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This Is What Reproductive Health Experts Think About The Comments Section On Abortion Stories

Sometimes you do have to read below the line.

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The reader comments under news reporting of people's experiences accessing abortion and the politics of abortion law reform in Australia are often very similar.

BuzzFeed News asked a manager at Australia's biggest pro-choice counselling service; the head of Australia's largest abortion provider; a medical education coordinator at a sexual health service; and the director of Family Planning NSW, to respond to some of the most popular comments and address any myths or misinformation.

Here is what they had to say.

Women have complete control over when and where they fall pregnant.

Dr. Philip Goldstone, medical director for Marie Stopes International, Australia's largest provider of pregnancy termination services, said the majority of women who seek an abortion are using some form of contraception at the time of conception, and yet the idea that a woman was "either too lazy or ignorant to access contraception" persists.

"Over half of all abortions are performed on patients who were actively trying not to get pregnant," Goldstone told BuzzFeed News.

"No contraceptive method is 100% effective and the risk of contraceptive failure increases further if they are not used correctly or consistently."

Goldstone said these comments also ignore the fact it takes two people to create a pregnancy.

"We have a habit of solely blaming women for the act of falling pregnant," he said.

"In many cases encouraging young people to practice abstinence as a form of pregnancy prevention is actually what leads to teen pregnancy rates, since it fails to provide education around safe sexual practices and relies solely on the willpower to overcome the body’s natural hormonal urges."

Kate Marsh of pro-choice counselling service Children by Choice in Queensland said the belief that sexual intercourse between men and women is solely for the purpose of procreation wasn't "widely held" anymore.

"The vast majority of Australian women use at least one form of contraception, 70% according to most research," Marsh said.

"There’s not a single method that’s 100% effective and that’s before you even get into the possibly very large numbers of women for whom contraceptive use is compromised or non-existent due to domestic or sexual violence, or reproductive coercion."

Marsh referred to World Health Organisation estimates that suggest even if every heterosexual couple in the world used contraception, and used it perfectly every time they had sex, there would still be six million unplanned pregnancies each year.

"They also estimate that around 33 million women experience an unplanned pregnancy while using contraception, worldwide, each year."

There should be compulsory ultrasounds for anyone terminating a pregnancy.

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Medical education co-ordinator of Sexual Health Information Networking and Education South Australia (Shine SA), Dr Amy Moten, said by the time someone presents to an abortion service they have already weighed up all their options.

"Showing them an ultrasound won't change their decision and is just a way of punishing women for having a termination," Moten said.

"At the gestation most abortions are performed in Australia [in the first nine weeks], the foetus does not resemble a baby."

Goldstone pointed out that in studies where women have viewed an ultrasound before the abortion, 98.4% of patients still elected to go through with the procedure.

"Those that chose not to had already expressed uncertainty about the procedure to begin with, so it is still unclear whether the ultrasound actually influenced their decision," he said.

Goldstone also said not every person who has an abortion is there because of an unplanned pregnancy.

"It might have been their first child, or their third, but at some point there has been a health complication or abnormality and they are unable to continue the pregnancy," he said.

"Forcing women to see the ultrasound of the child they want but cannot have seems to be a particularly cruel concept."

Marsh said 70% of the clients at Children by Choice who received financial assistance already had children.

"Mandatory ultrasounds don’t change women’s minds — because contrary to claims by anti-abortion campaigners, they know exactly what it is they are doing."

Criminalisation acts as a deterrent and decriminalisation is encouraging abortion.

Medical director of Family Planning NSW Dr. Deborah Bateson said the international data shows that where there are barriers to access – legal or financial – the rate of backyard and self-administered abortions rises.

"The total number of abortions remains the same, but evidence suggests women are accessing unsafe abortion including DIY abortion in the absence of a safe, legal option," she said.

"Once a woman has made the individual and personal decision to have an abortion, in general, she will find a way to access one."

Marsh said some of the lowest abortion rates in the world are found in European countries where abortion is safe, legal and accessible (as is contraception), and some of the highest rates are in countries where the law is highly restrictive: "You can’t ban abortion; you can only ban safe abortion."

Goldstone referred to a study that showed abortion rates in countries where it's legal and where it isn't weren't comparable - "this means the choice isn't between eliminating abortions or not, it's between making them safe or not."

Moten echoed the study: "In countries where abortions are illegal they are still performed, but lead to worse health outcomes including maternal deaths. In countries such as Romania in the '90s, when illegal abortion was made legal, there was a decrease in maternal death from all causes."

Keeping abortion expensive will prevent more abortions.

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Bateson said the cost of abortion is prohibitive for some people in Australia.

"Generally, in states where abortion remains in the criminal code, access is more difficult and more expensive through private providers," she said.

"The cost of an abortion can vary in NSW from less than $10 (medical abortion, with Medicare and a healthcare card, prescribed by a GP) to more than $800 for a surgical abortion with a private provider.

"This is before any travel is factored in. In other parts of Australia, like South Australia, abortions are provided in the public system and the costs to patients reflect this."

Goldstone referred to a recent study by the Australian and New Zealand Journal of Public Health which found abortion costs are substantial, increase at later gestations, and are a financial strain for many women.

"Something to consider when discussing the cost of abortions is the cost of pregnancy, childbirth and raising a child," he said.

"Women who do not have the money for an abortion most assuredly do not have the money to support a child."

The study found some women were going without groceries to pay for an abortion.

"Creating financial barriers to abortion doesn’t decrease abortion rates, it just increases the amount of unnecessary suffering women have to go through," Goldstone said.

Women are using abortion as their primary form of birth control.

Goldstone said much of the "abortion as contraception" argument comes from a misunderstanding of the use of the morning after pill.

"Many people mistakenly believe that the 'morning after pill' is actually a form of abortion and it’s not," he said.

"The morning after pill does not terminate a pregnancy, it prevents conception from occurring by preventing or delaying your body from releasing an egg. The morning after pill is essentially a concentrated dose of one of the hormones in the standard oral contraceptive pill."

There’s also a belief that women are using surgical or medical termination of pregnancy as a form of birth control, he said, but the majority of women who attend for an abortion are already using some form of contraception which hasn’t worked for them.

Bateson: "There is no evidence to suggest women use abortion as a form of contraception."

Moten: "There are a lot easier, more accessible, cheaper forms of contraception."

Women should continue with unwanted pregnancies and put the child up for adoption.

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Goldstone says an unwanted pregnancy "might mean making the choice to be pregnant during high school, TAFE or university; taking exams and trying to get good grades when you have morning sickness; rushing to make it to doctor’s appointments and not be late for class or work; trying to manage and afford a new diet if you get gestational diabetes; trying to hold down a job and raise the children you already have when you’re unable to sleep due to your pregnancy; trying to remain upright for eight hours at a retail job when your feet are consistently swollen and painful for five months."

Kate Marsh said anti-abortion campaigners often decried the dramatic fall in the adoption rate, but that this wasn't just attributable to better access to contraception and abortion services — Australia no longer often "forcibly removes babies at birth from unwed or ‘unfit’ mothers for adoption", she said.

"The trauma caused by those practices – which were still in effect in Australia as recently as the 1970s – lingers, and can influence younger generations’ attitudes to adoption."

Legalising abortion is the same as condoning the Holocaust.

"Comparing anything to the Holocaust generally means you are unable to put forward a logical, reasonable argument, and are relying on emotional and sensationalised language to make your point," Moten said.

"The Holocaust was a systematic program of genocide put forward by a single regimen and there is no comparison to individuals having reproductive choice that is safe and legal."

Bateson said: "Women making individual reproductive choices is not the same as the deliberate, State-sponsored genocide of an entire group of people committed in the context of invading Europe."

Philip Goldstone said comparing anything to the Holocaust was incredibly insensitive and "in poor taste".

"The Holocaust is not a yardstick of suffering to be waved about measuring how much hatred you can incite for the things you disagree with," he said.

"Abortion is the act of a woman, often with her partner, making the choice on whether or not to continue a pregnancy. It is a decision ultimately made by one person based on how a pregnancy would impact her life, and sometimes that of her existing family. It is not the systematic eradication of an entire collection of people based on their race, their faith, of their sexuality."

There needs to be better education about contraception.

All four experts agreed with this comment.

"The only thing that absolutely lowers abortion rates is education and access to contraception," Goldstone said.

Bateson said her organisation promoted the rights of all people being able to access services.

Moten said contraception education should be provided in schools and community from government funding.

Marsh said there needed to be better education for medical professionals and adults too, not just young people.

"We also need better training programs for medical professionals so more of them are able to actually provide long acting reversible contraceptives, because at the moment it can be hard to find a GP able to do this in some parts of Queensland," she said.

Women aren’t being given the support, counselling or options so they can continue with their pregnancy.

"We offer pre- and post-counselling to all patients at Marie Stopes, and have found that only a quarter of patients will choose to utilise this service," Goldstone said.

"Most women have made up their mind before making the appointment to have an abortion, often speaking first with their partner, family and friends or their GP."

Bateson referred to a 2013 study which found almost all women requesting an induced abortion had an unintended pregnancy, were certain of their decision, and did not wish to undergo counselling.

Moten said in South Australia there were many options for counselling including a government pregnancy, baby and birth helpline.

"Many people considering abortion will also have accessed online information, or discussed it with their GP or other health provider and don’t require further support," she said.

"Non-directional pregnancy counselling is also freely available through many community organisations, including family planning clinics and community health clinics."

Safe access zones promote abortion.

The zones exclude protestors from picketing and approaching women within a certain reach of a clinic where abortions are provided, to protect patients from harassment and intimidation. They are not enacted in every jurisdiction in Australia.

"If not being harassed is equal to promoting, then there’s not a single health service or indeed product in Australia that’s not being promoted," Marsh said.

Goldstone said the exclusion zones promote a safer environment for women.

"There have been extensive studies done on the effect of protestors at abortion clinics and they continually conclude that the only impact they have is to traumatise the women attending," he said.

"They do not deter patients, they do not influence the decision making process, they only put women through unnecessary anguish and suffering."

Moten said the zones removed privacy and had little impact on a woman's decision.

Decriminalising abortion allows "babies to be killed up until the moment of birth".

This comment was an "anti-choice talking point" but was untrue and completely unsupported by evidence, Bateson said.

"Most abortions take place before 12 weeks gestation," she said.

"Later-term abortions are very rare, with the consensus figure being that about 1% of abortions fall into this category."

Later term abortions take place in a hospital setting in "complex, challenging and extreme circumstances", she said.

Goldstone reiterated that this was a myth and said there were areas in the world where, in theory, abortion until birth could be allowed but this was "more a matter of not having placed a restriction on the gestational period".

"In these countries there are almost always strong caveats about the situation needing to be one of life or death for either the mother or foetus."

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Gina Rushton is a breaking news reporter for BuzzFeed News and is based in Sydney.

Contact Gina Rushton at gina.rushton@buzzfeed.com.

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