Philanthropy and the abortion postcode lottery

In the wake of the US Supreme Court overturning Roe v Wade, do you know the reality of abortion access in Australia? And how many cannot be delivered without philanthropic support? Sophie Keramidopoulos and Bonney Corbin from MSI Australia (formerly Marie Stopes Australia) explain. 

Abortion access in Australia is a postcode lottery. As seen in our Abortion Access Scorecard, there are more losers than winners.

Here are some examples of who, when and how people in Australia seek financial support for abortion care, starting with some anonymised examples.

• Aesha (she/her) is 27 years old, six weeks pregnancy gestation and wants a medical abortion via telehealth with $195 to contribute. Healthcare Card holder. $206 gap. She’s disabled with two children, receives child support and has $25 per week after expenses. Conception partner was an ex-boyfriend. She has contacted him for funds but he is refusing to contribute. She has a sister who has contributed $100, who lives interstate. She is currently calling her relatives asking for funds however so far they have been unsupportive of her choice.

• Bielle (she/her) is 31 years old, seven weeks pregnancy gestation and wants a medical abortion in clinic, with $370 to contribute. No Medicare card. $530 gap. Living with her husband and two children. She is on a temporary visa and most friends live on the other side of town. Husband works three casual jobs, he is supportive of her choice. She has requested a payment plan. They are behind on rent due to medical bills related to their oldest daughter. Payment plan could not start for three months and she would be reliant on husband’s income to pay.

• Celeen (she/her) is 21 years old, 19 weeks pregnancy gestation and wants a surgical abortion and hormonal IUD, with $400 to contribute. No Medicare card. $3,450 gap. Pregnant following a violent relationship, is on a temporary visa and is couch surfing with friends. She did not realise she was pregnant until 16 weeks gestation due to a history of sexual violence and disassociation. The local sexual assault service has crowdfunded the $400 from donations, and can act as her support person through the procedure. 

• Deme (they/them) is 35 years old, 21 weeks pregnancy gestation and wants a surgical abortion with $2,745 to contribute. Medicare Card holder. $4,805 gap. Planned pregnancy conceived via IVF. Recent scan showed a fetal anomaly indicating high risk of stillbirth. Their partner has a part time job, and they are also a full time carer for an elderly relative. Their friends and chosen family had previously supported IVF costs and now fundraised for this contribution.

These are some of the many people at the centre of a grossly under-resourced health system. They come to us every single day of the year seeking financial support.

Their situations are complex. Their pregnancies are planned and unplanned. They are First Nations women and pregnant people, migrants and refugees, many of whom are on temporary visas, they are women with disabilities, they are survivors of violence, they are LGBTIQ+ and experiencing homelessness.

They are all people who are experiencing financial hardship, who:

• can’t access abortion at their local public hospital or health service
• don’t have private health insurance or there is a waiting period on claims
• don’t have state/territory public funded pathways at clinics in their region
• have approached friends and family for financial support but still have a fee gap
• want a healthcare procedure that will increase in price and clinical complexity with every week that passes.

In every one of these cases, it is philanthropists in partnership with not-for-profit organisations that fill the gap.

Not-for-profit organisations that facilitate abortion funds include family violence services, women’s health services, disability support groups, youth organisations and counselling services. Australian Charities and Non-For Profits Commission (ACNC) accreditations mean that our organisations can offer tax deductible donations for abortion fund philanthropy.

Sometimes abortion providers will call not for profits and ask for a contribution. For example the client may be staying in a family violence refuge, so an abortion provider may call the refuge and see if they can assist with healthcare costs. The not-for-profit organisation may crowdfund for the one particular case by calling members on the phone or advertising on social media. All too often, not for profits dip into organisational reserves to find the funds. Other times they pass a collection box around the office and staff or volunteers personally donate.

Sometimes the philanthropists are GPs, nurses, midwives, Aboriginal and Torres Strait Islander health workers, psychologists or counsellors. They are health care workers in other parts of the health system who made an abortion referral, knowing there will be a funding gap. Sometimes philanthropists are already working in abortion clinics. At MSI Australia our own colleagues are our most regular donors.

Philanthropists give anywhere between $2 and tens of thousands of dollars – and every dollar counts.

We estimate demand for people in financial hardship and wanting to access abortion funds in Australia to be around $2.7 million each year. That wouldn’t fill the gap for everyone who has an abortion, but it would fill the gap for the most vulnerable people in our communities.

Yes, governments need to collaborate and fix this situation. Universal abortion access by 2030 is on the agenda for the bi-partisan National Women’s Health Strategy (2020-2030). Only long-term government investment and collaboration with healthcare leaders will end the postcode lottery.

In the meantime, people seeking abortion keep falling between the gaps. Short term, we need philanthropists and not-for-profit organisations to keep filling those gaps.

If you donate to not-for-profit social services or community based charities, you may already be supporting abortion access. You can contact places that you may donate to regularly and ask about their policies or procedures. See if their processes will provide abortion funds for clients who are experiencing financial barriers to abortion and contraception.

At the Australian Choice Fund every dollar goes directly to a woman or pregnant person experiencing financial hardship, who wants abortion or contraception, and who otherwise could not afford it. Donations can be once off or automated monthly. Any donation over $2 is tax deductible.

Whether you donate to the Australian Choice Fund, or another charity that provides abortion funds to abortion providers, thank you. 

To see abortion costs in any jurisdiction at MSI clinics, visit the MSI Australia cost estimate checker.

Read more about the patchwork of Australian abortion laws here, and visit the Australian Abortion Access Scorecard here.