title: Access, equity and costs of induced abortion services in Australia: a cross-sectional study.
abstract: OBJECTIVE
  To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation.
  
  
  METHODS
  Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression.
  
  
  RESULTS
  Over a third of eligible women opted for a medical abortion. More than one in 10 (11.2%) stayed overnight. The median Medicare rebated upfront cost of a medical abortion was $560, compared to $470 for a surgical abortion at ≤9 weeks. Beyond 12 weeks, costs rose considerably. More than two-thirds (68.1%) received financial assistance from one or more sources. Women who travelled ≥4 hours (AdjOR: 3.0, 95%CI 1.2-7.3), had no prior knowledge of the medical option (AdjOR: 2.1, 95%CI 1.4-3.1), had difficulty paying (AdjOR: 1.5, 95%CI 1.2-1.9) and identified as Aboriginal and/or Torres Strait Islander (AdjOR: 2.1, 95%CI 1.2-3.4) were more likely to present ≥9 weeks.
  
  
  CONCLUSIONS
  Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice. Implications for public health: Policy reform should focus on reducing costs and enhancing early access.
authors.affiliation: Judith Lumley Centre, School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Victoria.
authors.forename: Mridula
authors.initials: M
authors.lastname: Shankar
authors.affiliation: Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medicine School, University of Sydney, New South Wales.
authors.forename: Kirsten I
authors.initials: KI
authors.lastname: Black
authors.affiliation: Marie Stopes International, Victoria.
authors.forename: Philip
authors.initials: P
authors.lastname: Goldstone
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Victoria.
authors.forename: Safeera
authors.initials: S
authors.lastname: Hussainy
authors.affiliation: Department of General Practice, Monash University, Victoria.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
authors.affiliation: Law School, La Trobe University, Victoria.
authors.forename: Kerry
authors.initials: K
authors.lastname: Petersen
authors.affiliation: Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria.
authors.forename: Jayne
authors.initials: J
authors.lastname: Lucke
authors.affiliation: Judith Lumley Centre, School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Victoria.
authors.forename: Angela
authors.initials: A
authors.lastname: Taft
mesh_terms: D000028:Abortion, Induced / Q000191:economics* / Q000706:statistics & numerical data; D000029:Abortion, Legal / Q000191:economics* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014186:Transportation
keywords: Australia; abortion access; abortion costs; induced abortion; medical abortion