Telemedicine abortion service to expand access to care

 Whomever you are and wherever you live in Aotearoa New Zealand, you have the right to end a pregnancy if you want or need to. One way to do so is through early medical abortion, which uses pills and allows for self-managed abortion at home. This option has been available via telehealth for some time but has become more common in recent years, especially since the start of the COVID-19 pandemic. 

 A new service called DECIDE, launched in April by the Ministry of Health, is helping to expand existing telehealth services and close overall gaps in access to abortion care. DECIDE provides consultations and medications for early medical abortions, along with related services, including consultations, information, referrals, counselling, and after-care support. This service cannot replace in-person care, which will always be necessary in certain cases, but helps to enlarge access to safe and timely abortion. This is a great step forward for equitable sexual and reproductive healthcare. 

 There is a growing evidence base on telehealth abortion services, especially due to its increased of rollout across the globe due to COVID-19 restrictions. International research shows that telehealth abortion care is extremely safe and effective. Self-managed medical abortion conducted by telehealth is just as safe and effective as when the procedure is completed in person at a doctor’s office, clinic, or hospital. This option is not associated with higher risks of complications compared with pills accessed in-office. In fact, only 2% of medication abortions result in complications, and most of those are minor. Plus, most patients report being satisfied with their experience.

The research also suggests several advantages to telehealth abortion services, namely:

  • allow more privacy and autonomy (avoid harassment, conscientious objection, disclosing choice if unsafe)
  • help ensure timely care
  • greater flexibility reduces burdens of cost, travel, and time
  • reduce pregnancy-related deaths

 

 Telehealth services are especially beneficial to those who may not otherwise be able to access abortion care. This may be due to low resources, disability, caregiving or work responsibilities, or geographical distances, especially if disclosing an unintended pregnancy is difficult or unsafe. Indeed, researchers report that barriers limiting abortion access most profoundly affect communities that already face health care and social inequities and can therefore widen existing socio-economic inequalities.

 It is also important to note that access to early medical abortion through telehealth ensures timely care. While abortion is among the safest medical procedures, the earlier it is done, the fewer complications there could be. Reducing wait times for abortion, which has been a major problem in the past, can also help alleviate some of the stresses associated with unintended pregnancy.

The country is already seeing higher rates of earlier access to abortion and the final rollout of the DECIDE services will hopefully maintain this trend and contribute to more equitable access to sexual and reproductive healthcare for all.

ALRANZ welcomes good news from Kansas

ALRANZ Abortion Rights Aotearoa hails the failure of a Kansas referendum that would have removed protection for abortion rights from the state’s constitution. The vote is a strong demonstration of the popularity of abortion rights in the United States of America, even in conservative states like Kansas. US polls consistently show support for reproductive rights in the 60%’s.

ALRANZ president Dr Tracy Morison said, “It is a relief to see voters pushing back successfully against anti-abortion politicians’ undemocratic attempts to restrict the fundamental human right to bodily autonomy. It looks like the US Supreme Court decision in Dobbs may have provoked a backlash.”

Abortion access in the US in the wake of the overturn of Roe v Wade has become a patchwork with different states restricting or protecting access to abortion. Kansas has been a midwestern bulwark for protection of access to abortion. In 2009 Dr George Tiller was murdered by an anti-abortion extremist while Dr Tiller was serving as an usher at his church in Wichita, Kansas. 

New Zealand reformed its abortion laws in 2020, legalising abortion up to 20 weeks as a matter of right. The Ministry of Health is in the process of implementing the law to fulfil the promise of increased access to services. 0800 DECIDE (or www.decide.org.nz) is the most comprehensive element of that effort to date.

ALRANZ urges New Zealanders to remain vigilant regarding our rights. ALRANZ believes abortion is a fundamental human right, but as we have seen in the US, a hard won right is not always guaranteed.

 

Roe v Wade: the religious right has long influenced law in the US – here’s how abortion rights could be challenged elsewhere

Roe v Wade: the religious right has long influenced law in the US – here’s how abortion rights could be challenged elsewhere

  By Pam Lowe, Aston University

The US Supreme Court has formally announced its decision in the case of Dobbs v Jackson Women’s Health Organization. This has overturned the 1973 case Roe v Wade, which enshrined access to abortion as a constitutional right in the US.

The threat to Roe has been the outcome of a strategy specific to US culture and legal structures. But this does not mean that other nations should feel secure in their current access to abortion. There are conservative religious organisations, politicians and activists who seek to constrain reproductive rights around the world.

The Roe case in 1973 provided a landmark ruling that the law against abortion in Texas, where the case originated, violated a constitutional right to privacy. The ruling applied to the whole country and therefore abortion in early pregnancy could not be banned in any state.

Almost immediately after the Roe case, campaigns were launched to try to reverse the decision. An important part of this was repeated attempts to change the constitution of the US to explicitly protect the foetus as a way to ban all abortions. These attempts are known as human life amendments. None of the attempts to get a human life amendment came close to succeeding.

A concerted campaign

The 1980s saw the rise of the religious right as a political force in the US. The religious right established law schools and legal training programmes with the express intention of reversing legal secularism and promoting a vision of law rooted in their understanding of Christian theology. By training Christian lawyers, they could challenge issues they objected to through the courts.

Amy Coney Barrett, a Supreme Court justice nominated by Donald Trump, has been a speaker at a fellowship programme aimed at promoting Christian law.

This decades-long strategy of seeking power and influence in the US political and legal system has culminated with the end of Roe. This leaves each state with the power to decide the extent abortion is permissible, including many which will severely reduce access or ban it completely.

More generally, critics have argued that the conservative Christian justices, who hold the balance of power at the Supreme Court, are undermining the historic separation between church and state in the US. This criticism has even been made by an associate justice of the Supreme Court, Sonia Sotomayor.

While many people seemed shocked that Roe could fall, it is not a surprise to those who have been following the situation. This anti-abortion strategy is unlikely to be fully replicated elsewhere, as it was shaped specifically around the US structures of law, education and politics, but it is illuminating.

The history of abortion is complicated. In many parts of the world, abortion was not legally prohibited before the 19th century. Colonialism played a key role in spreading abortion bans, particularly the British Empire, which imposed British law against abortion on its colonies. The 20th century saw a push back against this, but there has not been uniform progress towards reproductive rights.

In Poland, the law was changed to allow abortion in the 1950s. Women travelled there from other countries to access abortion. This liberal position on abortion was reversed in the 1990s after the fall of the Berlin wall, and this is widely associated with the heavy influence of the Catholic Church.

Crowd with placards
Protest against abortion restriction in Kraków, Poland, October 2020. Silar/Wikipedia Commons, CC BY-SA

In Britain, the 1967 Abortion Act, which outlines when abortion is permitted, remains in place. But there have been repeated attempts in parliament to restrict abortion, which started shortly after the Act was passed.

Although access to abortion in Britain has not been seriously threatened for decades, this is due to constant vigilance and campaigning by pro-choice activists. It is worth remembering that Northern Ireland, which was excluded from the 1967 Abortion Act, only saw the liberalisation of abortion law in 2019.

Global movement

There are anti-abortion organisations, funders and political leaders around the world that seek to learn from each other in their overall mission to ban abortion. While the US religious right is a significant force in this, they are not the only major players.

Research by the European Parliamentary Forum for Sexual and Reproductive Rights found that European and Russian organisations were by far the biggest funders of “anti-gender” initiatives across Europe. “Gender” or “gender ideology” is the term that is used by the religious right to describe a range of issues such as abortion and same-sex marriage. Anti-gender organisations use a variety of legal, political and media strategies, depending on the situation in each country, to try to assert “traditional” family values, and prevent or reverse liberal and secular understandings of reproductive rights, marriage and family life.

The Catholic church plays a central role in the “anti-gender” position. In France and Slovakia, Catholic politicians with links to the Vatican founded or led both Christian political parties and NGOs that campaign against abortion. In the European Parliament in 2021, anti-abortion MEPs unsuccessfully tried to prevent a resolution that declared abortion as a human right and condemned countries where access is restricted.

Regardless of what happens in the US, reproductive rights in other nations have always been insecure. It is a constant battle to increase and maintain abortion access due to the power of those who are opposed. This will continue even without the influence of the US. The fall of Roe is a significant boost to the global anti-abortion movement. It will encourage this movement to pursue additional routes to power and influence in other nations and pan-national organisations.The Conversation

Pam Lowe, Senior Lecturer in Sociology, Aston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Roe v Wade Reversal: An Assault on Rights

On Friday, 24 June 2022 (local time), millions of United States citizens lost the right to control their bodies and make decisions affecting their lives, families, and futures. The US Supreme Court reached a majority decision to overturn the constitutional right to abortion care. The United States joins Poland, El Salvador, and Nicaragua in recent reversals of abortion rights.

 ALRANZ Abortion Rights Aotearoa joins reproductive health and rights organisations around the world in expressing grave concerns. ALRANZ President and sexual and reproductive health researcher Dr Tracy Morison stated, “This decision makes no legal or public health sense; it simply makes reproductive rights uneven across the United States. Restrictive laws are associated with more unsafe abortions; globally, the leading cause of avoidable pregnancy-related deaths”. 

 Experts warn that the Supreme Court’s judgement will cause wide-ranging individual and social harm, highlighting that countries where abortion is heavily restricted or banned fare far worse on health, social, and economic indicators than those allowing choice. Morison concurs. “This judgement will undoubtedly harm and place an undue burden on individuals seeking an abortion,” she said. “Along with poor health outcomes, there are likely to be negative social and economic effects too. We can expect to see widening social inequality because those from marginalised groups struggle most to access abortion. There are potential negative consequences for gender equity. Reducing women’s reproductive choices affects their education, employment, and earning potential, with knock-on effects for their families, communities, and wider society. There are also worries about LGBTQ health and recently gained rights”.

 Reproductive health experts are also concerned about global repercussions, as anti-choice groups elsewhere are emboldened to reverse hard-won gains. ALRANZ shares this concern and views the overturning of Roe v Wade as an assault on reproductive rights, human rights, and democracy, not only within the United States but the world over.

 As for Aotearoa New Zealand, ALRANZ has pointed to worrying remarks made by members of the opposition party and urges Kiwis to remain vigilant regarding our new-won freedoms. The organisation will continue to monitor the situation and advocate for the right to choose. 

ALRANZ condemns potential overturning of Roe v Wade in United States

ALRANZ Abortion Rights Aotearoa is deeply disturbed by the leaked draft opinion of the United States Supreme Court that purports to overturn the constitutional right to abortion. Abortion is a fundamental human right and, if the leak is accurate, the decision will jeopardise millions of Americans’ access to necessary reproductive healthcare.  

 

Despite being profoundly disappointed, ALRANZ is not surprised. ALRANZ spokesperson Ella Shepherd said “women in America have been warning us of this trend for years. This decision would be the culmination of decades of systematic efforts to erode women’s reproductive rights. The decision fails and endangers pregnant people in America”.

 

Striking down Roe v Wade would be a significant injustice falling hardest on those already struggling to access reproductive healthcare, including abortion. Shepherd continued “the overturning of a nearly-50 year old precedent is a stark reminder that women’s rights and reproductive rights more broadly are vulnerable to erosion”.

 

“Even though New Zealand legalised abortion in 2020, we must remain vigilant to ensure the right to abortion is preserved and abortion is accessible in Aotearoa. The United States has demonstrated that public opinion being overwhelming in support of legal abortion is not sufficient to protect the right”.

 

ALRANZ would remind everyone that abortion remains legal in all 50 states until the decision is formally released. For those who wish to show support, ALRANZ recommends donating to an abortion access funds in states such as Texas, Oklahoma, and Mississippi where abortion is already restricted.