'What Happens Next?': What Is Reproductive Justice?

Reproductive rights are human rights, and it's incumbent upon all of us to protect and advance them.

In the wake of the US Supreme Court's decision to strike down Roe v Wade, women and pregnancy-capable people were left reeling. It was a clear example of how hard-won gains can be reversed, even decades later.

The silver lining is that the decision brought attention to issues surrounding reproductive care that had long been overlooked or simply ignored. Protests in the US and beyond highlighted the global importance of continued advocacy for access to healthcare, better education, and adequate resources.

Listen: Senate submission to raise the bar in reproductive healthcare

On a new episode of Monash University's What Happens Next? podcast, host Dr Susan Carland talks to the healthcare providers and advocates working tirelessly to educate people about their health options, ensure that we don't lose ground in the global fight for reproductive justice, and dismantle the systems that have left women's healthcare on the back burner.

This episode's guests are human rights law expert Dr Tania Penovic; pharmacist Dr Safeera Hussainy; pharmacology researcher Dr Sab Ventura; Louise Johnson, former CEO for the Victorian Assisted Reproductive Treatment Authority; and Dr Danielle Mazza, head of Monash's Department of General Practice and director of the SPHERE Centre of Research Excellence in Women's Sexual and Reproductive Health and Primary Care.

A listener note: What Happens Next? uses the word "women" throughout the series, but we acknowledge and emphasise that these matters are not restricted to cisgender women alone. All people assigned female at birth are affected by these issues and often face even greater challenges because of them. Including everyone in the conversation and when advancing solutions is the only way forward.

"If you think about the average woman having two children, she might spend five years of her life trying to become pregnant, pregnant, or recovering from a pregnancy. But that's 30 years of her life that she spends trying to avoid a pregnancy or wanting to. And so we need to try our best to help her to do that."

Danielle Mazza

This is the final episode of season seven of What Happens Next?. The podcast will return in a few short months with a new series investigating new challenges and how each of us can make a difference. In the meantime, be sure to explore our back catalogue of episodes here on Lens, or on your favourite podcast app.

Do you have a topic you'd like the podcast to examine? Email [email protected] with your idea.

If you're enjoying the show, don't forget to subscribe, or rate or review What Happens Next? to help listeners like yourself discover it.

Transcript

[Music]

Susan Carland: Welcome back to What Happens Next?, the podcast that examines some of the biggest challenges facing our world and asks the experts: What will happen if we don't change? And what can we do to create a better future.

I'm Dr Susan Carland. Keep listening to find out what happens next.

[Music]

Danielle Mazza: It's really important that, when it comes to something like contraception, that women really make a choice that's best for them.

Louise Johnson: I think it's really important that women's reproductive health and men's reproductive health is talked about freely in the media.

Tania Penovic: So we are beginning to recognise reproductive healthcare as a corollary of women's equality, central to women's equality, but we haven't dismantled all healthcare barriers.

Susan Carland: Before we begin, I'd like to mention that although we use the word "women" throughout the series, these matters are not restricted to cisgender women alone. All people assigned female at birth are affected by these issues and often face even greater challenges because of them.

Last week on the podcast, the future of women's reproductive rights seemed a bit bleak, not to mention the history and current state of those rights. But I promise it's not all bad news!

Today we'll talk to the healthcare providers and advocates working tirelessly to educate people about their health options, ensure that we don't lose ground in the global fight for reproductive justice, and dismantle the systems that have left women's healthcare on the back burner.

Keep listening to find out what happens next.

[Music]

Danielle Mazza: So my name is Professor Danielle Mazza, and I'm the head of the Department of General Practice at Monash University, and I'm the director of the SPHERE Centre of Research Excellence in Women's Sexual and Reproductive Health and Primary Care. And most importantly, I'm a general practitioner and I'm involved in the delivery of clinical care. Susan Carland: Danielle, welcome to the podcast.

Danielle Mazza: Yeah, it's great to be here.

Susan Carland: Can you tell me, do you think women's healthcare is behind men's healthcare? Are they at the same point? Where are we?

Danielle Mazza: I don't really like to compare, to be honest, because I think it's a lot of different issues that goes on in women's healthcare.

There's really so much work to do. Women's healthcare in Australia is not ideal, and the areas that I'm focused on are around sexual and reproductive health, where we know that healthcare services are not currently being delivered according to best practice. And that's the work that I'm involved in trying to address.

Susan Carland: When you say that women's healthcare isn't always being delivered in a way that's best practice, what do you mean?

Danielle Mazza: Well, best-practice women's healthcare means that it is affordable, and accessible, and high quality. So particularly if I take the example of availability of contraception, for example, we know that about only 11 per cent of women of reproductive age in Australia are currently using intrauterine devices and implants.

I've just come back from Sweden and over there, it's about 20 to 25 per cent. And I think some of the reasons for that are probably around women's lack of knowledge about those products and how they might benefit them, and also that they're not being necessarily offered them by medical practitioners and we don't have services available to deliver them. So they're the kinds of gaps.

Susan Carland: So when you say only about 11 per cent of women are using those devices or products, what would the rest of the women be using?

Danielle Mazza: Well, in Australia, women mainly rely on the pill -

Susan Carland: Mm.

Danielle Mazza: - as their mainstay of contraception. And that's because that's often, as I said, what's being offered to them. Or when they come in asking for contraception, they just immediately go to what they know, or what they know their friends are taking, their peers. So there's a lot of change, cultural change, knowledge improvement that needs to go on.

Susan Carland: And is that relevant because implants are more effective, or have fewer side effects? Is that why it would be preferable for more women to be on that sort of birth control?

Danielle Mazza: Yeah, so it gets back to the underlying problem of unintended pregnancy rates.

And I was just doing a conference presentation this morning and explaining that in Australia, the estimates are that around 45 per cent of all pregnancies are unintended.

Women these days have fewer pregnancies, and those pregnancies are very precious. And they want to be able to optimise the pregnancy outcomes and ensure that they're in the best possible health going into a pregnancy, and that it's a wanted pregnancy. And so we need to ensure that in order for women to achieve their reproductive goals, to really get what they want, the outcomes that they want, the number of children that they want, and healthy children, that we have available really effective contraception so that they can plan and optimise those pregnancies that they do have.

And it's interesting, I was also talking to these health professionals this morning, explaining that average age of first intercourse in Australia is around 16 at the moment. The average age of first pregnancy is 32. The average age of menopause is 51.

So if you think about that, and if you think about the average woman having two children, she might spend five years of her life trying to become pregnant, pregnant, or recovering from a pregnancy, but that's 30 years of her life that she spends trying to avoid a pregnancy, or wanting to. And so we need to try our best to help her to do that.

Susan Carland: Louise Johnson spent 16 years doing just that as CEO of the Victorian Assisted Reproductive Treatment Authority. She spent a lot of time correcting the misconceptions around, well, conception.

Louise, thank you so much for joining us today.

Louise Johnson: Thank you. I'm delighted.

Susan Carland: Louise, I want to start by asking you what are the biggest factors that affect a woman's ability to conceive?

Louise Johnson: Age is the most important factor that affects a woman's fertility. It's not only the age of the woman, it's the age of her partner, and also lifestyle.