In 2020-21, Australian women claimed more than 293 million services through Medicare. Almost nine in 10 visited a GP in 2021-22. However, according to a Cleanbill report, less than one in four GP clinics offer bulk billing in 2024. Experts say that this, coupled with a general lack of contraceptive knowledge, can make it harder for women to access sexual and reproductive healthcare.

Professor Angela Taft, a social scientist and women’s health researcher, tells upstart that Medicare and bulk billing is crucial to ensuring women receive the healthcare they need.

“Obviously if there are more bulk billing GPs then there are going to be more affordable GPs for younger women to go to,” she says.

Medicare rebates mean the government covers a percentage of a patient’s medical fee and when clinics offer bulk billing, patients are not required to pay anything as Medicare covers the cost.

Currently, female Medicare card holders can access a three-month supply of oral contraceptive pills for anywhere between $10 and $35 plus about $115 for a GP consultation. A copper IUD can cost between $70 and $120, and as much as $300 per consultation with two consults required. Contraceptive implants, which last three years, cost around $37 and require at least two consults which can cost around $115 each.

Like many women, 27-year-old Keirah Metcalfe has paid for various forms of contraception since she started using it as a teenager.

“I started on the pill when I was about 15. I came off it because I was getting headaches for a little while,” she tells upstart.

In 2023, 60 percent of Australian women aged 18–23 reported using the contraceptive pill, while 45 percent reported using condoms as their method of birth control. Only 10 percent of women aged 28-33 and 24 percent aged 40-45 use long-acting reversible contraception like IUDs. According to Professor Taft, IUDs are the most effective form of contraception, but many women may not know they are available, especially if their GP is not familiar with them.

While contraceptives and GP consultations are still leaving Australian women out-of-pocket, countries like Canada have made these treatments free. Since April this year, contraceptives, including intrauterine devices (IUDs), contraceptive pills, and hormonal implants have been made free for Canadian women. It joins Ireland, the United Kingdom, and France in providing women with free access to prescription contraceptives.

This is something Professor Taft says her colleagues at SPHERE, a women’s reproductive and sexual health research network, are advocating for here in Australia.

She believes if more GPs were trained in contraceptive counselling it would be more accessible for women.

“There’s a push to educate GPs about providing better and more effective counselling around contraception and abortion choices,” Professor Taft says.

One in five Australian women who have ever been pregnant will undergo an abortion by age 45. There are many reasons why women may choose to have an abortion. For Metcalfe, who found out early on that she was pregnant, she felt that it wasn’t the right time.

“For me, the decision and doing it wasn’t the hard part because I knew what I wanted, and I had discussed with my partner at the time that I wasn’t ready to have children,” she says.

Metcalfe’s abortion was medical and cost between $500 and $600. She chose the private route and was required to travel to Melbourne for treatment.

“There was only one facility in Ballarat and at the time they only ran on Wednesdays, which I don’t know if that’s still a thing, but it’s not enough,” she says.

Many hospitals, particularly outside of major cities, either don’t provide abortions or have restricted availability. This can mean women have to travel for surgical abortions, which adds to the cost of the procedure, particularly if they have to take time off work and pay for accommodation.

A Senate inquiry into universal access to reproductive healthcare recommended that all public hospitals provide surgical abortions. It also recommended that contraception and abortion access in rural and regional areas be made available through publicly funded community and hospital-based services.

Along with more facilities, Professor Taft would also like to see nurses and midwives trained in providing contraceptive counselling and the prescription of medical abortions.

“I think it would take the pressure off GPs and make all of these things, contraception and abortion, more affordable for women,” she says.

Despite the cost of her treatment, Metcalfe remains thankful she was able to access an abortion when and how she wanted to.

“I feel very privileged and lucky to have the access that we do have considering things like America, but it’s still a process.”

Article: Tia Clarkson-Pascoe is a second-year Bachelor of Media and Communication (Journalism) student at La Trobe University. You can follow her on Twitter @Tia_pascoe.

Photo: A woman holding an IUD, a contraception device inserted in uterine. This is a birth control device by Robin Marty is available HERE and is used under a Creative Commons Licence. This image has not been modified.