The draft abortion law reform bill has passed first reading, 94 to 23. Yay!
Much of the bill is great! Some if it is not that great.
Let’s start with the things the government definitely got right.
Abortion care is out of the Crimes Act for health practitioners
Abortion is now only a crime if it is procured or performed by a non-health practitioner. Self-abortion is no longer an offence.
Self-referral to abortion service
This is so important. Abortion care is time-sensitive medical procedure. Forcing people to get a referral wastes their valuable time and money on a pointless gatekeeper. This way, people who can’t or don’t want to visit their doctor can refer themselves directly to a service.
Counselling offered, but not mandatory
Many people find counselling to be helpful in clarifying their decision. But, as the New Zealand Association of Counsellors has pointed out, it’s only helpful if it’s voluntary. This section makes sure counselling is available for those who want it, but does not present another hoop to jump through for those who don’t.
No certifying consultants
Instead, the only health practitioner a pregnant person needs to visit is the one that will be providing her termination.
Qualified health practitioners can provide service
In the past, only doctors could provide abortion care. Now other qualified health practitioners can do so as well. This is important for ensuring enough providers. Research in the USA has shown nurse practitioners and midwives can provide abortion care safely, with complication rates as low as doctors.
No more licensed premises
Clinics no longer need to have a licence to provide abortion care. They will be treated like every other place where health care is provided.
Abortion Supervisory Committee disestablished
In the past, they appointed certifying consultants and granted licences for abortion services. They won’t need to do that anymore. Their data collection responsibilities will shift to the Director-General of Health.
Under 20 weeks, it’s health care
For pregnancies under 20 weeks, there is no statutory test to apply. These cases are treated like other kinds of normal health care, with the pregnant person consulting a qualified health practitioner.
The bill gives the Minister of Health the power to make regulations setting up safe areas of a maximum radius of 150m; within those areas intimidating, interfering, obstructing, communicating with or visually recording people seeking or providing services is prohibited.
That’s a lot to get right. But let’s move on to some of the more questionable bits.
A statutory test after 20 weeks
After 20 weeks gestation, instead of two certifying consultants you have one qualified health practitioner applying a statutory test to see if they will give you approval for your abortion care. This person probably does not know you any better than the certifying consultants would have.
The health practitioner must have a reasonable belief that the abortion is appropriate with regard to the pregnant person’s physical and mental health and wellbeing. But why should a random health practitioner’s judgment that an abortion is appropriate be of more value than that of the pregnant person?
Women are still being treated like children, incompetent to choose their own medical care.
Why 20 weeks?
The bill sets the cutoff at 20, with no explanation why 20 weeks is better than 22. Is there ANY medical, scientific, or rational reason behind it? Nope, it’s more likely New Zealand First’s political pound of flesh for … calling for a referendum anyway?
Less than 1% of abortions in NZ occur after 20 weeks, and they generally happen because a wanted pregnancy has suffered some medical crisis. The last thing families in crisis need it to undergo a legal process to see if they will be allowed to deal with the crisis in the way they think is best for their family.
Health practitioners will still be able to refuse service and obstruct access to reproductive health care. But under this bill, in the case of abortion, the obstructing health practitioner must tell the pregnant person how to access a list of providers maintained by the Director-General of Health.
Which still leaves patients wasting time and money on a useless GP visit because they could not foresee their GP refusing them.
Wouldn’t it make more sense to compile a list of practitioners who WON’T provide services? Then, patients could completely avoid asking these GPs for service.
Self-referral means this kind of obstruction will come up less often for abortion referral. But that still leaves contraception or sterilisation services. In those cases, the obstructing health practitioner need only tell the person how to access the contact details of someone else who provides the service. Tell them to Google it and it’s done? Not very helpful.
At the very least, for contraception, the obstructing provider should be required to provide the name and contact details of another provider. In the case of an obstructing pharmacist, the pharmacy should be required to have a person on duty at all times during business hours who will provide all requested services.
The practice of obstructing access to care is still far out of balance in providers’ favour.
The Bill will be properly poked and prodded through the select committee process, with a fantastic roster of MPs on the committee. If you were ever going to do something to support abortion law reform, now is the time to make your mark by making a submission to the select committee. Keep your eyes open for submissions parties in your area!