The Reprieve

The Reprieve

by Terry Bellamak

The United States Supreme Court has struck down Louisiana’s law requiring abortion providers to have admitting privileges at local hospitals – a requirement made both unnecessary and impossible to fulfil by the very safety of early medical and surgical abortions. To maintain such privileges, doctors have to admit a certain number of patients each year, but complications requiring hospitalisation are extremely rare – too rare to maintain their admitting privileges.

If the facts of the case sounds familiar, well spotted. This law is almost identical to the one the Supreme Court struck down in Whole Women’s Health v Hellerstadt in 2016.

Chief Justice Roberts cast the deciding vote. But please, don’t make the mistake of imagining for a minute that this means his heart is in the right place. His concern is not for anyone’s bodily autonomy or moral agency, but for his court’s standing in the eyes of the world, and its legacy in the eyes of history.

Roberts cast his vote on the strength of stare decisis – the legal principle that courts should decide similar cases in similar ways, so that people can have a reasonable expectation they know what the law is. The Supreme Court reversing itself in such an obviously indistinguishable case would have brought the court into disrepute amongst those who still believe legal principles should not give way to political considerations, at least in the courts.

Abortion cases that arrive on the court’s docket in future may not fare so well. American conservatives, like those on the court, seem hell-bent on returning the USA to the 1950s. As Mary Ziegler notes in her New York Times op-ed of 29 June 2020, modern conservatives demonstrate

“a candid willingness to ‘legislate morality,’” including in cases of abortion, sexual liberties, free speech and contraception.

Some are attacking Roberts and the court for not having overturned Roe v Wade already.

But with this decision, defenders of reproductive rights live to fight another day.

Tribute to De Rex Hunton MBE

Tribute to De Rex Hunton MBE

by Dame Margaret Sparrow

I first met Rex soon after the opening of the Auckland Medical Aid Centre in May 1974. It was a great relief to those of us who were having to refer women to Australia at that time and I wanted to see for myself to where I was referring patients. I was impressed with his openness and humility and greatly admired his initiative in establishing the clinic. It was a courageous act in the face of huge opposition. As a lecturer in Community Health he had been asked to identify issues that needed attention and he identified two – homosexuality and abortion.  But he didn’t just identify a problem, he did something about it.

Rex preferred to be independent and never joined ALRANZ but was always supportive. He had the support of a number of ALRANZ members:  inaugural President Isobel Stanton worked at the clinic as social worker, counsellor and supervisor, ALRANZ secretary Anna Watson became clinic administrator and Professor John Werry became an operating doctor.

It was frustrating when the clinic was raided by the police in September 1974 and even though the confiscation of patient files was later deemed illegal, police were able to use the files for prosecuting the operating doctor, Dr Jim Woolnough. Twelve selected cases were brought to trial and as I was involved I saw more of Rex at this time. He was stalwart in defence of the clinic and had always maintained high professional standards. He introduced suction curettage, sending Dr Woolnough overseas to learn this technique. He was the first to introduce abortion counselling and this remained a priority. After two High Court trials, the first resulting in a hung jury, Dr Woolnough was acquitted and the not guilty verdict was upheld by the Appeal Court.

Then came the Royal Commission and the December 1977 legislation which closed AMAC because of the Wall clause “and the danger cannot be averted by any other means”. We were back again referring women to Australia until the law was modified in July 1978. However even then there was a legal battle to restore the licence to AMAC and this did not happen until August 1979. Having endured all the upheavals of the 1970s it was understandable that Rex then moved on to other less controversial areas of medicine. Rex was respected and admired and an inspiration to those of us who followed in his footsteps.

He wrote of his strict upbringing and how difficult it was for him to come to terms with abortion but how “gradually I came to realise that only the woman herself can know the correct course of action.” New Zealand women owe a great debt to this very caring physician. His death cannot pass without paying a tribute to his long lasting influence.                                                                                                                   

Final Abortion Statistics from Stats NZ

ALRANZ Abortion Rights Aotearoa welcomes Stats NZ’s final report on abortion statistics, for the year ending December 2019. In future this data will be collected and presented by the Ministry of Health, in keeping with the recognition that abortion care is a health matter.

The statistics show the number of abortions is down slightly over 2018, to 12,857 from 13,282 in 2018.

Although the majority of people receiving abortion care are in their twenties, there was a slight uptick in the percentage for people in their thirties. The decline continued in abortions for those under 20.

Just over 64% of abortions occurred before the 10th week of pregnancy.

“We hope next year’s statistics show an even greater trend toward early abortions, as the new law’s effect is felt,” said Terry Bellamak, ALRANZ National president.

“During the Covid-19 lockdown, the New Zealand Health System very sensibly moved toward offering telemedicine care for early medical abortions, which allows for even less red tape, and eliminates travel for abortion care. It will be interesting to see these changes reflected in next year’s statistics from the Ministry of Health.”

New Zealand reformed its abortion laws in March of 2020, decriminalising the procedure and aligning it with other health care.

Not the Standards We Were Promised

by Terry Bellamak

Refresh my memory – didn’t New Zealand reform its abortion laws a few months ago?

Wasn’t there something in there about qualified health practitioners (not just doctors) being allowed to provide abortions? 

And something about changing the rules so early surgical abortions, which are safer than getting your wisdom teeth removed, didn’t have to be provided in expensive, scary, full-on surgical theatres suitable for open heart surgery?

You wouldn’t know it from reading the Interim Standards for Abortion Services in New Zealand. This is the rulebook for providing abortions. Section 16 of the Contraception, Sterilisation, and Abortion Act 1977 gives it the force of law.

They read like someone did a cut-and-paste job on the old Standards, and deleted the bits about the Crimes Act and certifying consultants. Law reform was much more than that. 

Among other things, it enlarged the circle of people who can provide abortion care from doctors-only to qualified health practitioners, which includes properly trained nurse practitioners and midwives. Research has demonstrated qualified health practitioners can provide care with the same excellent safety record as doctors.

The new law also removed the requirement that early surgical abortions be provided in full-on surgical theatres, which is unnecessary. Experience in other OECD countries, like Australia the USA, shows early surgical abortions can be provided safely in settings like community health clinics and doctors’ surgeries. New Zealand’s experience during the Covid-19 crisis shows early medical abortions can be provided safely at home, via telemedicine.

But these interim standards do not mention anyone but doctors providing abortions. It sets no rules or standards for medical competency for any providers except doctors. They do not set out requirements for places where abortion can be provided, except to reiterate the old standards, i.e. full surgical theatre.

This is tantamount to making early surgical abortion unlawful unless provided by a doctor in a full-on surgical theatre. Wasn’t that one of the things that was supposed to change under the new law?

Granted, the Ministry of Health has been pretty busy of late. But New Zealand has medical professionals, experienced doctors and nurses, capable of doing a much better job revising the standards, even at short notice. Why were they not allowed to be of service? Is this patch protection on the part of the Ministry of Health?

The main problem we have with the interim standards is this: they do not follow the law. This is not the law reform New Zealanders fought for over 50 years for.

If you agree that this isn’t good enough, let your MP know.  

The Future for ALRANZ

The Future for ALRANZ

For almost 50 years, ALRANZ Abortion Rights Aotearoa was all about reforming New Zealand’s abortion laws.

Now, we have law reform. So where do we go from here?

Let’s talk about a vision for our organisation’s next steps. This discussion is open to all our friends, members, and supporters. It will help us set the stage for ALRANZ’s AGM.

Come with your ideas about the future of reproductive health and rights in Aotearoa.

To get tickets to this event, go here.