ALRANZ President Stepping Down

ALRANZ President Stepping Down

It is with equal amounts of bittersweet nostalgia and bracing anticipation that I announce I am stepping down from the ALRANZ presidency.

It has been an honour and a privilege to lead this organisation through the years in which our long-held purpose came to fruition. Abortion is now legal, it is health care, and it is the unquestioned right of every pregnant person up to 20 weeks gestation. When I reflect on abortion law reform, I am deeply proud of our country, and of our work.

I chose to step down now, because it feels like the right time. ALRANZ’s mission is changing. Our role now is to hold the health system, and by extension the government, to account for its implementation of the laws and regulations relating to reproductive health care and rights, and the systems and processes it develops to effect that implementation.

Of course, to hold the health system accountable we need the help of folks who have had trouble getting reproductive health care. We need to know what is happening. So ALRANZ has added a page to our website to make it easy to tell your story – anonymously it you prefer. We really want to hear from you – about any problems you experience with reproductive health care. If you experience harassment, disrespect, health practitioners who try to obstruct access, ‘unbiased’ counselling that turns out to be anti-abortion coercion, or just run-of-the-mill stuff-ups, we want to hear about it. This is how we can make sure problems get fixed.

Our shift in focus makes this the best time for me to step away into other things, and to let new faces and minds and hands take up the work. To this end, I am delighted to announce Dr Tracy Morison has agreed to serve as interim president of ALRANZ, from now till the AGM. Tracy is a distinguished academic whose focus is reproductive health care. She has been doing a bang-up job for years in this space, and ALRANZ is lucky to have her.

When I look back over the past 6 years, the best part of the whole experience has been the supporters and allies who have given so much to this struggle and ensured its success. To list everyone would take pages and pages. Many of them are now good friends. From the bottom of my heart, thank you.

I will still be around on ALRANZ’s executive committee to provide institutional knowledge and other annoyances. Many thanks to successive executive committees, to Dame Margaret Sparrow, and to all the membership of ALRANZ for the opportunity to be of service.

All the best,

Terry Bellamak

Select Committee Report on the Safe Areas Bill

Select Committee Report on the Safe Areas Bill

The Health Select Committee has reported back on the Safe Areas Bill. The result is a mixed bag.

The Committee has made changes to how the actions prohibited in safe areas are defined, but did not change the requirement for bespoke safe areas, approved and created one at a time.

Prohibited Actions

An earlier version of the bill described prohibited actions as ‘communicating with’ a ‘protected person’ in an emotionally distressing way. The Committee took the Attorney-General’s advice that ‘communicating’ was too broad. It restructured the prohibited actions accordingly, strengthening the bill by narrowing their scope and making it clearer what is prohibited. This part now reads:

(c)             do any of the following in a safe area in a manner that could be easily seen or heard by another person (A) who may be accessing, providing, or assisting with providing, abortion services:

(i)             advise or persuade A to refrain from accessing or providing abortion services (unless the advice or persuasion is by a person who is, with the consent of A, accompanying A):

(ii)             inform A about matters related to the provision of abortion services, other than during the course of providing those services, or assisting with provision of those services (unless the information is provided by a person who is, with the consent of A, accompanying A):

(iii)             engage in protest about matters relating to the provision of abortion services.

This catalogue of prohibited behaviours is both concise and comprehensive. It is difficult to imagine offensive conduct that does not fall under one of these sections (or alternatively, the Crimes Act).

The Committee retained from the earlier version sections that prohibit obstructing a person trying to access the service or recording them without permission.

You may notice the Committee has done away with ‘protected person’. This is a good move. It eliminates the need for a person to testify that they were a ‘protected person’ in order to prosecute someone for an offence. Given abortion stigma (or just personal circumstance) people might not wish to state that publically in a court of law. This way, bystanders could testify about protesters’ conduct without having to identify a ‘protected person’.

Bespoke Safe Areas

The Committee said they believed ‘that a case-by-case approach would be simpler’ than having safe areas everywhere, all at once. This seems counterintuitive, to say the least. They do not explain how teams in the Ministry of Health poring over Google Maps of hospital precincts could be simpler than a tape measure and a piece of chalk.

The Committee emphasised that the process should be streamlined to avoid delay in establishing safe areas. It goes on to describe a lengthy, convoluted application process that would need to include:

  1. Abortion provider makes request, supplies details about size and layout of the area, and give their reason for requesting it (really).
  2. Ministry of Health considers request in light of individual provider’s circumstances and consults with the Minister of Justice about NZBORA  matters
  3. Ministry of Health consults Minister of Health about application
  4. Minister of Health consults Minister of Justice, and they decide
  5. If approved, they could recommend a regulation be made for that one safe area
  6. Regulation submitted to and approved by Cabinet and Governor-General
  7. Regulation published in Gazette
  8. 28 days later, regulation comes into force

The Committee did not specify a time frame in which this ridiculous process ought to be accomplished. Instead, they said ‘we would still expect the Ministry of Health to provide advice to the Minister of Health within a reasonable period and for applications to be processed promptly.’

The Committee did not state the basis on which that expectation is founded.

The Committee made one improvement to this part of the bill – instead of having to wait for harm to actually occur to show that the safe area is ‘necessary’ and start the process, the bill now merely requires applicants to show the safe area is ‘desirable’. Respecting people’s privacy and dignity is always desirable, so we can have it now. Or, you know, after the process has been completed.

Why Can’t We Have Nice Things?

Why does the Committee expect each provider to have its very own, finely crafted, individual safe area?

Apparently because the Committee believes that in order not to breach NZBORA, each safe area must be hand-drawn so as to minimise the limitations on protesters’ free speech rights.

The limitations this bill would place on freedom of expression have been called ‘time, place, and manner restrictions.’ Why does ‘place’ loom so large in this scheme as to justify so much time being taken from actually protecting people accessing health care and instead devoted to drawing the lines just right?

After all, the point of the exercise is to make sure patients and staff are not harassed by protesters who came there specifically to harass them. The protesters’ purpose will be frustrated and their freedom of expression limited no matter where in the prescribed 150 metres the lines are drawn (unless they make the safe area too small). So why is the Committee making this more complicated than it needs to be?

The issue may be bigger than this one bill.

The trouble goes back to passage of NZBORA itself. Parliament did not make this constitutionally significant piece of legislation higher law, because higher law is an insult to parliamentary sovereignty; it suggests the possibility of an earlier parliament limiting the actions of a later one by restricting its power to change higher law. Instead, Parliament made NZBORA literally lower law. Any enactment found to breach NZBORA remains good law unless and until Parliament amends it.

Most countries put things like fundamental civil and human rights in written constitutions, or higher laws that are more difficult to change than regular laws. New Zealand is special because in law NZBORA is more of an afterthought, a legal nice-to-have but can-do-without.

Maybe the Government finds that a little embarrassing. So they dress up the realpolitik of parliamentary sovereignty with the trappings of pedantry around NZBORA. Unfortunately, this particular flavour of performance art can have real consequences for people trying to access health care.

Will the creation of safe areas be plagued by delays? We really hope not.

 

Why You Should Share Your Story

Information is power, and our stories are some of the most powerful tools we have in the fight for equitable access to reproductive health care.
We’ve launched a new page, ‘Hold Them to Account.’ It’s a form where you can tell us about any dodgy or upsetting experiences you have had with accessing abortion, sterilisation, or contraception since 2020.
Why are we asking this, and what will we do with the information?
New Zealand has excellent privacy laws. That means that when dealing with the health care system, everyone’s experience is their own, and the only people who will know about it are those that person chooses to tell. So far, so good.
But, that can make it difficult to identify recurring, systemic issues with locations, providers, or services. Let’s say you had a termination scheduled, and when you arrived there were protesters between you and the door, calling you a ‘baby killer.’ Maybe your GP said they ‘conscientiously objected’ and refused to tell you how to access services (which is against the law). Or perhaps you were looking for unbiased counselling, but stumbled into a ‘counselling service’ that turned out to be a front for anti-abortion proselytising.
Chances are, you weren’t the only one. But social stigma around talking about abortion and reproductive health care makes it hard for individuals and organisations like ALRANZ alike to recognise widespread issues.
That’s why we’re asking you to share your story – so that we can monitor what’s going on in this space and continue to advocate for better access to reproductive healthcare services. We need your help to challenge stigma and advocate for better services for everyone.
What we do with the information you provide is up to you. You can let us use your name and your story or just your story without your name. Or, if you’d prefer your story to remain completely private, that’s fine too – every bit of information helps us better understand what’s happening nationwide, identify patterns of error, and prevent other people from being denied proper healthcare.
We’ll use your stories to hold the health system to account. We might bring problems to the attention of the Ministry or Minister, or bring people together to file a group complaint with one of New Zealand’s dispute resolution bodies. Or, if someone wants to make an individual complaint, we can support them to advocate for themselves, or advocate on their behalf.
Abortion law reform was only the beginning. Changing the way the health system deals with reproductive health care, and women’s health care in general, remains both necessary and long overdue.
Problematic procedures and habits of behaviour from our old, dysfunctional abortion system may still be in place, making life difficult for people seeking health care.
We can only address the trouble we know about.
Please help us hold the system to account by sharing your experiences.
Applying the Oakes Test to the Safe Areas Bill

Applying the Oakes Test to the Safe Areas Bill

by Terry Bellamak

 

The Health Select Committee heard Crown Law’s submission on the Contraception, Sterilisation, and Abortion (Safe Areas) Bill a week ago last Wednesday. To refresh your memory, Crown Law is the office that supplies the Attorney-General with section 7 reports that explain whether any limitations a bill places on the rights and freedoms in the New Zealand Bill of Rights Act 1990 (‘BORA’) are demonstrably justifiable in a free and democratic society.

The representative talked about the Oakes Test. That is, he mentioned it, and described it, but did not apply it. He merely noted that Crown Law did not have enough data to determine whether the first limb was satisfied. He said gathering that data is the select committee’s role, which is true.

The Oakes Test is one of many useful things to come out of Canada. In New Zealand we use the test to see whether a proposed limitation on a right or freedom in BORA is demonstrably justified in a free and democratic society. It requires the examination of the two distinct things: first, the objective the limitation is trying to achieve; and second, the means by which the objective is achieved, i.e. the limitation itself. What are you trying to do, and how are you going to do it?

Oakes Test

  1. To justify the limitation, the objective sought must be pressing and substantial.
  2. The means of achieving that objective must be proportional. It must satisfy these criteria:
  3. a) the means must be rationally connected to the objective
  4. b) the impairment of the rights in question must be minimal
  5. c) there must be an overall proportional balance between the objective and the limitation

 

So let’s apply the test to the safe areas bill.

 

Justification

To justify the limitation, the objective sought must be pressing and substantial.

What is the objective of the bill? To allow people who want abortions and people who provide abortions to enter places where abortions are provided without being harassed by people who want them to stop providing or receiving abortions.

Seems a difficult objective to argue against on its face – very few would seriously suggest preventing harassment is not pressing or substantial. New Zealand’s international obligations under the Convention to Eliminate All Forms of Discrimination Against Women and other instruments, its responsibility to provide a safe working environment for providers it employs, and its duty to health consumers under the Health and Disability Code all add weight to the argument that preventing harassment is pressing and substantial.

The counterarguments would likely run:

The objective is NOT pressing and substantial because

  • it is not happening
  • it is happening but it is not harassment
  • it is harassment but it should be allowed

“not happening”

Submitters who argued harassment was not happening in Aotearoa relied on the lack of formal complaints of harassment to police or DHB management. They also relied on the Law Commission’s statement in 2018 about not seeing a need for safe areas, and its assumption that the Summary Offences Act 1981 would provide a means to address harassment, should it occur.

The answers to this counterargument lie in the evidence provided by submitters during the select committee process. They spoke of their own experiences trying to access abortion care and being chased, surrounded, verbally abused, and having things thrown at them. ALRANZ’s submission included firsthand accounts of harassment, excerpts from a survey of abortion providers about their experiences with protesters, and pictures of anti-abortion protesters and their signs (with faces obscured). Two of the select committee members, both health care professionals, shared their own stories of anti-abortion harassment directed at them.

Why are there no complaints? It turns out there are pragmatic reasons for that.

To use the Summary Offences Act, you need to call the police and wait around for them to show up. People who have just had an abortion want to go home and rest. People who deliver abortion care have enough to do in their jobs without pursuing complaints that will cost them time and energy but may not lead to any meaningful sanction.

Abortion is still stigmatised, so people may not expect police or the DHB to take their complaint seriously. Submitters who could have made complaints, including committee members, said they preferred to just get on with their lives.

For any member of the Health Select Committee to argue that harassment does not happen, they would need to presume that every person who told their story was lying, including their colleagues on the committee.

“not harassment”

Many submitters admitted protesters were out there on a regular basis, with or without signs and props. But they said what occurred did not constitute harassment.

Some spoke of the pledge they took in order to participate in “40 days for Life” protests. They said it required them to be “quiet and prayerful”, and not to speak to anyone unless spoken to. They spoke of quietly singing and praying the rosary.

But here’s the thing. The folks who signed the pledge could have followed it to the letter, and yet harassment could still be a problem. How? Two ways.

First, the shouting, name calling, and overtly offensive behaviour may be perpetrated by another group, perhaps one that did not make a submission. There are many actors in the anti-abortion activist space, and some are more extreme than others.

Second, what makes this kind of targeted harassment so toxic is the incipient threat of escalation to violence. Violent people are capable of behaving peacefully right up until they start acting violently. No one can tell whether a person might turn violent just by the way they look. After all, Shelley Shannon peacefully prayed and sang outside clinics for years before finally shooting Dr George Tiller.

Those who have experienced abortion harassment tell us they felt intimidated, targeted, harassed. It is reasonable to expect a reasonable person to feel that way about the behaviour they describe. Why would we not believe them?

“harassment but should be allowed”

Some anti-abortion submitters acknowledged that abortion patients and providers might be distressed by protesters presence outside services, but maintained it was important they remain there for several reasons:

  • some people find them helpful
  • they provide information about other options than abortion
  • they provide moral support for people who are being coerced into having an abortion
  • their actions are for the greater good

Are these reasons sufficient to render the objective not pressing and substantial?

First we should ask, how many people find their presence helpful? If we accept that some abortion seekers will find the protesters helpful, we must also accept that some will find them unhelpful, and some will be neutral. How do the numbers break down?

The short answer is: no one knows. There is no reliable research on how many people seeking abortions were persuaded not to proceed by protesters, nor how many panicked and bolted at the sight of protesters and had to reschedule, nor how many set their jaw and pretended to ignore the protesters as they entered, nor how many did not care about the protesters.

Other research from the USA may shed light on the issue, however. It stands to reason the people most likely to find protesters helpful would be people who might regret having an abortion. If we know how many later regretted their decision to receive abortion care, it might give us insight into how many people might want to hear the protesters out, or welcome their input.

Research into feelings of regret after abortions found 98% felt they had made the right decision one week after the abortion, and 99% felt that way five years later.

This suggests very few people come to regret their choice. If the people most likely to find protesters helpful are those who are poised to regret their abortion, then it follows that they are few.

What about information about other options? Abortion services already have unbiased, professional counsellors whose job it is to work through all the options, and all abortion patients have the right, by law, to consult with them. The protesters, while they may be across all the options, are far from unbiased.

Other research into abortion patients’ decisional certainty shows abortion patients are as certain or more certain than people making decisions about other kinds of health care. This suggests that abortion patients are less likely to be undecided about their course of action.

But there is one additional thing protesters can do: make offers of financial support as a reward for not proceeding with an abortion, apart from the usual governmental support. ‘Crisis pregnancy centres’ around the country make similar offers to people who may find them quite helpful if they wish to continue the pregnancy. They may even get a better offer outside the abortion service than in the centres.

What about support for people being coerced? Staff at abortion services (not just counsellors) are trained to watch for coercion, or mere ambivalence, on the part of patients, and to find out whether they really want to proceed. The Standard of Care, a document that establishes the protocols for abortion care in New Zealand, requires patients to be spoken with alone, away from support persons, so that they can speak frankly. It seems likely protesters would struggle to have such a private conversation out on the street with support persons present.

What is the greater good anti-abortion protesters seek to promote? The protesters make a foundational presumption that continuing a pregnancy is always better than having an abortion. It follows they would consider the harassment they engage in for the greater good of preventing abortions should be allowed.

This foundational presumption is not shared by the rest of New Zealand society. It is no longer government policy. Opinion polls have consistently shown a large majority of New Zealanders believe abortion should be available on request if the pregnant person wants one.

Neither the deeply held personal beliefs of anti-abortion protesters nor the chance their presence might benefit a few people negate the pressing and substantial nature of the objective, which is preventing harassment of people seeking or providing abortion care.

The first limb of the test is met.

Proportionality

The means must be rationally connected to the objective

Again, the objective is to allow people who want abortions and people who provide abortions to enter places where abortions are provided without being harassed by people who want them to stop providing or receiving abortions.

The means chosen is to prohibit “intimidating, interfering with, or obstructing” protected persons (those seeking or providing abortion care) in order to frustrate their purpose for being there in a manner that a reasonable person would know is distressing, or communicating with them (impliedly about abortion), or recording them, but only within 150 meters of the abortion service.

QED, they are rationally connected.

Impairment of the rights in question must be minimal

What are the rights being impaired?

  • freedom of expression
  • freedom of peaceful assembly
  • manifestation of religion and belief

How much are these rights impaired by the safe areas bill?

Freedom of expression and freedom of assembly

People would not be able to address protected persons in the safe area. They would not be able to gather with signs. There would be no ‘sidewalk counselling’ permitted.

They would not be able to pray or sing audibly. That sounds draconian at first. But what is the purpose of praying and singing as a display? To some protesters it might be “trying to save abortion patients’ souls.” To others, it might be an opportunity to shame abortion patients. But the simplest expression of the meaning must be “we are here to demonstrate we believe you are doing something wrong” – to create pressure on them to change their plans.

No obligation exists on the part of abortion patients or providers to give the protesters a hearing. But in that time and place, they cannot avoid it. The attack on their privacy and dignity is inescapable. This is the reason the bill moves protest activity out of the safe area, where patients and providers can avoid it if they wish.

Outside the safe area, protesters are welcome to gather, sing, pray, scream, and talk to whomever they want, including protected persons. Protesters are not being controlled, except in the safe area. The prohibited behaviour is not prohibited at all outside the safe area.

The US Supreme Court in Hill v Colorado called similar restrictions “reasonable time, place, and manner restrictions” and found they were justifiable limitations on the right to free speech. It is significant that what is arguably the most militant free speech jurisdiction on the planet found safe areas were reasonably justifiable.

This almost certainly does not feel minimal to the anti-abortion protesters, because trying to persuade or shame or frighten off those particular people is their whole reason for wanting to be there. The very people being protected are the very people they want to target, for the very reason they meet the definition of protected persons.

But the bill accomplishes the objective while minimally impairing their right to freedom of expression and assembly, because they are not silenced – they just cannot target those particular people. Anyone who wants to talk to the anti-abortion protesters is free to do so, and they are free to respond – outside the safe area.

Manifestation of religion and belief

Manifestation of religion and belief includes “worship, observance, practice, or teaching, either individually or in community with others, and either in public or in private.”

It is unclear whether protesters’ right to manifestation of religion and belief includes forcing others to participate as an unwilling audience.

Even if it did, however, the protesters are free to engage in whatever display suits their religious beliefs outside the safe area. It may be more difficult to dragoon non-consenting participants there, but it is not a limitation on their rights to freedom of expression or assembly or manifestation of religion that people are able to avoid them if they wish.

Again, anti-abortion protesters’ right to manifest their religious beliefs in any way is not limited at all, except inside the safe area. This limitation is minimal.

Overall proportional balance between the objective and the limitation

Once again, the objective is to allow people who want abortions and people who provide abortions to enter places where abortions are provided without being harassed by people who want them to stop providing or receiving abortions. The means of doing so is to limit what protesters can say or do in the safe area only. Everywhere else, their rights are the same as always.

On the one side we have anti-abortion protesters’ right to freedom of expression, freedom of assembly, and right to manifest religion and belief. On the other, we have abortion patients’ and providers’ right to privacy, right to seek medical care, right to a safe workplace, and right not to be discriminated against.

On the whole, the bill looks like it creates a rough-and-ready balance between the rights of protesters and the rights of protected persons.

The second limb is met. The Oakes Test is satisfied.

 

To those who really want to come at protected persons in safe areas, this application of the Oakes Test will not be convincing.

They are free to apply the test themselves.

Celebrating 60 Years of the Pill in New Zealand – The Pink and Green Pills Arrive

by Dame Margaret Sparrow

Setting the scene

Looking back to 1961 it was a year of major international tension but also significant achievements. In January John F. Kennedy was sworn in as President of the United States. The cold war was omnipresent and worsened with the USSR testing large nuclear bombs then masterminding the building of the Berlin Wall. American citizens were encouraged to build fallout shelters. The space race between USSR and the United States escalated. In April, Soviet cosmonaut Yuri Gagarin completed the first orbit of Earth, and less than a month later Alan Shepard became the first US man in space.

In the United Kingdom, marches were held by the Campaign for Nuclear Disarmament. The World Wildlife Fund and Amnesty International were both launched. The UK began talks to join the EEC. The Beatles started performing at the Cavern Club, in Liverpool.

In New Zealand, Keith Holyoake was the Prime Minister and Viscount Cobham was the Governor General. We celebrated the first national Waitangi Day. One of the last outbreaks of poliomyelitis caused seven deaths. The death penalty was finally abolished. A change to liquor licensing meant for the first time restaurant diners could legally be served wine with their meal. The population of New Zealand was 2.5 million. Over 65,000 kiwi babies were born, the most fertile year of the post-war baby boom. Illegal abortionists plied their trade and from time to time were prosecuted; seven were convicted. Six women died from an abortion.

The Pharmaceutical Industry

Something sinister was percolating which would have a bearing on the control of all drugs. Thalidomide was first marketed in 1957 in West Germany, where it was available over the counter for anxiety and insomnia. It later became popular for morning sickness in pregnancy. However in 1961 it was associated with congenital defects in babies. Due to public outrage the medication was withdrawn from the market in Europe in November 1961. It is estimated that the total number of embryos affected by use during pregnancy was at least 10,000, of which about 40% died around the time of birth. Those who survived had limb, eye, urinary tract, and heart defects. Its initial entry into the US market was prevented by Dr Frances Kelsey of the FDA who was concerned about the lack of safety evidence. For resisting the pressure from promoters and averting a thalidomide disaster in the US she received an award from President Kennedy.

Thenceforth much needed changes were made throughout the world, including in New Zealand, to procedures for the approval of drugs. This came at a time when the burgeoning cost of pharmaceuticals also mandated a scrutiny of the system.

Right: Dr Frances Kelsey (1914-2015) who refused to approve thalidomide in the USA.

Prior to 1961 the introduction of new drugs into New Zealand, under the Food and Drug Act 1947, could best be described as laissez faire. As long as drugs complied with the British Pharmacopoeia or some other recognised standard there was no need for local clinical trials, or testing to determine quality or safety. There was no formal inspection or regulation of manufacturers, importers, wholesalers, or distributors. The system relied on trust; that importers would access new medicines from reliable sources and the medical profession would ethically prescribe and chemists ethically dispense. Free medicines had been introduced with the 1938 Social Security Act and if a medication was deemed necessary it was funded and listed on the Drug Tariff. Although hormonal treatments for medical conditions by a specialist might be funded, the same pills used for contraception were not.

When Enovid, manufactured by Searle (US), was approved for use for medical conditions (menstrual disorders and endometriosis) by the FDA in June 1957, its distribution was expanded through Searle (UK) under the name Enavid. New Zealand obstetric and gynaecology specialists kept abreast of trends and were able to order supplies of this through N.M. Peryer, a Christchurch-based licensed wholesaler.

When Enovid was approved for use for contraception in May 1960 the potential for prescription by general practitioners widened the market but because of side effects, the lower-dosed Conovid became the preferred drug. In December 1961, the United Kingdom Minister of Health Enoch Powell announced (enviously) that the contraceptive pill Conovid would become available via the NHS at a subsidised price of two shillings per month.

In 1962 Conovid-E was introduced in New Zealand as a contraceptive. All three drugs were imported into New Zealand.

Enavid (UK)   10mg norethynodrel + 150mcg mestranol (from 1957 mainly for specialists)

Conovid          5mg norethynodrel + 75mcg mestranol (from 1961)

Conovid-E      2.5mg norethynodrel + 100mcg mestranol (from 1962)

The original packaging of Enovid (US) was in bottles of 20, 50, and 250

It was the pharmaceutical representatives who liaised with chemists and doctors, educating, advising on the availability and providing free samples. There were no regulations regarding the training or qualifications of these detailers.

Barbara Brookes recounts that in February 1961 the Medical Officer of Health in Hamilton wrote to the Director-General seeking clarification because the local president of the Pharmacists’ Guild told him that travellers were visiting chemists, providing Tabs Conovid and suggesting that they could be sold to the public. The Department ruled emphatically that they could only be sold by pharmacies on prescription.

Meanwhile in 1960 the West German pharmaceutical firm, Schering AG (now Bayer HealthCare) were conducting trials in Australia of Anovlar = 4mg norethisterone acetate + 50mcg ethinyloestradiol. In February 1961 Australia was the first in the world to approve this contraceptive and it would have been distributed in New Zealand at about this time. At first Anovlar came in strips of 20 but in July 1964 the packaging was changed with 21 pills encased in foil and labelled with the days of the week to improve compliance.

Original packaging of Anovlar in 1961.

Anovlar new packaging in 1964.

Schering representatives visited general practitioners persuasively marketing their product and distributing free samples. On 3 July 1962 NZ Truth reported that after a year there was an increasing demand for the two most popular pills then available, despite the relatively high cost: Schering’s Anovlar, the little green pills, which cost 28 shillings per month and Conovid, little pink pills, manufactured by Searle (UK), which cost 31 shillings per month.

This was a lucrative market and competition from a number of other firms would soon lower the price. By 1970 there were 14 pharmaceutical firms offering 34 different brands of contraceptive pills. Schering had added Gynovlar, Eugynon and Neogynon. Searle had added four different strengths of Ovulen. In addition to these so-called combined pills, containing a progestogen and an oestrogen, the first progestogen-only pill Normenon appeared in that list.

The New Zealand Department of Health

Unlike its counterpart in the UK, the Department of Health in New Zealand wanted nothing to do with birth control. In April 1961 when the Minister of Health was invited by Sir Julian Huxley to be included in the World Tribute to Margaret Sanger he was advised to send a curt refusal. Internationally overpopulation was a concern but this was considered irrelevant in the New Zealand context. Even contraception was regarded as controversial let alone population control and eugenics which Margaret Sanger had supported.

A 1961 statement declared that the Department considered ‘birth control was solely a question of public morals, not of public health’. This policy was challenged on a number of occasions especially as it prevented Public Health Nurses from giving advice on family planning. In December 1966 the Department sent a circular memo to all Medical Officers of Health emphasising that family planning was primarily the role of the family doctor, or if there was none, a Family Planning clinic.

In 1962 an amendment to the Food and Drug Act required notification of any new and changed medicines through a notice in the New Zealand Gazette. Medicines that were on the market at the time were accepted without evaluation (grandfathered). The approval of Enavid, Conovid and Anovlar were duly gazetted, effective from 1 July 1962. In 1962 it became mandatory to obtain consent for clinical trials and in 1965 the Committee on Adverse Drug Reactions was formed. In 1969 control was transferred from the Division of Public Health to the Division of Clinical Services and further regulations were introduced.

The medical profession

Until the arrival of the Pill the main methods of contraception were withdrawal (unreliable), condoms (embarrassing to purchase and of poor quality), diaphragms and caps (few doctors were trained to fit these correctly), natural family planning (abstinence not popular), and once a family was complete, female sterilisation (vasectomy was not yet available in New Zealand).

An older method, the IUD, had gone out of favour. In 1961 a New Zealand gynaecologist Dr A.M. Rutherford published a paper in the NZ Medical Journal on his less than satisfactory experience with the Gräfenberg ring. However, in 1962, an important IUD conference was held in New York drawing 60 people from 11 countries and this restored some faith in the method. A second conference in October 1964 attracted 600 people from 44 countries. The IUD was back. Coinciding as it did with the introduction of the Pill this was the start of what demographers call a contraceptive revolution.

1960s IUDs

But in 1961 there were few attractive contraceptive options and the Pill met an unfilled need for reliable fertility control. Writing a prescription was a familiar routine for doctors and that put them back into their comfort zone. Even those who previously disapproved of ‘messy’ birth control methods were converts. But it didn’t happen overnight.

An article in the Dominion 12 April 1961 on the Women’s page (more often featuring millinery styles) carried the headline HORMONE DRUG TABLETS NOT FAVOURED and continued: ‘The first synthetic hormone drug tablets which temporarily suppress ovulation (oral contraceptives) to appear on the New Zealand market, are being greeted with some suspicion by Wellington doctors. Specialists and general medical practitioners approached yesterday on the practicability and advisability of using the tablets were generally agreed that as yet, they would not prescribe them.’

However some GPs were already providing contraceptives through those free samples from enthusiastic, commercially incentivised, pharmaceutical reps. The uptake of the Pill by New Zealand women was described as phenomenal and one of the highest in the world. Writing in FPA’s Choice magazine in 1965 Professor Bonham estimated that 40% of all women at risk of pregnancy were taking the Pill. Some 100,000 packs were being sold each month.

Specialists were kept up to date through medical journals. The first advertisement in the Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) by Schering, ‘Anovlar for Ovulation Control’, appeared in Vol. 1, No 2, June 1961.

Family Planning Association (FPA)

Leading up to 1961 the relationship between the medical profession and FPA was strained. The New Zealand branch of the British Medical Association (BMA) regarded FPA as a lay organisation encroaching on its territory. Matters came to a head when in February 1960 the ethical committee of the BMA advised its members that it was ‘unethical to refer patients to clinics’. Fortuitously in June 1960 Dr Alice Bush, a respected Auckland paediatrician, was elected president of Family Planning and this paved the way for constructive dialogue. Early in 1961 a deputation met with a special sub-committee of the BMA, and as a result the offending policy was reversed.

Although individual FPA doctors prescribed the Pill when it was considered appropriate the Association was very cautious in recommending the Pill and in the early years continued to promote barrier methods as first choice. This caution was mainly for reasons of safety and the unknown effects of long-term use. In an article in the Otago Daily Times on 12 July 1962 Dr Swyer, an eminent O&G consultant visiting from London roundly criticised the Association for ‘simply falling behind the times’ in regard to contraceptive practices. The article did not mention that the good doctor’s visit was sponsored by Schering.

In 1963 in the very first issue of Choice, a magazine for FPA staff and supporters, there was a balanced article on the Pill by Dr Ruth Black, a member of the Medical Advisory Committee, and the back cover of the magazine carried an advertisement for Anovlar. However it was not until the 1964 FPA conference that the Pill received an endorsement.

Other influences: The Press and Feminism

New Zealand magazine readers knew about the development of the Pill in the US from articles in Time, and Reader’s Digest but less was known about developments in Europe and the UK. New Zealand newspapers and women’s magazines tended to avoid the topic in the early years. Even the FDA approval in May 1960 was not a major news item. In New Zealand Enavid was not promoted as a contraceptive (although it could have been) and was not newsworthy.

The introduction of specific contraceptive pills (Conovid and Anovlar) in 1961 came in under the radar. There was no specific event such as an official announcement of scientific approval; no press conference, no launch, or symposium. Even the Australian approval of Anovlar in February 1961, the second country in the world to approve a contraceptive pill, went largely unreported. Pharmaceutical firms did not wish to create controversy or arouse opposition due to religious or moral objections. The revolution happened quietly in doctors’ consulting rooms throughout New Zealand.

The Pill is often portrayed as a symbol of women’s empowerment but that was not how it was experienced in 1961. That came later. The Australian Women’s Weekly did not feature an in depth article discussing oral contraception until 22 July 1964, when Rene Lecler contributed the ‘Latest Medical Survey of the Pill’. It became the highest selling issue of the decade revealing an unmet need for information which was useful for women. Women waited until 1971 for the Boston Women’s Health Book Collective to publish Our Bodies, Ourselves: A Book By and For Women.

The feminist view of the Pill was multifaceted and ranged from liberation to victimisation. It changed over time and is still changing. On the one hand, it was seen as advantageous to take what advances in medical science could offer. Women welcomed the much-desired control of their fertility and enjoyed the freedom to explore new goals in education and career. Many women wanted to be more independent and less reliant on a male partner. On the other hand others argued that women were being exposed to harm from experimental medication with possible long-term consequences. Many women suffered from serious adverse side effects. A few died. But women also died because of pregnancy or childbirth. Some worried that being sexually available might lead to exploitation by men and a change in relationships. Some wished to maintain cherished feminine roles. Caution was seen by some as a virtue, risk-taking as reckless. The personal became political with a focus on women’s rights and gender equality.

There were many questions. Why wasn’t there a pill for men? Were women at the mercy of profit-driven powerful pharmaceutical companies? Why wasn’t there more research on better methods of fertility control for men and women? What was the role of the government and health authorities? Should contraception be free? Did there need to be such gate-keeping by the medical profession? What about a woman’s choice? These questions are still being asked.

Resources used in the preparation of this article

  1. Barbara Brookes, Claire Gooder, Nancy de Castro. Feminine as her Handbag, Modern as her Hairstyle.NZ Journal of History, 47, 2; 2013.
  2. Ministry of Health. History of Medicines and Medical Device Regulation in New Zealand: Regulation before the current Medicines Act 1981.

         Regulation before the current Medicines Act 1981          (medsafe.govt.nz) 

  1. Helen Smyth. Rocking the Cradle: Contraception, Sex and Politics in New Zealand. Wellington: Steele Roberts, 2000.
  2. Ian Pool et al. New Zealand’s Contraceptive Revolutions Population Studies Centre, University of Waikato, 1999.
  3. H1 Archives New Zealand, Wellington (Health Department files).

Contraceptives 1940-1965.

Maternal and Child WelfareBirth Control 1941-1966

Social SecurityPharmaceutical Benefits Searle and Co (NM Peryer) 1961-1964

March 2021