Regulating abortion services: a focus on equity

Manatū Hauora – Ministry of Health has a programme of work in place to regulate and monitor abortion services to ensure compliance with the Contraception, Sterilisation and Abortion Act 1977.

The overall goal of the work programme is to ensure accessible, equitable, and quality abortion services across New Zealand Aotearoa. This work is led by the Regulatory Assurance team, within the Regulation and Monitoring directorate.

The passing of the Abortion Legislation Act 2020, and the subsequent decriminalisation of abortion in Aotearoa, provided opportunity to address inequity of access. This includes increasing access to timely and equitable abortion care, and giving more of a voice to Māori, Pacific, rainbow, and disabled communities to create services that better meet the needs of these groups.  

Statutory obligations

The amended legislation contains several statutory obligations for Manatū Hauora (the Ministry) that are being addressed through the planned work programme. These include:

  • ensuring that pregnant individuals can self-refer to abortion services
  • taking reasonable steps to ensure that abortion and related counselling services are available throughout New Zealand
  • periodically reviewing whether there is timely and equitable access to abortion services and related counselling services and making any recommendations necessary to improve timely and equitable access
  • compiling and making available a list of the names and contact details of abortion service providers in New Zealand, if they have no objection
  • publishing information about abortion services and related counselling services. 

The Ministry is also required to collect and report on provision of abortion services. More information is available at Abortion reporting.

Regulating for equity

The Ministry’s vision for abortion services focuses on services meeting the needs of rangatahi, Māori, Pacific peoples, disabled people, transgender, ethnic minorities and those living in areas of the highest deprivation (as groups experiencing the greatest inequity of access) to support equity access for all people in Aotearoa New Zealand. The Ministry regulates and monitors equitable access to abortion services through abortion service reporting. Te Whatu Ora is responsible for abortion service provision and equitable service access.

Manatū Hauora has focused on the following activities.

  • Implementation of the DECIDE service, providing consumer focused information on abortion and abortion services via a website and free phone number (0800 DECIDE) to connect people to services, including the option of telemedicine EMA (early medical abortion where appropriate, to improve timely and equitable access to abortion.
  • Supporting practitioners to provide culturally safe abortion counselling services by the introduction of the New Zealand Aotearoa Abortion Clinical Guideline and the Standard for Abortion Counselling Aotearoa New Zealand.
  • Development of national first-trimester abortion training. Manatū Hauora contracted New Zealand College of Sexual and Reproductive Health (NZCSRH) to develop training is aimed at a wide range Health Professionals with abortion in scope of their role (includes medical, nursing, midwifery, and pharmacist prescribers.  Cultural safety is core to the training, which includes Māori holistic models and tikanga for abortion care.This training is now the responsibility of Te Whatu Ora.
  • Implementation of the Information Collection Regulations and review of the new data, including the quality and completeness of data being reported to Manatū Hauora. This work includes reviewing and working to improve abortion reporting and how it captures access for all groups. Improving data quality is particularly important for priority populations to understand their needs. This includes Māori, Pacific, ethnic minorities, and disabled people. It includes capturing data from a range of sources, including service users and their whānau, and ensuring data aligns with best practice data protocols and standards, such as the 2017 Ethnicity Data protocols.
  • Implemented Safe Areas work programme that enables providers to apply for a Safe Area around their premises. Once granted Safe Areas will allow people accessing the service, and health practitioners, to be free from intimidation and to have safe access to the service. See Safe Areas Amendment Act for more information.

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