Image: via freepik @ijeab
The New South Wales government is considering expanding the role of nurses and midwives by allowing them to prescribe medical abortion under a new bill.
The proposed legislation would also require doctors with conscientious objections to refer patients to abortion providers. The change aims to improve access to abortion services and enable healthcare professionals to take on more responsibility in reproductive care.
The bill is designed to implement key recommendations from an NSW Health review of the Abortion Law Reform Act, which found that vulnerable women, especially those in rural areas or unable to afford private clinics, face significant obstacles in accessing terminations.
NSW Health released its report on the Statutory Review of the Abortion Law Reform Act 2019, which included feedback from stakeholders and key recommendations.
The review’s findings and recommendations came just days before the Greens tabled the Abortion Law Reform Amendment (Health Care Access) Bill 2025 in the NSW Parliament on Tuesday, February 11. The proposed bill aims to:
- Allow nurse practitioners and enrolled midwives with proper training to prescribe medical abortions, in line with TGA guidelines, up to 9 weeks gestation.
- Remove mandatory reporting requirements deemed excessive for practitioners.
- Mandate local health districts to provide abortion services at no cost, with clear, publicly available information on how to access these services.
- Require practitioners with conscientious objections to refer patients to abortion providers.
Ministry’s Recommendations for Expanding Prescription Rights for Abortion
The Ministry, after reviewing submissions, consulting with the NSW Health Safe Access to Abortion Care Working Group, and considering recent legislative changes in other states, recommends amending the Act to allow qualified health practitioners, other than medical doctors, to prescribe MS-2 Step® for medical terminations.
The report also calls for changes to section 82 of the Crimes Act to support this. It emphasises the inclusion of nurse practitioners and endorsed midwives in prescribing the medication.
Dr Amanda Cohn, Greens spokesperson for Health including Mental Health, former GP and medical abortion provider stated that the review confirmed what “we already know” – the significant challenges in accessing abortions in NSW and the urgent need for reform.
“As a former prescriber of medical abortion, I know this is medically straightforward health care, but people are still blocked by cost, stigma, and geography,” Dr Cohn said.
“With reproductive rights rapidly being eroded in the US, it’s never been more important to enshrine access to abortion in our public health system here in NSW. The recommendation to allow nurses and midwives with appropriate training to prescribe medical abortion is common sense and already in place in other states,” Dr Cohn stated.
Dr Cohn stated that changing laws would not fix the issue, calling on the NSW government to fund abortion services in public hospitals and offer support to health workers providing this care.
Half of Australian Pregnancies Unplanned, One-Third of Women Experience Abortion
According to Children by Choice, a non-profit organisation committed to providing evidence-based information on all pregnancy options, it is estimated that half of all pregnancies in Australia are unplanned and that half of those are terminated. It is also estimated that between one quarter and one third of Australian women will experience an abortion in their lifetime.
A report from Family Planning Australia released last year called Use of medical abortion services in New South Wales Australia between 2018-2022 found that women in regional and rural NSW seek medical abortion at more than double the rate of city women.
In very remote NSW there were 10 medical abortion prescriptions issued for every 1,000 women in 2022 and in major cities there were just 4.2 prescriptions for medical abortions for every 1,000 women.
The report raises concern that while many abortions can be provided in clinics and GP offices, the shortage of prescribers in certain regions may leave patients needing assistance from public health, not-for-profit agencies, and private providers to access care.
Expanding the role of nurse practitioners and midwives to prescribe medical abortions would reduce the burden on doctors and ensure individuals have the right to exercise their reproductive and bodily autonomy.
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