodies Our Choices, South Australian Abortion Action Coalition, Sexual Health Quarters WA, SPHERE and Women’s Health Tasmania hosted a live and public event to discuss the future of abortion care in Australia.
Gina Rushton an award winning reproductive rights journalists spoke to health consumers with lived experience, abortion care providers, advocates, policymakers and event participants about what the future of abortion care should and could look like in Australia.
300 Tickets sold
2,900 People were reached with the Livestream on Facebook
Our Collaboration Partners
- Culturally Responsive Health Advisory Group
- Data Committee – University of Queensland and Griffith University
- Equality Rights Alliance
- Ending Violence Against Women Queensland
- National Alliance of Abortion and Pregnancy Options Counsellors
- Practitioner Engagement Group – ANROWS (Australia’s National Research Organisation for Women’s Safety)
- WorkUP Queensland Reference Group
- Termination of Pregnancy Steering Committee – Clinical Excellence Division
- Queensland Women’s Health Services Alliance
- QCOSS Women’s Equality Network
- QCOSS CEO Network
Pro Bono Professional Support and Advice
- McCullough Robertson
- Hamish Clift
- UQ Pro Bono Law Centre
We would like to recognise all our members, individual donors and supporting organisations whom without we would not be able to carry out the work we do.
The Children by Choice Team