The stigma surrounding late abortions comes largely from the public’s ignorance surrounding the medical and personal tragedies that require such choices.
It is estimated that more than 90 per cent of terminations nation-wide are done before 14 weeks.
Abortions after 20 weeks are extremely rare. Yet, even fervent supporters of choice express incomprehension at the need for timely, skilled and accessible services for the few women who require later terminations. “I don’t get it,” more than one has said to me over the years. “Why did she leave it so late?”
The unfolding tragedy of “Abyan” reveals much about the complex and compelling medical and social circumstances that delay women’s choice and access.
Abyan is a 23-year-old Somali refugee who became pregnant from a rape on Nauru, the desolate and desperately poor island where she has been detained for more than two years as part of Australia’s off-shore processing regime.
She was brought to Australia for a first trimester termination, but was spirited back to Nauru five days later without having undertaken the procedure. This was either because (according to the government) she repeatedly refused it or (according to her lawyers) she requested additional medical and psychological support to make the decision.
She is now more than 17 weeks pregnant.
Refugee expert Ian Rintoul has said that, “The treatment of Abyan is emblematic of the treatment of refugee and asylum seekers in general on Nauru.”
It’s also emblematic of the horrendous circumstances that lead women to seek abortion at later stages of pregnancy.
Disadvantaged women, including recent migrants and refugees, are over-represented in the small group of women seeking later abortions. Language, cultural beliefs about sex and histories replete with loss and violence are the usual backstory of refugees and all serve to complicate a woman’s path to a service provider who can and will help her.
These qualities make her easy prey for anti-choice activists who will seek to discourage or frustrate her, in hope of pushing her past the time period where she can access or afford a safe, legal service.
Rape is the form of trauma most likely to lead to a diagnosis of Post-Traumatic Stress Disorder (PTSD). A European Parliament report lists symptoms of PTSD as nightmares, flashbacks, heightened arousal and/or numbness.
It seems safe to assume that Abyan arrived on Nauru in a fragile state. After her family was killed in a rocket attack, she fled a country terrorised by al-Shabaab. After the long journey to Australia by boat, she was detained on Nauru as part of Australia’s off shore detention policy. Then, she was sexually assaulted.