Caroline de Costa

A review of maternal deaths at Goroka General Hospital, Papua New Guinea 2005-2008

Background:  Papua New Guinea is a developing country with a population of six million, facing significant geographical, cultural and economic barriers to the provision of antenatal and intrapartum care. The maternal mortality ratio (MMR) is an internationally regarded index of the quality of a country’s maternity services; the most recently reported MMR for Papua New Guinea of 773 deaths per 100 000 births is one of the highest in the world.

Abortion law across Australia – A review of nine jurisdictions

This article reviews the current legal status of abortion in Australia and its implications. Australian abortion law has been a matter for the states since before Federation. In the years since Federation there have been significant reforms and changes in the abortion laws of some jurisdictions, although not all. Across Australia there are now nine sets of laws, state and Commonwealth, concerned with abortion. The test of a lawful abortion varies greatly across jurisdictions. In a number of states and territories, it is necessary to establish a serious risk to the physical or mental health of the woman if the pregnancy was to continue. In some cases, the certification of two doctors is required, particularly for abortions at later gestations. There are also physical restrictions on access, such as in South Australia and the Northern Territory where abortion must take place in a hospital. Only in the ACT has abortion been removed from the criminal law altogether. Variations in the law and restrictions arising from these are not consistent with the aims and provision of the universal, accessible health care system aspired to in Australia. There is an urgent need for overall reform and the introduction of uniformity to Australias abortion laws, including removal of abortion from the criminal law.

Pregnancy characteristics of women giving birth to children with fetal alcohol syndrome in Far North Queensland

Background: Fetal alcohol syndrome (FAS) has been identified as a major cause of impairment to normal physical and intellectual development among Indigenous children in Far North Queensland; however, little is known of the pregnancy characteristics of mothers of those children diagnosed with FAS or of interventions that might assist in lowering the prevalence of the syndrome.

Developing an assessment tool for maternal morbidity ‘near‐miss’– A prospective study in a large Australian regional hospital

Background:  Maternal mortality is now a rare event in the developed world and its measurement is no longer a useful way of assessing obstetric care. Examination of cases of women who nearly died but survived a severe complication of pregnancy or childbirth – maternal ‘near‐misses’ ‐ is increasingly being recognised as potentially more useful, although severe maternal morbidity is much less easy to define and quantify than maternal death.

Knowledge of emergency contraception amongst tertiary students in far North Queensland

Background: Emergency contraception (EC) has been available in Australia without prescription since 2003. However, there has been little research into the extent of knowledge of the actions, effectiveness and availability of EC among the general population.

Vitamin D levels in pregnant women booking for antenatal care in Far North Queensland

Serum concentrations of vitamin D were measured in pregnant women booking for antenatal care in Cairns Base Hospital, Queensland. Of 116 women, none was found to be vitamin D deficient. With a threshold of 50 nmol/L, no woman demonstrated vitamin D insufficiency; with a threshold of 75 nmol/L, 6.9% would have mild insufficiency. Further investigation into vitamin D concentrations of women living in northern Australia is required before recommendations are made for universal vitamin D screening of all pregnant women in Australia.

Knowledge of abortion law and provision of abortion services amongst tertiary students in Far North Queensland

Abortion is an important health issue for Australian women, yet there are large variations across Australia in abortion service provision and in state laws regulating abortion practice. We conducted a survey of tertiary students in Far North Queensland to ascertain their knowledge of local abortion services and of abortion law in Queensland. Important gaps were demonstrated in their knowledge of the law and of the availability of abortion services.

Introducing early medical abortion in Australia: there is a need to update abortion laws

Recent changes to Federal Therapeutic Goods Administration legislation have seen the limited introduction of the drug mifepristone to Australia for the purpose of early medical abortion. At the same time it has become evident that both methotrexate and misoprostol, licenced and available for other indications, are being used safely and appropriately for early abortion by Australian medical practitioners. Early medical abortion is widely practiced overseas where its safety and effectiveness are well supported by current evidence. However, abortion law in many states is still contained within the Criminal Codes and does not reflect current evidence-based abortion practice. In other states and territories restrictions on where abortions may be performed pose potential barriers to the introduction of mifepristone for medical abortion. There is an urgent need for abortion law to be clarified and made uniform across the country so that the best possible services can be provided to Australian women.

A retrospective review of self‐reported alcohol intake among women attending for antenatal care in Far North Queensland

Background:  Fetal alcohol syndrome and fetal alcohol spectrum disorder are known to occur among children delivered to women in Far North Queensland; to date, the problem has not been quantified or related directly to maternal alcohol consumption during pregnancy.

Making it legal: abortion providers' knowledge and use of abortion law in New South Wales and Queensland

To explore the knowledge of state abortion law of doctors providing abortion in New South Wales and Queensland, their attitudes towards this law, and their application of both knowledge and attitudes to their day‐to‐day practice of abortion.