Groundbreaking Australian clinical study simplifies medical abortion care

16 Aug, 2023 | Advocacy, For doctors, Media

As families prepare to gather for Christmas, there’s a hidden crisis intensifying behind closed doors: reproductive violence, where someone uses coercion, manipulation, pressure or control to dictate another person’s reproductive choices, is affecting thousands of women and pregnant people across our region.

1 in 3 women globally will experience reproductive coercion in their lifetime, including sabotage of contraception, forced pregnancy, prevention or pressure related to abortion care, and financial or emotional threats linked to reproductive decisions.^[1]

In Australia, around 1 in 5 women accessing abortion services report some form of coercion or control from a partner, and frontline counsellors say cases are becoming more complex, particularly during holiday periods when isolation and family pressure escalate.^[2]

“Reproductive violence remains largely invisible, but it is happening right now, in homes, relationships, and families across Australia and the world,” said Grishma Bista, CEO, MSI Asia Pacific.

“No one should face abuse, pressure, or control over their reproductive choices. Access to safe, confidential care is essential, especially at a time of year when family dynamics can amplify risk.”

Holiday season increases risk

The end of the year is a peak period for relationship stress, financial pressure, travel, family expectation and isolation from support networks, all factors that increase risk of reproductive violence and reduce access to help.

MSI Australia’s psychosocial team reports a surge in women disclosing lack of control, fear, or pressure from partners in the lead up to Christmas, particularly around continuing or ending a pregnancy.

“We regularly support clients who are frightened, confused, or unsure if what they are experiencing is abuse,” said Alison Fonseca, Psychosocial Health Manager at MSI Australia.

“Reproductive violence can look like sabotaging contraception, hiding medication, pressuring someone to continue or terminate a pregnancy, or threatening to withdraw financial support. It is gendered violence, and it has devastating consequences.”

Regional impact demands regional action

Across the world, reproductive coercion is deeply connected to gender inequality, stigma, economic dependence, and access to health services. In many countries, there are no legal safeguards, limited counselling services, and severe stigma around reproductive healthcare.

“At MSI, we see resilience every day, people finding the courage to seek help, make their own decisions, and protect their future,” Ms Bista said.

“But access to safe pathways must be funded, protected and strengthened.”

Campaign launching: Help us support safety, choice and care

This Christmas, MSI is launching a donation campaign to support people experiencing reproductive violence, here and overseas.

Funds raised will:

Provide emergency psychosocial support including counselling
Cover the cost of abortion or contraception care for people facing coercion
Support local services in countries where reproductive violence is rarely acknowledged

Every donation, large or small, helps someone make a decision free from control, fear and pressure.

“No one should be forced into or out of a pregnancy,” Ms Fonseca said.

“With community support, we can make sure reproductive choices belong to the person, not their partner, not their family, and not their circumstances.”

Key facts

1 in 5 Australian women seeking abortion report pressure or coercion related to pregnancy decisions
Only 12 out of 43 Asia Pacific countries have legislation enshrining the right to choose the number, timing, and spacing of children ^[3]
Reproductive violence is one of the least recognised forms of gender-based violence, despite being reported in clinical and counselling settings worldwide ^[4]
Family violence is consistently one of the high-recorded months for family violence incidents ^[5]

[1] World Health Organisation. (2021)

[2] MSI Australia. (2020). Hidden Forces: Shining a light on reproductive coercion white paper

[3] IPPF. (2023). Asia Pacific Contraception Policy Atlas.

[4] Tarzia & McKenzie. (2024). Reproductive coercion and abuse in intimate relationships: Women’s perceptions of perpetrator motivations

[5] Crime Statistics Agency. (2025). Family Incidents

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For more information contact Anna Jabour on 0403 322 992

MSI Australia has published an Australian-first study which will change the way medical abortion care is delivered in Australia.

The findings reveal that women can bypass an unnecessary trip to the doctor following a medical abortion and test themselves from the comfort of their own home to confirm the abortion was complete. This new model of care was introduced during COVID19 lockdowns, and this study shows that this simplified care is safe and effective.

Deputy Medical Director Dr Catriona Melville said this study highlights the effectiveness of a more streamlined approach to post-abortion care, which have been successfully implemented in other countries, such as Scotland.

“Medical abortion is a quality, safe and effective form of abortion care,” she said.

“’Our study includes over two thousand people and shows that we can provide the same quality of care with less appointments and less intervention such as ultrasound scans.

“A post-abortion clinic visit can be replaced with a low-sensitivity urine pregnancy test and virtual health appointment.

“This new method is not only safe but has been welcomed by women and pregnant people we have cared for.

“A low-sensitivity urine pregnancy test was approved by the Therapeutic Goods Administration in November 2019 for use in Australia.

“This allowed us to change the way we deliver medical abortion care. It came at a crucial time as the COVID-19 pandemic began in early 2020 and brought about national lockdowns, making travel and face-to-face medical appointments more challenging.

“Previously, people who accessed a medical abortion at our clinics were required to undergo a face-to-face review approximately 14 days after taking the medication.

“This involved a consultation with a doctor who performed a routine ultrasound scan and checked for any adverse signs or symptoms.

“The simplified process replaced the in-clinic review with a telephone call to the patient 14–21 days after the medical abortion. Patients were given a special urine pregnancy test at their initial clinic appointment and during the call we discussed the results and asked some questions to ensure there were no complications and that the process was complete.

The study aimed to demonstrate the safety and efficacy of this process by examining patient outcomes. We also evaluated the impact on the number of face-to-face clinic appointments which can be a barrier to access and care.

“These findings are a significant step forward in improving the accessibility and effectiveness of follow-up procedures for early medical abortions.” Dr Melville said.

“By adopting this new model of care, healthcare providers can minimise unnecessary in-person visits, routine blood tests and ultrasound scans whilst ensuring high standards of care are delivered.”

The study was published in the Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) and can be read online here: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/ajo.13731

Donate to the Choice Fund to support people experiencing financial hardship or other barriers to abortion and contraception care here.

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For further information contact Anna Jabour on 0428 396 391.

MSI Australia is the only national not-for-profit provider of sexual and reproductive health services including permanent and long-acting reversible contraception and abortion care. For more information on our clinic network visit msiaustralia.org.au