A voice for women's health

Abortion Law Reform Submission September 2019

Abortion Law Reform Submission

Background to the Auckland Women’s Health Council

The Auckland Women’s Health Council (“AWHC”) is a voluntary organisation of individual women and women’s groups who have an interest in and commitment to women’s health issues. AWHC was founded in 1988 to provide a voice on women’s health issues in the Auckland region.

AWHC is made up of women from a variety of backgrounds, generations and occupations. We give this submission collectively from our personal and professional experiences as well as for the women of Auckland.

AWHC has a special interest in patient rights, informed consent and informed decision-making in health care, health consumer advocacy, the Code of Health and Disability Services Consumers’ Rights, the National Cervical Screening Programme, and medical ethics. Our vision is that all women in Auckland have agency over their physical, mental, emotional and spiritual well-being and are fully informed of health services available and have access to them. While we specifically serve and support Auckland women, we believe in this vision for all New Zealand women.

When using the term “women” we wish to refer to all those who identify as women. We are currently reviewing our use of gendered language as we acknowledge the importance of ensuring all those who identify as women have equal and adequate access to health care as well as advocacy and support from organisations like ourselves. Any legislation created for abortion services must be drafted using gender neutral terminology to prevent any limitations, restrictions or discrimination being placed on those who do not identify as women. This will be addressed further in our submission.

 

Our philosophy:

  1. Women users of health services have the right to make informed decisions regarding their own health care and treatment
  2. Women have the right to the information necessary to enable them to make informed decisions.
  3. Health care must be accessible, affordable and available, as well as culturally appropriate and acceptable to all women.
  4. Consumer participation in all decision-making processes for health care services is essential.

 

The Abortion Reform Bill

Gender Neutral Language:

We recommend gender neutral language is adopted in the Bill. Although we have used this terminology ourselves, its use in legislation has more profound effects then in our own manifesto and submission as it creates uncertainty and is discriminatory towards people who do not identify as women but need access to abortion services. We are concerned it may restrict accessibility of abortion services for people who do not identify as women. We therefore suggest the Bill adopts the term “consumer” when referring to people who use abortion services, consistent with other health legislation or the “pregnant person”. We shall use the term “consumer” throughout the remainder of our submission.
 

Decriminalisation

We support the removal of abortion from the Crimes Act. We believe abortion is a health issue and having an abortion is to access a health service, and no consumer should be punished for seeking or obtaining an abortion. We agree there must be sanctions in place under the Health Practitioner Competence Assurance Act for health practitioners, who do not comply with relevant standards or processes under the act for abortion services. We believe this is necessary to ensure the best interests of the consumer are upheld.
 

Statutory test for pregnancy over 20 weeks

We do not support the inclusion of a statutory test for consumers who are over 20 weeks pregnant. In our first submission on the Bill we expressed agreement with this restriction for consumers over 22 weeks. After consideration and conversations with women’s groups around the country we now believe it is unnecessary.

Changing the statutory test from 22 to 20 weeks is arbitrary. The majority of such abortions (which is a small number and perhaps should not be referred to as an abortion after 22 weeks) are due to factors that threaten the consumer’s life or the foetus’s life after birth if the pregnancy was to be carried through. In these situations, deciding to not carry through the pregnancy is different to having an abortion prior to 20 weeks. It is therefore unnecessary to have this inclusion in the Bill as it places unnecessary stress on the consumer making these decisions and is another sanction on a pregnant person’s autonomy.

It is recommended this section of the Bill be removed and pregnancies over 20 weeks be treated the same as pregnancies under 20 weeks in legislation. We support the inclusion of counselling services being made freely available to consumers of abortions at a time that suits them.

 

Conscientious objection

We understand conscientious objection is required to stay in the Act due to reasons of freedom of religion and freedom of speech. However, it must be acknowledged that doctors’ choice to object to offering consumers help or services will impinge on their decision making and emotions.

We are concerned the current entitlements of conscientious objection will prevent social change occurring. If the Bill is to be progressive and bring change to the current social taboo surrounding abortion there needs to be better access to information for abortion services. We suggest there be a public list available at all health care providers and clearly stated on their websites listing names of health care professionals who have raised conscientious objection in regard to abortion. This will prevent consumers wasting time and being judged when seeking an abortion.

 

Disestablishment of the Abortion Supervisory Committee

We support the disestablishment of the Abortion Supervisory Committee and the condition that there continues to be a collection of data, as this information is important. We support the development of abortion service standards by which service providers will be evaluated. The process of developing these standards should involve consumer as well as health professional input. Adequate resources need to be provided for data collection and monitoring.
 

Safe Spaces

We support the requirement for consumers accessing abortion services to be free from intimidation. Terminating a pregnancy may involve considerable emotional distress for consumers. Harassment and intimidation when accessing abortion services adds unnecessary distress and judgement to the situation.

No other health services attract the same overt judgement and objection as abortion services. As abortion services are health care, they should be afforded the same common decency and privacy. To ensure privacy is given to people accessing abortion services we suggest the safe space be extended from 150 meters to 500 meters and for this to be a mandatory requirement around all abortion service facilities.


Extension of health practitioners to offer abortion services

It is noted the Bill provides for “health practitioners” to carry out abortion services. We note this includes nurse practitioners and midwives as well as doctors. We believe an extension to other health practitioners will make abortion services more accessible, especially for those located in remote areas. For this to succeed there needs to be financial support and education given to the health practitioners who elect to incorporate this into their scope of practice. This is especially so for those who train to perform surgical abortions. There also needs to be financial recompense for those providers who travel to areas that do not have abortion services.
 

Informed decision making

Consumers must have the choice between having a medical or surgical abortion where a medical abortion is safe and possible. Information on the two options needs to be adequately and promptly provided to consumers so they can make informed decisions before time decides for them.
 

Concluding thoughts

This Bill should have been put into action many years ago. Although we have come a long way as a nation in regard to the health services we offer consumers, there is still a lot of work to do. Continued inclusion of abortion in the Crimes Act is archaic and discriminatory. However, this is not the only fault with the current system. In order to have legislation that stays relevant it is necessary to use a progressive approach that will ensure consumers have access to safe and equitable health care services and are able to make informed choices.

 

Video of the AWHC Oral submission can be found here.


 
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