A comparative analysis of abortion care and outcomes post-decriminalisation in a public sexual health clinic in Queensland, Australia

Abstract

Background The decriminalisation of abortions in Queensland since 2018 has allowed a framework to be established for people to access safe and legal abortion services. The Cairns Sexual Health Service has been offering medical termination of pregnancy (MToP) for 18years, and this has become part of the public healthcare system in an outpatient setting. Methods A retrospective audit of MToP conducted between 2019 and 2023 was undertaken to follow up on an earlier audit covering 2011-2015, before the decriminalisation of MToP. Results Within the 5years from 2019 to 2023, a total of 3060 clients were seen in Cairns Sexual Health Service for either a MToP or referral for an inpatient MToP or surgical termination of pregnancy. A total of 1956 had a MToP at Cairns Sexual Health Service during 2019 and 2023, compared with 1712 completed within the 5-year period from 2011 to 2015. A total of 28 were referred for an inpatient MToP, and 1076 were referred for a surgical termination of pregnancy. With ongoing improvements in clinical delivery, unsuccessful outcomes after an MToP have reduced from 0.9% between 2011 and 2015 to 0.5% in 2019 and 2023. Conclusion Since its decriminalisation, there has been a consistent and strong community demand for the service. Abortion care is an essential component of healthcare, and all pregnant people have the right to equitable MToP services within primary healthcare settings. However, further funding is required to maintain the service as a standard of care, and access to late abortions of pregnancy remains an issue.