Impact of legislative change on waiting time for women accessing surgical abortion services in a rural hospital in the Northern Territory.
BACKGROUND
Women face challenges when accessing abortion, including varied legislation and reduced access to services in rural and remote settings. There are limited clinical guidelines in Australia and little information regarding the patient journey, particularly the timeframe between referral to abortion procedure. Legislation reform in the Northern Territory (NT) legalised early medical abortion (EMA) in primary health care, providing an opportunity to review service provision of elective surgical abortion prior to and after these changes.


AIMS
To review the waiting time to access abortion, percentage eligible for EMA based on ultrasound gestation alone, percentage of Indigenous women accessing abortion in the NT and the effects of the legislation change.


MATERIALS AND METHODS
Retrospective audit-analysed surgical abortion data from 354 patient files who underwent suction curettage of uterus between 2012-2017 in one NT public hospital.


RESULTS
Mean wait-time ranged from 20 to 22 days in 2012-2016 and dropped to 15 days in 2017 following the law reform. Sixty-two percent of women waited longer than that in the recommended clinical guidelines. Indigenous women represented approximately 25% of patients accessing surgical abortion services. Average gestation at surgical abortion procedure increased following reform. Prior to reform up to 95% of patients accessing surgical abortion would have been eligible for EMA at time of referral.


CONCLUSIONS
Results demonstrate potential for changes in service provision of abortion in the NT with increased choice, patient-centred care and reduced waiting times. This audit demonstrated the possibility to move the majority of abortion services into primary health care leading to cost savings.
['Belton|Suzanne|S|0000-0003-3418-2298', 'McQueen|Georgia|G|', 'Ali|Edwina|E|0000-0002-8315-8799']
D000023:Abortion Applicants D000028:Abortion, Induced D000029:Abortion, Legal D005260:Female D005865:Gestational Age D006297:Health Services Accessibility D006780:Hospitals, Rural D006801:Humans D000081034:Indigenous Peoples D015876:Northern Territory D017060:Patient Satisfaction D011247:Pregnancy D012189:Retrospective Studies D012424:Rural Population D014619:Vacuum Curettage D014850:Waiting Lists
rural hospitals abortion induced abortion legal health-care disparities