In 2018, the Law Commission sought input from the public and appropriate health professionals into the Government’s intention to propose a policy shift to treat abortion as a health issue. The Minister of Justice had asked the Commission to provide advice on what alternative approaches could be taken in the legal framework to align with a health approach.
This is our submission into the public input process.
Te Whāriki Takapou – Submission to the Law Commission on Abortion and Māori
Te Whariki Takapou is a kaupapa Māori public health organisation involved in sexual and reproductive health promotion and research. The organisation, formerly known as Te Puāwai Tapu, is contracted to the Ministry of Health to deliver health promotion services to Māori communities with priority needs.
Te Whāriki Takapou has held contracts with the Ministry of Health for more than twenty-five years. As well, the organisation has won contracts with the Health Research Council of New Zealand to research kaupapa Māori models of sexual and reproductive health promotion (2003), barriers to testing and treating sexually transmitted infections among rangatahi NEET (2015), and takataapui and Māori LGBTQI health and wellbeing (2016).
2. Focus of submission
Māori women, as members of whānau, have a right to control their sexual and reproductive health, including access to high quality, local abortion services. The right to control their sexual and reproductive health is an outcome of tino rangatiratanga guaranteed by Te Tiriti o Waitangi. Where abortion is concerned, it is a requirement of the Crown to ensure that Māori women can exercise their right to an abortion. Moreover, the right to an abortion extends to the Crown ensuring that Māori women have easy and affordable access to abortion services and that access to abortion services is free of any form of discrimination. The exercise of one’s tino rangatiratanga; in this instance Māori women’s right to abortion as part of controlling their sexual and reproductive health, is critical to achieving good health for Māori women, their whānau, hapū, iwi, and Māori communities.
3. Māori and abortion
Each abortion reported by Statistics New Zealand and the Abortion Supervisory Committee has been included in every ethnic group specified by a woman undergoing a medical or surgical abortion. For this reason, some abortions will have been counted more than once (Abortion Supervisory Committee, 2017). The number of abortions among women reporting Māori as their ethnicity has, like the abortions among other New Zealanders, declined over the last decade (Statistics New Zealand, 2018). Proportionately, Māori women account for one quarter of the total number of abortions (Statistics New Zealand, 2014; Abortion Services in New Zealand, 2013a). There is some evidence that regions of the country with high Māori populations may experience inequitable access due to a failure to provide local abortion services, including medical abortions (Silva & McNeill, 2008). No doubt influenced by the evidence, the Abortion Supervisory Committee (2017) noted in their annual report that access issues were of concern in the greater Auckland region and recommended a local first trimester service in South Auckland.
4. Historical and contemporary Māori narratives about abortion
The term ‘abortion’, as defined by Statistics New Zealand (2013, p. 5) is ‘foetal loss excluding stillbirths’ and emerges out of a Western cultural tradition. Māori terms for ‘abortion’ suggest quite different understandings. For instance, Murphy (2011) notes the use of the term ‘tahe’ in mōteatea, which Williams (1991) translates as ‘menses’ or ‘flow’, and ‘abortion’. Murphy cites Williams’ translation of the term ‘whakatahe’ as ‘abortion’, as well as ‘the clearing of obstructions’, and ‘sacred food offered to atua’ (1991, p. 358, cited in Murphy, 2011). He Pātaka Kupu: Te Kai a te Rangatira (Te Taura Whiri i te Reo Māori, 2008), gives explanations in Māori for the terms ‘tahe’ and ‘whakatahe’ that correspond to Williams’ translations, and introduces two further terms: ‘materoto’ and ‘kuka’. Waka Reo ā-Ipurangi, an online Māori-English-Māori lexicon, provides the following translations for these terms:
kuka – dry flax leaves; abortion
materoto – miscarriage; abortion; spontaneous abortion
whakatahe – abortion
tahe – abortion, menstruation, exude, drop, flow
As highlighted by Murphy (2011), Māori terms, such as those referred to above, encapsulate broad concepts, connotations and referents that, for example, liken menstruation to abortion. The significance of the Māori terms and associated Mātauranga Māori or Māori knowledge around those terms could be explored in greater depth, in order to inform and enrich services and resources relating to abortion for Māori women and all other women in New Zealand.
One such example of the benefit of Mātauranga Māori or Māori knowledge associated with abortion is encapsulated in the metaphor for the name given to Te Māhoe Clinic, the regional abortion services based at Wellington Hospital. Te Atiawa kaumātua Sam Jackson gave the name Te Māhoe to the abortion clinic on the basis that the māhoe tree drops seeds that release a chemical inhibitor. The inhibitor has the effect of only allowing the strongest māhoe seed to flourish. The metaphor positively frames abortion as removing a pregnancy that has begun under sub-optimal conditions in order to make way for another pregnancy to flourish.
5. Abortion, fear, and discrimination
The experience of Te Whāriki Takapou is that speaking out about abortion, supporting a Māori woman to obtain an abortion, and obtaining funds to research Māori womens’ experiences of abortion are activities that are difficult to do in New Zealand today. The climate surrounding women and abortion in New Zealand is one of fear and discrimination. Anecdotally, many Māori women say they prefer not to talk about abortion lest they are criticised for holding a belief that is supposedly against Māori values and practices, yet there is no evidence to support that position. In fact, older Māori knowledges suggest that abortion was part of life and there are contemporary examples indicating Māori support for abortion. What is more likely is that Western conservative thinking, a feature of colonisation, has led some Māori to adopt the view that abortion is contrary to Māori values and practices.
Over the years, it has not been unusual for Te Whāriki Takapou health promoters and researchers to be told by mainstream sexual and reproductive health services and, sadly, some Māori health services, that abortion is a Western practice and is contrary to Māori culture. Clearly, the example involving Te Atiawa kaumātua Sam Jackson suggests this is incorrect; however, the climate of fear and discrimination associated with abortion prevents Māori and New Zealand communities from engaging in evidence-informed conversations, thereby allowing unsubstantiated myths to continue.
- Remove abortion from the Crimes Act, including the need for a certifying process;
- Abortion is a health issue (not a potential crime) and a community-based health service response to abortion is required, with hospital-based services available when required;
- Abortion, similar to other sexual and reproductive health services, should be regulated by the Ministry of Health and funded by District Health Boards and / or the Ministry of Health;
- Abortion services and sexual and reproductive health services should have close, collaborative relationships. Efforts should be made by both to actively destigmatize abortion;
- Establish culturally-informed, evidence-informed abortion services as part of ensuring comprehensive sexual and reproductive health services for all;
- Free pre and post-abortion counselling should be optional and available to all women if they wish it;
- Local first trimester abortion services should be available in areas of the country with high Māori populations;
- As part of comprehensive sexual and reproductive health services, ensure Māori women have equitable access to medical and surgical abortions and can exercise their choice;
- If new legislation maintains that a health practitioner can object to providing abortion services (i.e. conscientious objection), the practitioner must make a direct referral to a provider who can help;
- Promote and enable research to understand factors contributing to New Zealand’s reducing abortion rates, particularly as these do not match international figures (see Abortion Supervisory Committee, 2017, p. 17);
- Promote and enable research to identify Māori women’s positive experiences of abortion and use the findings to develop culturally-informed health promotion material about abortion;
- Promote and enable research to understand contraceptive practices associated with the need for an abortion (see Abortion Supervisory Committee, 2017, p. 24)
Te Whāriki Takapou
Abortion Services in New Zealand. (2014). Home. Available at http://www.abortion.gen.nz/
Abortion Services in New Zealand. (2012). DHB Responsibilities. Retrieved from http://www.abortion.gen.nz/
Abortion Services in New Zealand. (2013a). The Abortion Supervisory Committee. Retrieved from http://www.abortion.gen.nz/
Abortion Services in New Zealand. (2013b). Medical abortion. Retrieved from http://www.abortion.gen.nz/procedures/medical.html
Murphy, N. (2011). Te awa atua, te awa tapu, te awa wahine: An examination of stories, ceremonies and practices regarding menstruation in the pre-colonial Māori world (Unpublished master’s thesis). University of Waikato, Hamilton, New Zealand.
New Zealand Parliament. (2017). Report of the Abortion Supervisory Committee 2017, presented to the House of Representatives pursuant to Section 39 of the Contraception, Sterilisation and Abortion Act 1977. Retrieved from https://www.justice.govt.nz/assets/Documents/Publications/ASC-Annual-Report-2017.pdf
Silva, M., & McNeill, R. (2008). Geographical access to termination of pregnancy services in New Zealand. Australian and New Zealand Journal of Public Health., 32(6). Retrieved from http://www.alranz.org/documents/Silva_McNeill_2008-2.pdf
Statistics New Zealand. (2014). Abortion Statistics: Year ended December 2013. Retrieved from http://www.stats.govt.nz/
Te Taura Whiri i te Reo Māori. (2008). He Pātaka Kupu: Te Kai a te Rangatira. Wellington: Te Taura Whiri i te reo Māori.
Williams, H. W. (1991). A dictionary of the Māori language. Wellington, New Zealand: GP Publications.
He Pātaka Kupu: Te Kai a te Rangatira is the first monolingual Māori dictionary produced for proficient speakers of Māori. With approximately 24,000 entries, the dictionary gives the category, parts of speech, definitions, examples of the word used in context, and an etymology of the word, drawing on a wide corpus of written material in te reo (Te Taura Whiri i te Reo Māori, 2008).