GROWING numbers of women in desperate financial straits cannot afford abortions, say women's health advocates who are running out of funds to help them. They say women on Centrelink benefits cannot afford fees at private abortion clinics, and public hospitals must play a bigger role in providing a free service.
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''Women who are really poor are finding it hard to get bulk-billed abortion services,'' said Denele Crozier, the executive officer of Women's Health NSW, the peak body for women's community health centres. ''Either public hospitals must provide an abortion service or governments must further subsidise poor women to use the free-standing clinics.''
Women receive a Medicare rebate for terminations but out-of-pocket costs are high for many.
A women's service at Mount Druitt has twice written to the Minister for Health, Jillian Skinner, in the past 10 months, alerting her to an increased number of requests for financial aid for abortions from all over the state.
In one week, the service had three women seeking urgent help. All were turned away from Blacktown Hospital. One woman had five children under 10 and had just separated from her husband because of domestic violence. Another had four children, three of whom were in the care of Community Services. The third was homeless with two children.
Blacktown Hospital provides a limited number of so-called medical abortions using mifespristone (commonly known as the abortion pill RU-486) to women less than 10 weeks' pregnant.
The general manager of Blacktown/Mount Druitt Hospital, Andrew Newton, said: ''Any woman requiring medical termination in NSW receives care according to clinical needs.'' Surgical terminations ''are provided in the community sector''.
The manager of the Women's Activities and Self-Help House, Catherine White, said in her letter to the minister: ''Along with the adverse impact on the woman's mental health, continuing unplanned pregnancies has the potential for long-reaching economic impacts on the child protection system, as well as income support and welfare services.''
A response from the parliamentary secretary for regional health, Melinda Pavey, suggested women seek help from no-interest-loans schemes. These are provided by church organisations. The Western Area Adolescent Team was also cited as a source of help but it lost government funding for provision of such assistance last year.
Marie Stopes International (Australia), the local arm of a worldwide, not-for-profit women's health service, runs 15 clinics, including five in NSW.
For women on Centrelink benefits with a healthcare card, the out-of-pocket cost of a surgical abortion starts at about $340 under 12 weeks' pregnancy and rises with each week to about $610 at 14 weeks and $1365 at 19 weeks. Transport and accommodation costs are extra burdens.
Some women's health centres have struck memorandums of understanding with Marie Stopes for significantly reduced rates for women in severe financial hardship. ''Even big reductions, say to $450, is a mountain for a woman on a Centrelink benefit,'' said Margaret Kirkby, spokeswoman for the Women's Abortion Action Campaign.
Women's health workers praised the organisation as helpful and recognised it must cover costs. But one said the memorandums were ''fairly tenuous and when demand is rising you feel you're begging''.
A $30,000 fund from the Bessie Smyth Foundation was used for several years to subsidise abortions for poor women and to provide advice and referrals. But the funds, derived from the sale of an abortion clinic, ran out at the end of 2007. Attempts to secure government assistance failed.
Ms Kirkby said NSW was the only big state to lack a government-funded information and referral service, similar to Queensland's Children by Choice.
The medical director of Family Planning NSW, Deborah Bateson, said easing the restrictions on doctors prescribing mifespristone would also increase access to abortions.
