According to the Guardian Australia report, the situation escalated when Elham experienced severe pain: "I was going unconscious sometime and I got bleeding – and even with this situation they didn't pay attention to me and told me it's normal, no need to go to hospital" [1].
Weeks after the miscarriage, Elham stated she had been given no further ultrasound to determine what went wrong, and was told by medical staff: "Every time I am asking them, they keep telling me that you are in detention centre and should not expect a lot" [1][2].
The incident was documented in a "letter of concern" written by 15 doctors working for International Health and Medical Services (IHMS), the healthcare provider contracted by the Department of Immigration and Border Protection.
The letter detailed "unsafe practices and gross departures from generally accepted medical standards" experienced by asylum seekers on Christmas Island [1][2].
At a press conference on December 20, 2013, Morrison "refused to take questions about Latifa's case" (another pregnant asylum seeker) and regarding the doctors' letter stated only: "We are working through the issues of that letter" [3].
When the Labor government revived offshore processing (the "Pacific Solution") in August 2012, they did not send pregnant women to Nauru – they were exempted from offshore transfers [1].
As the Guardian reported: "the new Coalition government operates under a 'no exceptions' rule that means all asylum seekers who have arrived at Christmas Island since mid-July – even women with high-risk pregnancies – are sent to the immigration detention centre on Nauru" [1].
**Medical Infrastructure Limitations:** The doctors' letter highlighted systemic failures, including that ultrasonographers visited Christmas Island only every few months and "cater primarily for local residents" [1].
The island's hospital had an ultrasound machine but "there are rarely specialists available who know how to use it" [1].
**IHMS Response:** IHMS, the contracted healthcare provider, acknowledged the period was "high intensity, with an unprecedented number of arrivals and an increased number of people presenting with a range of significant complex medical conditions" [2].
IHMS stated they would work "constructively with Dr Sanggaran [the principal author] to review these matters and to resolve his concerns" [2].
**Multiple Cases:** The Elham case was not isolated.
The doctors' letter referenced other pregnant women in detention, including "Latifa" – a 30-year-old Rohingyan woman with a "very high risk" pregnancy (history of caesareans, thought to be carrying twins) who was sent to Nauru despite medical concerns [1].
**The Guardian Australia:** The original source is Guardian Australia, which is generally considered a reputable mainstream news organization with professional journalism standards.
The Guardian has a center-left editorial stance, which should be considered when evaluating coverage of politically sensitive topics like asylum seeker policy [1].
**International Business Times:** The IBTimes article corroborates the Guardian's reporting, confirming Elham's account and the doctors' concerns [2].
**Doctors' Letter:** The primary evidence comes from a letter written by 15 doctors working on Christmas Island.
Their professional credentials and firsthand experience lend credibility to the claims, though the letter represents their professional concerns rather than an official audit or investigation [1][2].
**Australian Human Rights Commission:** Professor Gillian Triggs, then-president of the AHRC, publicly supported the doctors' concerns, describing their report as "chilling in its objective scientific clarity" and stating that "Australia appears to fail to meet international legal standards of humane treatment of asylum seekers" [1].
The AHRC is an independent statutory body.
**Potential Bias:** The original source (Guardian Australia) and associated advocacy organizations (ASRC, Human Rights Law Centre) generally advocate for more humane asylum seeker policies.
**Labor's Policy on Pregnant Women:** When the Labor government (under Prime Minister Julia Gillard) revived offshore processing in August 2012, they specifically exempted pregnant women from being sent to Nauru [1].
This policy difference is significant – under Labor, pregnant women like Elham would likely have remained in onshore detention or community detention rather than being transferred to offshore facilities with limited medical infrastructure.
**Policy Reversal Under Coalition:** The Coalition's "no exceptions" policy, implemented after their September 2013 election victory, removed this exemption.
But the new Coalition government operates under a 'no exceptions' rule" [1].
**Scott Morrison's Statement:** The new Immigration Minister Scott Morrison explicitly contrasted the two approaches in October 2013: "The previous government sent very few people to Manus Island and Nauru for offshore processing because they didn't really believe in it...
The difference between the Coalition government and Labor is that the Coalition is actually implementing offshore processing properly" [1].
**Historical Context:** It's important to note that while Labor exempted pregnant women from offshore detention during their 2012-2013 offshore processing regime, the Labor government (1992-1996, 2007-2013) maintained mandatory detention policies that had their own documented issues with healthcare access.
The resulting documented medical consequences
appears to represent a deterioration in specific protections for pregnant asylum seekers compared to the immediately preceding Labor policy framework.
**Government Justification:** The Coalition government defended its strict offshore processing policy as necessary to deter dangerous boat journeys and prevent deaths at sea.
Scott Morrison's statement about "implementing offshore processing properly" reflects the government's view that Labor's more lenient approach (including exemptions for pregnant women) undermined the deterrent effect of the policy [1].
**Healthcare Provider Position:** IHMS acknowledged the challenges of the period, noting it was "high intensity, with an unprecedented number of arrivals" [2].
The issues included:
- Lack of regular ultrasonography services
- Inadequate antenatal care not meeting Australian standards
- Transfer of high-risk pregnant women to Nauru despite medical concerns
- Confiscation of medications and medical aids
- Lack of child-specific mental health services [1]
**Multiple Accountability Layers:** The incident raises questions about:
- The Department of Immigration and Border Protection's policy decisions
- IHMS's healthcare delivery standards
- The availability of medical infrastructure on Christmas Island
- The appropriateness of the "no exceptions" policy for vulnerable populations
**International Standards:** The Australian Human Rights Commission's assessment that Australia "appears to fail to meet international legal standards of humane treatment of asylum seekers" represents an independent statutory body's professional judgment [1].
**Key Context:** This is not unique to the Coalition in the sense that both major Australian political parties have supported offshore detention and mandatory detention policies with documented negative health impacts.
However, the specific policy change regarding pregnant women – removing the exemption that existed under Labor's 2012 offshore processing regime – appears to have directly contributed to the circumstances that led to Elham's case and other similar incidents.
The core facts of the claim are substantiated: an Iranian asylum seeker named Elham who was pregnant was denied timely medical care including an ultrasound on Christmas Island, subsequently suffered a miscarriage, and doctors reportedly indicated earlier intervention might have saved the pregnancy.
The government, specifically Immigration Minister Scott Morrison, did decline to comment specifically on the case, referring only to "working through the issues" of the doctors' letter [1][3][4].
The phrase "refused requests for medical treatment" somewhat oversimplifies a situation involving systemic healthcare infrastructure failures and policy decisions rather than a direct refusal to treat
2.
The claim that "she probably would have had a normal birth" is based on what hospital doctors reportedly told her husband – the baby "might have been saved" – but this is not a certainty
3.
The claim omits the important context that this represented a policy change from the preceding Labor government, which had exempted pregnant women from offshore detention
The core facts of the claim are substantiated: an Iranian asylum seeker named Elham who was pregnant was denied timely medical care including an ultrasound on Christmas Island, subsequently suffered a miscarriage, and doctors reportedly indicated earlier intervention might have saved the pregnancy.
The government, specifically Immigration Minister Scott Morrison, did decline to comment specifically on the case, referring only to "working through the issues" of the doctors' letter [1][3][4].
The phrase "refused requests for medical treatment" somewhat oversimplifies a situation involving systemic healthcare infrastructure failures and policy decisions rather than a direct refusal to treat
2.
The claim that "she probably would have had a normal birth" is based on what hospital doctors reportedly told her husband – the baby "might have been saved" – but this is not a certainty
3.
The claim omits the important context that this represented a policy change from the preceding Labor government, which had exempted pregnant women from offshore detention