As the anti-abortion lobby rears its head, access to abortion care remains costly and fragmented
By Adurty Rao
On paper, the right to choose remains settled. But a right you cannot reach is not really a right at all, writes MSI Australia chief executive, Adurty Rao.
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Abortion has been decriminalised in every state and territory in Australia, but after decades of advocacy to get here, the pro-choice movement is facing renewed attempts to roll that progress back. Just yesterday, One Nation MP Barnaby Joyce addressed a “rally for life” in Sydney, organised by anti-abortion activist Joanna Howe, and a bill purported to ban ‘sex selective abortions’ is set to be debated in the upper house of the NSW Parliament today.
Abortion care is basic healthcare and deserves the same critical protection as any other essential service. Now is not the time for regression- it is time for expansion. Thankfully, on paper, the right to choose remains settled and should remain so. But there remain plenty of barriers to access - and a right you cannot reach is not really a right at all.
Every day, women and pregnant people across this country discover the difference the hard way:
She is days over her hospital’s gestation limit, and the public system turns her away.
Her visa leaves her without Medicare, and locked out of care altogether.
She lives hundreds of kilometers from care, with no way to cover the travel, time off, or childcare.
She is trying to leave a violent relationship, and the pregnancy is how she is being controlled.
These are not edge cases. They are the women who come to us every week, arriving at our door because every other door has already closed.
Behind every story is a funding system that simply does not add up. In 2025, Medicare covered just 13 % of the cost of the abortion services MSI Australia provided. 53% came straight out of client’s pocket, hundreds of dollars asked of women at one of the most vulnerable moments of their lives. That is not a safety net. It is a gap that women are quietly falling through, every single day.
No woman’s access to legal and basic healthcare should come down to her postcode, her bank balance, her visa, or whether it is safe for her to ask. And yet, right now, it does.
Australia has built genuinely good things: Medicare, the Pharmaceutical Benefits Scheme, state-commissioned services in some jurisdictions. But these sit inside a fragmented system that no single part can fix alone. Provision varies wildly by postcode, gestation limits differ between hospitals, and Medicare excludes many of the women who need care most urgently. The costs that decide whether a woman can actually get there: travel, accommodation, childcare, counselling, all fall outside every existing funding framework.
As Australia’s leading provider of abortion, contraception and miscarriage care, and the only not-for-profit that also manages the national supply of abortion medication, MSI Australia sits at a unique vantage point. We see the whole chain: the care navigator, the clinic, the medicine, the telehealth appointment, the counsellor, the case manager who finds a way across a state border that no single hospital can cross.
So, we have chosen to carry a national responsibility, and to connect what the system leaves disconnected. We do this through our Choice Fund.
The Choice Fund is Australia’s only national safety net for abortion access. Since 2017, through the generosity of donors and MSI Australia’s own investment, more than 4,000 women and pregnant people have received care they could not have reached any other way. Of the 500 people the Fund supported in 2025, every single one had already been turned away from publicly funded services before they found us.
We are proud to carry this. But a permanent national safety net should not rest on philanthropy alone. Reliable access to legal healthcare is a shared responsibility, not a charitable one, and the Choice Fund shows exactly what becomes possible when every part of the system finally pulls in the same direction. Imagine that at scale: care that is coordinated, connected, and within reach of every woman, wherever she lives and whatever her circumstances.
None of this works without people who believe that reproductive healthcare is essential, urgent, and owed to everyone. If you have ever sat in a clinic waiting room and felt the relief of being met with care instead of judgement, you already understand exactly what is at stake when that care is out of reach for someone else.
Until the system reaches every woman, the Choice Fund is how we make sure no one is left to carry the cost of its gaps alone. With your support, we can keep that door open, so that whoever she is, and whatever has happened before she reaches us, there is always somewhere left to turn.
MSI Australia is currently running their annual Choice Fund donation appeal, to support visit: Shout For Good
About the author
Adurty Rao is the chief executive officer of MSI Australia, a national non-profit advocate and provider of abortion and contraception services. She has more than 15 years of senior leadership experience across healthcare and community services in public, private and not-for-profit settings. Adurty is deeply committed to collaboration across the health system and to advancing informed, accessible, equitable and compassionate sexual and reproductive healthcare for communities across Australia.
Excellent piece Adurty and thankyou for discussing the subject that no-one wants to discuss but is crucial to girls and women's rights. I have been following Jessica Valenti and her excellent blog and I am horrified to see that Australia could be going the same direction as the US. I have a real issue with hospitals like Mater declining to help unsustainable pregnancies. Women need the same support for reproductive care that you would get for any other medical need. I find when I contact politicians about this issue I almost never get a response. There is too much fear of the Anti-abortion lobby and too little medical awareness of why women need care without fear or judgement. Thanks again Adurty.
One nation has now picking up the baton from amerikkkas lead! We cannot be complacent in our right to choose, as it will be picked apart one bill at a time, just like they are until women and girls are charged with murder, which is what the far right want, to completely control women!