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Should the pill be free in Australia?

Ewa Staszewska examines how the availability and cost of the contraceptive pill is affecting the number of unwanted pregnancies in Australia.

Two-thirds of Australian women that are of reproductive age are currently using contraception.

According to a 2013 report by Family Planning NSW, the most common of these methods is oral contraception, also known as “the pill”.

Australia was the second country in the world to make the pill available, introducing it in the 1960s. It lags behind other countries, however, when it comes to the cost of the often-expensive contraceptive.

Under the current Pharmaceuticals Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS), the total amount paid for contraceptive benefits in 2011 was around $51 million. The two government schemes offer subsidies for generic brand pills, mini pills, IUDs and implants for those with a medicare card.

Our closest ally, the UK, ensures the pill and other contraceptives are widely accessible by making them free for most women across the country.

Similarly, until a recent initiative aimed at boosting the population was implemented, Iran’s health ministry issued free contraceptives to women.

Other countries like France do not fully subsidise the pill but it is free for 15- to 18-year-olds as part of a strategy to reduce abortion rates.

Melbourne University professor Roger Short says that Australia’s high abortion rates among youth are reason to further subsidise contraceptive measures.

“I think the government should certainly subsidise contraceptives, especially for teenagers,” he tells upstart.

“The first thing to do is take the pill off medical prescription, and make it available over-the-counter at all pharmacies.

“This should certainly reduce Australia’s extremely high rates of teenage pregnancy and teenage abortion, the second highest in the developed world after the USA,” Short says.

It is difficult to ascertain the number of abortions performed in Australia as only South Australia, Western Australia and the Northern Territory keep a record of abortion statistics. However, a 2003 report by the Medical Journal of Australia estimated abortion rates were 19.7 abortions per 1,000 women aged between 15 and 44 years.

Available information in NSW shows that abortions exceeded births among 15- to 19-year-olds in 2009. In that year, there were 4,053 abortions among teens in comparison to 3,152 live births.

The statistics highlight the need for better sexual health education. In addition, there should be easier access to contraception for adolescents who may be too embarrassed or unable to see a doctor about it.

Jayne Lucke, a science and health professor at La Trobe University, tells upstart that there are greater concerns in Australia’s contraceptive legislation.

“The UK subsidises contraception to a greater extent than Australia. However, in my opinion there are barriers to contraceptive access that are more of a problem for access than the cost of the contraceptive measure itself,” she says.

“The more important barriers for most women are: finding a doctor who bulk bills and you feel comfortable talking about contraption with, finding a doctor who knows all about the contraceptive options available and having doctors trained in the insertion of long-action methods such as Implanon and IUDs.”

Lucke says the need to visit a doctor every few months to refill prescriptions and the costs accrued by visiting a private gynaecologist to receive long-acting methods of contraception are additional barriers to access.

Similarly to Lucke, Dr Kathleen McNamee from Family Planning Victoria believes the real focus needs to be on access to long-lasting reversible contraception rather than making it free.

“Our main push is the long acting reversible method which is the IUD and the implant,” Dr McNamee tells upstart. “We’re keen for good easy access for all forms of contraception.”

Dr McNamee notes that there is already a moderate subsidy of contraceptive measures.

“Things like contraceptive implants and IUDs and some of the pills are subsidised,” she says. “If the government didn’t contribute they would actually cost a fair bit more, particularly for women without a health care card.”

According to Dr McNamee, women with a healthcare card can pay as little as $6.10 for a four-month supply of the pill.

Despite the low cost, the number of women who receive subsidies for combined oral contraceptives decreased sharply from around 391,00 in 2003 to 252,000 in 2011. This could be attributed to the fact that only a select few pills are subsidised.

All three experts agree that contraceptives should be made more accessible. They suggest that if the pill was available over the counter, an initial consultation with a doctor to find the right oral contraceptive would still take place, thereby eliminating one of the major concerns surrounding the debate.

For most women, it is a gruelling process to find a pill with the right balance of hormones. Many weigh up the possibility of hormonal disruptions with the financial burden of the pill, which can cost up to $120 for three months.

It is estimated that almost half of Australian pregnancies are unplanned and research shows that increased use of contraceptives does reduce abortion rates.

By following the UK’s lead and making the pill free, Australia could not only decrease abortion rates but also lift the financial strain of a purchase that is necessary for many Australian women.

 

Feature imaged by DailyBNBNEWS via Flickr

 

Ewa StaszewskaEwa Staszewska is a third-year journalism student at La Trobe University. You can follow her on Twitter: @EwaStaszewska.

 

 

 

 

 

 

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