Terry Bellamak: Law commission has its work cut out on abortion

Opinion

In February the Minister of Justice, Andrew Little, asked the Law Commission to undertake a review of New Zealand's abortion laws in order to transform abortion from a criminal matter to a health matter. It's a big job. It amounts to nothing less than reconceptualising abortion in the eyes of the law.

It is also a huge opportunity to bring relief to pregnant people who will be consumers of this service in the future.

Currently, three of the biggest barriers to abortion care in New Zealand are: lack of accessibility, poor integration of medical abortions, and delay in accessing care.

All three originate from our antiquated abortion law. These unnecessary barriers make it difficult to deliver the safest and best medical care to people who need abortions

Abortion is mainly available in main centres. One of the reasons for this is that doctors who provide abortions usually have to specialise in abortions to maintain their skill level.

The law requires that abortions be performed by doctors. But research demonstrates that trained nurse practitioners and physicians' assistants can perform early surgical abortions, with the same low rate of complication that doctors achieve.

Removing that rule would allow the health service to make abortion care more widely accessible in regions that have traditionally been under-served, like rural communities.

Uptake of early medical abortions has been relatively low in New Zealand, because the process is difficult. Our laws were written before the primary medication was invented, and the law says all abortions must be performed in a licensed facility.

But medical abortions involve taking two medications, optimally a few days apart. You would have to travel to the clinic at least twice to get an early medical abortion. For people who live far from a main centre, it makes more sense to get a surgical abortion.

International best practice currently allows people to take the second set of pills at home. Best practice may soon allow taking both medications at home. A reformed law should make that possible by treating early medical abortion separately from surgical abortion.

Delay is arguably the worst part of getting an abortion in New Zealand. Most of this delay comes from the necessity of seeking referral from one's own GP or Family Planning, and from the legal requirement that each abortion seeker get the approval of two certifying consultants, who have to waste time making sure the abortion satisfies the legal grounds, and the proper boxes are ticked, so that everyone stays within the law.

The grounds must be done away with. The fact that 97 per cent of abortions are granted on the dubious mental health ground captures its inherent absurdity. Any reason for an abortion is a good reason, because there is no good reason to force a person to remain pregnant against their wishes.

People must also be able to self-refer to an abortion service, because abortion is a time-sensitive process – the earlier the abortion, the safer and better for the person seeking it.

The Law Commission has its work cut out. We wish it well as it grapples with bringing common sense to our abortion law, for the first time.

• Terry Bellamak is National president of ALRANZ Abortion Rights Aotearoa.