Abortion providers say women should have final decision, not GPs

A group providing abortion services in New Zealand is telling MPs it should be women who decide when it's appropriate to have an abortion, not general practitioners (GPs). 

The Abortion Legislation Committee received oral submissions on Tuesday on the Abortion Legislation Bill, a proposed law to bring it out of the Crimes Act. 

It proposes that women need to have a doctor's approval to proceed with an abortion if she is more than 20 weeks pregnant - but providers are saying that's not fair.

"The reason why we don't think there should be a limit is because it places a GP in a situation where they make a decision on someone else's care," Dr Helen Paterson, a gynaecologist, told the committee. 

"If we want to improve gender equity, we should work towards autonomy, and this doesn't fit with that."

Her colleague Dr Carol Shand, a retired Wellington GP and part of the Abortion Providers Group, told the committee it's rare that women have abortions beyond that time. 

"It doesn't happen," she said, adding that women face "huge psychological distress" in confronting the decision to terminate. 

Dr Helen Paterson, a gynaecologist, and Dr Carol Shand, a retired Wellington GP.
Dr Helen Paterson, a gynaecologist, and Dr Carol Shand, a retired Wellington GP. Photo credit: Newshub / Zane Small

"Women going through pregnancy go through amazing distress," Dr Paterson added. "Women very rarely will be requesting an abortion that late."

Dr Samantha Murton, president of the Royal New Zealand College of General Practitioners, said a survey conducted by the college found that most supported 20 weeks, while others thought it should be even lower at 13 weeks. 

Her colleague Dr Bryan Betty, a medical director, said overall the college believes there should be more clarity on the 20-week period and why it was chosen. 

It follows a presentation to the committee by the Law Commission last month, when commissioner Belinda Clark said the gestation period in abortions is a "grey area and somewhat arbitrary".

The Abortion Legislation Committee.
The Abortion Legislation Committee. Photo credit: Newshub / Zane Small

Dr Robin Briant, who has worked in Family Planning and in conflict zones overseas, urged the committee not to "introduce processes to make abortion more difficult". 

She said her experience of providing abortions was that it was "almost exclusively of people anxious to have their procedure done, anxious right up to it, and extremely relieved afterwards". 

"I know many people who have had terminations, and I know none who have been severely damaged by it, or even particularly damaged."

The right to protest?

The committee also discussed whether women should have the right to get an abortion at clinics without being harassed by protesters. The abortion providers said protesters should have the right, but not outside the clinics - somewhere else. 

The legislation is proposing safe zones outside abortion clinics of up to 150 metres where anti-abortion protesters would be banned.

Dr Shand said there needs to be "clarification that if people do protest, it is illegal". 

"You need to look at intent causing emotional harm," she told the committee. 

ACT leader David Seymour suggested there could be implications around freedom of expression, because protesters might also feel like women getting abortions are causing them distress. 

"I get the right to protest politically, including abortion," Dr Shand said. "But they shouldn't be able to do it facing off to a patient... "Do it somewhere else - it doesn't have to be right there in front of the patient."

Dr Samantha Murton, president of the Royal New Zealand College of General Practitioners, and Dr Bryan Betty, a medical director.
Dr Samantha Murton, president of the Royal New Zealand College of General Practitioners, and Dr Bryan Betty, a medical director. Photo credit: Newshub / Zane Small

Justice Minister Andrew Little asked the Law Commission in February 2018 for advice on how to ensure New Zealand's abortion laws were consistent with treating abortion as a "health issue". 

Dr Paterson reflected on that, telling the committee, "We're looking for wellbeing for women... You shouldn't be protesting and impacting the wellbeing of women."

As for whether GPs should be able to conscientiously object, the Royal New Zealand College of General Practitioners representatives both agreed that GPs should let patients know of their views as soon as possible. 

The proposed law says GPs who object to abortion are still entitled to do so, but must refer the woman to other services.

Green MP Jan Logie suggested it could complicate things for women in rural areas, where the list of GPs is thin, and if their GP objects, they'd have to travel to big cities to have more options. 

"I support someone's right to hold their world view, but in a remote area, it could have a big consequence, because that has led to a profound consequence," Logie said. 

"It is tricky," Dr Murton said. "Rural areas have distinct issues around healthcare... Morality is a big disadvantage for postcode healthcare."

She said the committee needs to think about how to make sure services are equally available to everyone. 

"We don't have an answer... But rural healthcare is a difficult place to be."