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ACT Right to Life AssociationSUBMISSION |
General comments
It seems quite unusual to have a review of a program which is specifically limited to one group of service providers, rather than a review of a service area.
The Review appears to be focused on the structure and performance of a specific group of providers and comments on ways in which such performance could be improved, presumably in order to justify continued and perhaps increased Commonwealth Government support.
The Review appears to be based on an acceptance that only one broad philosophical approach in this area is legitimate and deserves consideration for government funding. It does not even contemplate the possibility that there might be other legitimate approaches in the community which might deserve, perhaps even more than Family Planning Organisations (FPOs), government support.
This focus on one group of service providers leads to an approach which is not objective. In this respect it is important to note the very valuable work which Pregnancy Support Services provide in this area by giving sympathetic counselling and support to help women in a very practical way to overcome problems experienced as a result of pregnancy. In addition, Natural Family Planning groups provide women with alternatives to the drug and device based approach to contraception.
These are surely legitimate alternatives to the provision of contraceptive products and abortion referrals.
FPO focus on contraception
The FPOs' approach to unplanned pregnancies is an area in which the ACT Right to Life Association has an interest. The idea that the FPOs should continue with the same broad approach in an attempt to reduce the number of unplanned pregnancies is not questioned in the Interim Report. The prevailing paradigm is more contraception, FPO education and FPO counselling.
This paradigm is convenient for FPOs because it allows them a cash business, in the form of contraceptives, to support their activities. The ACT Family Planning Association has in the past had a 100 percent markup on the contraceptives it sells. Selling contraceptive products as solutions requires little thought and effort (see Interim Report, pages 106, 131).
In contrast, many women are now recognising the benefits of Natural Family Planning which empowers them to understand and work with the natural cycles of their body rather than resort to various contraceptive drugs and devices (Catalano, 1993).
The routine failure of contraception is acknowledged on page 138 of the Interim Report.
"The study found that a large proportion of TOPs [induced abortions] stemmed from failed contraception."
However, the term "failed contraception" does not acknowledge the built-in failure rate of contraception and continues to promote the idea that contraception, when used correctly, can be 100 percent effective at preventing conception.
It appeared that this flawed approach of reliance on contraception had been acknowledged by Family Planning Australia in an article published last year, which reported on the inherent unreliability of contraception.
"Until a method of contraception which was 100-per-cent effective was developed, abortion would always be part of the contraceptive continuum, executive director of Family Planning Australia, Dianne Proctor said." (Uhlmann, 1994).
A report produced late last year at Flinders University, We Women Decide, stated its concern about the continued blind faith in contraception exhibited by some people and organisations.
"The assumption that abortion rates should and can be reduced dominates the medical literature. Related to this concern is the view that contraception education is the cure-all to the problem of abortion when in reality it is at best likely to reduce abortion only marginally" (Ryan et al, 1994, page 34).
"This longer extract ... illustrates the high level of self control and surveillance that women can put into contraception and still become pregnant" (Ryan et al, 1994, page 140).
"The womens' stories also demonstrated that contrary to popular and medical perception, their fertility is not readily controllable despite modern technologies, devices and strategies" (Ryan et al, 1994, page 162).
"Despite considerable evidence to the contrary women and health practitioners alike were more inclined to blame the women for careless contraceptive practice than to revise the tenet of faith that fertility is controllable" (Ryan et al, 1994, page 162).
"This myth [that fertility is controllable] is based upon the largely unchallenged belief that contraception can and should be relied upon to prevent conception. The Family Planning Association is one organisation which argues that conception can be `managed'" (Ryan et al, 1994, page 195).
It would be more appropriate to educate people about the inherent unreliability of contraception so that they have time to consider and accept the possibility of children coming into their relationship. The current faith promoted in contraception leads to couples considering unplanned pregnancies only when they occur, while they are in a crisis mode.
FPO focus on abortion
The apparent blind faith in contraception appears to be matched in FPOs by a strong support for abortion as a solution to womens' problems.
The following comment from a report produced by the Australian Catholic Social Welfare Commission (ACSWC) is about pregnancy advice centres, a category which includes FPOs.
"There was a general perception by many of those interviewed [in pregnancy support agencies] that counsellors at other types of centres place pressure on younger women to have a termination of an unplanned pregnancy. Some of the arguments cited for this pressure included: the client's age; interruption to education; reduced job opportunities; and economically poor future prospects" (ACSWC, 1991, page 76-77).
This perception is supported by the case of an 18 year old woman who telephoned the ACT Right to Life Association last year to complain about the treatment she had received when she visited the ACT Family Planning Association. She had gone to Family Planning to seek information on the support available to her during her pregnancy and afterwards. She already had the support of her partner and her parents. The young woman complained that the FPO counsellor she spoke to had tried to persuade her to have an abortion, although she had not expressed any ambivalence about her pregnancy.
"Other agencies recounted their experiences of some young women who had received minimal counselling before obtaining a referral for a termination. The speed at which some referrals, and medical intervention, had been made staggered many staff as typified by the following statement. `There is a lot of pressure placed on girls (by pregnancy advice centres) when they are in a vulnerable position to have an abortion - because it is an option that can be offered right away.'" (ACSWC, 1991, page 77).
"... it was apparent from the comments of the interviewees [from Pregnancy Support Agencies] that few referrals [to Pregnancy Support Agencies] were recognised as emanating from the Family Planning Association. This is despite the fact that the Association's agencies are not equipped to provide support services to women who decide to continue with their pregnancy and refer such women to other appropriate services including pregnancy support agencies" (ACSWC, 1991, page 79).
Indications are that FPOs are one of the largest sources of referrals for abortion in Australia. This is supported by figures provided to the ACSWC by the Western Australian FPA which "... reported that [of those women who approached WA FPA for pregnancy counselling] 76% of women identified as being pregnant chose referral for termination. Similar information is not currently available for other states" (ACSWC, 1991, page 95).
The evidence of a close relationship between FPOs and abortion has been strengthened by two other recent developments.
In 1993 the ACT Family Planning Association established a company, called Reproductive Healthcare Services Ltd, which opened an abortion clinic in Canberra in September 1994. The Interim Report is supportive of increased government lobbying ("advocacy") by FPOs (Interim Report, pages 37, 87). In the ACT this includes lobbying for an abortion clinic (Interim Report, Vol.2, pages 43-44).
The second development was when two FPOs undertook clinical trials of the abortifacient drug RU486 in 1994 (Tankard Reist, 1994). There is an apparent link of advocacy for RU486 to the Interim Report-advocated expansion of the availability of abortifacient post-coital "contraception" (Interim Report, page 134).
This illustrates further the Review's bias in favour of the philosophical approach taken by FPOs.
Alternatives to abortion
A 1992 FPO report on the reasons women sought abortions (Bitomsky, 1993) and page 140 of the Interim Report both mention economic reasons as a major reason women have sought abortions. However, the Interim Report makes no attempt to address these economic problems and suggest programs which might help to overcome them.
It should be a priority of FPOs to eliminate the reasons women seek abortions, not to opt for the "quick fix" solution of eliminating their unborn children. In the absence of such forms of positive assistance, statements to the effect that FPOs only contemplate the prospect of abortion as a last resort sound hollow.
One could be forgiven for thinking that the prime consideration of FPOs is to limit the birth rate, not to eliminate the distress encountered by many women with unplanned pregnancies.
Appropriate government approach
It would be more appropriate for the Commonwealth Government to use the Family Planning Program to also support organisations which offer women support to continue with their unplanned pregnancies, not just those organisations which refer for abortion.
This would include pregnancy support agencies such as those in the Australian Federation of Pregnancy Support Services. The government should acknowledge the role of Pregnancy Support Agencies as just as significant in the area of womens' reproductive health.
"... the ACSWC found that Pregnancy Support Agencies see possibly more clients than the Family Planning Associations, especially if the comparison is restricted to pregnancy counselling. However, unlike FPAs, Pregnancy Support Agencies do not receive any Commonwealth Government funding" (Sertori in O'Donovan and Stuparich (eds), 1994, pages 21-22).
FPOs should also amend their approach to contraception and pregnancy counselling so that non-abortifacient contraception is presented in a way which is more consistent with the reality. That is, contraception should be presented as a way of reducing the incidence of conception rather than as a way of eliminating the chance of conception and pregnancy.
Couples must be encouraged to recognise and consider the possibility of conception resulting from sexual intercourse. It is only by encouraging a greater awareness and recognition of the possibility of pregnancy that we can reduce the "crisis" nature of many unplanned pregnancies. It is the crisis nature of the situation which leads many women to seek abortions.
FPO membership base
It is surprising that FPOs attract such a high level of government funding despite the fact that they have a low level of community support in the form of members.
The review acknowledges this low level of community support.
"The membership base of the State and Territory FPOs is ... fairly narrow" (Interim Report, page 34) and "... the concerns of the IPPF that FPA Inc is too narrowly based to be truly representative" (Interim Report, page 36).
"The Review considers the current organisational structure of FPA Inc is narrow and unrepresentative of the family planning field in Australia" (Interim Report, page 38).
"The Review has also noted the potential for State FPOs to broaden their membership bases and to establish regional organisations" (Interim Report, page 38).
Given the narrow membership base of FPOs it is hard to understand why FPOs receive such significant government support. Certainly their current programs could not survive on the support of their current small membership base. It is our submission that government funding for this area of activity should be available to all organisations which are involved, based on an objective assessment of the value of their services to the community and the level of community support, both financial and practical. Government funding in this area should not be restricted to FPOs.
Bibliography
Australian Catholic Social Welfare Commission, (1991) Review of Pregnancy and Parent Support Services. Australian Catholic Social Welfare Commission, Canberra.
Bitomsky, M., (1993) Why do women seek abortions? Medical Observer, 20 August, pages 28-29.
Catalano, A., (1993) Naturally it works. The Sydney Morning Herald, 29 October, Agenda, page 11.
Interim Report of the Review of Family Planning Associations for the Commonwealth Department of Human Services and Health, Consultation Document, March 1995, Canberra.
O'Donovan, M. and Stuparich, J., (1994) The Abortion Debate: Pro-Life Essays. ACT Right to Life Association, Canberra.
Ryan, L., Ripper, M., and Buttfield, B., (1994) We Women Decide: Women's Experience of Seeking Abortion in Queensland, South Australia and Tasmania 1985-1992. Women's Studies Unit, Faculty of Social Sciences, Flinders University, Adelaide.
Tankard Reist, M., (1994) RU486 Trials - Controversy in Australia. Bioethics Research Notes, Vol.6(3), September, pages 25-26.
Uhlmann, A., (1994) Abortions follow failed contraception. The Canberra Times, 11 May, page 7.
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