Tanya Plibersek (Sydney, Australian Labor Party, Shadow Minister for Childcare) Share this | Hansard source

I want to begin my comments today on the Therapeutic Goods Amendment (Repeal of Ministerial Responsibility for Approval of RU486) Bill 2005 by congratulating the four female senators who have sponsored this bill for their courage and determination. I want to congratulate National Party Senator Fiona Nash, Liberal Senator Judith Troeth, Democrat Senator Lyn Allison, and the remarkable Senator Claire Moore, who I see here today.

The question before us today should be: should RU486 be treated differently from other drugs? The debate really should have been about whether there is a case to be made that this drug is so dangerous that it should be treated in a unique way. Unfortunately, we have drifted into a proxy debate about the morality of abortion and about whether parliamentarians have a right to inflict their views on Australian women. This is an enormous disappointment for many Australians suffering from different types of cancer, Cushing’s syndrome and so on, who have been waiting for RU486 to be approved for some of the other therapeutic uses of the drug.

The opponents of this bill have two main arguments for why RU486 should not be used in Australia. The arguments centre around the safety of the drug for the women using it and around the broader moral question of whether women should have access to abortions at all. Any drug, any surgical procedure, has risks. When the use of RU486 was first discussed in Australia, there was a great deal less evidence of its safety and efficacy than there is today. We are now able to look at evidence stretching back 15 years. More than 21 million women internationally have used the drug in more than 30 countries, including throughout Europe, the United Kingdom, the United States and New Zealand.

There have been five deaths after the use of RU486 which may or may not have been related to the use of the drug but were related to a virulent but rare infection. Clostridium sordellii is an organism found in soil and in the human gut. But there have been other deaths from infection with this same organism, including after a liver biopsy, colon disease, bowel dysfunction, a caesarean section, a prostate biopsy and an ear infection. Sadly, there have also been five deaths in women following live births.

Four of the women who died from this infection after using RU486 lived in California, and one in Canada. The jury is still out in the United States about whether the deaths were related to RU486 at all. There was also, sadly, a death early on in France, of a woman who died of heart failure after taking RU486. A woman with such a heart condition today would not be prescribed the drug.

Opponents of the drug would say that even one death, of any woman, is one death too many, and of course in a sense that is true. The logic of the argument falters, however, when you look at the comparative figures for other drugs and the figures for alternatives to RU486.  No drug is risk free. Paracetamol, aspirin, even Viagra have their risks. In 2003, 59 deaths were caused in the United States as a result of taking aspirin. In 2003 in Australia, there were 48 deaths to which paracetamol was a contributing factor; 22 of those were suicide and 26 were accidental. In the United Kingdom, there are about 150 deaths each year from paracetamol but so far there have been none from RU486, although 31,000 British women use it as an abortifacient each year.

The Therapeutic Goods Administration reported on Viagra in 2002, after it had been used in Australia for three years. The Adverse Drug Reactions Advisory Committee had received 20 reports of myocardial infarction, which included four fatalities. A recent editorial in the journal Contraception noted that Viagra had a mortality rate of five deaths per 100,000 prescriptions, which is much higher than the worst-case scenario that we have been given for RU486, which is about one death per 100,000 patients. It seems passing strange to me that men, in consultation with their doctors, can be trusted to make decisions about a drug that has a higher death rate than RU486 but women contemplating a termination cannot be trusted to make such decisions for themselves.

The safety argument also falters when you consider the alternatives to legal medical or surgical abortions. Women die from unsafe abortions. Nineteen million unsafe abortions are estimated to take place each year. Most of these are in developing nations. There are 68,000 deaths associated with these procedures. Australian women used to die in large numbers when abortion was illegal in Australia. Illegal abortions performed prior to 1971 were second in the five main causes of maternal death for Australian women. In 1965 in Australia there were 45 maternal deaths due to abortion. There are some circumstances, we know, in which a woman will do whatever it takes to terminate a pregnancy—and that has always been the case. Restricting access to surgical or medical abortions is not about women’s safety. We also know that women die in childbirth.  Fatality rates both from live births and from miscarriages are higher than for medical or surgical abortions. If safety were the real concern, we would stop giving birth.

I do not raise these figures for any frivolous reason but to point out that there are opponents of this legislation who say that RU486 has to be treated in a special way, as a special category of drug, because it is so much more dangerous than other drugs—and that is just not right. If the opponents of this legislation genuinely believe that their objections are about the safety of the drug, let them give the evidence of its danger to the Australian Drug Evaluation Committee and the Therapeutic Goods Administration—and, surely, based on that expert evidence, those bodies would not pass it.

If opposition to this legislation is not about the safety of women using a particular drug, what is it about? Unfortunately, this debate has become a proxy debate about abortion itself. I say this is unfortunate because this parliament does not have the power to amend laws affecting the legality or otherwise of abortion—the states do that. All we can do is harass women who decide to have a termination, if they so choose. We cannot make abortion illegal where it is legal; all we can do is make it more humiliating, more expensive, more difficult or later in the term of a pregnancy, after a ‘cooling off period’ and mandatory counselling and so on.

All the emotional rhetoric and dishonesty usually used in abortion debates unfortunately has been dragged out and dusted off in this debate, so I would like to set a few things straight. The first thing I want to say is that there is no such thing as ‘pro-abortion’. Everyone in this chamber is pro-life. The notion that there are some parliamentarians or some people in the community who think abortions are just great and that there should be more of them is an absolute nonsense. I believe that every Australian would be happier if there were fewer abortions because that would mean fewer women going through what is at best an uncomfortable and unpleasant experience.

People who are pro-choice are just that. We do not want to make women have more abortions; we do not want to try and convince people who are unsure whether they should terminate a pregnancy. We are pro-choice. We believe that for most women it is a terribly difficult thing to decide to terminate a pregnancy, but we respect women enough to believe they have the ability and the right to make such decisions for themselves.

Being pro-choice means giving women genuine choices. Most are making a decision that they just cannot cope with one more child—they cannot cope physically, emotionally, mentally, financially or for some other reason. They do not feel they can be a good mother to a child or to another child.  If we are genuine about giving women choices then we have to be prepared to provide the support that would make it possible for them to continue with the pregnancy if they want to—support like paid maternity leave; affordable and accessible child care; workplaces that respect the needs of working parents; and affordable housing, so they are not flogging themselves to pay the mortgage. All too often I hear people telling other people that they should have children but offering no constructive help or support when it comes to raising those kids. On the contrary, if you end up a single mother this government will hound you and traduce you, telling you that mothering is worthless and that you should get out into the workforce and make some real contribution to society.

The second great myth that has been trotted out in this debate is that giving women a choice between medical and surgical abortion will make having an abortion easy and that will increase the rate. There is absolutely no evidence of this. The countries that allow the use of RU486 have had no associated increase in abortion rates and, in some cases, rates have fallen. The notion that throwing a few obstacles in a woman’s way will make her continue with a pregnancy is just foolish. I believe that this argument is actually code for saying that women should be punished for terminating a pregnancy, that the procedure should be as nasty as possible to teach them a lesson. It is a reminder of our original sin and a punishment for having had sex with anything but procreation in mind. It is like the old days when women were denied pain relief during childbirth because it was thought that it was good for us morally to suffer.

An associated myth is that, if we make abortions more difficult to obtain, we will decrease the abortion rate. I think that there are two ways to decrease the abortion rate: reduce unwanted pregnancies and reduce the pressure of having kids. The Netherlands has the lowest abortion rate recorded worldwide. But, since November 1984, women in the Netherlands have been able to obtain abortions free of charge under the government sponsored national health insurance system. They teach their young people to use the ‘double Dutch’ method of contraception—condoms and contraceptive pills at the same time—and have contraception readily available. They have open and extensive sex education classes starting early in a child’s life. They have extremely low teen pregnancy rates. If the Australian government wants to lower abortion rates it should support better sex education in schools, including frank discussion about contraceptive options and also a focus on teenagers’ self-esteem so they can resist pressure to have unwanted or unsafe sex.

The fourth argument being used is that the ‘experts’ are unaccountable and, conversely, only politicians are accountable. Politicians are generally accountable—I agree—but politicians can also be subject to electoral pressures. Of course, the greater objection to parliamentarians deciding the fate of this or any other medicine is that we just do not have the necessary technical knowledge. We could—and should—spend our lives reading the medical evidence for safety and efficacy. I already have a job: it is representing the people of the electorate of Sydney in the federal parliament. If I wanted to spend my life reviewing medical literature, I would have chosen another field of endeavour. I also find it extraordinary that the Minister for Health and Ageing, the man leading the charge on giving parliament the responsibility for making a complex decision about the efficacy and safety of RU486, is the same man who said we could not be trusted to decide who should be our next head of state.

The fifth area which needs clearing up in this debate is the notion that this is the Catholics against the world. Frankly, I thought Senator Nettle’s T-shirt was a juvenile stunt that put Tony Abbott right where he wanted to be—that is, at the centre of the debate. I do not believe in promoting the health minister that way, and I do not believe in insulting Australian Catholics. Although the official position of the Catholic Church in Australia is clearly opposed to the use of RU486 and to any other method of procuring an abortion, I would say that the Catholics in this place, as well as other people of faith, and people of faith in the community do not have a homogenous view on this legislation. I know plenty of Catholics who say they might not have an abortion themselves but that they do not believe their view should determine public policy. There are many people of faith in this place who feel the same way, and they have every right to their views and I respect their views. I do not think we progress the argument at all by making this a sectarian attack or by insulting people of good faith with genuinely held beliefs.

Finally, I want to canvass another argument that is used by antichoice campaigners—that is, the argument that women who have abortions suffer trauma as a result. This is a variation on the ‘it is all about women’s health’ argument, which I mentioned earlier. Sadness, a sense of loss and feelings of grief are natural for some women after a termination. Some women even suffer depression. Some women who have beautiful, much wanted, living children suffer from antenatal and post-natal depression or even post-partum psychosis. So do some women who give up for adoption the babies they carried in utero for nine months. A sense of loss or grief which some women feel after terminating a pregnancy does not mean the woman believes she made the wrong decision. Sometimes hard decisions, even sad decisions, are still right decisions. For most women, though, there is no question about the right decision for them. Nearly all of the women surveyed in a recently published Swedish study described their abortion as a relief.

In the end, although I feel that this debate should simply have been about whether RU486 is so much more dangerous than other drugs as to require a separate approval process to deal with it, the debate has in fact widened. I think some of the comments of members and senators opposed to the private member’s bill point to their real agenda. Comments such as Barnaby Joyce’s in Melbourne comparing a pregnant woman with a pram and Danna Vale’s exhortations yesterday to populate or perish show there are still people who believe a woman’s role in life is to be a vessel to carry the next generation of men—that is, that we have no right to make decisions about when we have children, how many children we have, with whom we have them and in what circumstances. These are not easy decisions. Much as we like to fool ourselves, we do not control our fertility. We can get pregnant accidentally, we can miscarry spontaneously, we can try but not conceive, we can lose the love of our lives without ever having had a child or we can seek but never find the mate we want to share the experience of parenting with. Life is uncertain and sometimes dangerous. Having children is a wonderful gift, but I think that all children deserve to be wanted and welcomed.

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