KEY POINTS:
The Auckland District Health Board has had "critical" difficulties in providing surgical abortions to women in mid-pregnancy because of an increase in nurses refusing to perform the work.
The board provides surgical abortions for women who are 13 to 18 weeks pregnant from throughout the Auckland region, plus some from other areas. It also provides medical abortions.
This is in addition to terminations in the first third or "trimester" of pregnancy, which have not been affected by the shortage of nurses.
Nurses are not required to be involved in performing abortions; they can refuse on grounds of conscience and work in other areas.
In papers written for a committee meeting today, the general manager of the board's National Women's Health Service, Kay Hyman, said the second trimester surgical abortion service was at "critical" risk.
She considered closing the service to those from outside the Auckland and Northland regions, noting the board would incur "fallout" from other DHBs, the Abortion Supervisory Committee and the Ministry of Justice.
Yesterday, however, she said the problem of having too few nurses prepared to take part in surgical abortions for women up to 18 weeks pregnant had been resolved a fortnight ago by employing some who did not object, and by changes to staff rosters.
"[It is] an issue of nurses expressing an unwillingness to continue contributing to this particular service. It's not an area of practice where many staff choose or are comfortable to work."
And some changed their minds and withdrew from abortion work after having done it for some time, Ms Hyman said.
When the shortage of consenting staff developed last year, she canvassed options such as changing the patient access criteria, providing the operations in other hospitals and asking the three surgeons, who are contractors rather than employees, to provide the necessary operating theatre staff. But none of these proved necessary.
Abortion Law Reform Association president Margaret Sparrow said staffing abortion services generally did not pose problems, although those for the second trimester were more difficult.
"A lot of those nurses are quite happy to be involved in early abortions but with the increasing gestation they do find it difficult."
Dr Sparrow said this was because of the greater development of the fetus, "rather than having a complete moral objection to abortion".
