We are looking for an Auckland member willing to support Eileen Slark who is our representative on the Auckland Branch of the National Council of Women (NCW). Please write to National Office PO Box 28008 if you are interested in attending meetings where a wide range of women’s issues are considered.

              Eileen was our delegate at the NCW biennial meeting held in Masterton on 2-5 October. One remit of particular interest to ALRANZ was remit 5 calling for more research on abortion and mental health put forward by Voice for Life and amended by Hamilton Branch to include research on mental health and other pregnancy outcomes.

              Eileen writes: “It was a great experience for me, with remit 5 being the only controversial issue. Voice for Life called the amendment ‘Out of Order' because it did not represent the intent of their remit!! This took us all by surprise and took 10-15 minutes for the Committee and Meeting to sort before I could get to my feet and put the ALRANZ viewpoint. I then spoke to the amendment and said what a great opportunity this was to foster research for all pregnant women in the country who suffered from depression during and after pregnancy and not only those seeking an abortion. Having worked in the field myself, I outlined some of the harsher reasons some women sought an abortion and concluded that it was not surprising that some element of depression was present.” The final wording of the remit that was passed was that NCWNZ urges further research into the mental health outcomes for women experiencing pregnancies, both planned and unplanned, and also during the post-natal phase.”

              Our second representative at the conference was Lesley Smith. She reported back on the excellent speakers and events. At the Saturday night dinner they showed old films including one of the East Cape district nurse driving through rivers and on horseback. Our thanks to Eileen and Lesley for their participation.

Abortion and Mental Health

              A document that proved timely for the NCW debate on mental health was the publication of the Report of the American Psychological Association Task Force on Mental Health and Abortion released on 13 August 2008. The task force found that there is no credible evidence that a single abortion is a threat to women’s mental health but the evidence regarding the relative mental health risks associated with multiple abortions is more uncertain. The task force called for better designed future research.

              They evaluated studies published in English in peer-reviewed journals since 1989 that compared the mental health of women who had an induced abortion to comparison groups of women or that examined factors that predict mental health among women who have had an abortion in the USA. They observed that many of the studies published during the period reviewed (including the Fergusson study from NZ) suffered from serious methodological problems.

              They found that some women do experience sadness, grief and feelings of loss following an abortion, and some may experience depression and anxiety. However, there was no evidence to support the claim that this was caused by the abortion per se, as opposed to other factors. The report noted that other co-occurring risk factors, including poverty, prior exposure to violence, a history of emotional problems, a history of drug or alcohol use, and prior unwanted births predispose women to experience both unwanted pregnancies and mental health problems after a pregnancy, irrespective of how the pregnancy is resolved. Failure to control for these co-occurring risk factors, may lead to reports of associations between abortion history and mental health problems that are misleading. Women terminating a wanted pregnancy, who perceived pressure from others to terminate their pregnancy, or who perceived a need to keep their abortion secret from their family and friends because of stigma associated with abortion, were also more likely to experience negative psychological reactions following abortion.

A full copy of the APA Task Force on Mental Health and Abortion's report may be accessed at http://www.apa.org/releases/abortion-report.pdf

Research from New Zealand

              Pregnancy outcomes and intimate partner violence in New Zealand by Janet Fanslow, Martha Silva, Anna Whitehead and Elizabeth Robinson. Aust N Z J Obstet Gynaecol August 2008; 48(4): 405-14.     This study describes pregnancy outcomes for a population-based sample of NZ women, and explores the relationship between lifetime experience of intimate partner violence (IPV) and two pregnancy outcomes: spontaneous abortion (miscarriage) and induced abortion. Face-to-face interviews were conducted with a random sample of 2,391 women who had ever been pregnant, aged 18-64 years, in two regions (urban and rural). Women were asked if they had ever had a miscarriage or an abortion. Almost one in three women reported having had at least one miscarriage, and at least one in ten reported terminating a pregnancy. Controlling for potential confounders, women who had ever experienced IPV were 1.4 times more likely to have had a miscarriage compared with women who had never experienced IPV, and were 2.5 times more likely to have had an induced abortion. Ethnicity was significantly associated with experiencing a miscarriage. Asian and Pacific women were less likely compared with women of European origin. Asian women were 3.5 times more likely to have ever had an abortion compared with women of European origin. In this sample IPV was significantly associated with both induced and spontaneous abortion. The conclusion was that healthcare settings that see women experiencing these pregnancy outcomes need to be aware of the link with current and historical IPV, and be able to respond to women appropriately.

              It is good to see NZ based research to support those local organisations involved in reducing domestic violence. We could also add how this research ties in internationally with the APA Task Force which identified partner violence as one of the contributing factors to adverse mental health outcomes and with the UNIFEM ‘Say No’ (to violence against women) campaign launched in November 2007.

New Zealand election results

              On Saturday 11 November NZ voted for a change in government from a Labour-led coalition government in power for nine years to a more right wing National-led coalition government (59 MPs) in partnership with the Act party (five MPs), the United Future party (one MP) and the Maori party (five MPs). Labour (43 MPs), Green (six MPs) and Progressive (one MP) are now in opposition.

              Abortion did not feature as a major election issue which was understandable given the state of the world economy and the fact that NZ is in recession. In one of the televised debates National’s leader John Key said he had no plans to change the abortion law implying that there were other more important issues that the new government would have to tackle. Prime Minister (at the time of the debate) Helen Clark expressed her personal opinion that abortion was a serious matter to be decided by the woman and her doctor.

              So what does this mean for ALRANZ? It will be harder to get liberal reform but when in power Labour did not seek reform so that is nothing new. In December 1999 Phil Goff as Minister of Justice supported the Abortion Supervisory Committee (ASC) in their recommendation for a review of the abortion laws but nothing eventuated. A more positive sign came in November 2004 when parliament voted against restrictive clauses in the Care of Children Bill (mandatory reporting for under-16s). Hopefully the new parliament will similarly reject any restrictive legislation.

              One election plus is that the NZ First party did not gain any seats and they held seven predominantly anti-abortion votes in the last parliament. Act and United Future are unlikely to support restrictive changes. The Green party, the only party with a pro-choice policy has increased its representation from six to eight seats and when special votes are counted it is possible that this may add another seat. Being in opposition means that they will have less influence but in the past abortion has been regarded as a conscience issue so every vote is important.

              Although the final results will not be available until later this month, on the provisional results, the number of women in parliament has increased from 35 to 40 = 33% and this may bring a greater awareness of women’s issues. There is also an increase in ethnic diversity. Provisionally we have a parliament of 122 seats with representatives from Maori, Pacific Islands, Hawaiian, Fijian Indian, Sikh Indian, Chinese and Korean cultures.

              With 35 new MPs their views on abortion are untested except for Sir Roger Douglas who voted liberal in the great abortion debates of 1977-78. If you have information on any candidates through attending local political meetings or articles in the local press please let ALRANZ know. While we will be writing to MPs this first hand information is particularly useful.

              What the new parliament does could also be influenced by the right to Life case against the ASC winding its way from the High Court to the Court of Appeal. Of one thing we can be certain, that Right to Life will be lobbying for restrictive changes to our abortion laws and ALRANZ will need to keep reminding MPs about the benefits of pro-choice policies.

Conferences

              On 16 October President Margaret Sparrow spoke at the AGM of Children by Choice in Brisbane and was awarded Honorary Life Membership as was the second guest speaker Professor Caroline de Costa. The following day she also gave the opening address at an all day conference held at the University of Queensland Medical School. The conference was opened by Karen Struthers MP, parliamentary secretary to the State Minister for Health and addressed by Bonny Barry MP, a long-time advocate of women’s choice.

              Queensland providers discussed with envy the decriminalisation changes that had been made in the state of Victoria in the week before on 10 October. Abortion law in Queensland is based on the criminal code which makes unlawful abortion a criminal offence but does not define what is lawful. Unlike Victoria in 1969 and NSW in 1971 there has been no definitive ruling from a High Court. The precedent set by these other two states has been used when arguing cases taken to court.

              The law may be decriminalised in Victoria but access to services could be improved and delegates recognised the value of having an organisation like Children By Choice which provides information, education, and advocacy as well as telephone counselling and face to face counselling for those contemplating abortion in Queensland.

              On 23-25 October Dr Sparrow attended the biennial European conference for abortion providers (FIAPAC) in Berlin. The opening address was given by Christine McCafferty, MP, UK who had been involved with the resolution in April to the Parliamentary Assembly of the Council of Europe (PACE) calling for all member states which have not already done so to decriminalise abortion.

              It was inspirational to hear how the law had been changed in other places against formidable opposition. In Mexico City (although not Mexico) Maria Luisa Sanchez Fuentes explained that abortions are now available on demand during the first 12 weeks of pregnancy. In August 2008 the Supreme Court upheld the new law in an 8-3 vote after a strong challenge from the Catholic Church. In Colombia lawyer Monica Roa showed a video of the changes that had taken place there in May 2006 when the Constitutional Court issued a historic decision using international human rights arguments. The Colombian Constitution states that international human rights treaties ratified by Congress take precedence over national laws.

              Joyce Arthur from Canada asked “Do we need a law at all?” and described the situation in her country where there has been no law at all since what is often referred to as the Morgentaler decision of 1988. The Supreme Court then found the previous laws unconstitutional. Canada has proved that abortion restrictions are unnecessary. Furthermore the abortion rate in Canada has steadily decreased since 1999. Although there have been several attempts to bring in restrictions, she said that the interpretation of the Charter of Rights and Freedoms, only six years old in 1988, has evolved to the point that it would be extremely difficult for any abortion restriction to pass constitutional muster. She concluded “We do not live in the same legal world we did 20 years ago. Women now have well-established constitutional rights to life, liberty, conscience, security of the person, and equality. Such rights cannot be easily removed or compromised and all are directly implicated in the abortion issue.”

              More sobering was the anger of UK delegates who felt that they had been let down by Westminster. On the day before the conference (22 October) parliament ruled out any debate on abortion related amendments to the Human Fertilisation and Embryology Bill which passed its third reading with a comfortable majority (355-129). At a later date the Bill will go to the House of Lords before becoming law.

              This ruling meant no changes to the abortion laws, either anti-abortion or pro-choice. Ann Furedi and Marge Berer who both spoke at the conference were most disappointed that an amendment to allow the women of Northern Ireland to have legal abortions the same as women in Great Britain (England, Scotland & Wales) was not allowed to proceed. It is estimated that 40 women per week cross the channel to have abortions in the UK. In other respects they are regarded as citizens of the United Kingdom of Great Britain and Northern Ireland. [Abortion tourism is also the only choice for women in the Republic of Ireland which under its own constitution has one of the most draconian abortion laws in Europe.]

              Other pro-choice amendments were to remove the requirement that two doctors must give their consent for abortions, to allow nurses and midwives to carry out abortions and to allow medical abortion drugs to be taken at home. None of these could be debated.

              Anti-abortionists were also disappointed. They had called for the defeat of the bill in its entirety, given its provisions allowing in certain cases the creation and destruction of cloned human beings and waiving donor consent for embryos to be used for research. There was also opposition to the provision allowing embryo testing for serious conditions in order to create a so-called ‘saviour sibling’.

              Abortion safety was the predominant theme of the conference with papers comparing different methods. Medical (non-surgical) methods are now being used more widely in European countries for both early and late abortions. NZ lags behind in the uptake of early medical abortion and delays within the system mean that more abortions are done later than desirable.

OIA request denied

              Anti-abortion group Right To Life NZ was outraged that a request under the Official Information Act to the ASC was refused. The request was for the names and qualifications of members of a new advisory committee established under the Contraception, Sterilisation, and Abortion Act 1977 to consider standards for performing abortions. Members of the ASC’s subcommittees are employees, and as such have a general right to privacy and disclosure could hardly be justified on the grounds of public interest. By law employees have a right not to be harassed in the workplace. However, one of the strongest reasons against disclosure is to protect staff from extremists, given events in other countries where lives have been put at risk.

Book Reviews

              This Common Secret: My journey as an abortion doctor by Susan Wicklund. 2007 Published by Public Affairs, New York. Hardback 268pp.

              This is the personal story of an abortion provider and is cautionary reminder of the stress that can be caused by the harassment of anti-abortionists. It is as good an argument as any for the ASC refusing the above OIA request. Susan had an abortion in Portland Oregon in 1976, legal but traumatic and expensive. Later as a solo mother she embarked on a medical career which led to practising in abortion clinics in the North and West of America in Wisconsin, Montana and North Dakota. For years she commuted wearing a bulletproof vest and carrying a revolver. This is a clear example of what we do not want to see in NZ. Anti-abortion extremists are a dangerous breed.

              The New Zealand Pregnancy Book: A guide to pregnancy, birth and a baby’s first three months by Dr Sue Pullon and midwife Cheryl Benn. Third edition 2008. Published by Bridget Williams Books. Soft cover, 432pp. Price $44

              Since the first edition in 1991 this has become a NZ classic. Beautifully produced with many photographs and illustrations it is a comprehensive guide to pregnancy from pre-birth planning to delivery and after care. There is a section on Unplanned pregnancy – your options which discusses abortion and adoption. Abortion is not discussed in great detail but the legal position is outlined and readers are referred to the website www.abortion.gen.nz  for further information about abortion services. There is also a reference to the Family Planning website changed in 2007 from www.fpanz.org.nz to www.familyplanning.org.nz although the old address will still get you there.  Abortion is also discussed in the section dealing with fetal abnormalities.

Overseas News

Australia

              Victoria's Abortion Law Reform Bill 2008 was introduced by the Minister of Women’s Affairs Maxine Morand and strongly supported by Premier John Brumby and Coalition leader Ted Baillieu. It was opposed by National leader Peter Ryan and Deputy Premier and attorney-general Rob Hulls. The Act which was passed decriminalises abortion up to 24 weeks' gestation. After 24 weeks a woman must have the approval of two medical practitioners for an abortion. This was one of the three options (the middle one) presented by the Victorian Law Commission.

              It was not an easy passage. First the bill had to pass the Lower House. After a week of long, passionate and emotional debates, including 41 amendments, all rejected, MPs passed the third reading in a conscience vote 48-28 in the early hours of the morning on 12 September. Exactly seven minutes after Lynne Kosky finished speaking in favour of the Bill, the Transport Minister received a personally abusive email from anti-abortion group Tell the Truth Coalition. Ms Kosky was not alone in receiving such correspondence. All pro-choice MPs were targetted with insulting emails. Other tactics included bringing in Gianna Jessen from the USA, a personable 31-year-old with cerebral palsy, born prematurely after her mother underwent a failed mid-trimester saline abortion. Even more powerful was the Catholic Church threatening to withdraw obstetric services from Catholic run hospitals if the Bill went through.

              The Bill then had to pass the scrutiny of the 40 member Upper House. There were three days and three nights of debate. One MP (Liberal Bernie Finn) spoke for nearly six hours against the Bill! The third reading was taken at 10.30pm on the evening of Friday 10 October and the conscience vote was 23 to 17. The public gallery erupted in applause.

              Ms Morand and long time pro-choice campaigner Dr Jo Wainer said that for 40 years women have had to face uncertainty around abortion services. There is now clarity and certainty for both women and practitioners in Victoria.

              In September Judge Margaret Wilson of the Queensland Supreme Court in a landmark decision ordered doctors to perform a medical abortion (using misoprostol) on a 12-year-old Queensland girl, known as B, with an intellectual age of six, 18 weeks pregnant after a suspected rape. It is not the first time the judiciary has ordered an abortion in Australia, but it is believed to be a first for Queensland. B’s parents, who are divorced, had previously consented to the abortion and evidence was also given to the court that this was B’s wish. B normally lives with her mother, who moved interstate a month before these events, leaving her in the care of her father and grandmother.

              In her written decision, Justice Wilson cited previous cases in which a court had ruled that parents could not validly consent to the sterilisation of an intellectually disabled girl because of the risks of making the wrong decision. So far a tragic story but as the pregnancy progressed to 20 weeks, things got worse. The first procedure caused major side effects but did not work and B had to return for a second procedure. This time she miscarried but had to have surgery for complications. The case highlighted many issues. Most importantly what effect would this have on B and what steps are being taken to ensure her safety in the future? Why was RU486 (mifepristone) not used as a more effective method? One specialist said that it confirmed his opinion that abortion, in difficult cases is best managed by experienced doctors, not a court of law mandating a particular treatment.

              In the Federal Parliament, in September Tasmanian Liberal Senator Guy Barnett sought to disallow Medicare funding for late term abortions between 14 and 26 weeks. Instead he agreed to the issue being explored by a parliamentary committee and observers believe the inquiry will turn into a de facto investigation into the numbers and cost of abortions in Australia. The matter will be investigated by the Finance and Public Administration Committee which will report by the end of the year, meaning it may not be voted upon until next year. If successful, women would still be able to seek late-term abortions but would have to pay more because Medicare would no longer fund them.

U.S.A.

              Abortion featured in the presidential election in the USA with liberal Barack Obama and conservative John McCain providing voters with a real choice. The debate intensified with the selection of Sarah Palin, Governor of Alaska as McCain’s vice-presidential running mate. The 44-year-old has two sons Track 18, and Trig born in April with Down Syndrome. She has three daughters Bristol, 17, unmarried and pregnant, Willow, 13 and Piper, seven. Palin was applauded by anti-abortionists for choosing not to abort her most recent pregnancy and for supporting her daughter. The important thing is that they were both able to choose the course they decided upon, which ALRANZ agrees with. What ALRANZ does not agree with is pregnant women not being able to choose the course of action that is best for them.

              In September 2008 the Guttmacher Institute issued a report Trends in the characteristics of women obtaining abortions 1974-2004 documenting a 30-year low in abortion rates and a major shift in abortion demographics. The report found that the U.S. abortion rate is at its lowest level since 1974 dropping from a high of 29 per 1,000 women (age 15 to 44) in 1980 to 20 in 2004.

              The report found that the decline has been more significant among white women and teenagers than among blacks and Hispanic and older women but. one commentator said the disparity in the abortion rate is more the result of income than race or ethnicity. The proportion of abortions obtained by women younger than 20 during that time steadily declined, falling from 33% in 1974 to 17% in 2004. Among those younger than 18, the proportion of abortions fell from 15% of all abortions in 1974 to 6% in 2004. The proportion of abortions obtained by women in their 20s rose from 50% to 57% and increased from 18% to 27% among women age 30 and older.

              The decline in teen pregnancies began before the emphasis on abstinence-only education and is largely a result of more effective and widespread use of contraception. However, the report also said the decrease in the abortion rate among teens has been accompanied by an increase in teen births in part because of a greater societal acceptance of unwed mothers, increased difficulty in obtaining abortions in some parts of the country and changing attitudes toward abortion.

              The report found that the proportion of all abortions performed for women who already had a child increased from 46% in 1974 to 60% in 2004, reflecting the trend of women turning to abortion when they cannot afford to support another child.

Uruguay

              On 13 November President Tabare Vazquez vetoed legislation that would have legalised abortion in the first trimester. The bill was passed in the Senate earlier in the week and would have allowed women to end a pregnancy in the first 12 weeks due to hardship on the basis of economics, family, age, health, or risk to the mother's life. A three-fifths vote from both houses of the Uruguayan Congress is needed to overturn the veto, but is unlikely. Current law in Uruguay criminalises all abortion except in cases of rape or endangerment of the mother's life.

Spain

              In September a panel of experts was appointed by the Spanish government to make recommendations on liberalising the abortion law by the end of 2009 or early 2010. Equality Minister Bibiana Aido said that the number of abortions performed during the past 10 years has doubled, although the procedure is still controversial in the traditionally Roman Catholic country. She said the law must guarantee the fundamental rights and legality of women and the professionals who attend them and it must guarantee geographical equality, reducing the differences between autonomous regions. The present law dates back to 1985.