Waitemata DHB Refuses Second Woman’s Abortion

The NZ Herald has revealed the Waitemata DHB refused another pregnant woman an abortion at 18 weeks, suggesting she travel to Australia for an abortion at her own expense instead. This is the second time the Waitemata DHB has refused an abortion without allowing the patient to meet with certifying consultants in the last 12 weeks.

ALRANZ National President Terry Bellamak questioned whether the DHB was meeting acceptable standards for natural justice.

“Apparently, the DHB decided Erica was not eligible for an abortion without her meeting with or even speaking to any certifying consultants. Nor did the DHB make any inquiries into her mental health. I question whether the DHB has met its duty of care to Erica,” she remarked.

“This is the second instance we have learned of in past weeks where the Waitemata DHB has refused an abortion to a pregnant woman with valid claims of mental distress from an unwanted pregnancy. Both Erica and Kate, the woman whose story was told in the Wireless on 18 September 2017, may well have satisfied the criteria for an abortion under 20 weeks gestation under the mental health ground. But apparently the DHB never gave them a chance to put their case.

“ALRANZ wrote to the Abortion Supervisory Committee on 3 October 2017, in response to Kate’s case, requesting clarification on whether the Waitemata DHB’s policy around abortion meets standards of natural justice. The ASC has a responsibility to supervise the provision of abortion in New Zealand. ALRANZ would like to know whether the ASC is satisfied with the Waitemata DHB’s process for determining whether people are eligible for abortion care. The DHB is making decisions that will affect people’s lives forever.”

Under New Zealand’s abortion laws, two certifying consultants must approve every abortion under a narrow set of grounds set out in the Crimes Act. Those grounds do not include rape, nor the most common reasons cited overseas: contraception failure and the inability to support a child.

Poll results show a majority of New Zealanders support the right to access abortion on request.

 

The Definition of Mental Health

The Definition of Mental Health

In correspondence with Dr Helen Paterson, the Abortion Supervisory Committee did New Zealand a service by clarifying the meaning of ‘mental health’ in the context of determining eligibility for a termination of pregnancy under s 187A of the Crimes Act 1961.

The Crimes Act s 187A (1)(a) sets out the first ground for approving an abortion as:

continuance of the pregnancy would result in serious danger (not being danger normally attendant upon childbirth) to the life, or to the physical or mental health, of the woman or girl

In a letter dated 3 August 2017, the committee said, “the ASC is comfortable with certifying consultants’ adoption of the definition of mental health developed by the World Health Organisation.”

The WHO defines mental health in this way:

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

The positive dimension of mental health is stressed in WHO’s definition of health as contained in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

This definition of mental health is quite wide, and brings most patients seeking abortion into its ambit. Pregnant people seeking abortion should keep this definition in mind should their requests for termination of pregnancy be denied.

It seems likely “Kate” met this definition when she was denied an abortion at 18 weeks the abortion service at the Waitemata DHB.

The Courage of the Abortion Supervisory Committee

The Courage of the Abortion Supervisory Committee

The Abortion Supervisory Committee showed courage when it refused to sack Dr Helen Paterson for holding the view that abortion should be a matter between a pregnant person and their doctor.

Our archaic abortion laws put the ASC between a rock and a hard place.

The Contraception, Sterilisation, and Abortion Act 1977 s 30 directs the ASC to appoint certifying consultants “whose assessment of cases coming before them will not be coloured by views in relation to abortion generally that are incompatible with the tenor of this Act.” It goes on to describe those views as: a) “that an abortion should not be performed in any circumstances”; or b) “that the question of whether an abortion should or should not be performed in any case is entirely a matter for the woman and a doctor to decide.”

But the New Zealand Bill of Rights Act 1990 s 13 recognises people’s freedom of thought, conscience, religion and belief, including the right to adopt and to hold opinions without interference.

If these two laws sound incompatible, you’ve got it right. The CSA directs the ASC to discriminate based on opinion, which the Bill of Rights Act proscribes.

Oops.

BORA s 7 directs the Attorney General to tell Parliament when a bill likely contravenes BORA, but that process was never retroactive.

So the ASC, faced with the choice of either breaching a glorified regulation in the CSA, or breaching a fundamental human right in the BORA, chose to breach the regulation. The choice they made shows integrity.

This decision has consequences for the ASC. It is possible Right to Life New Zealand will seek judicial review, costing Crown Law time and money.

ALRANZ applauds the ASC for making the principled choice.

Busting Some Myths

Busting Some Myths

New Zealand may be on the verge of having a grown-up conversation about abortion. After forty years, we are ready.

For this conversation to produce light as well as heat, New Zealanders will need to keep their critical thinking skills sharp. Whatever else it may be, abortion is a public health issue. Public health decisions must be based on the best available evidence.

There are a number of myths about abortion Kiwis are likely to hear repeated over the course of this conversation. This may be because anti-choice types wish they were true. Here is a sample, with research that debunks them. I have restricted myself to one citation each, to limit word count.

MYTH: Abortion is dangerous

In 2016, the US Centers for Disease Control and Prevention said abortion had a greater than 99% safety record and is one of the safest medical procedures. It also said abortion has no impact on future fertility.

MYTH: Abortion increases the risk of breast cancer.

In 2014, the American Cancer Society said there is no scientific evidence showing abortion increases the risk of breast cancer, or any other kind of cancer.

MYTH: Abortion leads to mental illness.

In 2011, the Academy of Medical Royal Colleges found abortion does no harm to mental health.

MYTH: People regret their abortions.

In 2015, the University of California found 95% of people who get abortions do not regret their decision.

MYTH: Late term abortions will increase if they are unregulated.

In 2015, the Canadian Institute for Health Information estimated only 0.59% of abortions occurred after 21 weeks. Abortion in Canada has not been regulated since the 1980s.

 

New Zealand has a reputation for being one of the most secular countries in the OECD. If anyone can conduct an evidence-based discussion of abortion, we can.

Pro-choice Certifying Consultant Keeps Her Job

The Abortion Supervisory Committee (ASC) has decided Dr Helen Paterson can keep her appointment as a certifying consultant in spite of her pro-choice views on abortion.

In July, Dr Paterson informed the ASC she believed abortion should be a matter between a woman and her doctor. The Contraception, Sterilisation, and Abortion Act 1977 directs the ASC to regard such views as incompatible with the Act.

ALRANZ National President Terry Bellamak welcomed the ASC’s decision not to dismiss Dr Paterson.

“Certifying consultants have freedom of thought just like everyone else in New Zealand,” she said.

“The Bill of Rights Act guarantees everyone freedom of thought, conscience, and religion. The Human Rights Act prohibits discrimination on the basis of ethical belief and political opinion. The ASC rightly recognised sacking a certifying consultant on those grounds would violate their human rights.

“Certifying consultants need no longer hide their views for fear of losing their appointments.”

Under our abortion laws, two certifying consultants must approve every abortion under a narrow set of grounds set out in the Crimes Act. Those grounds do not include rape, nor the most common reasons cited overseas: contraception failure and the inability to support a child.

Poll results show a majority of New Zealanders support the right to access abortion on request.