Tuesday 11 May 2010

Abortion Access in New Zealand: Maia's Handmirror Reflections

I originally wrote this post nearly four years ago - some of the details of where DHBs send people to obtain abortions may have changed, but the system has not.


As I've said before, abortion law in New Zealand is an awful mess and I have a life-long goal to dance on the grave of every man who voted for it. But abortion practice, at least in the major cities, is better than in many countries that have laws that are based on women's rights. The main reason for this is a public health system which pays for abortions.

But I want to talk about the inequalities in abortion system, and I thought I'd start with the geographical inequalities. This is a map of New Zealand's provision of first-trimester abortion services*:

The black dots are towns where you can get abortion services - the colour blocks are areas where those abortion clinics, or hospitals serve. The way the health system works the if a District Health Board (DHB) doesn't wish to provide a service itself (and there are two DHBs with no hospitals licensed to perform abortion in the area - presumably on general grounds of ickiness) then you purchase it from somewhere else. So unless you're prepared to pay both for the abortion and the trip to Auckland to go to the only private abortion clinic in New Zealand, you go where your DHB sends you. So, despite the fact that the people of Dannivirke are far closer to Hastings than they are to Wellington, they have to make the 4 hour drive to Wellington and back to have terminations (probably twice, because it usually takes two appointments - more on that later).

Incidentally just because these places do provide abortions doesn't mean that you'd necessarily want to go there - New Plymouth hospital only performs abortions under general anesthetic, that sounds like a great starting point for health care.

The white dots are hospitals that are fully liscened to perform abortions, but choose not to (there are other hospitals that could provide abortions and don't, but they're part of the same urban area). There are DHBs that have registered as providers of abortions under the Act, but only want to perform abortions to deserving women (and in some cases, they don't actually want to perform abortions at all). Christchurch is a seven and a half hour drive from Invercargill, but the people who run the Southland DHB think that that's a pefectly reasonable distance to travel for an abortion.

It's not just the DHBs' fault (although there's plenty of blame to spread around), the legislation says that every abortion must be signed off by two certifying consultants. This means that to run a useful abortion service you have to be able to have two certifying consultants on hand.

The current situation is awful, and puts women in a position of real hardship. The West Coast DHB only provides help travelling to Christchurch if a woman has a community services card. If you live with flat-mates and work full-time, even if you're only on the minimum wage, you're not eligible for a community services card. So women with minimum wage jobs have to find the money to make it from the West Coast over to Christchurch (although they should be able to get help from Work and Income).

* This information from this post came from this website.


Anonymous said...

So you would force medical professionals to perform abortions against their wishes?

Anonymous said...

Absolutely anon, it's not their choice to make.

DPF:TLDR said...

If doctors don't want to perform abortions, they shouldn't apply for jobs where it will be part of their duties.

McFlock said...

Actually, I'd force administrators to hire doctors who were prepared to do the job. But then I'd also enable those administrators to pay a competitive salary via taxpayer funds, etc etc etc.

lenore said...

When I had an abortion in Nelson, it was also under general anesthetic. I was put in the same ward as a woman who had a miscarriage. I thought that was a bit insensitive for this woman as I didn't know she had experienced a miscarriage until she told me. Hopefully that has changed. The doctor and nurses I experienced certainly didn't support abortion by the way I was treated. I would certainly ensure that if my daughters wanted a termination, that they had it in a bigger city with a separate clinic rather than in the main hospital. At least in a clinic, you know the staff will be supportive.

Anonymous said...

Of course is should be the choice of the doctor.

What if this is a late term abortion that the doctor is against on idealogical or religious grounds?

I just cannot see how you can force them to do it.

Lilly said...

Anon - would you become a police officer if you knew you wouldn't want to arrest people? Would you become a fire-fighter if you knew you wouldn't be able to put out fires?

Why on Earth would you become a doctor if you knew you were unable to perform medical procedures?

It's part of your job. If you're not prepared to do your job you shouldn't have that job.

If you're a doctor who won't perform abortions you should quit and become something more suitable like a street preacher.

If I go to a doctor I want medical advice - not their uninformed opinion. If I wanted religious beliefs I'd go to a church.

Anonymous said...

It's not necessary for every doctor to perform terminations but if the DHB does have a responsibility to ensure that abortions are available then there may well come a point where willingness to perform terminations is a condition of employment for some doctors.

Anonymous said...

It is also worrying to me that in NZ law women are only entitled to an abortion if they can produce some psychological grounds for not having a baby. This leaves a woman's right to choose in danger of being reinterpreted by more conservative policy makers and governments.

A Nonny Moose said...

I can't believe we keep having to return to Abortion and Feminism 101each time any abortion conversation comes up.

Original Anon, if you want to better argue your side, please be informed of ALL the issues before you jump in with your knee-jerk emotional responses. Bringing up old arguments is just derailment.

Let me ask you this: should a doctor be able to refuse to do vasectomies? Because if it's OK for a guy to get sexual health/fertility related procedures, but not ok for a woman, then you are commiting discrimination.

Julie said...

Further to (an) Anon's point about doctor's refusing to perform vasectomies (or rather not refusing to, but refusing to provide termination or contraception for women), here's a post I wrote a little while back on just that very thing.

Mike said...

Lilly/Hugh, I think you have missed anon's point, a doctor takes a hypocratic oath to preserve all life.
Only you as a person can decide if life starts as an egg or on the day of birth or somwhere in between.

So therefore it is quite reasonable for a doctor or nurse to be pro-life/anti-abortion.
So your argument of signing up to a job and refusing to do basic procedures does not wash, as some doctors will see abortion as a breach of their oath.

I am not pro or anti abortion, I have good friends who have taken both courses after an "accident". and I agree that it is the womans right to decide their own position on it. But it should also be the doctors right to choose where they too draw their moral line.