What to do
A step-by-step guide to the process of obtaining a pregnancy termination.
- Have a pregnancy test
- Discuss with a doctor
- Certification
- Referral to a licensed hospital/clinic
- At the clinic/hospital
1. Have a pregnancy test
Early diagnosis of a pregnancy is very important. Early abortion is safer and there are more choices available with pregnancies in the early stages.
Home pregnancy tests
- Home pregnancy tests or pregnancy diagnostic kits can be readily obtained at any pharmacy/chemist's shop.
- These tests provide an accurate diagnosis, providing you follow the instructions CAREFULLY.
- Testing kits can be quite expensive, so it may be cheaper to visit a doctor.
- Positive pregnancy tests should be quickly followed up by a visit to a doctor, especially if abortion is being considered..
Doctor or Family Planning Clinic
- Maternity care is free at most doctors for most New Zealand residents. (Refer to www.moh.govt.nz for eligibility criteria.) A positive pregnancy test and following consultations are free for eligible patients.
- Note: a consultation with a negative test might not be free.
- Midwives are also able to perform pregnancy tests, but most clinics do not accept referrals from midwives.
2. Discuss with a doctor
- Before seeing a doctor, wherever possible, it is recommended that the situation be discussed with a trusted partner, relative or friend.
- An early consultation with a doctor is a good idea to ensure the best care for every pregnancy. If the pregnancy is unwanted, or there are other reasons why you are considering termination of pregnancy, then an early consultation is even more important; request a double appointment time (there is no need to tell the receptionist why).
- A doctor will have to diagnose the pregnancy or confirm the test done at home. Take an early morning urine sample in a clean bottle if possible.
- They will have to accurately date the pregnancy by examination and/or scan and exclude complications such as a tubal/ectopic pregnancy.
- Other tests needed are antenatal blood tests and infection screening, the same as for routine maternity care.
- Women that are unhappy about being pregnant and want to consider a termination will want to discuss this with a health care provider as early as possible.
- Termination may become an issue later in the pregnancy, because of changes in your social situation, or complications of the pregnancy. Many women choose to have some antenatal screening tests done and these tests may identify problems with the fetus/baby which may make abortion an option to consider.
- Doctors should know the referral requirements for the TOP service in their district, and be able to offer information about the methods they provide, e.g. medical or surgical.
- There is no reason at this stage to make a final decision about termination. All abortion providers have a legal obligation to provide counselling and a referral for early counselling may help you in making a decision.
- If a doctor refuses to refer to an abortion provider because they don't "believe" in abortion, they have a legal obligation to refer to another doctor who will. If s/he is uncomfortable with making a referral, ask to see another doctor who will be able to do so.
3. Certification
- To obtain an abortion a woman must have certificates from two doctors who are certifying consultants. One of these consultants must be classed as a specialist in obstetrics.
- The certifying consultants are required to decide whether the individual's situation meets the legal criteria for abortion.
- The doctor may be a certifying consultant, provide one certificate and then refer the individual to other certifying consultants in their district.
- The larger clinics will have certifying consultants on site, and so the referral may be directly to a clinic to obtain one or both of the certificates. Other clinics may require that two certificates are obtained before the individual is seen.
- Certifying doctors are required to assist women to find an abortion provider. They will know how to access the facilities in their area.
- If the two certifying consultants disagree about whether an abortion can be provided under the law, the woman may be seen by a third certifying consultant who will determine whether the abortion can be performed.
4. Referral to a licensed hospital/clinic
- For details of how this process works in each district, refer to the map or list of regional services.
- Not all parts of New Zealand have adequate abortion services. In some districts, accessing abortion services may require travelling significant distances.
- District Health Boards (DHBs) have a legal obligation to provide adequate health care for women. Most DHBs will assist financially if an eligible woman needs to be seen outside of her DHB for services, including for a legal termination of pregnancy.
- Once a referral has been made, the doctor may call the clinic for an appointment time or may ask that the individual call and arrange the appointment herself. The appointment should be made as soon as possible, so calling right away is advisable as there may be unavoidable delays at the clinic itself.
- Abortions can only be performed in a licensed
clinic/hospital.
- Up to 12 weeks (First trimester): clinics only need a limited license as this is a safer and easier procedure.
- After 12 weeks: a full licence is required.
5. At the clinic/hospital
Counselling
- There is a legal requirement to offer unbiased counselling. Depending on the clinic, this may be offered routinely or on request by the patient or the referring doctor.
- Counselling can be very useful for obtaining information, assisting to clarify issues in relation to abortion in general, and individual decisions in particular. It can also be useful for partners and/or families of the patient.
- Early counselling can assist women to look at all options, including guardianship, adoption and single parenting.
Medical examination/assessment
A doctor in the hospital/clinic will medically assess and advise the woman about her suitability for abortion. This entails:
- Looking carefully at the information already provided by the woman and her referring doctor and taking a full history of this pregnancy, previous pregnancies and previous medical and surgical history.
- Checking results of blood tests, swabs and smears, and pregnancy ultrasound if this has been performed.
- Performing a vaginal examination if this has not been done, or if indicated to do this again.
- Assessing the emotional health of the woman and discussing the background to her request for an abortion.
- Arranging further tests if needed.
- Discussing what method of abortion is appropriate and/or available.
- Completing the certification process, ensuring that the woman fully meets the legal criteria for termination in New Zealand, or checking certificates already provided.
- Advising the woman about contraceptive choices and prescribing appropriately.
Performing the abortion
- Each clinic will have its own operating procedure. Patients should not hesitate to contact the clinic beforehand to ask for information.
- In some clinics the operation may be provided on the day of counselling. However, in others it may be a two stage process, with counselling one day and the termination procedure at a later date.
- For information about types of procedure offered in New Zealand see abortion procedures.
- For more information on services offered in a particular clinic look under your own region.
Last Updated: 20 May 2006