Vigilance needed over New Zealand’s hard-won abortion rights

On March 23, 2020, Aotearoa New Zealand introduced the Abortion Legislation Act,1 and in doing so decriminalised one of the most common gynaecological procedures anyone will have in the course of their life. An estimated one in four pregnancies result in abortion globally.2

Statistics in Aotearoa show that in 2020 there was a slight increase in abortions compared to 2019. However, in general there is a continuing trend towards a decline in the number of abortions.3 Abortion will always be necessary — no method of contraception is 100 per cent effective and there are always reasons why people will choose to have abortions.

In Aotearoa, people who choose to end their pregnancies up to 20 weeks’ gestation can do so without providing a reason and they cannot legally be declined.1 It is their choice, and their reason is their business. The legislation also allows abortion to be provided in multiple settings (including via telemedicine) and by a range of health practitioners (including nurses, nurse practitioners and midwives).1

We have also recently seen the introduction of The Contraception, Sterilisation and Abortion (Safe Areas) Amendment Act 2022,4 whereby abortion providers can apply to the Ministry of Health to enact a safe zone around their service to protect people accessing and providing abortions.

If, as anti-choice campaigners believe, safe abortion is murder, then so is banning access to safe legal abortion. The difference in these views is only in who dies.
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From a pro-choice perspective, these developments demonstrate a positive change in advancing access to safe, legal abortion in Aotearoa. However we must not be complacent. This advance in sexual and reproductive health and rights was won by a democratic process and could just as easily be lost in the same fashion.

Roe v. Wade

In June we saw the American Supreme Court overturn Roe v. Wade. This was a 1973 Supreme Court ruling which ensured legal access to abortion in the first trimester as a constitutional right, across all states. For pro-choice advocates, its loss is seen as a major step backwards in human rights. Anti-choice (otherwise known as “pro-life”) campaigners are celebrating this as a win.

There is no doubt that anti-choice activists are as earnest in their beliefs regarding the wrongfulness of abortion, as pro-choice activists are in their belief in the right of the individual women/pregnant person to decide. However, if the overturn of Roe v. Wade was truly about the preservation of life, why would the same country tolerate such relaxed firearm controls?

If this was really about the sanctity of life, why does the United States of America (USA) not have universal access to funded health care? And why would the same country still have states that impose the death penalty?

This advance in sexual and reproductive health and rights was won by a democratic process and could just as easily be lost in the same fashion.

When abortion is illegal or highly restricted, people still have abortions but they are more likely to die from unsafe procedures.5 Furthermore, it is people who are most disdvantaged in society (ethnic minorities and those with disabilities, complex health needs or living with high deprivation) who experience the most significant morbidity and mortality rates associated with pregnancy, when there is restricted access to safe abortion.

If, as anti-choice campaigners believe, safe abortion is murder, then so is banning access to safe legal abortion. The difference in these views is only in who dies.

No room for complacency in New Zealand

We would be wrong to think that people’s right to safe, legal abortion is ensured for the future in Aotearoa. The Abortion Legislation Act 2020 was enacted because people of New Zealand used the democratic process to make it happen. Equally, a democratic process can be used to take it away.

Those of us who believe that abortion is an essential part of sexual and reproductive health and rights need to continue to be vigilant and actively participate in local and national advocacy to support increased access to safe, equitable, accessible abortion care.

Emma Macfarlane, RN, NP, MHSc, is a member of the NZNO Women’s Health College committee and a lecturer at Dunedin School of Medicine’s Department of Women’s and Children’s Health.

References

Abortion Legislation Act 2020.
Amnesty International. (2020). Key facts on abortion.
Stats NZ: Tatauranga Aotearoa. (2020). Abortion statistics: Year ended December 2019.
Manatu Hauora: Ministry of Health. (2022). Safe Areas Amendment Act.
World Health Organization. (2021). Abortion: Key facts.

Uncut – news briefs

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18 Dec	Extra security to again keep EDs safe this summer Health Minister Dr Shane Reti is again reminding New Zealanders that violence against patients, visitors and health workers won’t be tolerated, with additional security for hospital emergency departments across the country this summer.
13 Dec	Mental health and addiction targets implementation plans released Health New Zealand \| Te Whatu Ora has today published its first quarterly results for four of the five mental health and addiction targets, covering the period 1 July – 30 September 2024.
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29 Nov	Minister reminds public health officials of priorities Minister of Health Dr Shane Reti says the National Public Health Service should concentrate its focus on prioritising serious public health issues facing New Zealanders.
29 Nov	Community providers rally to protect hapū māma and pēpi as national whooping cough case numbers surpass 1,000 for 2024 Hapū māmā are being urged to get immunised, and parents and caregivers are encouraged to get their babies immunised on time, as whooping cough case numbers continue to climb across Aotearoa New Zealand.
28 Nov	Govt ignores health crisis, plans to axe 1500 public health roles The health of New Zealanders will suffer because of the Government’s plan to axe nearly 1500 roles at Te Whatu Ora, coming at a time when the public health system is already under severe pressure.
27 Nov	Health New Zealand Establishes Technical Advisory Group to Lead Transformation in Maternity Care This team of experts and community representatives will play a key role in the development of the Maternity Commissioning Framework, a core element of the wider Kahu Taurima programme, which aims to make maternity and early years services more equitable, accessible, and whānau-centered.
22 Nov	Whooping Cough epidemic declared across Aotearoa New Zealand Health agencies have confirmed today that Aotearoa New Zealand is now in the early stages of a Whooping Cough epidemic, with a nationally coordinated response now in place.
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18 Nov	Potential travel disruption expected with Tuesday’s national Hīkoi Health New Zealand \| Te Whatu Ora urges those with an appointment scheduled at Wellington Regional Hospital on Tuesday morning or early afternoon, to please allow extra time to get to appointments.
15 Nov	ICN’s calls on G20 leaders to address international health worker migration crisis Ahead of the G20 Leaders Summit in Rio de Janeiro next week, the International Council of Nurses (ICN) welcomes the Declarations recently adopted by the G20 Health Working Group and health ministers.
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31 Oct	General practices welcome fast-track approvals process A new fast-track approval process is a good start, but more is needed to fix New Zealand’s chronic GP shortage, says the General Practice Owners Association (GenPro)
24 Oct	International Council of Nurses Bucharest Declaration priorities for the future of nursing The International Council of Nurses (ICN) marked the 125 years since its founding in 1899 with an anniversary conference held in Bucharest, Romania and hosted by the Order of Nurses, Midwives, and Medical Assistants of Romania.
10 Oct	Call to immunise now as New Zealand at high risk of whooping cough outbreak Pregnant people, babies, children and others at high risk from whooping cough are urged to get vaccinated as soon as possible, as Aotearoa New Zealand stands at high risk of an outbreak.
9 Oct	New pilot with Plunket to deliver childhood immunisations To increase access and boost immunisation rates, Health New Zealand \| Te Whatu Ora and Whānau Āwhina Plunket will pilot the delivery of childhood immunisations at a select number of sites across the country.
8 Oct	Health NZ Begins Development of National Perinatal Bereavement Care Pathway As Baby Loss Awareness Week shines a light on the heartbreak faced by many, Health NZ is taking a compassionate and hopeful step forward in transforming the support available for whānau who experience the loss of a baby.
7 Oct	Govt takes the scalpel to regional health budgets At Labour’s insistence, Te Whatu Ora financial documents have been released by the Health Select Committee today showing more cuts are on the way for our health system.
2 Oct	Orion Health and Streamliners form strategic partnership Orion Health, a global leader in digital health solutions, has announced a strategic partnership with Streamliners, creators of HealthPathways which provides an online manual used to assist with clinical assessments.
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27 Sept	New Dunedin hospital: Southerners deserve better The Government’s announcement today that it will scale back the new Dunedin hospital will negatively impact patient care, the New Zealand Nurses Organisation (NZNO) Tōpūtanga Tapuhi Kaitiaki O Aotearoa says.
26 Sept	Govt not addressing health workforce crisis The National Government is hiding the gaps in the health workforce from New Zealanders, by not producing a full workforce plan nearly a year into their tenure.
25 Sept	New programme offers step up for jobseekers seeking a career in health and wellbeing Local jobseekers have an exciting new opportunity to begin a career in Health following the launch of a new community-based kaiāwhina programme in the Hutt Valley.
23 Sept	Ministers oblivious to cuts’ effect on families The National Government is oblivious to the impact cuts to services will have on New Zealanders who are doing the hard yards caring for mentally ill family members.
19 Sept	Wānaka community to benefit from new overnight health service Health Minister Dr Shane Reti says an Overnight Acute Care Service opening in October will provide people in Wānaka and the surrounding area with the assurance of quality overnight care closer to home.
17 Sept	Dr Le Heron takes title of 2024 Alzheimers NZ Fellow Distinguished neurologist and cognitive neuroscientist, Dr Campbell Le Heron, has been made the 2024 Alzheimers NZ Fellow for his work researching and managing cognitive disorders.
11 Sept	Aged care will be worse off if redesign rushed New Zealanders needing aged care support and the people who care for them will be worse off if the Government pushes through a flawed and rushed redesign of dementia and aged care.
11 Sept	Govt takes action on mpox response, widens access to vaccine The Government is taking immediate action on a number of steps around New Zealand’s response to mpox, including improving access to vaccine availability so people who need it can do so more easily, Health Minister Dr Shane Reti and Associate Health Minister David Seymour announced today.
10 Sept	ICN launches new position statement and discussion paper setting out a revolution in the delivery of Primary Health Care The International Council of Nurses (ICN) is launching its new position statement and a discussion paper on Primary Health Care (PHC) at its Nurse Practitioner/Advanced Practice Nursing Network (NP/APN Network) Conference in Aberdeen, Scotland.
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6 Sept	Health agencies working with Police on rebalancing roles for mental health responses Health New Zealand \| Te Whatu Ora and the Ministry of Health - Manatū Hauora are working with Police to change some of the ways agencies respond to mental health. The change will see an increased health-led response, supporting Police to focus on core Policing.
4 Sept	Nurses’ bargaining starts with action for safe staffing Nurses are kicking off their collective bargaining with Te Whatu Ora by taking action for safe staffing on Friday, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.