Abortion

Use the Abortion Notification e-form (external site) to notify of an abortion (termination of pregnancy) within 14 days of the procedure or prescription. 

 
Abortion e-form
 

Introduction of the new laws ensures WA has modernised abortion laws that address inequity of access in line with other Australian jurisdictions and has removed clinically unnecessary barriers for women accessing an abortion.

The amended laws have:

  • reduced the number of registered health practitioners required to be involved in most abortion care from 2 to 1.
  • abolished the Ministerial Panel approval requirement for late abortions.
  • abolished the mandatory counselling provision.
  • abolished the requirement for Ministerial approval for a health service to be approved for the performance of late abortions.
  • increased the gestational limit at which an abortion may be performed on request from less than 20 to 23 weeks to better reflect current clinical practice.
  • removed abortion from the Criminal Code Act Compilation Act 1913 (Criminal Code) however, it will remain an offence for an 'unqualified person' to perform or assist with an abortion.
  • enabled prescribing practitioners (nurse  practitioners and endorsed midwives) to prescribe the medical abortion medicine (MS-2 Step) within their scope of practice and training.
Medical practitioners

A medical practitioner is authorised to perform surgical and medical abortions on a pregnant patient when the procedure used is within their scope of practice. 

Medical practitioners have certain obligations which are detailed in the questions below.

Nurse practitioners and endorsed midwives

Nurse practitioners and endorsed midwives may issue a prescription for an abortion drug (MS-2 Step) to a patient.  MS-2 Step is indicated in females of childbearing age for the medical termination of an intrauterine pregnancy, up to 63 days of gestation.

Nurse practitioners and endorsed midwives are also authorised to supply or administer an abortion drug to the pregnant patient when the prescription is issued by a medical practitioner or another prescribing practitioner.

Nurse practitioners and endorsed midwives have certain obligations which are detailed in the questions below.

Pharmacists

A pharmacist is authorised to supply an abortion drug to the pregnant patient when prescribed (that is, the prescription is issued by a medical practitioner or a prescribing practitioner the pharmacist can dispense the abortion drug to a patient).

Restrictions on dispensing have also been lifted by the Therapeutic Goods Administration (TGA) (external site)

Other registered health practitioners

A registered health practitioner in a relevant health profession is authorised to supply or administer an abortion drug to the pregnant patient when the prescription is issued by a medical practitioner or an endorsed midwife or a nurse practitioner. Relevant health profession means the following fields: an Aboriginal and Torres Strait Islander health practice, medical, nursing, midwifery and pharmacy.

In addition, registered health practitioners in one of the relevant health professions or a student in one of these professions, is authorised to assist in the performance of an abortion being performed by a medical practitioner or prescribing practitioner (nurse practitioner or endorsed midwife).  Assisting relates to activities that would normally fall within the scope of practice of the particular registered health practitioner e.g. a registered nurse or student may set up the operating theatre for a surgical abortion.

Training for MS-2 Step

Prescribing the MS–2 Step

The new laws allow medical practitioners, nurse practitioners and endorsed midwives to prescribe the abortion drug within their scope of practice. Under the Therapeutic Goods Administration (TGA) (external site), no additional training is required, although practitioners may wish to undertake training.

MS-2 Step is indicated in females of childbearing age for the medical termination of an intrauterine pregnancy, up to 63 days of gestation.

For more informaiont visit the MS 2 Step website (external site).

Practitioner requirements by gestational age

Requirements of the medical or prescribing practitioner for gestations not more than 23 weeks

The historical legislated provisions requiring a pregnant patient to undergo mandated counselling in order for a health practitioner to obtain the patient’s informed consent for the abortion have been removed. In practical terms, this negates the need for a pregnant patient to see two medical practitioners prior to accessing an abortion up to and including 23 weeks (23+0).

Under the new legislation, a minimum of one registered health practitioner (medical or prescribing) is permitted to provide an abortion service for a patient with a pregnancy gestation not more than 23 weeks i.e. up to and including 23 weeks (23+0).

Informed consent must be obtained from the pregnant patient in line with existing standards of care and professional obligations.

Free, non-directive pregnancy options support and counselling (external site) continue to be available.

For information on informed consent go to WA Health Consent to Treatment Policy

For information on pregnancy choices go to: King Edward Memorial Hospital - Pregnancy choices (including abortion) (external site)

Requirements of the medical practitioner for gestations more than 23 weeks

Only a medical practitioner (the primary practitioner) is authorised to perform an abortion on a patient who is more than 23 weeks pregnant. The primary practitioner is not necessarily the first medical practitioner the patient visits; they may be the medical practitioner to whom the patient is referred, to perform the abortion. The primary practitioner must consider whether performing the abortion is appropriate in all circumstances.

In making a determination, the primary practitioner must take into account:

  • all relevant medical circumstances
  • current and future physical, psychological and social circumstances
  • professional standards and guidelines commonly accepted by members of the medical profession in relation to the performance of the abortion.

The primary practitioner must also consult with at least one other medical practitioner who, having also taken into account the above considerations, reasonably believes that performing the abortion is appropriate in all the circumstances. The primary practitioner must obtain informed consent from the pregnant patient in line with existing standards of care and professional obligations

What does more than 23 weeks mean?

Gestation is measured in weeks and days that have passed since the first day of the patient’s last menstrual period (LMP). If the LMP is not known, an early ultrasound enables calculation of the gestation. More than 23 weeks gestation means that the gestation of the pregnancy is at least 162 days or 23 weeks and 1 day or older.

For abortion at greater than 23 weeks, can the primary practitioner refuse to participate?

Yes.  If the primary practitioner considers all circumstances above and makes the determination that an abortion is not appropriate, then they do not have to participate in the abortion care.  They are not obliged to refer to another practitioner, although, they may refer or provide other relevant information.

If the primary practitioner objects to participation in an abortion prior to considering whether performing an abortion on a patient is appropriate in all circumstances, this then may be considered ‘conscientious objection’ and the practitioner must follow the pathway for conscientious objection (PDF 500KB).

Consent

A registered health practitioner is required to obtain informed consent from the pregnant patient in line with existing standards of care and professional obligations.

The historical legislated provisions requiring a pregnant patient to undergo mandated counselling in order for a health practitioner to obtain the patient’s informed consent for the abortion have been removed.

What consent is required for an abortion on an adult without capacity to consent?

Where a pregnant adult is unable to make reasonable judgements about abortion care, the law enables relevant parties to apply to the State Administrative Tribunal (SAT) to make a decision on their behalf.

A guardian previously appointed to the pregnant adult under the Guardianship and Administration Act 1990 is not permitted to give consent to an abortion on the pregnant adult’s behalf. A specific application to the SAT is required to seek decision and consent for an abortion.

More information on how to apply to the SAT is available on their website (external site).

Help cards for how to register to the eCourts Portal and how to make an application to the Tribunal using the eCourts Portal.

What consent is required for an abortion on a patient aged less than 18 years?

Mature Minors

A pregnant patient aged less than 18 years is not required to involve their parent or guardian in their abortion decision if they have been assessed as having sufficient understanding and intelligence to consent to their own medical treatment.

Non-mature Minors

If a pregnant patient aged less than 18 years is deemed not competent to make a medical decision, they can:

  • agree to allow the registered health practitioner to defer to their parent or guardian for a decision. In this circumstance, the health practitioner may obtain informed consent from the parent or guardian.
  • refuse to allow the registered health practitioner to defer to their parent or guardian for a decision. In this circumstance, the registered health practitioner must apply to the Supreme Court or Family Court of WA for a decision on whether the abortion should occur.
Conscientious objection by health professionals

A practitioner who will not participate in an abortion, and who objects to providing advice on abortion, still has professional obligations to fulfill. 

When a registered health practitioner has been requested by a patient for information on abortion or has been asked to participate in an abortion and has a conscientious objection to abortion, the practitioner must disclose their conscientious objection to the patient immediately.

A medical practitioner or prescribing practitioner (nurse practitioner or endorsed midwife) who will not participate in an abortion for any reason (including conscientious objection) must, without delay, refer the patient to a health practitioner or health facility which they believe can provide the requested service(s); or give the patient information that has been approved by the Chief Health Officer (PDF 500KB), about how the requested services can be accessed.

Practitioners who cannot participate in an abortion for other reasons

A practitioner may determine that they are not able to participate in an abortion for reasons other than conscientious objection. This could include when a practitioner, having considered the clinical details of a case, determines that performing an abortion is outside of their scope of practice.

A medical practitioner or prescribing practitioner (nurse practitioner or endorsed midwife) who will not participate in an abortion for any reason (including conscientious objection) must, without delay, refer the patient to a health practitioner or health facility which they believe can provide the requested service(s); or give the patient information that has been approved by the Chief Health Officer, about how the requested services can be accessed.
Notification

Under the new legislation, some statutory notification requirements will change.

Interim WA Abortion care clinical guidelines

Register to provide feedback on the interim WA Abortion care clinical guidelines (PDF 2MB).

Health service providers, clinicians, administrators and other interested parties are encouraged to register their interest to provide feedback.

The intention is that feedback on the interim Abortion care clinical guidelines (PDF 2MB), will take place in October 2024, 6 months after legislation came into effect.

To register your interest email direct to: HealthPolicy@health.wa.gov.au with the subject heading Interim WA Abortion care clinical guidelines feedback registry.

Interested people would be required to submit their feedback via an online survey.

About the interim Abortion care clinical guidelines

The guidelines are designed to assist healthcare professionals to provide care to women and pregnant people requesting an abortion. Over time this work is likely to evolve into a statewide Standard of Care

The WA Department of Health has released the interim Abortion care clinical guidelines with permission and under license from Queensland Department of Health to reproduce and adapt the industry recognised guidelines: Clinical Guidelines – Termination of Pregnancy (Qld Guidelines).

There is a high level of confidence that the clinical information in the interim WA guidelines is valid and reliable. However, addition of culturally appropriate Aboriginal and culturally and linguistically diverse guidance, where care considerations may differ, would strengthen the WA guidelines. 


More information

For further information please contact us at abortionlaws@health.wa.gov.au

Last reviewed: 26-03-2024