New South Wales decriminalised abortion in 2019 – but it’s still inaccessible for many people in the state.
In February, the Greens NSW spokesperson for health, Dr Amanda Cohn, introduced a new bill in the state’s upper house seeking to amend the Abortion Law Reform Act 2019 to improve access to services, particularly in regional and rural parts of the state where there arevast abortion deserts.
The bill’s second and third readings last week prompted heated debate in parliament. It also spilled out on to the steps, with an anti-abortion rally attended by prominent campaigners, including the former prime minister Tony Abbott.
A watered down version of Cohn’s original bill passed the Legislative Council late Thursday. This week it will move to the Legislative Assembly, with debate expected to begin on Tuesday afternoon, and if passed it will become law.
Amid all the loud voices on this issue, what’s the debate around NSW’s abortion law reform actually about?
Cohn’s Abortion Law Reform Amendment (Health Care Access) Bill 2025 had four key components when it was introduced:
Ensure abortion services are provided across the state within a reasonable distance of residents’ homes, and giving the health minister the power to compel public health services to comply with any directions to offer abortion services. Information about access to abortion services also needed to be publicly available;
Expand access by allowing nurse practitioners and endorsed midwives to prescribe medical abortions up to nine weeks gestation;
Require practitioners who object to abortion to refer a patient to someone who will provide the service;
Remove unnecessary mandatory reporting requirements to give the health ministry information about the termination, which create barriers for practitioners.
The bill was passed in the upper house with significant amendments so that only the second component – enabling nurse practitioners and endorsed midwives to prescribe medical abortion care – would come into law if the bill also passed the lower house. A surgical abortion is a procedure undertaken in a clinical setting, while a medication or medical abortion involves taking prescribed abortion pills.
Cohn told Guardian Australia that the bill as originally drafted included a duty for the public health system to provide abortion services. “This is something that can be achieved without legislative change, and the Greens will continue to advocate for services to be funded in public hospitals, as promised by the premier,” she said.
In December Guardian Australia revealed thatjust three of NSW’s 220 public hospitals were routinely providing surgical abortions.In response,Cohn said “far too little has changed”since abortion was decriminalised in the state.
When Cohn introduced the bill,she saidexpanding who could perform medical terminations was necessary to bring the state’s legislation in line with changes made by the national medicines regulator, the Therapeutic Goods Administration, in 2023. Cohn said this had been one of three recommendations of the NSW Health review of abortion lawpublished in September.
Many members supported the bill but also voted in favour of the amendments on access to abortion care.
Penny Sharpe, the leader of the government in the Legislative Council, said she understood “the issue of access is real” but said “legislating this will not fix the problem. We do not legislate to require health ministers to provide cancer services or heart services in this way.”
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Many Legislative Council members said they opposed Cohn’s bill to strengthen the 2019 legislation for the same reasons they opposed the original law.
In theparliamentary debate on the bill last Tuesday,the upper house Liberal MP Chris Rath compared abortion to the Nazi genocide of Jews, arguing “it is bizarre that abortion is increasingly being categorised as a human right to health care”.
Rath later told the Sydney Morning Herald in a statement that he regretted and apologised for the insensitive language used. Rath was contacted for comment.
A rally against the NSW abortion bill was organised last Wednesday night outside the steps of parliament by theanti-abortion campaigner Joanna Howe’s coalition, which was attended by Abbott and the Catholic archbishop of Sydney, Anthony Fisher.
The rally’s poster stated the “NSW Greens have tabled a bill that could force the closure of Christian hospitals and compel all health workers to be involved in abortions” – claims which wereechoed by Abbott on Sky News later that evening.
Cohn had already addressed concerns about the impacts of the part of the original bill on faith‑based hospitals that are part of the public health system.
“While I know that there are many people who believe these hospitals should have to provide abortion services, that is actually not what is proposed by this bill,” Cohn said.
“The handful of faith-based hospitals in the public system are located in metropolitan areas close to public hospitals, and there would be no reason for the minister to direct these hospitals to do anything to fulfil the requirement that abortion services are available within a reasonable distance of where people live.”
Cohn said advocates for women’s rights and reproductive rights have been anxious that hard-fought rights could be eroded, especially with the impact of abortion bans in several US states.
“In this context, it’s significant for the NSW parliament to not only uphold, but improve reproductive rights – especially in the face of an organised campaign of disinformation that has caused considerable distress in the community.”
She said the change in law to allow nurse practitioners and endorsed midwives to prescribe medical abortions has the support of the minister and shadow minister for health, as well as NSW Health, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Ranzcog), Family Planning Australia, the NSW Nurses and Midwives’ Association, the Royal Australian College of General Practitioners, and the AMA (NSW).
According to medical groups, yes. Dr Gillian Gibson, the president of Ranzcog, said the inclusion of nurse practitioners and endorsed midwives in the provision of early medical abortion is a “safe, evidence-based reform – and a necessary step toward ensuring timely, equitable, and patient-centred access to abortion services for women across NSW”.
International evidence from comparable jurisdictions such as Canadashowed enabling nurse practitioners and midwives to deliver this care resulted in the frequency of early medical abortions to rise substantially, while the overall abortion rate remained stable because less surgical abortions were needed.