Seven months after the state voted to decriminalise abortion, there remains a “postcode lottery” in Queensland for women attempting to access termination services, but overall the effect is being seen as positive.

As New South Wales prepares to vote this week on a decriminalisation bill, the last Australian state to do so, doctors and support services in Queensland say access has improved in many places but demand for services has not increased.

In some places, such as Cairns in the far north, where last year more than 10 women a month were flown interstate for procedures, doctors say the law change has had a radical effect.

In other parts of regional Queensland, particularly where options for medical services are limited, women’s advocacy services still hear stories about doctors treating women with disrespect.

“Some doctors are actually still counselling the woman that she should keep the pregnancy,” says Holly Brennan, the manager at all-options counselling service Children by Choice.

Brennan says doctors who are conscientious objectors have in some cases refused to refer women to another practitioner, despite a requirement to do so under law.

“These are women who are disenfranchised, they’re distressed, they’re upset; in some cases women are going to two doctors who have done the same thing.”

The sorts of hysterical claims by abortion opponents last year – now replicated in NSW – have largely fallen away.

“A lot of people got really scared that some sort of floodgate of people wanting abortions would happen,” Brennan said. “That hasn’t happened. We’re still seeing the same amount of abortions we’ve always had. It’s not this huge service need, it’s just that it’s treated as a healthcare issue now.”

The last four times Children by Choice has held a conference, anti-abortion groups have picketed. Last week, protesters stayed away from the fifth event. At clinics, where some groups had employed aggressive tactics and turned up daily with placards, the “safe access zones” have had the desired effect.

Brennan says the overall picture in Queensland “is good news” and that access to abortion has radically changed in many places. More doctors are registering as providers of medical abortion, via medication.

“It is still a bit of a postcode lottery. There are still women who have to drive 2,000km to access a service and their neighbour needs to look after their kids. But then there are some areas of Queensland we just don’t hear from anymore. The communities have got it sorted.”

Heather McNamee, a Cairns-based GP specialising in reproductive health, last year shared a laundry list of horror stories, where women had faced disrespectful attitudes and obstacles attempting to access abortion services.

The experience in Cairns and elsewhere is instructive for those in NSW. It shows the importance of decriminalisation to allow for improved access. But also that changes to the law must then be met with a commitment by hospitals and the public health system to ensure they provide access; that abortion is considered a public health issue.

“It’s had quite a radical effect, and a much bigger effect than I certainly expected,” McNamee said.

“I had thought in my own head that [the repealed 1899 law criminalising abortion] was just an excuse for the state of things. But the biggest thing that has happened, only because we have a health minister [Steven Miles] who is modern and pro-choice, once the legislation came into effect there was a directive to all Queensland health services hospital districts to create a pathway.

“Obviously the best scenario is that every public hospital in Queensland would have a termination facility, medical and surgical.

“It’s been a bit piecemeal. I get calls from GPs that [it has] not been the reality across Queensland, some … public hospitals are on the opposite end of the scale and basically offering nothing. They are required by the minister to offer a pathway, and that can involve funding private services.”

“But overall the knock-on effect to services has been surprising in the best possible way.”

McNamee says it’s ironic that Ireland beat Queensland to decriminalisation of abortion, and that Queensland led the way for NSW.

“They’d think of us as redneck, backward type of people,” she jokes. “But we have shown them the way here.

“Overall the change in the law was much more dramatic than I expected. The day it was passed was much more significant than I expected. When it did pass that was a pretty great day for Queensland. The knock-on effect to services has been surprising in the best possible way.”