In her second opinion piece on the need for change to New Zealand’s abortion law, Associate Professor Liz Beddoe talks through the options proposed in the Law Commission’s briefing paper, Alternative Approaches to Abortion Law, released last Friday.

After many decades of calls for reform of our outdated abortion law, change is finally in our sights. The Law Commission’s briefing paper Alternative Approaches to Abortion Law, commissioned by Justice Minister Andrew Little in February, provides three alternative legal models for consideration.

Model A proposes there would be no specific abortion legislation and the abortion provisions in the Crimes Act 1961 and the Contraception, Sterilisation, and Abortion Act 1977 would be repealed. There would be no statutory test and the decision to have an abortion would be made by a woman in consultation with a health practitioner.

Model B proposes a statutory test in health legislation, rather than under the Crimes Act. This test would require the health practitioner who intends to perform the abortion to believe it is appropriate considering the woman’s physical and mental health and wellbeing.

Model C combines aspects of A and B and focuses on gestation. For pregnancies of not more than 22 weeks gestation, model A would apply. For those more than 22 weeks, a statutory test of B would be required. 

All options would lead to the repeal of current grounds in the Crimes Act and the need for certifying consultants.

No doubt, over months to come, these options will be subject to much debate and intense political lobbying. It is vital we keep in mind that, while this debate is happening, real people are facing decisions over an unplanned and unwanted pregnancy, or a wanted pregnancy where hopes have been dashed by a medical diagnosis. Waving frequently misleading and lurid posters or emotive symbols is not only unhelpful to rational debate, it is cruel and lacking in human empathy and respect.

There are several important concerns that may not have as much airtime in the debates to come.  Firstly, whatever the model chosen, there will need to be access to safe, free, legal health services, reasonably close to where the pregnant person lives. Option A and C would mean an increase in providers, particularly of medical abortions. Where a surgical service is needed, it will be important that medical, financial and social support is available to reduce barriers for young, rural, people and those in financial hardship. The Law Commission report suggests self-referral could potentially help. This will cut the time it takes to get a referral from one practitioner to another, and recognise the agency of the pregnant person to make their own decision to seek advice and assistance. 

The third barrier, likely to be the subject of heated debate, is the issue of conscientious objection. The current law allows practitioners to refuse to provide services on the grounds of conscience. The Law Commission notes the government might consider retaining that right, but the health professional must refer to a service in a timely manner. This is an important matter that must not get lost along the way. 

A recent report by the International Women’s Health Coalition, Unconscionable: When Providers Deny Abortion Care, notes that according to the World Health Organization, more than 70 jurisdictions worldwide allow for denial of health care based on personal belief. It is reasonable that a person’s need for legal, safe health care services, including access to contraception, sterilisation, fertility treatment and abortion should take precedence over a provider’s religious or personal beliefs.

The second issue that needs to be considered is the link between reproductive justice and reproductive coercion, an aspect of interpersonal violence. Social workers are concerned about the links between intimate partner violence and coercive behaviour aimed at reproductive autonomy. 

In a recent study reported by the National Collective of Independent Women’s Refuges on reproductive coercion in Aotearoa New Zealand, nearly 35 per cent of participants had experienced partners trying to prevent them having an abortion; 80 per cent had experienced partners controlling contraception; 60 per cent had been coerced into pregnancy and had contraceptives tampered with; 27 per cent had experienced a partner trying to coerce them to have an abortion.  Almost a third had experienced partners deliberately trying to bring about a miscarriage with physical violence.

Social workers can also report situations where violence and coercion from people other than intimate partners leads to unwanted pregnancy. In my own work I met women whose family members denied them reproductive and sexual autonomy: for example, an adult woman, who was terrified of abuse if her father and brothers discovered her pregnancy. Or the young women who hid their contraceptives in a neighbour’s garden for fear that their parents would beat them if they knew they were having sex. 

Reproductive autonomy is crucial to women’s wellbeing and is a human rights issue when denied or controlled. Whether it is a violent manipulative man, controlling religious parents, evil traffickers controlling their victims or the seemingly benign face of an anti-choice GP or midwife, the outcome can be much the same. A person forced into pregnancy, or forced into an unwanted abortion, is a person denied autonomy over their own body and future. 

The consequences can be dire — downstream social and mental health challenges and, for pregnant people in violent relationships, damage to health and future fertility. These are the realities social workers deal with. The pious, moralising, ignorant older people who stand ostentatiously praying across the street from an abortion clinic go home feeling virtuous, never seeing the distress set in motion. The GP who turns a woman away without a referral isn’t the doctor who treats her for her injuries from her abusive partner, or the counsellor who sits with her in her grief over her fertility, lost to male violence.

Whether option A or C wins the day, we must ensure the best reproductive health care for all. This requires very clear responsibilities for health professionals to provide honest information on abortion as a health matter: It is not an opportunity for moral judgment and ignorance to prevail.

Read Liz Beddoe’s first piece here

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