More than 60 women from far north Queensland have been forced to go interstate to have abortions, often to Sydney, in the first six months of 2018.

Other women from regional parts of Queensland, where abortion remains a criminal offence under the 1899 criminal code, have taken round trips of up to 2,600km to undergo procedures, health professionals and support workers have told Guardian Australia.

The state cabinet will on Monday be handed a report by the Queensland Law Reform Commission, which has been asked to modernise the laws.

Guardian Australia understands the reform package that will be considered by the cabinet would remove abortion from the criminal code entirely. It would make abortions legal to 22 weeks, and thereafter legal with the approval of doctors, similar to legislation passed in Victoria in 2008. Safe access zones would restrict protests near abortion clinics.

But specialists and pro-choice groups have warned that law reform must be followed by an overhaul of the state’s health system to ensure doctors have proper training and experience, and that women will be able to access procedures without enduring hardship.

‘Young and terrified’

Caroline de Costa, professor of obstetrics and gynaecology at James Cook University, said the public health service in Cairns, Australia’s 14th largest city, would not provide surgical abortions.



The story is similar across the state. There is only one regularly operating surgical termination clinic north of the urban south-east of Queensland, in Rockhampton. De Costa said 60 women, “some of them young and terrified”, had been sent away from Cairns, mostly interstate, for procedures.

Because of the stigma attached to abortion, but also because of the legal situation, it means there’s a lot of secrecy Daile Kelleher

“[Public hospitals] can provide them, they in a sense choose not to and the law is a part of the reason. They cannot provide what is openly abortion on demand but we have a sexual health clinic here ... They have been excellent at providing medical abortion [through medication]. It’s funded by Queensland Health and it takes part in another building so the administration doesn’t have to see what’s going on.

“There are some excellent guidelines written by Queensland Health. But each time they’re couched [as]: ‘You must be within the law.’ Queensland Health administrations and doctors have been able to use this and say: ‘Well, this is not legal.’”

De Costa said trainee and junior doctors who gained practical experience, or were employed in the public health system, often had not had exposure to women requiring an abortion.

“Our registrars, our trainees do not go to the sexual health clinic, that’s not part of their training. They don’t actually meet a woman who is requesting a surgical abortion or a medical abortion. They would have to learn about it theoretically.”

The Queensland health minister, Steven Miles, said the government is aware of “issues surrounding access to terminations in the Cairns region” and has held discussions with a private business about establishing a local clinic.

“Health providers, including public hospitals in Queensland, provide women with access to therapeutic termination of pregnancy (in circumstances of medical necessity). If a service is unavailable at a specific hospital – for whatever reason – but is required by a patient, it will be provided within the Queensland public health system.”

‘We’re talking about really vulnerable women’

The all-options family counselling, information and referral service, Children by Choice, has functioned in Queensland as a sort of traffic controller, attempting to connect women to services in a range of often difficult circumstances. That sometimes requires funding for women experiencing financial hardship, negotiating dangerous domestic violence situations and arranging long-distance travel.

The service’s manager, Daile Kelleher, said the average distance for people in south-east Queensland to travel for a procedure is 41km. Outside of the urban areas, it is five times that. Kelleher said one woman travelled 1,300km each way.

“We’re talking about really vulnerable women,” she said. “If you’re in a domestically violent relationship, you cannot travel that sort of distance. If you’ve got people in your care you can’t travel that sort of distance.

“Sometimes the vulnerable women are in a casualised workforce, or in situations where they can’t tell their employer they need time off to get an abortion. If they take time off, they might lose their job.

“I think because of the stigma attached to abortion in society, but also because of the legal situation, it also means there’s a lot of secrecy in the industry and in the health sector, in terms of providing information to people.



“Women are getting blocked by doctors who don’t want to touch abortion because the legislation is so murky. So many times we’ve heard that women are getting the runaround because their GP or the local hospital won’t help them.

De Costa said the women who do go to great lengths to access services would be “the top bit of the iceberg”.

“There would be many women who could have gone who haven’t,” she said. “There are women who should have had a surgical abortion because it’s the safest thing for them, but don’t.”

The political flashpoint

The law reform debate remains a likely flashpoint in a state that retains many socially conservative pockets, including among rusted-on supporters of the Labor government. Anti-abortion groups have already increased their presence and are employing aggressive tactics outside abortion clinics.

In 2016, the independent MP Rob Pyne attempted to introduce a reform bill that was rejected after a parliamentary inquiry. The push caused some internal problems for the Palaszczuk government, whose left wing at one point considered publicly shaming colleagues who opposed law reform.

It is understood the government’s bill would be subject to a conscience vote and that some Labor MPs, including those who represent working-class regional areas, will oppose it.

Given Labor’s thin majority, the government will likely need support from Liberal National party MPs to pass the bill. There remains some concern that strong laws could discourage support from MPs who might have personal concerns.

Some parts of the legislation are likely to be contentious. Conservative MPs who might otherwise support the bill are understood to prefer a 16-week term limit before a woman requires the consent of two doctors. The proposal to the state cabinet is understood to be 22 weeks, which is short of the 24 weeks allowed in Victoria.

Rules allowing doctors to object on moral grounds are also likely to be controversial. In 2016 the entire obstetrics and gynaecology department at Logan hospital, south of Brisbane, demanded any laws should allow doctors to refuse to provide procedures.

Kelleher said the laws needed to ensure that conscientious objectors were required to refer women to doctors who would perform procedures.