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Peer-reviewedCC BYWomen's Health

Travel time modelling of access to surgical abortion services in Australia: A nationwide spatial analysis of distance, geographic, and socio-economic inequities

Abstract

Background In Australia, abortion is fully decriminalised in all states and territories. Despite advances in telehealth and the expansion of prescribers of medication abortion, surgical abortion services are scarce. The absence of national service-location data further limits both accessibility and assessment of service coverage. Objectives To calculate private vehicle travel times from all private dwellings to their nearest surgical service to identify accessibility inequities by area-level remoteness and socio-economic status. Design Cross-sectional spatial analysis of publicly available data. Methods A nationwide dataset of 83 public and private surgical abortion services (i.e. excluding medication abortion) was compiled and geocoded. Travel times were calculated from 10.6 million private dwellings to the nearest service along the road network. For each state and territory, the rate of public surgical abortion services per 100,000 reproductive-aged females was calculated. Analyses were stratified by remoteness using the area-level Modified Monash Model and Index of Relative Socio-economic Advantage and Disadvantage. Results Nationwide median travel time from private dwellings to the nearest surgical abortion service was 19.6 minutes (IQR 11.9–35.3). Public-hospital-based services had a longer median travel time of 47.6 minutes (IQR 17.8–118.6) than private services, at 27.3 minutes (IQR 16.3–55.1). Public service provision varied across jurisdictions, ranging from 0.1 per 100,000 reproductive-aged females in New South Wales to 9.2 per 100,000 in the Northern Territory. Travel times increased with area-level socio-economic disadvantage and remoteness. An interactive web-based tool was developed to visualise these findings at national and local scales. Conclusion Spatial inequities in access to surgical abortion were evident, particularly outside metropolitan areas and in socio-economically disadvantaged areas. These findings highlight geographic barriers compounding existing financial and logistical challenges to care. This analysis was limited to publicly listed surgical abortion services and did not account for service capacity, affordability, or medication abortion access. Future analyses of medication abortion access, alongside improved national service location data, are needed to monitor changes in access and support equitable reproductive healthcare.

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BibTeX
@article{wood2026travel,
  title = {{Travel time modelling of access to surgical abortion services in Australia: A nationwide spatial analysis of distance, geographic, and socio-economic inequities}},
  author = {Sarah M. Wood and Anna Noonan and Neil T. Coffee and Vincent L. Versace},
  journal = {Women's Health},
  year = {2026},
  month = oct,
  doi = {10.1177/17455057261502030},
  url = {https://doi.org/10.1177/17455057261502030},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Travel time modelling of access to surgical abortion services in Australia: A nationwide spatial analysis of distance, geographic, and socio-economic inequities
AU  - Sarah M. Wood
AU  - Anna Noonan
AU  - Neil T. Coffee
AU  - Vincent L. Versace
PY  - 2026
DA  - 2026/10/28
JO  - Women's Health
DO  - 10.1177/17455057261502030
UR  - https://doi.org/10.1177/17455057261502030
AB  - Background In Australia, abortion is fully decriminalised in all states and territories. Despite advances in telehealth and the expansion of prescribers of medication abortion, surgical abortion services are scarce. The absence of national service-location data further limits both accessibility and assessment of service coverage. Objectives To calculate private vehicle travel times from all private dwellings to their nearest surgical service to identify accessibility inequities by area-level remoteness and socio-economic status. Design Cross-sectional spatial analysis of publicly available data. Methods A nationwide dataset of 83 public and private surgical abortion services (i.e. excluding medication abortion) was compiled and geocoded. Travel times were calculated from 10.6 million private dwellings to the nearest service along the road network. For each state and territory, the rate of public surgical abortion services per 100,000 reproductive-aged females was calculated. Analyses were stratified by remoteness using the area-level Modified Monash Model and Index of Relative Socio-economic Advantage and Disadvantage. Results Nationwide median travel time from private dwellings to the nearest surgical abortion service was 19.6 minutes (IQR 11.9–35.3). Public-hospital-based services had a longer median travel time of 47.6 minutes (IQR 17.8–118.6) than private services, at 27.3 minutes (IQR 16.3–55.1). Public service provision varied across jurisdictions, ranging from 0.1 per 100,000 reproductive-aged females in New South Wales to 9.2 per 100,000 in the Northern Territory. Travel times increased with area-level socio-economic disadvantage and remoteness. An interactive web-based tool was developed to visualise these findings at national and local scales. Conclusion Spatial inequities in access to surgical abortion were evident, particularly outside metropolitan areas and in socio-economically disadvantaged areas. These findings highlight geographic barriers compounding existing financial and logistical challenges to care. This analysis was limited to publicly listed surgical abortion services and did not account for service capacity, affordability, or medication abortion access. Future analyses of medication abortion access, alongside improved national service location data, are needed to monitor changes in access and support equitable reproductive healthcare.
SN  - 1745-5065
ER  -