Thursday 29 November 2012

Guest post: Abortion access being undermined in NZ

Reproduced from the November ALRANZ newsletter with permission from the really rather awesome author, Alison McCullough.

The Abortion Supervisory Committee’s annual report has been released. The report includes
the abortion stats previously released by Stats New Zealand in June (See ALRANZ’s August
Newsletter for a report on those, downloadable at www.alranz.org), plus a few extras and the ASC’s
commentary. A PDF of the report is available for download at www.alranz.org under “The Latest”
column.

As ALRANZ wrote on their blog, the impression the report gives is of a system that is increasingly unworkable, with fewer certifying consultants who, the ASC reports, are facing distressing amounts of harassment (as are patients and others associated with abortion care), and all this as timeliness of abortion care and uptake of early medical abortion are barely budging. No matter what the situation on the ground is for providers and women, though, you can be sure that Parliament will do nothing to fix any of it.

The ASC report addresses the harassment of certifying consultants and patients in general,
and of Invercargill staff in particular. Here’s what the report says:
 “We are … concerned about the impact of being known as a certifying consultant in some locations.  During the last year the Committee has heard distressing reports from certifying consultants where they, their families, patients and wider public have been the subject of harassment.  Particularly distressing are reports of women seeking fertility assistance who have been harassed when they were mistakenly thought to be seeking pregnancy termination.”
 

It’s important that the ASC is talking about this, though it’s pretty hard not to draw the
conclusion from that last sentence that it’s of less concern to the committee if women seeking
abortions are harassed than, say, women mistaken for those seeking abortion. Way to go to reinforce
abortion stigma ASC!

And here’s what the ASC had to say about Invercargill:
“It has also come to our attention that harassment of medical staff is taking place in Invercargill resulting from services now being offered at Southland Hospital. We are disappointed that this is occurring.”
“Disappointed”! Strong words. Not. And no mention of what the ASC intends to do about
this.

Readers will recall that the seven-year-long Right to Life v ASC case finally ended on 9
August of this year when the Supreme Court dismissed RTL’s appeal. In its decision, the Court ruled
that the ASC did not have the power to scrutinize individual doctors’ decisions regarding approval of
abortion but that the ASC could ask consultants how they were approaching their decision-making in
general. This report is the first comment we’ve had from the ASC on that case, and it writes:
“The Committee notes it already makes regular enquiries of all certifying consultants. At the time of annual reapplication consultants report on qualifications, continuing professional education, peer support, intended years of service and the nature of the practitioner’s practice. Other enquiries will continue to be made as issues arise.”
The ASC is not saying much here, but this seems to suggest that it thinks it’s already doing
what the court said it should do.

The ASC notes the continued downward trend in abortion numbers overall, and points
particularly to the sharpest decline being in child to teenage groups. It expresses concern that there is
no decline in abortions sought by women who have had two or more previous terminations:
“Key to reaching these women will be further increasing the availability of various forms of
long-term contraception as well as increasing access to publicly funded tubal ligation or ablation so
that unwanted pregnancies are avoided. It is concerning to note that the number of publicly funded
tubal ligations performed has been declining.”

Cue the media focus: According to a report in the DomPost, reality TV shows are helping
push a decline in teen pregnancy. The ASC says this is because “extensive reality television
programming depicts the struggle most young people have in attempting to raise a child of their
own…”

It goes on to say, that “the decline is also likely a result of younger New Zealanders
practising safer sex and having less sex overall”. Apparently not watching so much reality TV are
the 20-24 year olds. There’s a new graph this year on “no contraception by age group.” In other
words, what were the ages of the 52% of women who had abortions and said they’d been using no
contraception? According to the report, the biggest group, at 32%, were 20 to 24 year olds; the next
biggest, at 20% each were under-20s and 25-29 year olds.

When it comes to timeliness, Northland and Southland are still coming in last, meaning
women in those districts are accessing abortion care much later than those elsewhere. (The median
gestation in those districts for first trimester abortion is nearly 10 weeks! That is not a good stat, and
that’s the median, meaning access is much later for some women.) Here’s hoping the Invercargill
service will help improve that stat for Southland. But what is going on in Northland?

Finally, there are 170 certifying consultants, down from 175 in the previous year’s report,
and the amount spent on certifying consultants was $4,427,120, also slightly down on the previous
year.

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