We have officially had 40 years of the Contraception, Sterilisation, and Abortion Act. How do you like it so far?
That’s forty years going through the degrading process of getting the approval of two random certifying consultants in order to give effect to your own decision about your own body. And if you don’t get their approval, your life will take a very different turn – you will become a parent when you’re not ready.
That’s 40 years of certifying consultants acting as a law unto themselves, mostly in the interest of increasing access to abortion. But sometimes having that much power over others turns out less well, like in the case of the consultants at the Waitemata DHB, who unilaterally decided 20 weeks gestation was too long, 18 weeks was plenty.
That’s forty years of having to lie about your mental fragility, and impugn your own mental health, because the alternative involves sickness, fatigue, and financial stress, not to mention childbirth. Forty years of stressing over saying the right thing to get what you need. Forty years where your alternatives were to lie, or to suffer.
That’s forty years of surprise lectures from your GP about how irresponsible you are, how you are a bad person for refusing to fulfil your biological destiny at the drop of a hat. Or maybe your GP just empathetically explaining how they are not judging YOU, it’s just that THEY can’t bring themselves to do something so morally repulsive as refer you for an abortion. But no judgment.
That’s forty years of the law treating you like second-class citizen whose uterus ultimately belongs to the state. The law will decide whether or not you fill the cradles of the Empire. Ask your husband to explain that to you.
I’m thinking we can do better. Let’s change the law. More on that soon.
This week the Dominion Post came out in favour of abortion law reform. It correctly called out forty years of past governments willing to live with our sham of a system that requires pregnant people to pretend to be mentally fragile and doctors to pretend to believe them, in order to get health care.
The article also repeated tired, old abortion stigma tropes about abortions after 20 weeks, saying even the staunchest liberals found them horrifying.
Do they? I don’t know if that is true. But you know what else is horrifying? Open-heart surgery. In fact, just about every kind of surgery is pretty horrifying if you ignore the fact that its purpose is to preserve the health of the patient.
This is why we don’t restrict medical procedures based on how gross they are to watch. If we did, many people who are alive today would be dead.
Last year only 6.2% of abortions in New Zealand occurred after the 14th week. The number of abortions after 20 weeks is not included in the official statistics, but it is likely miniscule.
This is because no one endures pregnancy for 20+ weeks and then lightly changes their mind. To suggest otherwise is rank misogyny.
Pregnancies that last that long are wanted pregnancies. Abortions at 20+ weeks happen because the people involved are in crisis, usually because the mother is catastrophically ill, or the foetus is.
The last thing a family in the midst of a health crisis needs is to be forced to justify themselves in a legal process on top of the medical process. Why do so many people want to make their lives even harder?
People sometimes say they oppose abortion being available right up to the due date. But abortion is already available right up to the due date, in crisis situations like we are discussing.
Perhaps what they mean is, they oppose large numbers of abortions for frivolous reasons in the third trimester. Fair enough. If such a thing were happening, you would naturally expect to see it in a place where there are no legal time limits on abortion.
Such a place exists – Canada has had no abortion restrictions of any kind, including time limits, since 1988. They treat abortion just like other health care.
Does Canada see large numbers of abortions for frivolous reasons? Well, no. Last year in Canada only 0.59% of abortions occurred at 21+ weeks, and likely they were all because of medical necessity.
Why is it so hard to trust people to know what is best for themselves and their families? Is it because the people making the decisions are women?
New Zealand is about to have a national conversation about abortion. Kiwis will need to keep their critical thinking faculties sharp to deal with anti-choicers’ bad faith arguments and ridiculous narratives.
The bad faith arguments usually take the form of trotting out debunked research as though it were reliable. I’ve talked about it before.
The narrative, however, goes something like this: women and children need to be protected from abortion.
Let’s take a few minutes and unpack that.
“Children”: when anti-choicers talk about children being harmed by abortion they mean to imply children are aborted. This is false – neither children nor babies are the subject of abortions, only zygotes, embryos, and foetuses. They use the word “children” to imply people are out there aborting five year olds.
“Abortion”: anti-choicers like to imply abortion is dangerous. It isn’t. Abortion has a very low complication rate. It is about 14 times safer than childbirth. Which is, you know, the only other alternative if you are pregnant.
“Protected”: this is a euphemism for “controlled”, meaning prevented by law from accessing health care anti-choicers don’t want you to access. Of course, that hasn’t worked too well for the past few hundred years. Experience has demonstrated again and again that pregnant people will take a chance on black market abortions if safe abortion care is no longer legal. The best way to protect people from unsafe, illegal abortions is to make abortion legal and easy to access. But you never see anti-choicers talk about protecting women from the inevitable effects of the abortion laws they want.
“Women”: this narrative frame presents abortion as something that happens without their consent, like a mugging. It conveniently ignores the reality that abortion is something women seek out, and will go to great lengths to access. It assumes women are not too bright, little more than children, not competent enough to govern themselves, likely to fall prey to … I dunno, evil abortion doctors? Like DHBs are out there trying to lure unwary pregnant women into their abortion services?
It would be a good critical thinking discipline to run anti-choice narratives through a kind of bullshit meter. All you need to do is examine their implications logically and realistically, with the common sense of a five year old child.
That is the proper use for imaginary five year olds.
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.
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 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.
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.