Abortion patients to be sent to Sydney

An Auckland district health board has been forced to pay for abortions in Australia after hospital staff refused women wanting terminations in late pregnancy on mental health grounds.

Waitemata District Health Board has decided to stump up the $1800 cost for women between 18 and 21 weeks pregnant to get the procedure done in Sydney. But the women will have to pay their own airfares.

Chief executive Dwayne Crombie said the board was required by law to provide the service, though neither its staff - nor private providers - were willing to perform the procedure.

He said the problem was particularly in the nursing area but sometimes occurred with doctors.

"Some staff are prepared to do a termination for fetal abnormality and some are not. Very few are prepared to do it on mental health grounds.

"From our point of view, the law is clear ... so it's not a judgment issue. It's how do we offer that on a practical basis when, in fact, nobody publicly or privately actually wants to do it?"

Dr Crombie said staff had the moral right to choose whether to take part, but he suspects that many do not because they are "uncomfortable or intimidated" by the procedure at that stage of pregnancy.

Dr Crombie expected no more than 20 cases of the problem a year.

"What's happened in the past is these women have gone to Sydney and have paid for it themselves. But the issue was raised with us by some women who couldn't afford to pay."

The health board had some earlier stage abortions performed privately, but no private providers were willing to do terminations at the late second trimester on mental health grounds.

Dr Crombie said only a few health boards in the country were able to provide the service - and only for women who lived in their area.

Counties Manukau refers women to a "centralised regional service" but would not elaborate further.

The Auckland District Health Board provides the service on mental health grounds only for women living in its catchment area.

It said: "We have a limited number of staff members willing to undertake the process and at this point we have not had to send any patients overseas for treatment, nor do we think we will have to."

Medical association chairman Dr Ross Boswell said under its code of ethics, doctors did not have to perform procedures they were uncomfortable with, unless it was an emergency.

Dr Joy Bickley Asher, the Nurses Organisation's professional services manager, did not know of the situation at Waitemata but said late second trimester terminations were a "very, very difficult area of care, and one where conscientious objection can come into play".

Christchurch abortion doctor Pippa Mackay said staff were perfectly within their rights to refuse on moral grounds.

"I just have an anxiety that this particular issue is being separated out with the sort-of morality hung about it.

"I understand people's distaste for late terminations, but the distaste for the procedure I don't think should be enough.

"If morally it's all right when the pregnancy's earlier, then morally it's all right when it's later."

Dr Mackay said the only exceptions were fetuses in the 22nd or 23rd week of pregnancy. But she said abortions beyond 20 weeks were rare.

"The ones who have the tough job are the nurses, because they're the ones that see the woman through."