For a woman living in 1920s Australia, options to prevent pregnancy were limited. Latex condoms had been invented but weren’t readily available due to concerns about birth rates declining. Instead, the ‘pull out’ method, home-made animal intestine or linen condoms, and even douching with dangerous chemicals were the main contraception methods used in the early 20th century.
Added to this was the taboo nature of sexual and reproductive health, where even discussion about family planning and contraception was frowned upon, no matter your age, marital or parental status. This was the environment from which Family Planning Australia emerged in 1926 – first known as the Racial Improvement Society and later known as the Racial Hygiene Association of New South Wales.
A lot has changed, and been achieved, in sexual and reproductive health and rights since Family Planning Australia opened its doors 100 years ago.
The early organisation was founded with three principal aims: to promote sex education, prevent and eradicate venereal diseases like syphilis, and educate the public on eugenics. Despite modern understandings, the use of the word ‘racial’ in the Association’s title at the time refers to the whole of the human race.
Ruby Rich and Lillie Goodisson, the organisation’s leading founders, were considered vocal feminists in the 1920s. They believed eugenics provided a useful and safe framework to engage in public discussions about sexual and reproductive health, which were taboo outside of eugenics discourse.
Rich explained in a 1976 interview that eugenics was a ‘a large umbrella under which we could shelter…and do lots of things.’ viii such as provide birth control and sex education, because the notion of women not having children by choice was so frowned upon in the 1920s.
Post World War I, Australia’s federal and state governments saw population growth as imperative to growing the country’s workforce, boosting economic development and improving national security; they wanted women to have more children, not less.
It was a contentious, conservative beginning, for a team of volunteers with a few hundred Aussie pounds in their pockets and a passion to be among the first in the country to bring discussions on reproductive and sexual health into public and political focus.
Learning from the past
The link to eugenics is not a proud part of our history and we are mindful of, and sorry for, the harm or hurt this may have caused communities we now partner with.
In our centenary year we will look to better understand the impact of eugenics at the time and the sentiment in the community today, so we can move forward and ensure our healthcare is for everyone.
We will do this by meaningfully exploring our history and engaging with and learning from key populations impacted by eugenics. We cannot change the past, but we can learn from it and behave differently today.
A decade of firsts and innovation despite the Great Depression
We overcame significant economic hurdles during the 1930s in furthering the cause to improve access to contraception for Australian women. The Great Depression saw population growth, fertility rates and migration into Australia decline, as many people simply didn’t have the means to emigrate or to support large families.
These challenges were compounded for women, who couldn’t even access ‘the susso’ payment – the precursor to modern unemployment benefits – at a time when a third of the country was unemployed.
They were also subject to pronatalist government policies based on social and religious values that condemned contraception. The importation of contraceptive devices and literature containing information about contraception and spacing of children was illegal during the 1930s.
Clinical training for doctors included very little information on sexual and reproductive health, let alone contraception, due too to these early 20th century social beliefs.
Married women living in Sydney, however, finally had a place to get contraception when we opened Australia’s first birth control clinic at 14 Martin Place in 1933. The organisation didn’t stop there: in 1935, it lodged a patent application for the diaphragm to ease the burden and difficulty of getting contraceptives through customs.
The world took pause, but reproductive and sexual health advocates didn’t
As World War II raged on in the early 1940s, leaving hundreds of millions of people dead, the Board of Health and many members of the public were outraged that our birth control clinic was still operating.
The clinic stayed open as long as it could but was eventually forced to close its doors due to rubber supply for the diaphragm being redirected into the war efforts. The organisation shifted its strategy in turn, introducing sex education for adults into NSW communities in 1942.
Once the war was over and the dust had started to settle the Martin Place clinic was reopened in 1944. In the 1950s, we started opening clinics: one in Newcastle, and one in Leichhardt, which was later moved to Chippendale and became the headquarters in 1958.
Women’s rights come to the fore
Family planning – the concept of choosing how many children to have and when to have them – became more broadly accepted in the 1960s as women fought for more rights and for equality.
This was reflected in the National Health and Medical Research Council’s recommendation that “family planning services should be readily available for the people”, a proclamation that paved the way for family planning services to open in different states and territories.
In response, we renamed as the Family Planning Association of Australia. Our mission to improve sexual and reproductive health outcomes evolved during the 1960s, aiming to grow from a grassroots group to a national force with stronger policies and state structures, advocacy to make services more accessible, increased capacity to provide education to the community and stronger links with research.
In 1961 we helped bring the pill to Australia by making the first oral contraceptive, Anovlar, available to married women.
Sexual and reproductive health services and training expand
Our leaders formed relationships with like-minded organisations overseas and we became an associate member of International Planned Parenthood Federation (IPPF) in 1953 and were granted full IPPF membership in 1969.
The Family Planning Association of Australia began to advocate more actively for the rights of all adults to have access to birth control in the 1970s, regardless of gender or marital status and this expansion was when we shifted to a more professional organisation with mostly paid staff, rather than volunteers.
Clinics were opened in baby health centres, hospital outpatient clinics and community health centres all over Sydney, and education and training became another priority. Comprehensive research programs guided the introduction of training courses for nurses, empowering them to deliver crucial sexual health services including pregnancy testing, breast examinations and pap smears with stronger clinical skills.
The late 1960s and early ‘70s saw increased interest and influence of the medical profession and growing community support for family planning clinics to be established in other states. Opportunities for federal and state government funding for family planning services in this period also motivated the formation of a national body and state associations. Our Medical Advisory Council became national to support this process, and it was a respected body, with membership including experts from across Australia.
We took on the role of a national organisation with interstate branches and received a small grant from the IPPF to help with the work of establishing associations in each of Australia’s other states and territories, between 1970 and 1973.
The Australian Federation of Family Planning Associations was formed in 1974 as a new and separate national body, with the state and territory associations as members. We changed our name to the Family Planning Association of New South Wales to reflect the change. Increased government funding and growing demand saw sexual and reproductive health services double between 1974 and 1978.
Status quo disruption with provocative campaigns
In the 1980s and 1990s our activism increased and we worked to become more inclusive and relevant to communities across NSW, including people in regional, rural and remote parts of NSW.
We launched the Feeling Sexy Feeling Safe project, which championed people with disability making independent and informed decisions about their sex lives and sexuality.
The ‘Fact and Fantasy Files’ debuted the following decade to much outrage from the media. It was a youth focused resource in the form of a diary with candid information about sex, relationships and health.
We were also a part of the movement that called for the Married Persons (Equality of Status) Act to be scrapped. This removed the requirement for spousal consent to undergo healthcare procedures.
In 1992, the organisation took on a new face: Family Planning NSW.
During this period, our teams started to work with migrants and refugees from culturally and linguistically diverse communities to develop resources which reflected their diverse needs, including health promotion resources and campaigns in community languages, and establishing our multicultural service in Fairfield in 1992.
We also worked more closely and consistently with Aboriginal and Torres Strait Islander communities to provide relevant education programs for Aboriginal health workers, nurses and other professionals working with Aboriginal people. This also included developing health promotion campaigns and culturally appropriate clinical services and resources.
Fighting for access and the right to choose
With the new millennium came the campaign for the Therapeutic Good Administration to have the right to decide the availability of RU486, a medication now known as mifepristone used in medical abortions. Prior to this, the Federal Health Minister had the right to veto any application to allow the use of mifepristone, a right that was lost in 2006.
We expanded our services throughout the 2000s, opening our Dubbo clinic in 2006 to bring more services to regional and rural NSW.
Come the 2010s, the organisation trained the first registered nurse in Australia to insert and remove an IUD, thereby paving the way for nurses to have greater scope in providing sexual and reproductive healthcare.
The Pacific benefits from Australian reproductive and sexual health services
Our International Programme in the Pacific began in 2008 and managed eight projects across six countries for its national association, Sexual Health and Family Planning Australia, thanks to funding from AusAID, the Asia Pacific Alliance, and private donors.
2011 saw our International Programme secure direct funding, allowing it to grow and today we operate across 12 countries. Initially, we were providing comprehensive sexuality education and family planning, but our scope grew and we began working in partnership to eliminate cervical cancer in the Pacific. Cervical cancer screening was implemented in Fiji, the Solomon Islands and Vanuatu, and Tuvalu became the first Pacific nation to meet the World Health Organisation global screening goals for cervical cancer elimination, a goal met with the support of FPNSW.
The decriminalisation of abortion
Mifepristone was accessible in 2018, but another hurdle stood in the way of women’s rights to choose whether to have a child or not: abortion remained in the Crimes Act.
That changed when we led the NSW Pro-Choice Alliance, comprised of more than 70 partner agencies, in a political push to have abortion decriminalised and recognised as healthcare in Australia. This was achieved in 2019.
Sexual and reproductive healthcare during the COVID-19 pandemic
During the pandemic we introduced telehealth services and kept clinics open so people had access to safe and essential reproductive and sexual healthcare despite lockdowns.
We continued offering medical abortion services and began offering surgical abortion services from our current Newington clinic, which opened in 2022.
Outreach clinics commenced across Western NSW for communities who needed them the most, in Nyngan, Brewarrina, Walgett and Cobar. Blacktown, Campbelltown, Liverpool and Mayfield also benefitted with our outreach services.
We took to the global stage in 2022, when we addressed the United Nations about the global surge in gender-based violence and declining access to reproductive and sexual healthcare. A driving force in this was the overturning of Roe v. Wade in the United States, which removed the federal right for women to get an abortion and allowed each state to introduce its own, often very restrictive, laws.
The information age
We rebranded to Family Planning Australia in 2022, representing the organisation’s commitment to improving the reproductive and sexual health of every body, in every family and beyond borders.
And our digital footprint grew with the launch of websites including Planet Puberty, Body Talk, Frank and Freedom Condom, each with its own goal of providing information and resources to people of different ages, life circumstances and demographics.
The next 100 years
For a century, we have been championing choice and access to sexual and reproductive healthcare, even when the conversations were taboo or difficult.
Over this century we have evolved alongside society and its attitudes to sexual health, so the people we care for now and the services we offer are much broader than when we started.
In our centenary year, we’re looking forward to a future where we continue to start the tough conversations and bring all people the healthcare they need, near where they live.
