The Aotearoa New Zealand Association of Social Workers (ANZASW) welcomes the recent release of the Law Commission’s report on Abortion Law reform.
The Association is pleased that the restrictive, decades-old laws that regulate abortion look set to be updated. We are encouraged by the fact that all the options for reform proposed in the report call for the practice to be decriminalised and treated instead as a matter of health, in keeping with the Prime Minister and the Minister of Justice’s past statements on the issue.
Social workers are committed to walking with women / wahine through their decision-making process when considering a termination of their pregnancy. Members of our profession work with the affected person to help them make an informed, clear-minded and independent decision, free from judgment and in an environment where they are not subject to external coercion.
Health social workers who support women / wahine in such circumstances adopt a rights-based, client-centred, client-in-context, holistic view of both inter-personal and intra-personal aspects of decision making; throughout the process we seek to support the service user and their family / whanau before and after any decision is made, regardless of whether they choose to terminate or keep a pregnancy.
ANZASW, as the professional body for social workers in the country, hopes that, whatever model for modernisation is adopted by government, the law will place the greatest emphasis on the rights and needs of the woman. We believe the relationship between women / wahine and health professionals should be consultative rather than determinative, so that the service user is supported to pursue what is in their best interest.
The law as it currently stands does not meet such standards. At the present time, women / wahine in Aotearoa New Zealand have to go through an overly complicated and often lengthy process when seeking access to a safe, free, lawful termination of their pregnancy, which offers no guarantee of approval. Certifying consultants currently wield the right to approve or deny such requests.
Under the current system, abortion is permitted only in cases of incest, foetal abnormality. where the pregnant person’s mental or physical health could be seriously impacted, or if she has a condition of “mental subnormality.” Victims of rape and teenagers are at the mercy of the consultants’ decisions.
We are pleased that the Commission’s report recommends that certifying consultants should not retain the power to authorise terminations. The Association believes that it is appropriate that the pregnant person should be at the centre of the decision-making process, in contrast to the current paternalistic model of care which disempowers those most affected. We also believe that the money that is paid by the state to certifying consultants would be better spent on programmes and measures designed to prevent unwanted pregnancies.
ANZASW finds it incomprehensible that a rights-based approach has been sidelined for so long in Aotearoa New Zealand in favour of maintaining a system that is patently unfair. As the United Nations’ Office for the High Commission on Human Rights (OHCHR) has stated “criminalization of health services that only women require, including abortion, is a form of discrimination against women.”
Furthemore, as Amnesty International has observed criminalising abortion does not make abortion less likely; it only makes it less safe. Decriminalisation is not likely to produce a rise in terminations- as the World Health Organisation has noted: “countries with less restrictive abortion laws generally had lower abortion rates than countries with highly restrictive abortion laws.”
ANZASW also believes that reform is necessary because of the need to reduce unsafe abortions or restrictions that disproportionately affect already marginalised populations. The current system not only increases the likelihood that women / wahine will seek dangerous abortion care outside of the law, but can discourage them from seeking out post-termination healthcare.
With this in mind, we also welcome the report’s recommendation that the only criminal offence associated with abortion should apply to unqualified persons who perform the act on a pregnant woman. This serves both as a deterrent against unsafe termination and is consistent with abortion being redefined as a healthcare issue and not a crime.
On a more general note, ANZASW believes that social workers providing important services such as termination of pregnancy counselling are undervalued within the abortion care system, despite offering unique expertise, especially in providing specialised therapeutic and psychosocial support.
An ANZASW member experienced in termination of pregnancy counselling observed that, at the present time, a majority of abortions are performed on the grounds of mental health, a fact which suggests that “the reasons for women seeking abortion are primarily psycho-social rather than medical.”
Regardless of the impact of the coming reforms, women / wahine are likely to continue to require the specialised support that only social workers can provide. With this mind, the Association hopes that the role of social workers in the abortion care system is protected and receives greater recognition going forward, so that service users receive the best possible support.
However, the 2018 Standards for Care allow for any health professional involved in the relevant care pathway to provide counselling for women / wahine seeking abortion. As our member noted, while this is not problematic in itself, it does mean that “there is a risk that the process could become overly medicalised and the depth of counselling offered by trained social work abortion counsellors could be viewed as superfluous.”
Finally, we also welcome the report’s proposal that access to safe termination is expanded, through a repeal of restrictions on which qualified health professionals can perform abortion or provide medication that brings about an abortion. This means that pregnant women would be able to attend a wider range of facilities to legally access this form of care, including family planning centres.
ANZASW will continue to follow the progress of reform on this matter. The Association presented a submission to the Law Commission during the review process; once the report is adopted and decisions are made about law change options, we will do so again to the Select Committee.