by Dr. Morgan Healey
(This is a longer version of an article included in our May Newsletter.)
At ALRANZ’s 2015 pro-choice gathering in March, Dr. Simon Snook announced the introduction of a new service, New Zealand Abortion Assessment Clinic or NZAAC that seeks to streamline abortion referrals over the telephone. Pregnant people will be able to ring 0800-ABORTION (226784) be assessed over the phone by a medical professional. This person will help the woman locate the nearest clinic/hospital, provide advice on options regarding the type of abortion available (early medication or surgical), schedule the procedure along with any counselling, lab work and scans that are required by the operating physician. It will also enable the first certification to be done without a face-to-face appointment (one of two required to have a legal abortion in Aotearoa/New Zealand).
The service, which expected to be live the first week of June, is designed to reduce the wait times women are currently forced to endure (sometimes up to 3 to 4 weeks) and help to reduce the gestational age of terminations (currently only 56% of New Zealand’s abortions are done before 10 weeks). This is not only good medical practice (World Health Organisation guidelines suggest best medical practice is before 8 weeks), but one that is specifically woman-focused.
As Dr. Snook described, the idea for the new service came from 2010 research conducting on abortion wait times – “Ladies in Waiting: the timeliness of first trimester services in New Zealand” by Martha Silva, Rob McNeill and Toni Ashton. Silva et al. found that delays in treatment was primarily caused by the fact that women cannot self-refer to a clinic that performs abortions, and instead must go through a primary care provider. Some women have to ‘shop around’ for a doctor who is willing to provide the referral to the appropriate abortion provider. The time between first contact with the health care system and first certification was such a contributing factor, that Dr Snook saw the potential for improvement. To put it into perspective, Silva et al. stated:
Overall, there was a 24.9 days difference between the first contact with the health care system to procure a TOP and the date of the TOP procedure. An average of 10 days went by between first contact and the date the appointment at the TOP clinic was booked, and another 10 days went by between the date the appointment was booked and the first appointment with the TOP clinic. From the first appointment with the TOP clinic to the date of termination, an average of 4 days went by (2010: 8).
For those who have ever had to wait for a medical procedure, one where time is of the essence, we all know that 25 days is far too long to wait. The stress and anxiety this creates is completely unnecessary and is not replicated in other Western countries like the United Kingdom or the United States where abortions can be done almost immediately or within days.
The service is a simple idea, but one that has the potential to greatly reduce waiting times, barriers to access and provide greater choice in terms of the type of abortion procedure available – medication abortions can only be done up to 9 weeks. This could be particularly helpful for women in rural areas, women with limited means of accessing transportation to and from appointments, or those with physicians that refuse to refer women for an abortion. Pregnant people will now have the choice between anonymous medical advice or the personalised assistance of their GP. It is certainly a step in the right direction in terms of improving abortion services in Aotearoa/New Zealand. Dr Snook should be applauded for leading in an area of medical care that is not popular or often lauded for innovation. ALRANZ is incredibly grateful for launching the service at the gathering and for all the work he does to ensure abortion care is safe, available and tailored to the needs of those who access the service.
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