Medical abortions have been suspended in Queensland. What does this mean?

A 24-YEAR-OLD Brisbane woman was last night preparing to terminate her pregnancy at home or in a hotel room after being told no local hospital would perform the medical abortion she must have.

Shay is the human face of Queensland's abortion law crisis – a standoff between doctors and the Queensland government that has led to the withdrawal of medical abortion services by hospitals, and the referral of sick and traumatised women interstate for treatment.

Until Monday, Shay believed the baby she had carried for 19weeks was thriving. But a routine fetal abnormality scan picked up problems that were diagnosed on Thursday to be fatal to the fetus. She has asked The Weekend Australian not to publish her surname.

The diagnosis, coming late in the second trimester of Shay's pregnancy, meant a surgical termination would create complications for her and husband Brad having other children.

Her obstetrician recommended that she have a drug-induced abortion in hospital.

But acting on concerns raised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists that such medical abortions were technically illegal under Queensland criminal law, Brisbane's North West Private Hospital refused to admit her. Queensland's largest public hospital, Royal Brisbane and Women's Hospital, followed suit, having been the first in the state to suspend its medical abortion service last week.

Prominent Brisbane obstetrician Adrienne Freeman has now offered to perform a medical abortion using the drug misoprostol at Shay's home, or in a hotel.

That prospect, however, appals the young woman.

After all she has gone through, Shay wants the security of being treated in a hospital in her home town, and is angry that the standoff between doctors and the Queensland government over the state of the abortion law has compounded her predicament. "I've cried myself silly," Shay told The Weekend Australian, as she waited anxiously by the telephone last night for a hospital to agree to take her.

"But I have got over the upset … I have made myself that angry we have not been able to make this choice straight away as to what our wishes are.

"I mean, this pregnancy was a planned pregnancy. I have been married to my husband for three years now. This wasn't some silly accident; we wanted this baby so much. And then to have this happen to you – it's the worst thing in the world," Shay said.

"I just can't believe someone thinks they have the right to tell you what you can do to your body and your unborn baby … we are not doing this for our husband and I; we are doing it for the baby's sake.

"This baby, we have been told, is not going to survive. It's a miracle it is surviving right now."

Shay's father, Gary, said the issue was not about the rights and wrongs of abortion. "This is a medical issue, not a moral issue at all," he said. "The best medical advice was it is not wise for Shay to continue with the pregnancy, and that was the decision she had to take. It's hard enough for a woman going through the joy of knowing she was going to have a baby and getting to this stage to find out she couldn't, and then having all these other hurdles put in front of her.

"The reason we're speaking out is this needs to be fixed. Shay needs to get into a hospital here, and no other woman needs to be put into this terrible situation again."

The Queensland government is resisting pressure to repeal provisions of the criminal law banning abortion, which are being used to prosecute a couple in Cairns for illegally procuring a termination, allegedly with contraband drugs.

In a bid to allay concerns in the medical community about the case, the government has offered to amend the defence in the Queensland criminal code allowing doctors to perform surgical abortions to preserve the life or health of the mother to explicitly cover medical procedures.

Such drug-induced terminations are typically performed in hospitals on pregnant women with medical complications or who are found to have fetal abnormalities, usually later in pregnancy. So-called elective abortions are usually carried out in the first trimester of pregnancy, but in Queensland this occurs in the limited number of private clinics offering abortion services, not in public hospitals.

Queensland Health director-general Mick Reid yesterday assured hospitals in writing they were not at risk of breaking the law by performing medical abortions, contrary to advice from the college of obstetricians and gynaecologists and medical negligence insurer Avant Law.

The office of Deputy Premier and Health Minister Paul Lucas said Mr Reid had outlined an intended amendment to section 282 of the criminal code "to afford the same level of protection to doctors providing medical abortions as is currently provided for doctors providing surgical abortions", in his letter to hospital administrators yesterday.

"He also confirmed Queensland Health would continue to provide indemnity to doctors performing these procedures in Queensland Health facilities, in accordance with current and future legislation," Mr Lucas's spokeswoman said.

Shay's father said this did nothing to help his daughter, who was caught in legal limbo. "It's just a case of bureaucracy interfering with what is right and proper for my daughter," Gary said. "I just find it is unacceptable."

Shay said she was thinking about taking up the offer by Dr Freeman, who is not her regular obstetrician, to perform a "bedroom" termination with drugs.

Dr Freeman yesterday advised Royal Brisbane and Women's Hospital this was an option, under an agreement to notify nearby hospitals in case of complications to the patient. The medical abortion would be the 20th she has performed in the home of a patient using misoprostol, which she is licensed to prescribe.

Shay said she would prefer to have the procedure done in a controlled environment in a Brisbane hospital, so she could be close to her family. Three other Queensland women have so far been referred to hospitals interstate for medical abortions.

Shay said the termination was necessary for her own sake and that of her unborn child, which could not survive much longer.

"I can be walking through the shops, and I could start having a miscarriage," she said. "I could have a miscarriage tonight; I could have it in a week's time, two weeks' time. Let's just get the grieving process over and done with … so we can move on with our lives.

"You can't live like that – I'm sorry, it just doesn't work."

One of the country's most eminent maternal and fetal medicine practitioners, Nicholas Fisk, director of the University of Queensland Centre for Clinical Research, warned yesterday that the suspension of medical abortion services in Queensland would cause more babies to be born with brain damage and physical handicaps. About one in 70 pregnancies in Australia involves a birth abnormality, and one in 200 is aborted for these reasons.

The government will amend a section of the criminal code, exempting doctors from prosecution for performing otherwise illegal abortions, to cover recently developed medical techniques involving drugs such as RU486 and misoprostol.

Police allege a consignment of these drugs was illegally imported by Cairns mechanic Sergie Brennan, 21, to terminate the pregnancy of his 19-year-old girlfriend Tegan Simone Leach. The couple are due to face Cairns Magistrates Court on Thursday for committal proceedings.

With state parliament sitting this week, Shay's family is hoping legislation amending section 282 of the criminal code can be rushed through, clearing the way for medical abortion services to be resumed.

Cairns obstetrician Caroline de Costa, who has also suspended her clinical service using RU486, said yesterday amending section 282 would not remove doctors' concerns.

Royal Australian and New Zealand College of Obstetricians president Ted Weaver separately advised members "the threat of prosecution remains".

"It would not be enough for us to resume, no," Professor de Costa said of the proposed amendment to section 282. "We would still be concerned about the possibility of prosecution."

Anti-abortion group Cherish Life Queensland said "pro-abortion doctors" were running a "contrived campaign" to put pressure on the government to decriminalise abortion.

President Teresa Martin said no doctor in Queensland had been charged with an abortion-related offence since the late Peter Bayliss and Dawn Cullen faced court in 1986. The case formed one of the planks of case law that widened access to abortion, even though it remained banned by criminal statute.

"The law as it stands should be enforced," Ms Martin said.

Professor de Costa said the position of colleagues working in the public hospital sector was that they would not perform medical abortions while there was question over their legality.