H I D D E N W O M E N : T H E I M P A C T O F P O V E R T Y O N A B O R T I O N A C C E S S

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1 H I D D E N W O M E N : T H E I M P A C T O F P O V E R T Y O N A B O R T I O N A C C E S S S E L I N A U T T I N G, R E S O U R C E M A N A G E R S U S A N S T A R K, S E N I O R C O U N S E L L O R N I C O L A S H E E R A N, G R I F F I T H U N I V E R S I T Y

2 A C L I M A T E O F P O V E R T Y Women are more likely to live in poverty and lone mothers with dependant children represent 17% of all persons living in low economic resource households. (ABS 2012) Gender pay gap is currently 16%. Women defer health visits, such as screening tests and dental work, due to cost.

3 A C L I M A T E O F P O V E R T Y Poverty data in Australia is limited, one 2016 survey reports that one in four Queenslanders don t have more than $500 for an emergency. Men are more likely to have larger savings than women. An American study indicated that 47% of people could not cover a $400 emergency.

4 A first trimester abortion in Queensland can cost between $250-$790. There are 3 QLD Health sexual health clinics offering free medical termination services (though with strict catchment areas and limited availability).

5 U S A : 42% of abortion patients are poor and 27% are low income. (Jones, Upadhyay, Weitz (2013) C H I L D R E N B Y C H O I C E D A T A : 45% of contacts were Health Care Card holders and 67% reported abortion cost as a barrier to access. (three years to 30 June 2017)

6 C H I L D R E N B Y C H O I C E R E S P O N S E : F I N A N C I A L A S S I S T A N C E P R O G R A M Eligibility : Health Care Card (or parallel). 553 completed cases in last two years. Average of $405 per client. Lowest case $80; highest $1800.

7 P R O G R A M R E S O U R C E S $225,000 over the past two years. LARC subsidy No Interest Loans Other Organisations CbyC Donations Clinic Discounts $0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000

8 S O U R C I N G F U N D S : A C A S E S T U D Y

9 H O W D I D J E S S M A K E I T?

10 H O W M U C H D E L A Y W A S C A U S E D T R Y I N G T O F I N D M O N E Y? Average gestation of first CbyC contact: 9.37 weeks Average gestation of clinic appointment: Number of women in 1 st trimester at first contact: 83.7% Number of women in 1 st trimester at time of TOP: 77.2%

11 H O W M U C H O F A N A B O R T I O N C A N W O M E N A F F O R D T H E M S E LV E S? 5 3 % F R O M H E R (including own money, borrowing from friends/family, and/or NILS). 4 7 % F R O M S T R A N G E R S (eg our grants, asking providers for discounts, calling other services, social media callouts). The Tiller Fund Report (USA) indicates that on average their clients could only meet 25% of the cost from their own funds.

12 T H E M A N I N V O LV E D I N T H E P R E G N A N C Y ( M I P ) Out of 553 cases, 44 men contributed: 7.9% Cases that involve violence with the MIP: 34.7% STD: otherwise known as Sexually Transmitted Debt

13 P R E S E N T I N G I S S U E S ISSUE Percent % Number Alcohol/drug MIP alcohol/drug Child safety Mental health Single parent Suicidality International Physical health Self abortion MIP incarcerated Refugee/asylum seeker.5 3 Students Disability Historic RC.7 4 Historic SA Historic DV MIP DV MIP DVO

14 C O M P L E X I T Y O F I S S U E S

15 T H E A B O R T I O N E X P E R I E N C E I N V O LV E S : Multiple disclosures. Judgement from others when asking for money. Asking a violent or unsupportive man. Gestation advancing while trying to find funds. Escalation of mental health issues. Increased poverty from raising the money housing/rent arrears, not paying bills, etc.

16 C H I L D R E N B Y C H O I C E R E S P O N S E Choosing to be client centred Prioritising women s needs Commitment to including financial support as core part of our service

17 W H A T Y O U C A N D O : R E C O G N I S E T H E N E E D I N T H I S A R E A Are you ready to be the stranger a woman asks for money? Provide continuity of care don t just give her a phone number. Develop a response to women needing support on unplanned pregnancy and abortion. Think creatively about how you can support them.

18 W H A T Y O U C A N D O : C R E A T E A S A F E E N V I R O N M E N T T H A T E N C O U R A G E S D I S C L O S U R E A N D E M P O W E R M E N T Eg. Anonymity of our telephone service. Counsellors providing financial assistance program. Best practice principles. Trauma-informed framework.

19 W H A T Y O U C A N D O : U S E S T R E N G T H S B A S E D P R A C T I C E Eg. Successful repayment in loans program. This is to thank Sian, for helping me achieve my goal and thanks to the help from the team at Children by Choice too. I feel human again. I hope to be able to help other women achieve their choices by donating to this cause every fortnight once my loan is fully paid off Thank you so much for everything. (Client via )

20 W H A T Y O U C A N D O : A D D R E S S M U L T I P L E P R E S E N T I N G I S S U E S Can take action on co-occurring problems. Build a coordinated response both internally and sector wide. Eg. Free LARC insertion. Violence screening and referrals. Good referral networks for variety of issues.

21 W H A T Y O U C A N D O : T A L K T O U S A B O U T I N T E G R A T I N G T H I S I N T O Y O U R P R A C T I C E

22 T H A N K Y O U Thanks to Chloe, Brooke and Leah for their major volunteering on the data! Thanks to Gretchen Ely, Buffalo University for sharing their work on the Tiller Fund Report. Further references available on request to finance@childrenbychoice.org.au.