Reform in NSW Abortion Law
Reigniting abortion care discussions … Unsplash
The Abortion Law Reform Amendment (Health Care Access) Bill 2025 (NSW) (‘Abortion Bill’) has reignited the abortion debate in New South Wales (‘NSW’).[1] The Abortion Bill was introduced by Dr Amanda Cohn, member of the Greens party, in the Legislative Council on 19 February 2025.[2] Dr Cohn sought to amend the Abortion Law Reform Act 2019 (NSW) (‘Abortion Law Reform Act’) to increase access to abortion health care.[3]
Since 1900, abortion was explicitly listed as a crime in NSW.[4] NSW was the seventh jurisdiction in Australia to decriminalise abortion in October 2019, shortly after Queensland passed the Termination of Pregnancy Act 2018 (QLD).[5] The Reproductive Health Care Reform Bill 2019 (NSW) was introduced into the Legislative Assembly and amended 32 times before being passed as the Abortion Law Reform Act.[6] It prescribes that a registered medical practitioner may perform an abortion ‘on a person who is not more than 22 weeks pregnant’ after obtaining informed consent.[7] After 22 weeks, abortions can only be performed in a hospital or approved health facility by a specialist medical practitioner who has obtained consent, consulted with another specialist medical practitioner, and ‘considers that, in all the circumstances, there are sufficient grounds for the termination to be performed’.[8]
The Abortion Bill was proposed in response to several NSW hospitals denying women access to abortion services. In November 2024, Orange Hospital reportedly implemented an explicit ban on abortions for non-medical reasons, directing obstetrics and gynaecology team staff to no longer provide abortion services for patients with ‘no identified pregnancy complications’ and ‘send them elsewhere’.[9] The nearest Family Planning Australia clinic, which is two hours from Orange Hospital, does not provide surgical pregnancy terminations and is not open on weekends.[10] Health Minister Ryan Park has since stated that ‘the level of abortion services previously provided at Orange Hospital will be restored’.[11]
The Abortion Law Reform Act provides that registered health practitioners with a conscientious objection to abortion must advise the patient of this as soon as practicable, and provide them with information about an alternative practitioner, or transfer their care to an alternative practitioner.[12] The conscientious objection clause only applies to individual practitioners, and not hospital executives or Local Health Districts (‘LHDs’).[13] The situation at Orange Hospital raised concerns that conscientious objection was being used to hinder access to abortion services.[14]
The Abortion Bill contained provisions mandating that NSW LHDs ensure abortion services are accessible within ‘a reasonable distance’.[15] LHDs would have to provide publicly available information about abortion services.[16] The Abortion Bill also legally requires practitioners with a conscientious objection to abortion to refer a patient to another practitioner who would provide the abortion,[17] rather than simply provide them with information about alternative practitioners. Additionally, it permitted nurse practitioners and endorsed midwives to prescribe medication to terminate pregnancies.[18] This aligns with the 2023 Senate inquiry into universal access to reproductive health care, which recommended that all Australian public hospitals ‘be equipped to provide surgical pregnancy terminations, or timely and affordable pathways to other local providers’.[19] The Committee emphasised that this would improve access to reproductive health care, especially in regional areas.[20] The 2024 statutory review of the Abortion Law Reform Act also recommended allowing qualified nurses and midwives to prescribe abortion medication.[21]
The provisions in the Abortion Bill requiring abortion services to be accessible within a ‘reasonable distance’ of people’s homes and obliging doctors with conscientious objections to abortion to refer a patient to a different practitioner, were stripped out by the Legislative Council.[22] Opponents argued that these provisions were unworkable and a step too far , particularly as other forms of health care, such as cardiac and cancer care, were not required to be accessible within a ‘reasonable distance’.[23] On Wednesday 14 May 2025, NSW passed the Abortion Bill with amendments, allowing nurse practitioners and registered midwives to prescribe abortion medication.[24] This result aligns NSW with all other Australian states and territories excluding Tasmania.[25]
The Abortion Bill has reignited debate in NSW. It received vocal opposition by former Prime Minister Tony Abbott, who told the crowd at a large anti-abortion protest outside Parliament in recent weeks that the Abortion Bill represented a ‘fundamental assault on freedom of conscience’.[26] Furthermore, Liberal MP Anthony Roberts stated that he would not support ‘legislation that increases the number of people who can administer a procedure that takes a life’.[27] In contrast, opposition leader Mark Speakman argued that the Abortion Bill ‘will probably lead to better … health outcomes for many pregnant women seeking abortions’.[28] The Health Minister, Ryan Park, and Shadow Health Minister, Kellie Sloane, also supported the Abortion Bill.[29] This discourse illustrates that there is still disagreement in the public arena regarding abortion access. Now that the Abortion Bill has passed in amended form, its supporters still hope that it will improve access to abortion services in NSW.
Edited by Alison Thai
[1] Abortion Law Reform Amendment (Health Care Access) Bill 2025 (NSW) (‘Abortion Bill’).
[2] Ibid.
[3] Ibid; Abortion Law Reform Act 2019 (NSW) (‘Abortion Law Reform Act’).
[4] Crimes Act 1900 (NSW) ss 82-4.
[5] Termination of Pregnancy Act 2018 (Qld); Anna Walsh and Tiana Legge, ‘Abortion Decriminalisation in New South Wales: An Analysis of the Abortion Law Reform Act 2019 (NSW)’ (2019) 27(2) Journal of Law and Medicine 325, 325.
[6] Reproductive Health Care Reform Bill 2019 (NSW); Abortion Law Reform Act (n 3); Walsh and Legge (n 5) 326.
[7] Abortion Law Reform Act (n 3) ss 5(1)-(2)(b).
[8] Ibid s 6(1)(a)-(d).
[9] Lucy Barbour, ‘Orange Hospital Directs Staff to No Longer Provide Abortions to Patients Without ‘Early Pregnancy Complications’’, ABC News (online, 8 November 2024) <https://www.abc.net.au/news/2024-11-08/orange-hospital-directs-staff-to-stop-providing-some-abortions/104537862>.
[10] Ibid.
[11] Ibid.
[12] Abortion Law Reform Act (n 3) ss 9(1)-(3)(b)(ii).
[13] Barbour (n 9).
[14] Nick Dole, ‘NSW Politicians Will Vote on Abortion This Week. Here’s What Could be Changing’, ABC News (online, 13 May 2025) <https://www.abc.net.au/news/2025-05-13/nsw-politicians-to-vote-changes-abortion-bill-what-are-they/105282854>.
[15] Abortion Bill (n 1) sub-cl 4A(1)(a); Joanna Woodburn, ‘Abortion Law Reform Proposed in NSW After Orange Hospital ‘Ban’’, ABC News (online, 18 February 2025) <https://amp.abc.net.au/article/104944828>.
[16] Abortion Bill (n 1) sub-cl 4A(1)(b); Woodburn (n 15).
[17] Abortion Bill (n 1) sub-cl 9(3)(a).
[18] Ibid sub-cl 5(4).
[19] Community Affairs References Committee, Parliament of Australia, Ending the Postcode Lottery: Addressing Barries to Sexual, Maternity and Reproductive Healthcare in Australia (Report, May 2023) 75.
[20] Ibid.
[21] NSW Health, Report on the Statutory Review of the Abortion Law Reform Act 2019 (September 2024) 5.
[22] Dole (n 14).
[23] Ibid.
[24] Natasha May, ‘Abortion Pills to Be Easier to Access After Greens Bill Passes in NSW Despite Opposition from Tony Abbott’, The Guardian (online, 14 May 2025) <https://www.theguardian.com/world/2025/may/14/nsw-medical-abortion-access-bill-passes-both-houses-ntwnfb>.
[25] Ibid.
[26] Dole (n 14).
[27] May (n 24).
[28] Ibid.
[29] Ibid.