People Will Talk

People Will Talk

Harvey Weinstein and his vaunted career are foundering under the weight of one simple fact: people will talk. His disgusting behaviour was an open secret in Hollywood for years.

It seems New Zealand’s abortion bureaucracy has come to a similar pass.

For many years, abortion seekers have been abused by a system that denies them the right to make their own decisions about their bodies and their lives, forces them to lie and run around from pillar to post getting a long list of pointless boxes ticked in order to get the approval of two random strangers to get the health care they need. At the end of the process, people just wanted to forget about it.

But now, people are starting to speak out about how the abortion bureaucracy has treated them. Over the past year, women have spoken out about judgmental doctors who lectured them about ‘woman’s true calling’, rude pharmacy clerks who slut-shamed them for asking for Plan B, and creepy old men who are allowed to lurk outside abortion services with grisly pictures and foetus dolls.

Moreover, women are speaking out about the abortions they were refused, exploding the fantasy that New Zealand’s abortion bureaucracy amounts to abortion on request.

In the past few weeks, the Waitemata DHB has seen its policies around abortion repeatedly exposed in the Wireless and the NZ Herald. The WDHB has refused to allow patients to meet with certifying consultants, even though the patients were within the legal time limits for consideration. This amounts to refusing them an abortion. Their stated policy is to suggest these women travel to Australia at their own expense, if they don’t want to be mothers yet.

But now, we know about it. That’s the first step to doing something about it.

Old stigmas are breaking down. Good.

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.

“Broadly satisfactory”

“Broadly satisfactory”

by Terry Bellamak

Bill English on abortion law: “It seems to operate in a day-to-day way that is broadly satisfactory, and so I support the current law.”

What happened to a woman in Auckland recently demonstrates how current abortion law is not “broadly satisfactory”.

The Wireless reports a woman came to the Waitemata DHB with an unwanted pregnancy. She wanted an abortion, and was within the time limit. She had the right to have her case determined by two certifying consultants, and a third if the first two disagreed. But according to the story, a social worker employed by the DHB prevented her from having a consultation with any certifying consultants.

Under the Contraception, Sterilisation, and Abortion Act, doctors refer their patients to certifying consultants. There is no provision for gatekeeping counsellors to prevent that consultation.

And yet that is what is said to have happened. Enough time was wasted to put the woman out of time for an abortion in New Zealand.

What is it like to be so vulnerable that one person’s seemingly trivial action can change the course of the rest of your life? Ask any woman who has had to beg a certifying consultant for a signature that gives her back her health, her future, her education, her career, her dreams for the future. A signature that saves her from poverty, depression, and beneficiary-bashing bureaucrats. A signature that can cut her tie to an abusive partner.

Just wanting to be free of an unwanted pregnancy is not enough. She needs the abortion bureaucracy to turn in her favour and make the right people available, in order for her to put her request to them.

What is it like when one person in a position of power over you by virtue of their role in the abortion bureaucracy decides not you, not today? You don’t know why. You can ask, but they don’t have to tell you. They can refuse your plea, and send you away. If this embarasses their boss, they may get a letter in their employment file. They may get sacked. You will get a child, and a life change you never wanted.

This is what happens when women do not have the right to an abortion: it means someone else has the right to refuse them. No one should have that much power over another human being.

Lord Bingham of Cornhill wrote the rule of law requires the law be certain and accessible, not arbitrary or discretionary, and that everyone must be equal before the law. Our abortion laws and their inconsistent application violate all these principles. A pregnant person’s fate is determined by an act of discretion by two certifying consultants. What the law is and how it is applied depends on where the pregnant person lives. That is not equality before the law.

This outrageous situation has continued for 40 years. It is well past time for change.

Evidence based and patient-focused

Evidence based and patient-focused

Finally, after 40 years, a New Zealand politician has the courage to admit what many of us have known all along: New Zealand’s abortion bureaucracy is not fit for purpose.

It’s a good start. Acknowledging the problem is the first step toward solving it.

But merely taking abortion out of the Crimes Act is not enough to transform the abortion bureaucracy into a patient-friendly system. Theoretically, it’s possible to take abortion out of the Crimes Act and keep the certifying consultants, and everything else that makes the system a waste of time and money.

Assuming the next government achieves abortion law reform, perhaps no one will want to touch it for another 40 years. We had better make sure Parliament comes up with a system we can live with, one that is responsive to changes in technology and best practice.

Any new system must be evidence-based and patient-focused. This is because abortion is health care. It should be regulated just like other forms of health care. No more, no less.

For any given proposal for a rule or regulation we should be asking ourselves: does the best evidence support this regulation? Is it based on reality or misogynist stereotypes? Is it based on evidence or emotion?

New Zealanders have had enough of abortion law based on old prejudices that were falling out of use even as the Royal Commission of 1976 was writing its reporton abortion. It is time to trust women to decide what is best for themselves and their families.

Norms have changed since the 1970s. Most people no longer believe women are inferior or incapable of making decisions for themselves.

It is incumbent on those who do not trust women to say why they do not find women trustworthy. And provide evidence.