ALRANZ News

              We always welcome new members and the reasons for joining are diverse. Here is an account (edited only for reasons of space) from one responding to the publicity surrounding the paper by David Fergusson linking abortion and mental health:  “I recently experienced an unplanned pregnancy as a result of contraceptive failure. I have had three children and decided for many good reasons not to continue the pregnancy and to seek an abortion. At times during the process I have struggled and my mental health has, I believe been affected. However I would most definitely argue that the majority of the issues that have arisen for me have been around the stress and disempowerment of the process of procuring an abortion and I think improvements to this aspect of abortion would certainly have eased the stress for me.

              At the outset of the process I was horrified to discover that in 2007 I still had to claim I wouldn’t cope mentally/psychologically with having another child. All the rational and reasonable reasons I gave for seeking an abortion were, I was informed, not grounds! Disempowerment number one! Having to claim I wouldn’t cope psychologically with another child, even though I probably would, was not good for my mental health. Where is my choice? I had to abdicate my power and hand the decision over to doctors.

              On top of this I encountered the trauma of having to wait for three weeks for a surgical abortion as medical abortion is not yet available in Christchurch. They claim they are in the process of introducing it but don’t seem to be placing much urgency on the matter. Still some women, I have heard wait even longer! I can certainly vouch that carrying a baby you are ultimately going to abort is not good for mental health!

              Not only would a medical abortion have alleviated the waiting but I feel it would have placed greater control of the process in my own hands. I have experienced a miscarriage and believe the medical procedure would have been a similar experience and more akin to a natural process. Another aspect for me was the shock that arose out of the suddenness of the surgical procedure. I was also devastated at not being able to have a support person with me during the surgical procedure and instead I was expected to feel comfortable being supported by someone I had met two minutes previously! Very stressful!

              The decision to have an abortion was never something I entered into lightly, in fact it was the most difficult decision I have ever had to make. I have however worked through the issues surrounding the decision. I have absolutely no regrets – I made the right decision for me. I am concerned that in the current climate in NZ abortion is far from being a right. It also seems that any perceived negative effect or impact of abortion on women is quick to be seized upon by the anti-abortion lobby and touted as a reason for further restricting a woman’s access to abortion How this would ever improve women’s mental health is a question these people fail to ask themselves. I think such a climate can lead pro-choice people to underestimate the potential impact an abortion has on a woman. I was for example, told by the doctor who would perform my abortion that I would be able to return to work the next day if I wanted to. However with my prior experiences of pregnancy and miscarriage I knew that this would be unwise and instead took a week’s leave - which in retrospect was only just enough time. I think that encouraging women to carry on as usual as though nothing has happened other than a heavy period is likely to have a negative impact on mental health.

              Another aspect of the social/political climate I found difficult was not being able to talk about what I was going through with friends or colleagues as I felt there is such division on the issue, and I didn’t know most people well enough to say how I was feeling. Not being able to talk openly about a stressful event you are experiencing has its own impact on mental health.

              I am, as a result of my experience committed to seeing a change in the abortion legislation and in people’s awareness in general and have joined ALRANZ as a step towards this. Because so many women are silent about their abortion experiences we do not hear their voice.”

Obituaries

              Pat Syme of Christchurch contributes this obituary: Margaret Duckworth, a long-time committee member of the Christchurch branch of ALRANZ died in July this year. She suffered a stroke eight years ago and never really recovered. Her huge funeral was testament to the high regard in which she was held by the community. Her daughters talked at the funeral about her activism: she believed strongly in many causes, in particular, a woman’s right to choose. She provided accommodation and transport for many out of town women who came to Christchurch for an abortion and prior to that, she was active in SOS. She was at the forefront in street protests and regularly joined an ALRANZ protest group outside Lyndhurst when SPUC tried to block access. She was an active committee member who was always there to help with mundane matters such as taking minutes or mailing out newsletters. She had amazing energy and a great sense of humour. It was fun having Margaret as a friend and supporter of women.

              Graeme White, 46, religious eccentric of Christchurch drowned on 11 August while trying to swim back to the Mainland from Quail Island in Lyttelton Harbour. He was a familiar face in Christchurch courts due to several high-profile cases involving his bizarre behaviour. In 1999 he served a jail term for tunnelling into the Lyndhurst abortion clinic, Christchurch.

Parliament

              Prime Minister Helen Clark announced changes to her cabinet on 31 October 2007. Those of relevance to women and abortion issues: Congratulations to Steve Chadwick for being elevated to cabinet with responsibility for Women’s Affairs, (replacing Lianne Dalziel) and being appointed associate Minister of Health. She has taken a special interest in sexual and reproductive health issues. David Cunliffe is the new Minister of Health, (replacing Pete Hodgson) and Mita Ririnui and Peter Dunne retain their positions as associate Ministers of Health. Annette King is now Minister of Justice (replacing Mark Burton) as well as retaining Police. Associate Ministers of Justice are Lianne Dalziel and Rick Barker, both new appointments.

Peter Dunne, United Future, pointed out an error in the table of MP’s voting record. He did not vote in favour of the Copeland amendment and should have been given three ticks. If you are using it please amend your table provided in the August newsletter.

Christian Party

              On 20 September Independent MP Gordon Copeland got off to a bad start when forming his new Christian based party. His plans were sabotaged by Destiny’s Bishop Brian Tamaki and the incompatible former Destiny NZ party leader Richard Lewis with whom he could not work. Copeland has now teamed up with former MP Larry Baldock to register his new party with the name Future New Zealand. Divisions among fundamentalist and Christian groups do not augur well for approval from voters at election time.

Right to Life v. ASC

              The long running saga of Right to Life seeking a judicial review of the ASC continues. The latest skirmish took place in the High Court in Wellington on September 24 when Justice Simon France heard arguments on the admissibility of further affidavits from two paediatricians describing the present medical capabilities in relation to fetal surgery and fetal diagnosis. The ASC argued that this evidence was irrelevant but the judge ruled in favour of Right to Life deciding that it was admissible. It was up to a later court hearing of the full case to decide whether it was relevant or not. New Zealand generally adheres to the common law “born alive” principle where a child has no rights until it is born alive. Right to Life argues that this principle is outdated now that a child can be partially removed from the womb for fetal surgery and then replaced.

Amnesty International

              Amnesty’s new abortion policy, outlined in the August newsletter, was confirmed overwhelmingly by the international council at its Mexico City meeting in August 2007. The Vatican and some Catholic bishops have spoken out against the policy and in NZ Amnesty has lost the fund raising support of at least one Catholic college - Carmel College in Auckland, which will still allow pupils to support Amnesty’s letter-writing campaigns. The NZ Catholic Education Office said that it is up to individual schools to decide whether to support Amnesty International, however it’s counterpart in Melbourne issued an edict advising schools to cut their long-standing ties with the organisation.

Road sign goes

              For ten years a sign erected by SPUC faced motorists on State Highway 1 just south of Gore. The council notified Voice for Life that it did not fit with council’s policy of prohibiting all signs that faced a highway where the speed limit was >50km/h. The sign has now been removed.

Educational Review Office Report

              Five years after sex education became compulsory in schools, most schools are not meeting students’ learning needs effectively. This was the finding in an ERO report “The Teaching of Sexuality Education in Years 7 to 13” which studied 100 primary, intermediate and secondary schools throughout New Zealand. A multi-department group led by the Ministry of Women’s Affairs called for the study. Weaknesses included the assessment of pupils, repetitive programmes, lack of teacher training and lack of resources. Schools definitely could do better.

Health and Disability Commissioner

              Ron Paterson, Health and Disability Commissioner released a report in August 2007 after investigating the death of Ms B, 36, who died in September 2004 less than five hours after her stillborn baby was delivered by emergency Caesarian section at 30 weeks gestation. Ms B suffered from congenital aortic stenosis and when she became seriously unwell during the pregnancy she wanted to terminate the pregnancy, her second after an interval of five years. Poor communication between the various teams involved in her care led to what the commissioner described as ‘suboptimal’ care. In her case an abortion may have been life saving. The hospitals involved were not named. For further details see www.hdc.org.nz and click on Commissioner’s Decisions 29 June 2007, 05HDC13407.

Conference Reports

              President Margaret Sparrow attended three abortion conferences in London in October coinciding with the 40th anniversary of the passing of the 1967 legislation which liberalised abortion in the UK by including socio-economic reasons as a ground for abortion. The changes effectively extinguished the trade in backstreet, illegal abortions for the poor and dubious private abortions for the rich as portrayed in the film “Vera Drake”. This film was screened as part of the commemorations. A panel which included Lord David Steel, the young MP who had sponsored the legislation in 1967 spoke after the film with Mike Leigh, director in the audience.            Everyone agreed that the effects of the 1967 legislation were beneficial although Lord Steel expressed reservations about the numbers of abortions being carried out.

              No-one was complacent. There was still plenty of campaigning for improvements especially as abortion was being considered by the parliamentary science and technology select committee hearing submissions on the Human Tissue and Embryo Bill.

              That committee has now reported on proposed changes to the current law and significant findings were: (1) No change to the upper limit of 24 weeks, despite emotive lobbying from anti-abortionists. The committee found that survival rates of babies born before 24 weeks did not warrant a reduction in the limit and this view was supported by the Minister of Health Dawn Primarolo. (2) Changes recommended to the authorisation of abortion, currently requiring the signature of two doctors. The committee recommended that this should only be retained for abortions over three months. Medical organisations favoured one signature, some pro-choice groups none. (3) Nurses and midwives with proper training and professional guidance should not be prevented from administering medical abortions at all stages of pregnancy, as well as surgical abortions at early stages. (4) There is no safety reason for barring a woman from taking at home the second of two pills required for an early-stage medical abortion. The conclusions were not unanimous and are not binding but will influence the parliamentary debate when the Bill goes before the Commons in the near future. There have been no amendments since 1990.     

              The first conference with the theme “Women Deliver” was also the largest with 1800 participants. It was not exclusively on abortion (as were the other two conferences) but dealt more widely with other causes of maternal mortality. While European and North American speakers were predominant, there were also significant contributions from African and South American nations but fewer participants from Asia and none from China. In addition to high profile plenary sessions there were many concurrent streams dealing with the unacceptable rate of maternal deaths in developing countries, the preventable risks of childbirth, deficiencies in antenatal care, obstetric fistula, the toll of unsafe abortions, the collection of better statistics, HIV/AIDS, legal issues, social justice, human rights, gender equity, child marriages, sexual abuse, female genital mutilation and the role of media. There was an art display, book launches, information booths, film screenings and a speaker’s corner for less formal sessions.

              In parallel with the main conference was an even more important conference exclusively for members of parliament and representatives of government from over 30 countries. If change is to occur it must have support at the highest level. At the opening ceremony the United Kingdom showed the way by announcing a £100Million donation to UNFPA (United Nations Population Fund) to enable progress on achieving the millennium goals especially Goal 5: to improve maternal health and reduce by three quarters (between 1990 and 2015), the maternal mortality ratio. Although statistics are unreliable, the average contribution of unsafe abortion to maternal mortality is about 13% worldwide.

              The second conference was sponsored by Marie Stopes International and attended by one of the nurses at Level J Unit who reports: “I was recently lucky enough to attend the Global Safe Abortion Conference in London. This was made possible by a generous grant from Istar. Though only recently a member of ALRANZ I registered as such and proudly wore a badge denoting my affiliation.

              This was the largest ever gathering of people interested in abortion issues with approx 800 delegates from 60 countries attending. It was also the first time that such a conference had been unashamedly titled an “abortion conference”. It was quite something for all the tourists visiting Westminster Abbey to look across the road at a huge sign stating as much.

              One major focus of the conference was the impact that legalising abortion has had on reducing maternal mortality. Currently 70,000 women die annually as a result of unsafe, illegal abortion and many times this number are left with permanent injuries. In some countries up to 50% of the maternal mortality rate is due to unsafe abortion as many of the women whose deaths are recorded as being due to haemorrhage or septicaemia have actually had undisclosed abortions. Most of these women are young and have already had several children. Their loss has a huge impact on the societies in which they live.

              In Nepal the maternal mortality rate has reduced by 48% in the last 10 years and a lot of this is credited to abortion now being legal. However as the government representative was very keen explain it is also due to better roads and maternity care.

              It was also pointed out time and again that just because abortion is legal it doesn’t make it accessible. With countries as diverse as the USA and Cambodia, access can be limited by a number of physical and legal hurdles such as shortages of trained providers, differing interpretations of what constitutes a risk to a woman’s health, financial barriers and consent issues to name just a few. There was a great address by a young Colombian woman who told us that we need to target judges as it is often case law that determines how the legislation is interpreted. In Colombia they have shifted the debate from moral and religious issues to social justice and women’s equality.

              Needing the approval of two or more doctors is a problem in many countries. One woman doctor from Zambia said in her country three signatures were required and one of those had to be a specialist. As there were only a handful of specialists and all were based in the capital city it in effect made abortion impossible to obtain legally.

              Medical abortion was described by one speaker as being the most important revolution in reproductive health since the introduction of oral contraception. It was described as being a “no touch” technique, the scientific development of a “potion” to induce an abortion that women have been seeking for centuries. Despite all the statistical evidence to the contrary there still seems to be a lot of concern, even at this level, that it makes abortion “too easy” and that women will rely on it rather than contraception

              As well as the plenary sessions there were many breakout sessions occurring simultaneously and as always it was difficult to decide which to attend. I decided that I would go to sessions that might have practical information that I could bring back and share with my colleagues. This did mean that I missed out on some very interesting sounding talks such as “Clandestine Abortion Providers” and “The Influence of Islam on Abortion Access.”

               I have returned feeling that though far from perfect we provide very good care for most women in NZ. I accept that I am lucky to be in Wellington working at a unit that provides the most comprehensive range of services in the country. If I were based in a smaller town or a rural location I might view things differently. Rather than wanting major change I would like us to think about some smaller “adjustments”. I would like more women to be able to access medical abortion and where possible for them to go through the process at home, as happens with over 90% of the women at the Marie Stopes Clinic in Leeds. In our own unit I think we could change some aspects of the care of women undergoing 2nd trimester surgical terminations, making it less traumatic for them and less time consuming for the staff,  thereby freeing us up to help more women.”

              The third conference was organised by Professor Wendy Savage of Doctors for a Woman’s Choice on Abortion. This was a smaller conference for abortion providers in the United Kingdom and Ireland. While the main emphasis was on current practice, it was also historical in that several speakers were long time campaigners for abortion law reform, Dilys Cossey, Diane Munday, David Paintin and Wendy herself who has recently published “Birth and Power: A Savage Enquiry Revisited” on the politics of childbirth. A trans-Atlantic perspective was provided by Professor Marji Gold from New York who spoke positively on the training of medical students in the United States. Dr Gill Greer, earlier this year appointed Director-General of IPPF was invited to speak at all three conferences and contributed effectively to the international perspective, emphasising the growing trend towards the recognition of human rights in reproductive health care.

              Prior to arriving in London Margaret also attended two conferences on the Gold Coast, Australia. At the O&G conference Dr Carol Shand contributed to a workshop on medical abortion and at the Sexual Health Conference Dr Darren Russell of the Cairns Student Health Service spoke on the introduction of a medical abortion service using methotrexate, as RU486 is not yet widely available in Australia.

Overseas News

Australia

              On 20 August 2007 Victorian Labour backbencher Candy Broad withdrew her private member’s bill to decriminalise abortion after newly appointed premier John Brumby foreshadowed reforming legislation in 2008. The Government will receive advice from the Victorian Law Reform Commission by March 2008 on how to remove abortion offences from the Crimes Act and clarify under what circumstances terminating a pregnancy would be legal. Polls indicate support for decriminalisation.

              Medical Abortion. Professor Caroline de Costa has published a book “RU486: The Abortion Pill” covering the recent debate and change to legislation in Australia. It is an informative account by someone at the centre of the debate. For further details go to www.boolarongpress.com.au  Professor de Costa’s practice in Cairns was the first to receive authorisation for prescribing mifepristone in Australia. That privilege has now been extended to doctors at the Royal Women’s Hospital in Melbourne, Westmead Hospital in Sydney and King Edward Memorial Hospital for Women in Perth.

U.S.A.

              A British film-maker Tony Kaye has produced a documentary on abortion “Lake of Fire” which has been made primarily for USA audiences. It took 16 years to make, is in black and white and at 152 minutes is long. His personal ambivalence towards abortion is reflected in the conflicted messages it sends and according to critics it is unlikely to appeal to either side of the abortion debate. He has interviewed both operating doctors and protesters (archival footage of Paul Hill, John Salvi and Randall Terry) and commentators such as Pat Buchanan, Noam Chomsky and Professor of Law Alan Dershowitz. Norma McCorvey and Sarah Weddington of Roe v. Wade fame are interviewed and some of the footage such as a late term abortion is sensationalist. It is unlikely that it will progress the abortion debate in the USA.

              A malpractice suit in New Jersey finally reached the supreme court. The plaintiff, a woman with two daughters complained that in 1996 when she requested an abortion, her gynaecologist failed to tell her that she had been carrying “a complete, unique, irreplaceable human being” before performing the abortion. The Court ruled in favour of the doctor but what a waste of professional time, money and expertise. On a more positive note New Jersey now requires pharmacists to provide the emergency contraceptive pill or help customers to locate a pharmacy that will provide it. Pharmacists cannot justify a refusal with philosophical, moral or religious beliefs. Some other states also have “Refuse and refer” policies.

              On 7 November the Senate approved increased spending on community based abstinence-only programmes for the 2008 financial year despite a report from a non-partisan group, National Campaign to Prevent Teen and Unplanned Pregnancy that found that abstinence-only campaigns have little effect on teenage sexual behaviour.

Poland

              One of the panellists to speak after the showing of “Vera Drake” in London, was Wanda Nowicka, Federation for Women and Family Planning, Poland who said that the new government elected that week would not be introducing changes to their strict abortion laws. Poland refused to join the other 26 EU member states when the UN General Assembly in New York, in September proposed an official European day against the death penalty. Poland uncooperatively linked the death penalty to abortion and euthanasia.           

Italy

              Abortion has resurfaced as a public issue following the disclosure of a case in Milan in June when a 38-year-old woman carrying twins had the healthy fetus inadvertently terminated in the 18th week instead of the twin with Down syndrome. The mother of one then had the second twin aborted. Italy’s 1978 law allows for abortion on request up to the 90th day of gestation and at a later stage if there is a danger to the mother or if the fetus is malformed.

Nicaragua

              By refusing to reauthorise therapeutic abortion, The Nicaraguan National Assembly in September recriminalised abortion yet again. There are no exceptions. For the provider the penalty is one to three years in prison. If the provider is a health professional there is also a sanction of a two to five year prohibition to practice medicine or hold a health post. For the woman the penalty is one to two years in prison. Already there have been several deaths, doctors fearing to intervene even to save the mother’s life.

Argentina

              In September 2007 Judge Claudia Salomon of Parana decreed that an abortion could not be performed on a 19-year-old retarded girl who was raped by her cousin. After protests from both government and non-governmental supporters the ruling was overturned by a higher tribunal. The girl has the support of her mother but her estranged father (who had not seen her for 17 years) sent a letter urging the hospital not to perform an abortion on his daughter.