Is it time for abortion law reform?

Falling pregnant is a life-changing experience. It was for A*, but not in the usual way.

"I was in a long-term relationship, it wasn't very healthy towards the end. I was using contraception for years and then all of a sudden something happened - I must have made a mistake with it and I was pregnant."

She didn't have the financial means or the support to raise a child.

"It was very sad, and I spent weeks agonising over what I should do and running over all the options in my mind, and it was a very upsetting time.

So she went to the local family planning clinic.

"I thought I'd go in there and explain my situation and my decision and I would get access to an abortion. But she then said, 'We've got to go get a test done, you have to get an ultrasound, you have to get another doctor to sign off.'

"I said, 'What do you mean sign off?' She said, 'Well, you need to justify to me why you need this and why you can't have a child.'"

Law 'unnecessarily complicated'

The Nation has spoken to a number of women about their experiences. Some didn't want to be identified.

The common theme is that seeking an abortion in New Zealand is a drawn-out process that adds stress and discomfort to an already fraught situation.

"It's unnecessarily complicated, it's out of date," says Dame Margaret Sparrow, who has been advocating for abortion law reform for decades.

"I think it's demeaning to women because women can't make the decision for themselves - the decision has to be made by two certifying consultants.

"And also, I don't think we need grounds for abortion - 98 percent are done on the grounds of mental health. I think that's ridiculous."

Under New Zealand law, abortion is a crime. But the law outlines a few scenarios where women can obtain an abortion at under 20 weeks' gestation:

  • if the pregnancy is a risk to the physical or mental health of the mother
  • if there's a substantial risk that the child would be "seriously handicapped"
  • if the child is a result of incest
  • if the women is "severely subnormal".

Handicapped and subnormal are not terms you hear much anymore.

Month-long waits

Katie Ruscoe had an abortion a few years ago and struggled to find information on the process - so she came up with her own.

Her series in the online magazine The Villainesse describes the process of terminating a pregnancy in detail, based on interviews with several women.

"I guess the overall thing was just stress over the wait time," says Ms Ruscoe. "I don't think anyone had a super-negative experience - it was just more that it could have been a better experience for them had it not dragged out over such a long time."

When a woman decides to seek an abortion, she first has to get a referral from her doctor. She has to undergo a number of tests, including an ultrasound.

She'll see two doctors, called certifying consultants, who give the sign-off for the termination.

She'll also be offered counselling. In some areas it's compulsory.

Ms Ruscoe said for her, the process took a month.

"I had pretty much every side-effect it is possible to get. It made it really difficult to work, really difficult for me to keep it from people around me. Emotionally it was really difficult, it was stressful, it was pretty much the longest month of my life."

For A, the process was similar.

"It was extremely tiring. It took every ounce of energy to be able to continue to just go through my day-to-day without letting everything go. That was hard."

And a bad experience with a social worker made it much more difficult.

"It felt like I was at the mercy of everybody else and their opinions, and what they thought was best.

"It is my body and I made the best decision I could at the time and I don't regret it.

That whole process added just so much extra pressure on me - I was definitely in my right mind, but it could have pushed me over the edge afterwards because of the stress involved in that."

The cost of going private

The most recent research in 2010 found the average time from referral to the procedure was 25 days. Another study in 2011 found the process took 10 fewer days at private clinics - but it comes at a cost.

"Over $1000, and I think that's not doable for a lot of women," says Ms Ruscoe. "If I could have gone back, I would have found the money, but not everyone can do that."

Dame Margaret says the lengthy process also increases the medical risks and limits the options.

"The earlier the better for abortions, and under eight weeks is a good time, a very safe time to have an abortion.

"In our country, the figures are well down on countries that do provide a good medical abortion service."

Medical abortion is when a woman takes pills that induce a miscarriage. It's only available up to nine weeks' gestation.

In 2015, 55 percent of terminations were carried out before 10 weeks - but in the UK the same year, that figure was 80 percent. In the United States, the latest available data from 2013 had the figure at 81 percent.

Terry Bellamak from the Abortion Law Reform Association says that's not good enough.

"It stacks up pretty poorly. So you could be timed out of the opportunity to have a medical abortion you have to have a surgical abortion - or you could be timed out of the early surgical abortion, which is less intense.

B* has had two terminations - one 10 years ago, and another more recently. For her the process was shorter, but during counselling she was told the reason she wanted an abortion wasn't valid.

"It was a moment of real terror - like, if she says no, that could be the end of it.

"The thought of being forced into something as massive as parenthood was terrifying. I really had to backtrack and kind of say what they wanted to hear, which was obviously that it would negatively affect my mental health.

"I felt like I had to lie about the reasons."

Access not guaranteed

In 2015, clinics in New Zealand performed 13,000 abortions, but access is by no means guaranteed for women.

Last year, certifying consultants found 250 abortions "not justified". The Abortion Supervisory Committee (ASC) could not clarify the reasons or whether a third certifying consultant went on to approve the abortion.

The ASC oversees the law in New Zealand. In a statement to The Nation, it said there a number of factors that can influence the length of time from referral to procedure, and it's important that women take the time they need to decide.

It says it encourages providers to see women in a timely manner. But speaking at a recent select committee hearing, it also outlined some changes it wants made.

"What we were signalling is that we are doing our best to operate within legislation that is 40 years old," says Dame Linda Holloway.

"Now that may not be the Magna Carta, but in terms of what is essentially health law, that's a long time for legislation not to be significantly updated."

Among those changes, the committee wants the Government to update the term "mentally subnormal" in the legislation.

It also wants to improve data collection and pre- and post-procedure care, but warns "it is important to understand that there are limitations on the ASC's ability to implement some of the recommendations due to legislative restrictions and resourcing".

But the Government says change isn't necessary.

"We've made it quite clear it's not something we're planning to review at the moment," said Minister of Justice Amy Adams.

"Our main concern is that the law is working as Parliament intended, and I haven't' seen any indication that that clumsy language is affecting its operation. That's the critical thing for me."

National isn't the only political party apparently ducking for cover. The Labour Party wants a Law Commission review of abortion law, but justice spokesperson and deputy leader Jacinda Ardern declined to be interviewed for this story.

Her spokesperson says that's because it's a conscience issue rather than a party one.

The Greens and ACT support decriminalising abortion. The Green Party's Jan Logie says changing the law isn't a topline priority, but it's a fundamental human rights issue.

"When we have a law that is being loosely interpreted, we can feel grateful but we can't feel secure. I really think that is another call for us to act and make sure our law reflects what we want."

Change needed sooner, rather than later

Meanwhile, the women we spoke to say there needs to be change.

"I didn't realise until I was in the waiting room how many women were there, and there are doctors and nurses doing this daily," said A.

"It is something that needs to be more openly discussed and we need to offer more support to our women, not judgement."

* Names withheld by request.

The Nation