Abortion legislation changes
On 24 March 2020 changes were made to the law to decriminalise abortion, better align the regulation of abortion services with other health services and modernise the legal framework for abortion services in New Zealand.
The abortion legislation is available on the New Zealand Legislation website.
Please note this amendment updates the primary legislation for abortion, set out in the Contraception, Sterilisation, and Abortion Act 1977 and the Crimes Act 1961.
Abortion Services work programme
The Ministry of Health is delivering a work programme to support the vision of greater abortion service accessibility and equity within Aotearoa New Zealand.
Transformation of abortion services procurement – accessible abortion services
The Ministry of Health has opened a registration of interest (ROI) to support the vision of greater abortion service accessibility and equity within Aotearoa New Zealand.
The ROI is open from 15 March and closes on the 16 April. We welcome ROI applications across three streams;
- service design (co-design of a new service with rangatahi Māori)
- service innovation (to improve access to an existing service) and
- abortion workforce training (inclusive of those supporting access to abortion).
Abortion workforce training must be designed to be inclusive of Māori, Pacific and Disabled service users and aligned with culturally safe work practices. The focus of all three streams is accessible abortion services for Māori, Pacific and Disabled people, with rangatahi (youth) access within these communities a sub-focus.
Applications will be evaluated against a range of criteria, including supplier expertise in rangatahi Māori engagement (for service co-design) and their approach to partner with local Māori, iwi, youth, community and other priority groups.
Each application must be for ONE of the three streams (service design OR service innovation OR workforce training). Each stream has different pre-conditions and evaluation criteria. Further details on all three streams is available on the New Zealand Government Electronic Tenders Service. Please contact [email protected] for a copy of the ROI documentation or support with the application process.
Applicants are welcome to submit more than one application and make applications for more than one stream.
Following the ROI, the Ministry will follow up and work with the shortlisted providers. Selected applications will then progress to the contract stage. It is anticipated several contracts will be awarded in June 2021. The contracts will be funded for two years (30 June 2021 to 29 June 2023).
A provider briefing will be held on Friday 19 March 11am-12pm – please contact [email protected] for meeting details. This briefing is an opportunity to hear more about this procurement and ask any questions you may have.
Changes for health practitioners
Key changes include:
- allowing a woman to self-refer to an abortion service provider
- allows a wider range of registered health practitioners (eg doctors, midwives, nurse practitioners, registered nurses) to provide abortions (subject to scopes of practice and training). Registered nurses trained in abortion care will provide early medical abortion using a standing order. Expanded practice protocols may allow registered nurses to provide other abortion care as per agreed protocols and training. Registered health practitioners will not be able to perform surgical abortions or prescribe medicines for medical abortions unless:
- it is a health service permitted within their scope of practice
- the practitioner holds a current practicing certificate
- the practitioner has the necessary qualifications, skills, competency and resources to provide abortion services in accordance with the Ministry of Health's Interim Standards for Abortion Services
- a qualified health practitioner may provide abortion services to a woman who is not more than 20 weeks pregnant (no statutory test requirements)
- a qualified health practitioner may provide abortion services to a woman who is more than 20 weeks pregnant if they reasonably believe that the abortion is clinically appropriate in the circumstances. In considering whether the abortion is clinically appropriate in the circumstances, the qualified health practitioner must:
- consult at least one other qualified health practitioner
- have regard to:
- all relevant legal, professional and ethical standards to which the qualified health practitioner is subject
- the woman’s:
- physical health
- mental health
- overall wellbeing
- the gestational age of the fetus
- ensuring that health practitioners advise women of the availability of counselling services if they are considering an abortion or have had an abortion, although counselling will not be mandatory
- if a health practitioner has a conscientious objection and declines to provide or assist with providing contraception, sterilisation or abortion services, or to provide information or other advisory services relating to abortion, they must tell the woman of their objection and how to access the contact details of the closest provider of the service requested. A conscientious objection does not override a health practitioner’s professional and legal duty to provide prompt and appropriate medical assistance to any person in a medical emergency (including a surgical emergency). Practices should find the best ways to communicate objections for the benefit of both patients and health practitioners (eg, by providing this information on your website and in waiting rooms)
- ensuring that employers accommodate an employee’s conscientious objection, but not if doing so would unreasonably disrupt the provision of health services. Accommodating the employee’s objection may include arranging for those duties to be carried out by an existing employee
- removing the requirement that abortions may only be performed in licenced premises
- the Director-General of Health must compile and maintain a list of the names and contact details of abortion service providers in New Zealand. An abortion service provider means an entity that provides abortion services. The list, or the information on the list, will be accessible to any person on request. The list will not contain the name and contact details of any abortion service provider who advises the Ministry that they do not want their name and contact details included in the list. Please email [email protected] to advise the Ministry about including or withholding your entity’s details from this list.
For full details please refer to the updated Contraception, Sterilisation, and Abortion Act.
Standards of Care
Interim Standards for Abortion Services in New Zealand are available via the link below.
These interim standards are based on the previous standards from the Abortion Supervisory Committee (ASC) ‘Standards of Care for Women Requesting an Abortion in Aotearoa New Zealand’. The Ministry has made changes to the text of the ASC Standards where necessary to ensure the interim standards reflect the new legislation and its implications. Four new standards have been added in the interim standards to ensure compliance with the amended CSA Act.
Over the course of 2020, the standards have been aligned with broader health and disability services standards, supported by service specific guidance. We will work with the sector to ensure that the new standards continue to provide safe care for women while reflecting modern models of care for abortion services. There will be opportunities for inclusion of a range of voices in setting the new standards, including DHBs, providers, the current and future workforce, consumers, and Māori.
The Ministry is also working to further develop the clinical guidance for abortion services, with particular reference to international best practice and consideration of a specific Aotearoa New Zealand perspective. The Ministry is drawing on expertise from key stakeholders within the abortion services sector including Nursing, Midwifery, General Practice, Gynaecology and Obstetrics, Maternal Fetal Medicine, Sonography, Counselling and Social Work, Pharmacy, Sexual and reproductive health, and Academic specialists in abortion.
Notification of abortion
To comply with new Section 20 of the Contraception, Sterilisation, and Abortion Act, abortion service providers must submit a notification to the Ministry of Health within one month of an abortion. This notification must include all details specified and not include the name or a unique identifier of the woman. Please email [email protected] if you require access to notification forms.
The notifications are required to be submitted to support the collection of abortion data that the Ministry must collect and report on. The data will also be used to support periodic reviews into the timely and equitable access to services.
Engagement with key stakeholders
The Ministry of Health will continue to work with abortion service providers, non-governmental organisations, GPs and other health practitioners to increase their knowledge of the new legislation and what it means in practice, to ensure the most up-to-date information is available.
The Ministry of Health will also work with the sector to improve equitable access to affordable reproductive health services for women in New Zealand.
DHB quarterly survey
Earlier this year, the Ministry surveyed all district health boards about abortion services they currently provide. The intent of this survey was to clarify where gaps in service provision existed, as well as to provide a snapshot of services at a certain point of time.
The Ministry has developed a detailed work programme to modernise the legal framework for abortion services in New Zealand, better align the regulation of abortion services with other health services, and ensure everyone who needs abortion care has timely and equitable access.
The findings of the survey have helped inform the development of this work programme. For example, workforce sustainability has been identified as a priority issue, and the Ministry is working to take steps to address this.
The summary report of key survey themes can be found below.