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Steve Chadwick’s Abortion Reform Bill


Updated March 2012: In 2010, Steve Chadwick made public the news that she was preparing an Abortion Reform Bill to present to her parliamentary colleagues with the intention of this eventually going into the ballot as a Private Member’s Bill.

Steve first made the announcement on TVNZ 7 Back Benches programme on 31 March 2010. On the panel, chaired by Wallace Chapman, Steve was joined by John Boscawen (ACT), Catherine Delahunty (Green), and John Hayes (National) with “Soap Box” commentator in the audience Kerryn Baker. What was the reaction to this announcement? Not much until three months later when Weekend Herald health reporter Martin Johnston wrote an article “MP’s bill aims for abortion on demand”(Saturday 3 July, see image above) and suddenly it became a hot topic as opposed to the silent topic Steve had called it in the Back Benches programme.




Some questions


Who is Steve Chadwick?
What does Steve’s Bill propose and on what is it based?
Does ALRANZ support the proposal?
What are the chances of it being debated?
How would MPs vote?
Have other countries decriminalised?
What do the present laws say?
What is wrong with the present laws?
How will Steve’s Bill change this?
Why have a limit of 24 weeks?
What are the main objections to the proposal?
What about issues being debated in the courts?
What can members do?


Who is Steve Chadwick?


Full name
Stephanie Anne Chadwick
but has always been called Steve

Former Labour MP.

Former parliamentary roles
Junior Whip, Spokesperson for arts, culture and heritage, Vice-Chair of the NZ Parliamentarians Group on Population and Development (NZPPD).
Member, Health select committee 1999-2002 and chairperson September 2002-August 2005
Minister of Women's Affairs November 2007-November 2008
Associate Minister of Health November 2007- November 2008
Chairperson, Standing Committee on Women, Asian Forum of Parliamentarians' on Population and Development
When in Government Chairperson, NZ Parliamentarians' Group on Population and Development.


Politics
Entered parliament in 1999 as MP for Rotorua. In 2008 lost seat to Todd McClay. In 2004 took a lot of criticism for the Smoke Free Environments (Enhanced Protection) Bill. Remained in Parliament as a list MP.
Steve left Parliament in the November 2011 election after being bumped down Labour's list, some say as punishment for her work on reproductive rights.


Education
Karamu High School, Hastings, School Certificate, University Entrance, NZ Registered Nurse, NZ Registered Midwife. Nurse training Hutt Hospital and St Helen’s Hospital, Wellington.


Career
From 1983 several Health Manager positions at Rotorua Hospital.
Founding member, NZ College of Midwives 1989-1991
Manager, Women Child and Family Services, Lakeland Health 1991-1996
Founding member, NZ Women’s Health Manager Group 1993.
CHE representative, Coopers and Lybrand review of Maternity Services 1994. Working party member of publication First Steps Towards an Integrated Maternity Services Framework.
Client Services Director, Lakeland Health 1996-1999
Chairperson, Community and Social Policy Committee, Rotorua 1996-1999
Councillor, Rotorua District Council 1996-2002


Community activities
Patron, Rotorua & District Multiple Sclerosis Society Inc
Trustee, Te Utuhina Manaakitanga Drug and Alcohol Trust
Involved with Parents centre, Playcentre Association, Kohanga Reo and Kawaha Point School Board of Trustees 1975-1991
Union representative, NZ Nurses Association 1976-1986
Regional representative, Obstetrics Review Committee 1990
Member, Establishment committee for first Women's Refuge in Rotorua 1980 Steering committee for Rotorua Family Planning Clinic 1975


Personal
Born 15 December 1948, Hastings, née Frizzell. Married 1968 John Te Manihera Chadwick, lawyer of Ngati Tuwharetoa, Ngati Kahungunu, and Ngati Tama descent. Based in Rotorua. Three children Eli born 1972, Hana born 1974 and Rama born 1980 plus mokopuna.

 

What did Steve’s Bill propose and on what was it based?


Steve’s Bill was based on the legislation passed in Victoria, Australia in 2008. Following public debate and a failed attempt to introduce modernising legislation the premier John Brumby requested that the Law Commission investigate ways to remove abortion from the Crimes Act and make it legal for women and their doctors under certain circumstances, bringing the law into line with existing clinical practice. The commission received more than 500 submissions, about 80% from anti-abortionists, but the commission’s research showed that this did not accurately represent the Victorian community in which only about 10% strongly oppose abortion (about the same as in New Zealand).

The Law Commission came back with three options and the Victorian Parliament in a cross-party decision chose the middle ground giving women the power to choose abortion up to 24 weeks gestation with restrictions after that but abortion still possible in extenuating circumstances such as to save the life of the mother.


According to the preamble, the purpose of the Bill was to

(a) decriminalise abortion; and

(b) make it an offence for an unqualified person to carry out an abortion and

(c) provide a modern legal framework under which abortions may be carried out, in order to

              (i) encourage earlier service by reducing the procedural delays for a woman seeking an abortion, and

              (ii) regulate health practitioners involved in termination of pregnancy.

A health practitioner may carry out an abortion on a woman who is not more than 24 weeks pregnant.

After 24 weeks a medical practitioner may carry out an abortion on a woman only if the medical practitioner

(a) reasonably believes that the abortion in appropriate in all the circumstances; and

(b) adheres to the relevant Ministry of Health guidelines when carrying out the abortion.


Anonymous records shall be made by the health practitioner carrying out the abortion.

The Director-General of Health shall provide an annual report to the Minister on abortions carried out in New Zealand.

The penalty for an abortion carried out by an unqualified person is up to 10 years imprisonment. The woman who has an abortion shall not be charged.

The grounds for abortion in the Crimes Act are repealed. The relevant sections in the CS&A Act are repealed.

Section 67(b) (iii) of The Health Practitioners Competence Assurance Act 2003 Section 174 is amended so that it is the duty of a health practitioner who has a conscientious objection to abortion to inform the woman that she can obtain the service from another health practitioner of from a family planning clinic. In the present legislation abortion is not specified.


Did ALRANZ support the proposal?


Yes, definitely

How would MPs have voted?

If a vote were taken at the time the bill was being discussed in 2010, Steve Chadwick estimated that the voting would have been about 50-50 but that could change with public opinion supporting a more liberal stance.

Should Parliamentarians get a Conscience Vote?

Given past debates on abortion they will expect this to be a matter of conscience but there are even stronger grounds to argue that this should apply to women making a decision about abortion. Only the woman has to live with that decision and it will not be one that she will make lightly.

Have other countries decriminalised?


Steve in her previous government roles has also visited other countries including the UK, Europe, and North America. Canada decriminalised abortion in 1988, the Australian Capital Territory in 2002 and in 2008 the Council of Europe recommended decriminalisation of abortion in its 47 member states.

Decriminalisation means removal of abortion from the Criminal code where historically it has resided.


What do the present laws say?


The present laws on abortion are to be found in:
The Crimes Act 1961 and amendments (grounds for abortion)
The Contraception, Sterilisation and Abortion Act 1977 and amendments (the procedures)
The Health Practitioners Competence Assurance Act 2003 (conscientious objection)
The Care of Children Act 2004 (under 16s)




The Crimes Act 1961 and amendments

Section 183 The penalty for carrying out an unlawful abortion is up to 14 years imprisonment.

Section 186 The penalty for supplying the means of procuring abortion is up to 7 years imprisonment.

Section 187A defines “unlawfully”. The grounds for abortion are:

Serious danger (not being danger normally attendant upon childbirth) to the life, or to the physical or mental health of the woman or girl.

Substantial risk that the child would be physically or mentally abnormal as to be seriously handicapped.

The pregnancy is the result of incest or unlawful sexual intercourse with a guardian.

The woman or girl is severely subnormal.

The following matters are not grounds in themselves but may be taken into account:

Age near the beginning or end of the usual child-bearing years.

If there are reasonable grounds for believing that the pregnancy is the result of sexual violation (previously termed rape.)

After 20 weeks gestation abortion is only lawful if necessary to save the life of the woman or girl or to prevent serious permanent injury to her physical or mental health.


The Contraception, Sterilisation, and Abortion Act 1977 and amendments.

Section 10-17 Sets up the Abortion Supervisory Committee.

Section 18-27 All abortions to be performed in a licensed institution. Details of licensing.

Section 28 The Abortion Supervisory Committee may state case for Supreme Court on any question of law.

Section 29-36 System of two certifying consultants and certifying procedures.

Section 37 Penalty for offence under this Act up to 6 months imprisonment or a fine up to $1,000.

Section 38 Must comply with Crimes Act 1961 (grounds).

Section 39 Abortion Supervisory Committee must submit annual report to parliament.

Section 40 Protection for persons acting in good faith.

Section 41-42 Costs of administration.

Section 43 Regulations to be made for forms, fees and other administration.

Section 44 Self abortion is an offence with a penalty of up to $200 fine.

Section 45 Records to be forwarded to Abortion Supervisory Committee.

Section 46 Conscientious objection. Rights of objector defined but no requirement to refer.




The Health Practitioners Competence Assurance Act 2003

Section 174 If a health practitioner has a conscientious objection to contraception, sterilisation, or other reproductive health services it is the health practitioner’s duty to inform person where such a service can be obtained. Dispute over whether the term ‘other reproductive health services’ includes abortion.


The Care of Children Act 2004

Section 38 A female child of any age my consent or refuse to consent to abortion.


What is wrong with the present laws?


ALRANZ members will be very familiar with our arguments pointing out the problems with the present laws but we are not alone in calling for a review. The Abortion Supervisory Committee has reiterated the need for a review in several annual reports.


In brief

1. They are expensive. In 2008 the fees to certifying consultants alone amounted to around $5 million. This money could be better spent on preventing unplanned pregnancies.

2. They are unrealistic. They ignore the importance of socio-economic factors in making a decision. It is hypocritical that almost 99% are carried out on the grounds of mental health.

3. They are punitive, punishing women for contraceptive “mistakes”. To err is human. Enforced pregnancy is not in the long term interests of society. Women want to give their children the best start in life.

4. The procedures are unnecessarily complicated and erect barriers to good health care. Vulnerable women are disadvantaged. The system of certifying consultants is unnecessary.

5. Because of the complicated procedures delays in the system are inevitable and result in abortions being carried out later than is desirable for safety. The Abortion Supervisory Committee states that it is best practice for abortions to be carried out before 9 weeks. In 2009 only one third of abortions were carried out before 9 weeks.

6. The laws result in inequitable services. In part they are responsible for the geographical variation in abortion services throughout NZ.

7. Because they do not conform to best medical practice the laws are not respected and are not strictly adhered to. For example, counselling, according to law, should come after the decision has been made by the certifying consultants. Most services provide counselling before certifying, some even insisting on it, although this is not what the law says. The referring doctor may accompany the woman to see the certifying consultant but in practice this never happens.

8. There is a problem for abortions on the grounds of fetal abnormality. This is a ground up to 20 weeks but sometimes the diagnosis is not made until after 20 weeks and the abortion must then be done on the grounds of serious permanent injury to the mental health of the woman. In the past the Abortion Supervisory Committee has pointed out this anomaly to Parliament more than once but no action has been taken. This situation is distressing for the woman and her family.

9. They are outdated. There have been many changes in society since 1977 resulting in a change of public attitudes towards abortion and other reproductive health issues. There have also been advances in medical technology. The laws were written primarily for surgical abortions. In 2002 it was necessary for the ASC to seek a ruling from the High Court (under Section 28 of the CS&A Act) with respect to the procedures for carrying out early medication abortions.

10. They are disempowering for women. ALRANZ firmly believes that a woman should decide whether or not to continue her pregnancy, not parliamentarians with a conscience vote and not state-funded doctors. With respect to informed consent they do not conform to The Code of Health and Disability Services Consumers’ Rights.

11. Self-abortion is a crime subject to a penalty of up to $200. Prior to 1977 the penalty was up to seven years imprisonment. In the 21st Century this should no longer be a crime and in practice no prosecutions are made.

12. The sections on conscientious objection (Sect 174 HPCAC) and the referral to a certifying consultant (Sect 32 and 32 CS&A Act) are confusing. There are differing interpretations on the need to refer a woman seeking an abortion. The Medical Council’s draft guidelines (March 2009) are being challenged by a group of eight anti-abortion doctors in the High Court. There must be a balance between the right of doctors to freedom of beliefs and the patient’s entitlement to appropriate care and treatment.

13. They ignore the human rights of women and are not in accordance with international treaties to which New Zealand is a signatory especially with respect to the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW). Sexual violation is not a ground for abortion but only a matter which can be taken into consideration.  It is a matter of discrimination that women are not entitled to make a decision on having an abortion.

14. They are undemocratic. In a democracy there should be tolerance for different beliefs and anti-abortionists should not be allowed to impose their views on others, however sincerely these views are held.

15. They are ineffective. If one of the intentions was to reduce the number of abortions, they have failed.

 

How would Steve’s Bill have changed this?


Removal of the system of certifying consultants and removal of the grounds will save money, simplify procedures, reduce delays and thereby increase safety, remove the need for unnecessary consultations, get rid of the dishonesty of squeezing women into mental health grounds, and give women the dignity of making an informed decision themselves. It will be possible to provide a more efficient early medication abortion service. It will remove any ambiguity about referring on for those with a conscientious objection to abortion. It will remove anomalies in the present law such as fetal abnormality not being a ground for abortion after 20 weeks and sexual violation not being a ground for abortion but only a matter which can be taken into consideration. Self-abortion will no longer be a crime. It will not interfere with the provision of good health care and will allow nurses to take a greater role in abortion services.

Why have a limit of 24 weeks?

This is abortion on request up to 24 weeks. Here Steve is basing her Bill on the Victorian legislation. The Law Commission’s third option of having no upper limit was rejected in favour of 24 weeks, this being the stage of pregnancy on the cusp of viability and also the stage where some people have concerns about the fetus experiencing pain. Both of these reasons are vigorously contested, opponents saying that it is now possible with advanced medical technology to keep babies alive as young as 22 weeks while others point out that these cases of survival are rare without advanced medical technology and the development of a seriously premature infant is less favourable. There are many opinions on when a fetus will experience pain but reputable authorities put this at between 26 and 29 weeks.

In New Zealand although the law changes at 20 weeks there has never been a defined upper limit when abortion is not permitted. Very few abortions, less than 0.5% take place over 20 weeks. The reason is that most women do not seriously contemplate an abortion at this late stage and there are few medical practitioners who will provide a late-term abortion service. On the grounds of safety it is preferable for the woman to continue the pregnancy and most medical practitioners will advise this and women will accept this. The few late-term abortions are proof that the law as it stands has not been abused. At the same time we must allow for extenuating circumstance and especially to save the life of the woman.

The same arguments can be applied at 24 weeks in the UK (until 1990 it was 28 weeks) and 24 weeks in Victoria. Stricter rules apply but abortion is not banned. For the foregoing reasons it could be agued that there is no need for an upper limit. It is only provided to assuage those who do not understand that good medical practice is not necessarily dependent on laws.

To highlight the need for abortion in extenuating circumstances it is sobering to read the Health and Disability Commissioner’s report (05HDC13401 29 June 2007) on the death of a woman with serious heart disease at 30 weeks gestation, four hours after an emergency Caesarean stillbirth. Earlier in the pregnancy she had requested abortion and the public hospital system failed both her and her child.


What were the main objections to the proposal?


Anti-abortion groups are opposed to all abortions although some will make exceptions to save the life of the mother. These groups are vocal in expressing opposition but represent a minority point of view as shown in public opinion polls. They will be unable to outlaw abortions but they will attempt to bring in restrictions on the grounds of morality, or purported concerns about safety or the interests of women. Tactics in the USA are likely to be imported such as mandatory involvement of parents, compulsory viewing of ultrasound scans, delays between the decision to have an abortion and the procedure, stringent requirements for licensed premises, restrictions based on viability and fetal pain, and strict counselling requirements.

Some argue that the present system is working well enough and it is a safe system. There have been no deaths directly attributable to abortion since accurate statistics have been collected since 1980. The reason for this excellent safety record however is not because of the law but because of good medical services. As noted above there has been one maternal death due to refusal of a request for abortion.

Certifying consultants will present arguments to justify the continuance of their role but it must be remembered that they earn $135 for each consultation in addition to the sessional fees they are paid. They deserve credit for making a bad law work but will be reluctant to recommend discontinuation of this lucrative system.

What about issues being debated in the courts?

Parliament makes the laws and the Courts provide an interpretation of those laws. Currently there are two cases where abortion laws are in dispute:

(1) Right to Life v. Abortion Supervisory Committee. A long standing case which is due to be heard again in the Appeal Court in October 2010. At the centre of this case is the legality of over 98% of abortions being carried out on the grounds of mental health.

(2) A group of anti-abortion doctors disputing the Medical Council’s draft guidelines for doctors with a conscientious objection to abortion in the High Court.

These cases have arisen because of the deficiencies of the present law and will not prevent Parliament considering changes to the law.


What can members do?


Be informed and then inform others.

Write or preferably visit your local MP and provide feedback on his or her views.

Contribute to the public debate such as radio talk back, letters to editor and the internet.

Contribute in your community when issues arise e.g. church, schools, recreation and sports clubs.

Contribute by making use of your own talents.

Counter misinformation whenever you can.