Following changes introduced by SA Health in 2019, all surgical abortions were relocated from the main abortion provider in the state, the Pregnancy Advisory Centre (PAC) at Woodville, and into the Queen Elizabeth Hospital.

The decision was due to concerns that the PAC’s ageing operating theatre no longer met safety standards.

Now, women are consulted and have medical abortions performed at the PAC’s Woodville site, but those requiring surgery – including for pregnancies of more than seven weeks – must go to the Queen Elizabeth Hospital’s day surgery ward.

Australian Medical Association SA obstetrician and gynaecologist representative Dr Brian Peat said it was not safe for surgical abortions to performed in general operating theatres, as some women “may come up against people who have different views” about abortion, which could be a “traumatic” experience.

“There’s a lot of people there (at the Queen Elizabeth Hospital) having all sorts of things done – colonoscopies and things like that – so it’s not really a safe environment for a client having an abortion,” he told InDaily.

“There’s lots of awkward things, for example, if someone is having medication to start the process of their abortion and they start to get pain and bleeding, they have to go onto a bed and to do that they have to go into recovery with all the other recovery patients, which just is not ideal.

“If we are going to protect that clientele through this difficult situation then safety is a big element.”

Peat, who is also a member of the South Australian Abortion Action Coalition, which successfully lobbied state parliament to decriminalise abortion last year, said past governments had promised that the PAC would have a “new home”, but “nothing had come to fruition”.

He said a current $314 million redevelopment of the Queen Elizabeth Hospital did not include space for the PAC and the government had previously indicated that it was unwilling to renovate the Woodville theatre to bring it up to standard.

“Our ideal model is going back to what we had originally, but maybe adjacent to a hospital,” he said.

One suggestion is to move the PAC into the new $3.2 billion Women’s and Children’s Hospital at the police barracks site.

Peat said the new hospital scheduled to open in 2030-2031 was a “natural fit” for the PAC, provided the centre remained “its own little silo” so that women could be treated by doctors in a separate area away from other patients.

“I think when you think about it from a safety point of view, where that works really well is where you have a dedicated team and a dedicated service with the possibility of being able to call in expertise as you need it,” he said.

“Some people see a contradiction between saving a preterm baby at great expense and terminating another one, but I don’t see any contradiction there because one person wants their baby and another person for whatever reason doesn’t want to be a parent.

“It seems to me just perfectly reasonable that these things should be side-by-side, but obviously clients don’t want to be side-by-side.

“They want to be in the same campus for referral if there are complications and things like that.”

Peat acknowledged that waiting for the new hospital to open by 2031 was “kicking the can further down the road”, but he said there were no other options.

“If it’s not going to be included into the Queen Elizabeth then the next option is to put it into the Women’s and Children’s,” he said.

“That’s what a lot of people that I talk to are saying – they would like to see that in the long-run.”

In the meantime, Peat said PAC staff were “doing the best job they can”, but they were “forever having to deal with problems that they can’t solve”.

“Every day people will grizzle about what they couldn’t do because of the space limitations,” he said.

“That’s not uncommon across the medical service at the moment, but this is just one of those.”

InDaily contacted SA Health for comment.

The PAC is Australia’s only dedicated, publicly-funded service for women with an unplanned pregnancy and celebrated its 30th anniversary earlier this year.

According to its website, it offers “non-judgemental, client-centred multidisciplinary health services for women”, including counselling and support for women with an unplanned pregnancy.

Latest SA Health data shows in 2020, there were 4662 abortions recorded in South Australia, compared with 4462 the year prior.

The abortion rate in South Australia has been declining over the past decade, despite slightly increasing in the most recent reporting year.

Overall, in 2020, 150 women with complications progressed to a surgical abortion, including 138 who had a termination of pregnancy with Mifepristone and Misoprostol as the initial procedure.

Legislation to decriminalise abortion was implemented in July this year.