Barrier to abortion access

Barriers to Termination of Pregnancy in Australia: Cost, Access, and the Importance of Affordable, Local Care

Access to safe and legal abortion is a fundamental part of reproductive healthcare, yet many people across Australia still face significant barriers to termination of pregnancy — particularly when it comes to cost, geography, and service availability. These obstacles can delay care or prevent access altogether, especially for people experiencing an unplanned pregnancy.

If you are exploring your pregnancy options, read more here.

1. Cost and Financial Insecurity

Even though medical termination of pregnancy (MTOP) is partially covered by Medicare, the out-of-pocket costs for abortion can be prohibitively high. In many private clinics across Australia, a medical abortion can cost anywhere from $250 to $600 or more. For people who are unemployed, studying, caring for others, or in financial distress, this creates a major barrier to timely access.

2. Geographic Isolation

People living in rural and remote areas of Australia face unique challenges when seeking an abortion service. There may be no local providers, and accessing a clinic could require significant travel, accommodation, and time off work or study — all of which add to the emotional and financial burden. Even within cities like Brisbane, some suburbs lack accessible services.

3. Limited Provider Availability

Not all GPs provide medical abortions, and referral pathways can be unclear or fragmented. Patients are sometimes told that their doctor "doesn't do that here" without being given clear information on where to go next. Delays in accessing care can reduce the available options, particularly for medical abortion which is only offered up to 9 weeks’ gestation.

4. Stigma and Privacy Concerns

Although abortion is legal, abortion stigma remains a real concern for many people, particularly in smaller or more conservative communities. Fear of being judged, concerns about confidentiality, or even past negative experiences with the healthcare system can stop someone from seeking help.

5. Misinformation and Confusion

Many people are unaware of their legal rights when it comes to abortion in Queensland and may not know that telehealth abortion is an option. Confusion around gestational limits, the difference between medical and surgical abortion, and concerns about safety or side effects may cause unnecessary anxiety and delay.

Low-Cost Medical Abortion in Brisbane — In Person or Via Telehealth

To help address some of these barriers, I now offer low-cost medical termination of pregnancy in Brisbane at Gladstone Road Medical Centre, located in Highgate Hill. This service includes:

• A thorough consultation and bulk-billed follow-up care

• A $25 gap fee or bulk billing available on request

• Access to care in person or via telehealth, anywhere in Queensland*

Whether you're seeking abortion care in Brisbane or need telehealth abortion services from a more rural* area, I aim to provide respectful, inclusive, and affordable support. No referral is required.

If you're experiencing an unplanned pregnancy and want to discuss your options, you can book online at mitchkrosch.com or contact Gladstone Road Medical Centre directly. Everyone deserves timely, compassionate reproductive care — without financial or geographic barriers.

*You must be within two hours drive of an emergency department, in case of a complication.

10 Facts About Endometriosis

1. Endometriosis affects 1 in 9 people assigned female at birth.

Endometriosis is a chronic inflammatory condition estimated to affect around 1 in 9 people assigned female at birth by age 44 in Australia. It can have profound impacts on quality of life, including pain, fatigue, fertility concerns, and impacts on work and relationships.
📚 Source: Australian Institute of Health and Welfare. Endometriosis in Australia: Prevalence and hospitalisations

2. It’s more than “just bad periods.”

While period pain is common, the pain of endometriosis is often chronic, disabling, and can occur outside of menstruation. Dismissing it as “normal” can delay diagnosis and care.
📚 Source: Endometriosis Australia. Understanding Endometriosis

3. Pain during sex, or while going to the toilet can be a sign.

Endometriosis lesions can affect pelvic organs, leading to pain with intercourse (dyspareunia), bowel movements, or urination, especially during menstruation.
📚 Source: World Health Organization. Endometriosis fact sheet (2023)

4. It often starts in the teenage years.

Symptoms of endometriosis can begin soon after the onset of periods (menarche), but many teens are dismissed or misdiagnosed, increasing the emotional and physical toll.
📚 Source: American College of Obstetricians and Gynecologists. Endometriosis in adolescents

5. Diagnosis can take up to 7 years.

On average, people with endometriosis wait 6.5 to 7 years for a diagnosis due to normalisation of symptoms and lack of awareness among healthcare providers.
📚 Source: AIHW. Endometriosis in Australia

6. You don’t need visible endometriosis to have severe pain.

Pain severity doesn’t always correlate with how much disease is seen on imaging or laparoscopy. Even microscopic or deep infiltrating lesions can cause disabling symptoms.
📚 Source: Royal College of Obstetricians and Gynaecologists. Endometriosis: diagnosis and management

7. Fertility problems are common—but not inevitable.

Up to 50% of people with endometriosis may experience infertility, but many still conceive naturally or with assisted reproductive technologies. Early management and support matter.
📚 Source: ASRM. Endometriosis and infertility: A committee opinion

8. Hormonal treatments don’t cure it—but can help.

Medications like the pill, progestins, and GnRH analogues may reduce pain and slow progression, but they do not eliminate endometriosis. They are part of a toolbox—not a fix.
📚 Source: NICE Guidelines. Endometriosis: diagnosis and management (NG73)

9. Surgery can help—but isn’t always the answer.

Laparoscopic excision can reduce pain and improve fertility—but not all patients benefit, and recurrence is possible. Surgery is most effective when combined with long-term care.
📚 Source: Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Endometriosis

10. There is support—and you deserve care.

You’re not alone. Advocacy groups, specialist GPs, pelvic physios, and psychologists can all help. Early recognition and a multidisciplinary approach can make a huge difference.
📚 Source: Jean Hailes for Women's Health. Managing endometriosis

For amazing Queensland based support, look at qendo.org.au.

Struggling With Low Iron? You Might Need More Than Just Tablets

Disclaimer: This article is for general information only and does not replace personalised medical advice. If you’re concerned about fatigue or iron deficiency, please speak to your GP.

Feeling tired all the time? You’re not alone. Fatigue is one of the most common reasons people visit their GP. And one of the biggest causes? Low iron, also known as iron deficiency. Many people — and even some doctors — don’t realise just how much iron deficiency can affect your energy levels, mood, and quality of life. So let’s break it down.

What Does Iron Actually Do?

Iron is essential for your body to make red blood cells. These red blood cells carry oxygen around your body — to your brain, muscles, and every other organ. If your iron levels stay low for long enough, you might become anaemic — which means you don’t have enough haemoglobin or red blood cells to carry oxygen efficiently. Anaemia can cause serious health problems. But here’s the important part: you don’t have to be anaemic to feel awful.

There’s strong evidence now that iron deficiency alone — even without anaemia — can cause significant fatigue.

Why Do People Become Iron Deficient?

There are a few common reasons iron levels drop:

• Not enough iron in your diet – Red meat is the richest source of iron, but plant-based eaters need to pay special attention to getting enough iron through other foods (like legumes, leafy greens, and fortified cereals).

• Losing iron through bleeding – This could be heavy periods or, more concerningly, bleeding from the bowel.

• Pregnancy and breastfeeding – These are times when your iron requirements go up significantly.

If you’ve been told you’re low in iron, your doctor should help you figure out why — because that helps determine the best treatment approach. Sometimes a dietitian can help you boost your intake, and sometimes managing bleeding (such as with an implanon or IUD) can reduce iron loss.

Iron Tablets: A Good First Step

If you’re iron deficient, your doctor might recommend trying iron supplements first. And here’s a handy tip: taking iron every second day actually helps your body absorb it better.

For many people, iron tablets are effective — but not for everyone.

Some people:

• Don’t absorb iron well through the gut

• Can’t tolerate the side effects (like nausea, constipation or stomach pain)

• Or just never get their levels up despite months of tablets

But What If Tablets Don’t Work?

This is where things get frustrating. Too often, people try iron tablets, feel unwell, and then… give up. They live with ongoing fatigue, brain fog, poor sleep, low mood, or worsening menstrual symptoms — all linked to iron deficiency.

But it doesn’t have to be that way.

If tablets don’t work (or just aren’t realistic for you), there’s another option: iron infusions.

Iron Infusions: An Underrated Game Changer

Iron infusions are safe, fast, and often life-changing. They deliver iron directly into your bloodstream through a drip, bypassing the gut. Most people feel significantly better within a few days to a few weeks.

So why aren’t they used more?

• Some doctors are unsure of the guidelines

• Others are concerned about rare side effects

• Cost and access can be a barrier for many patients

• And sometimes… we just don’t talk about it enough

But for the right person, an iron infusion can mean the difference between just getting through the day — and actually enjoying it.

What’s Involved in an Iron Infusion?

• A small cannula is placed into a vein in your arm

• The iron is infused slowly over 15–30 minutes (sometimes longer)

• You’ll be monitored for a short time afterwards to make sure you feel okay

There is a very small risk of an allergic reaction, but this is extremely rare, especially with the newer iron formulations we use today. Some people get a temporary metallic taste, or feel a bit achey afterwards. Most people tolerate infusions really well.

The Bottom Line

If you’ve been told you have low iron, and you’re still feeling exhausted — don’t settle. Ask your doctor if an infusion might be right for you. You deserve to feel better, and iron deficiency is both common and treatable.

Sometimes a simple iron check — and the right treatment — can completely turn things around.

Ready to Feel Better?

If you’re struggling with fatigue, low mood, or poor concentration and wondering if iron could be part of the picture — book an appointment to chat about testing and treatment options, including infusions.

You don’t have to keep running on empty. Let’s figure it out together.

Bacterial vaginosis breakthrough study

A recent groundbreaking study has unveiled a significant shift in our understanding and treatment of bacterial vaginosis (BV), a common vaginal infection affecting nearly one in three women. Traditionally, BV was viewed as an imbalance in vaginal bacteria, not classified as a sexually transmitted infection (STI). However, new research indicates that BV can be sexually transmitted, and treating both female patients and their male partners simultaneously leads to higher cure rates and reduced recurrence.

Understanding Bacterial Vaginosis

BV occurs when there's an overgrowth of certain bacteria in the vagina, disrupting the natural balance. This imbalance can cause symptoms like a fishy odour, unusual discharge, and discomfort, though some women may not experience noticeable signs. If left untreated, BV can lead to complications, including an increased risk of acquiring other STIs and issues during pregnancy.

The Landmark Study

Researchers from Monash University and Alfred Health conducted a study involving 164 heterosexual couples, where women diagnosed with BV were treated alongside their male partners. The men received a combination of oral antibiotics and topical antibacterial cream. The results were striking: BV recurred in only 35% of women whose partners were also treated, compared to 63% in the control group where only the women received treatment.

Implications of the Findings

This study challenges the previous notion that BV is not sexually transmitted and highlights the importance of treating both partners to prevent reinfection. The findings suggest that men can harbor BV-associated bacteria and transmit them back to their female partners, leading to recurrence. By treating both individuals, the cycle of reinfection can be broken, offering more effective management of BV.

What This Means for You

If you or someone you know is dealing with recurrent BV, it's essential to consider the role of sexual partners in treatment. Here are some steps to take:

• Consult Your Healthcare Provider: Discuss the possibility of simultaneous treatment for both you and your partner. This approach may significantly reduce the chances of BV returning.

• Practice Safe Sex: Using condoms can help reduce the transmission of BV-associated bacteria between partners.

• Maintain Vaginal Health: Avoid practices that can disrupt the natural balance of bacteria in the vagina, such as douching or using scented products.

Looking Ahead

While this study marks a pivotal step in understanding BV's transmission and treatment, further research is needed to develop comprehensive prevention strategies and update clinical guidelines. In the meantime, awareness of the potential for sexual transmission and the benefits of treating both partners can empower individuals to take proactive steps toward better vaginal health.

Vodstrcil, L. A., Plummer, E. L., Fairley, C. K., Hocking, J. S., Law, M. G., Petoumenos, K., Bateson, D., et al. (2025). Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. New England Journal of Medicine, 392(10), 947-957. https://doi.org/10.1056/NEJMoa2405404

Which IUD should I choose?

If you're thinking about getting an intrauterine device (IUD) for contraception, you might be wondering which one is best for you. In Australia, there are three types of IUDs available: Mirena, Kyleena, and the Copper IUD. Each has its own benefits and drawbacks, so let's break it down to help you decide.

Kyleena size comparison

There are three IUDs to choose from in Australia:

1. Mirena - levonorgestrel 52mg

2. Kyleena - levonorgestrel 19mg

3. Copper IUD

Mirena —

• Mirena can stay in place for up to 8 years.

• Mirena is larger than Kyleena but similar in size to the Copper IUD.

• The Mirena is inserted in a similar way to the other IUDs. Some people experience cramping during and after insertion, but pain relief options can help.

• Mirena is over 99% effective at preventing pregnancy.

Best suited for:

• Mirena is a good choice for both people who have had children (parous) and those who haven’t (nulliparous). Because it's slightly larger, some people who haven’t had children may find insertion more uncomfortable. If we can time the insertion during or just after your period, the insertion tends to be more straightforward. It is also one of the best methods to reduce or stop heavy menstrual bleeding or irregular cycles.

Risks:

• Irregular bleeding or spotting in the first 4-6 months

• Possible hormonal side effects like mood changes or breast tenderness ( though this is much less likely than other hormonal methods such as The Pill)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Kyleena —

• Kyleena can stay in place for up to 5 years.

• Kyleena is smaller than Mirena and the Copper IUD, making it a good option for people who prefer a smaller device.

• Kyleena is over 99% effective at preventing pregnancy.

Because it is smaller, Kyleena may be slightly easier and more comfortable to insert than Mirena, especially for people who haven’t had children.

Best suited for:

• People who have never been pregnant (nulliparous) because of its smaller size. It is also a good option for those who want a lower dose of hormones than Mirena.

Risks:

• Irregular bleeding or spotting, especially in the first few months

• Possible hormonal side effects (probably less than with Mirena)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Copper IUD —

• The Copper IUD can stay in place for 5 to 10 years, depending on the type.

• The Copper IUD is similar in size to the Mirena.

• The procedure is the same as with hormonal IUDs, and some cramping is normal during and after insertion. The Copper IUD does not contain hormones, which can be a benefit for those who want a completely non-hormonal option.

• The Copper IUD is over 99% effective at preventing pregnancy. It can also be used as emergency contraception if inserted within 5 days after unprotected sex.

Best suited for:

• The Copper IUD is suitable for both parous and nulliparous people. However, those who already experience heavy or painful periods may find that the Copper IUD makes this worse.

Risks:

• May cause heavier, longer, or more painful periods

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Which One is Right for You?

• If you want long-term contraception with light or no periods, Mirena might be the best choice.

• If you want a smaller IUD with fewer hormones, Kyleena is a great option.

• If you prefer a hormone-free method, the Copper IUD is your best bet.

All IUDs are highly effective, long-term contraception options, but the right one for you depends on your body and preferences. Talk to your doctor to discuss what suits you best!

What to Expect During an IUD Insertion

Thinking about getting an IUD (Intrauterine Device) but feeling a bit nervous about the procedure? You’re not alone! Many people have questions about what to expect, and it’s completely normal to have some concerns. The good news is that IUD insertion is a quick, routine procedure that provides long-term, highly effective contraception. In this post, we'll walk you through what happens before, during, and after the insertion so you can feel informed and prepared.

What is an IUD?

An IUD is a small, T-shaped device that sits inside the uterus to prevent pregnancy. There are two main types:

• Hormonal IUDs (Mirena or Kyleena) - These release a small amount of progestogen, which thickens cervical mucous and thins the lining of the uterus.

• Copper IUDs - These are hormone-free and work by creating and environment that is toxic to sperm.

Both types are over 99% effective and can last between 5-10 years, depending on the type you choose.

Before the Appointment

1. Consultation with Your Doctor

Before getting an IUD, you’ll have a chat with your doctor to discuss your medical history, contraception needs, and which IUD is best for you. They may also perform a pelvic exam or STI screening to ensure there are no infections before insertion.

2. Preparing for the Procedure

Here are a few tips to make your appointment smoother:

• Take ibuprofen and paracetamol about 30-60 minutes before your appointment to help with discomfort.

• Eat a light meal beforehand to avoid feeling lightheaded.

• Bring a pad or panty liner in case of light spotting afterward.

• Ideally, have someone drive you to and from the appointment (in case you feel a little crampy or lightheaded afterwards).

During the insertion

The actual procedure only takes a few minutes and happens in a standard GP or clinic room. Here’s how it works:

1. Positioning & Examination

You’ll lie on an examination table (similar to a Pap smear position). The doctor will insert a speculum to gently open the vagina, allowing them to see the cervix.

2. Measuring the Uterus

The cervix is gently grasped, which can cause a pinching feeling (although a lot of people don’t feel anything). A small instrument called a sound is used to measure the depth of your uterus to ensure proper placement of the IUD. This may cause a brief cramping sensation.

3. Inserting the IUD

The IUD is introduced via a thin tube, which is inserted through the cervix into the uterus. Once in place, the arms of the IUD open up, and the tube is removed. The doctor will trim the IUD strings, which stay inside the vagina so the IUD can be checked or removed later.

4. All Done!

The entire process usually takes 5-10 minutes.

After the procedure

1. How Will I Feel?

• Mild to moderate cramping (like period pain) is common for the first few hours.

• Light spotting or irregular bleeding may occur for a few weeks.

• Some people feel totally fine right away, while others may prefer to rest for a little while.

2. What to Watch For

While complications are rare, contact your doctor if you experience:

• Severe pain or heavy bleeding

• Fever or unusual discharge (possible infection)

• Inability to feel the IUD strings (which may indicate it has moved)

3. When Does It Start Working?

• Hormonal IUD: If inserted within the first 7 days of your cycle, it's effective immediately. Otherwise, use backup contraception for 7 days.

• Copper IUD: Works immediately, even as emergency contraception.

Getting an IUD is a safe, quick, and effective way to prevent pregnancy, and for many people, the benefits far outweigh any temporary discomfort. If you’re feeling anxious, remember that your doctor is there to support you and make the experience as comfortable as possible. If you have any concerns before or after the procedure, don’t hesitate to reach out to your GP.

Thinking about getting an IUD? Book an appointment today to discuss your options and find the best contraception for you!