Expression of Interest for Australian Abortion Story Podcast

Thank you for your interest in sharing your abortion story with us. Please complete the following form to give us some background to your story.

By submitting this form you acknowledge that neither Kelsey or Cassidy are qualified mental health care professionals, and are not providing a counselling service.

If you would like to contact us for another reason, you can email us at australianabortionstories@gmail.com.

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* 1. What are your pronouns?

She/Her

He/Him

They/Them

I'd rather not say

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* 2. What is your name?

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* 3. I only conduct interviews with individuals who have had at least 6 months since their most recent abortion. Has it been a minimum of 6 months since your experience?

Yes

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* 4. Have you spoken about your abortion with anyone since it happened?

Yes

Other (please specify)

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* 5. What State or Territory did you have your abortion/s? Tick all that apply

South Australia (SA)

Western Australia (WA)

Northern Territory (NT)

Queensland (QLD)

New South Wales (NSW)

Australian Capital Territory (ACT)

Victoria (VIC)

Tasmania (TAS)

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* 6. How many abortion stories are you sharing?

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* 7. Please select if any of the following apply to your story/stories

Early Medication Abortion

Procedural Abortion (aka Surgical Abortion)

Abortion for Genetic Reasons

Multiple Abortions

Second Trimester Abortion

Incomplete Abortion

Sexual/Emotional/Domestic Abuse

Haemorraghe

Religious Upbringing/Circumstances

Issues with Healthcare Providers/Professionals

Abortion Stigma

Abortion as a Mother

Any other important factors?

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* 8. At what email address would you like to be contacted?

If you are distressed as the result of this survey, we encourage you to seek out support from a trusted loved one, or health care professional. If you need to speak with someone urgently, Lifeline (13 11 14) and Beyond Blue (1300 22 4636) both provide free crisis counselling, via phone or internet.

We will be in touch with you as soon as we are able, and thank you for your interest in sharing your abortion story on the podcast. Your story matters.