Abortion deserts

The Abortion Desert Data Visualisation Tool uses mapping and forecasting techniques to present a new easy-to-understand conceptual approach to understanding abortion (in)access. The tool focuses on the places and people who are excluded from abortion access due to their geographic location or distance from service options.

The Abortion Desert Tool visualises how changes in policy and service availability affect the size and shape of the abortion deserts across NSW using a composite data set of abortion service options. It also offers a means to approximate how many people of reproductive age and capacity are affected by different advances in abortion provision across the state.

We acknowledge that distance and geography are two of many obstacles people face when accessing abortion services in Australia and seek to demonstrate ways that policy change in Australia’s health system can meaningfully address these barriers.

The Abortion Desert Tool is led by Dr Madeleine Belfrage and Dr Anna Noonan, co-convenors of the Access All Areas abortion research collective at the University of Sydney’s Sydney Social Sciences and Humanities Advanced Research Centre, in collaboration with Ri Liu, an independent data visualisation technical expert.

Abortion care in NSW

Abortion is healthcare. Despite this, it is not routinely provided in public hospitals in NSW.

There are two types of abortion care:

Surgical abortion - a procedure undertaken in a clinical setting (a private abortion clinic or in a hospital) and

Medication abortion - using abortion pills prescribed by a GP and dispensed at or by a pharmacy. It is also available at an abortion clinic or sometimes through telehealth.

Abortion services in 2024 in NSW

This map shows all abortion services in NSW listed in publicly available online directories in mid 2024.

Where are the gaps

We rarely hear about places where abortion care is difficult to access, where there are no or limited services, or what it's like for people who need care in these contexts.

We focus on these people and places.

What is an abortion desert?

‘Abortion desert’ is a term from USA-based researchers to describe places that are 100 miles or more from the nearest abortion service.

We adapted this term to map current abortion deserts in NSW. That is, where the nearest abortion service is more than 160 kilometres away.

What is an abortion desert?

For example, Broken Hill is an outer regional town in far west NSW.

There are currently surgical and medication abortion services available there.

What is an abortion desert?

We mapped 160km by road in different directions from Broken Hill.

What is an abortion desert?

Any area beyond this distance was considered an abortion desert.

This is what the abortion desert around Broken Hill looks like.

Where are the abortion deserts in NSW?

This map shows abortion deserts in NSW.

  • Accessing services for people living in a desert requires (at a minimum):
  • Access to a form of transport
  • A minimum round trip of 4 hours by car
  • Possible overnight accommodation
  • Additional travel funds beyond the cost of the abortion itself

This assumes a person is able to travel, take time off work or carer responsibilities, and in some cases, have someone come with them to support them through the process (including driving back if it is a surgical abortion).

How do abortion deserts change?

Abortion deserts are not static.

They shift and change according to the type of abortion care people need or prefer.

For example, medication abortion is only currently available for pregnancies of 9 weeks (63 days) gestation.

In some parts of rural NSW, there is one single healthcare practitioner providing this service. If they move away, retire or stop providing this service, the abortion desert would immediately expand affecting everyone in that location.

What if you need/want a surgical abortion?

There are only three public hospitals that formally offer surgical abortion in NSW. Most of them are located in major cities on the coast.

Abortion deserts expand if people need or want surgical abortion.

How can we shrink these abortion deserts?

Abortion deserts can shrink if healthcare policies change and healthcare worker willingness to provide abortion care increases. We have mapped the impact of these potential changes.

What if all NSW public hospitals provide abortion?

This is how abortion deserts change in NSW if all public hospitals provided free and public abortion services.

The World Health Organisation (WHO) recommends all public hospitals provide abortion care.

Also, it is important to remember that public services are usually only available to people with Medicare. This excludes people on temporary visas like international students, tourists, or people seeking asylum.

And what if all GPs prescribed abortion pills?

Since August 2023, Australia’s pharmaceutical regulator removed requirements for GPs to prescribe abortion pills without undertaking any additional training or registration. Yet the percentage of GPs currently prescribing remains low (less than 15%).

This is how abortion deserts change in NSW if all GPs prescribed abortion pills.

And what if all pharmacies dispensed abortion pills?

Finding pharmacies that stock and dispense abortion pills is not always easy. This is especially the case in rural locations where there may only be one pharmacy in town or in a nearby town.

This is how abortion deserts change in NSW if all pharmacies dispensed abortion pills.

What could an abortion oasis look like?

An abortion oasis in NSW would mean:

  • All healthcare professionals are trusted to provide abortion care (this means not only doctors, but nurses and midwives too)
  • Barriers like unnecessary ultrasounds are removed in accordance with Australia’s clinical guidelines
  • Abortion care is free for all, including those who do not have Medicare
  • Abortion services are openly advertised and easy to find
  • All people are able to access abortion pills irrespective of where they live
  • All abortion care modalities including self-managed and accompanied abortion are available in Australia
  • Distance is not a disadvantage (no matter how far).
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