Reproductive justice: Improving access to abortion services in Aotearoa New Zealand
With the recently introduced Abortion Legislation Bill 2019, 2020 could be the year that Aotearoa decriminalises abortion. The Bill, if passed, would remove abortion from the Crimes Act 1961 and treat it, instead, as a health issue. Current legislation has been heavily critiqued for undermining patients’ human rights to healthcare and bodily autonomy, causing lengthy delays in treatment, and contributing to stress. Access to abortion is unequal for different members of society, particularly for those who face socioeconomic disadvantages, are marginalised, rural, Māori, religious, migrant, or a combination thereof. Factors that obstruct access may be legal, geographical, socioeconomic, cultural and societal. Additionally, stigma, the lack of availability of willing abortion practitioners, and conscientious objection represent significant barriers. Improving access to abortion would assist in the achievement of reproductive justice and Aotearoa’s national and international agreements, such as Te Tiriti o Waitangi and the United Nation’s Sustainable Development Goals. This study explores how access to abortion can be improved, particularly for the most disadvantaged, whether or not the law changes. It aims to contribute to improved and more equitable access to abortion services. Undertaken from a social constructivist and transformative epistemology, semi-structured interviews were conducted with 13 abortion providers, academics and advocates, as they are the knowledge-holders of abortion access. The research is guided by the framework of reproductive justice, which recognises every aspect which may hinder or empower a person’s right to control their fertility. The study found that decriminalisation and telemedicine have the greatest potential to improve access to abortion in Aotearoa, particularly for the most disadvantaged. Other ways to improve access, regardless of law change, include improved cultural competency, efforts to reduce stigma, changes to conscientious objection, and integrated services. Decriminalisation would assist in improving access to abortion and making advancements towards reproductive justice and human rights. However, questions remain over the future of funding, training and access.