An historical perspective on abortion in New Zealand

On 17 May 1974, the Auckland Medical Aid Centre opened in Remuera. The hand-picked staff offered professional counselling, advice on contraception and if necessary, a legal abortion. AMAC provided a specialised counselling service, and performed abortions using a technique called vacuum-aspiration. Both were innovations in New Zealand and AMAC became the standard against which future services would be judged. Staff were determined the service should be safe, legal and affordable by all women.

Before the Centre opened, the only options were to pay for a private operation; face an interviewing panel at a public hospital - with every chance of being turned down; or to travel overseas. Some women visited illegal abortionists or tried to procure one by themselves, with injury, infection and eventually infertility, the most likely results.

In 1974, the laws regarding abortion were ambiguous, and doctors and lawyers alike were uncertain precisely what constituted a ‘legal’ or ‘illegal’ abortion. For several years both major political parties had resisted mounting pressure to conduct an official inquiry into the whole area of abortion and to clarify the law. With the opening of AMAC it became impossible to ignore the issue any longer. The Remuera Centre became the battleground on which pro- and anti-abortion groups confronted one another. Within six months of opening, doctors from all over the country were outraged when highly confidential patients' files were removed by the police, using a warrant that was later declared to be invalid. Thus the history of AMAC is interwoven with the social and legal reform of abortion in New Zealand. This in turn is part of a worldwide movement towards easier access to abortion services.

Historically abortion was a traumatic and dangerous operation and thousands of women died every year from botched attempts to use drugs or instruments. More reliable surgical techniques were developed from the end of the nineteenth century, but even under the best of circumstances an abortion was a major operation, requiring a general anaesthetic and several days in hospital afterwards. This was radically changed in the late 1960s with the refinement of the vacuum-aspiration technique that had originally been developed in China. A soft perforated tube is inserted through the cervix and the contents of the uterus sucked out with a small vacuum pump. The operation can be performed under a local anaesthetic, has a low complication rate and most patients go home a few hours later, so medical staff can be kept to a minimum.

Early New Zealand law regarding abortion was much the same as in England. As a British colony, New Zealand had adopted all English legislation in force in 1840, including the Lord Ellenborough Act of 1803, which had made abortion before quickening a crime in England for the first time. The Offences Against the Person Act passed in England in 1861, which also made the pregnant woman liable to prosecution, was re-enacted in the New Zealand statute of the same name, in 1867.

This was replaced by the 1893 Criminal Code Act which introduced a new offence: causing `the death of any child which has become a human being in such a manner that he would have been guilty of murder if such a child had been born' unless it was done `in good faith to preserve the life of the mother.'

In 1910 the Indecent Publications Act was passed to prevent the dissemination of material relating to birth control or abortion, although for all practical purposes there was no effective legal restriction against the distribution of contraceptives until the 1954 Police Offences Act.

Thus parts of the law stemmed from much earlier English legislation which was designed to outlaw all abortion, at a time when the operation was too dangerous for the concept of `therapeutic abortion' to have much meaning, while later sections permitting the killing of an unborn child to save the mother's life were originally intended to apply at the time of delivery. The 1893 legislation was replaced by the 1908 Crimes Act but the sections on abortion remained intact.

As operating techniques improved in the early twentieth century, the legislation was understood to cover the legal grounds for performing therapeutic medical abortions as well. Furthermore Section 220 of the 1908 Crimes Act which read, `No-one is guilty of any crime who before or during the birth of a child causes its death by means employed in good faith for the preservation of the life of the mother' was interpreted by doctors to include the woman's health. Economic hardship, the sheer drudgery of the day-to-day work, and a desire to provide the best for children already born, also encouraged women to limit the number of children they had.

Women who were fortunate enough to know a sympathetic doctor, and who had the money, could have an unwanted pregnancy terminated under the guise of a dilation and curette operation in a private hospital. Others had the choice of inducing an abortion themselves or visiting an illegal operator. Backstreet abortionists varied considerably in their methods, skill and prices. Some premises were set up like small hospitals, with beds, towels and instruments but in most cases operations were carried out in hotel rooms, brothels, doctors' surgeries or the abortionist's own home.

The underground abortion industry flourished, particularly in the 1930s when severe hardship drove hundreds of women to desperate measures. A skilled operator at this time could charge up to 35 pounds. A lot of women used knitting needles to get rid of pregnancies. They used all sorts of contraptions: sitting in a hot, hot bath and swallowing half a bottle of gin was a very popular one. In the earliest stages women jumped from tables, fell down stairs and carried heavy loads to try to bring on a late period. Failing this they would try alcohol, laxatives and stronger drugs such as quinine and ergot. Many women did not dare to tell even their husband or best friends that they had obtained an illegal abortion and carried the guilt for years.

Whatever the method or circumstances, procuring an illegal abortion was a very risky business. Drugs that could theoretically bring on a miscarriage would only do so if taken in quantities large enough to endanger the mother as well. The most common cause of death following an abortion was sepsis caused by using non-sterile instruments. During the 1930s the death-rate from septic abortion soared. Between 1931 and 1935, 176 women were known to have died of septic abortion.

In 1936 the Labour government appointed a committee of inquiry to investigate the causes of illegal abortion and make recommendations to reduce its incidence. The committee estimated that some 4000 illegal abortions were being performed every year. Its main recommendations were concerned with providing resources that would encourage women to have larger families including increased financial assistance, a National Domestic Service and the dissemination of information about New Zealand's decreasing maternal mortality rate to allay women's fears of childbirth. The committee conceded that reliable information about birth control was required and recommended that it be made available through `responsible channels' that would ensure women would also be advised of `the privileges of motherhood' and the requirement for `self-discipline in certain directions.

Following the release of the Report on Septic Abortion, women activists in the Labour Party had high hopes that contraception would be made more readily available, particularly for working class women, who were under the worst economic pressure. The government did not implement the committee's recommendation to establish birth control clinics, while most doctors lacked both the training and the willingness to provide the service themselves. In 1936 Elsie Freeman established the Sex Hygiene and Birth Regulation Society in Wellington. This small group of dedicated women campaigned for birth control information and ‘scientific’ contraception to be freely available to married women and, in the absence of specialised clinics, referred people to general practitioners known to be sympathetic.

In 1939 the Society changed its name to the New Zealand Family Planning Association. Between 1941 and 1946 the association received 2,317 letters, most of them requests for birth control information. In spite of this obvious need, the stereotyped and patronising attitude that women should have babies to preserve ‘civilisation’ and that doctors knew better than their patients what was good for them, hindered the Association's efforts and the first family planning clinic did not open until 1953.

At the same time that access to reliable contraception was coming to be regarded as a right by many women, the grounds for a legal abortion were slowly broadening to take into account a woman's personal and family circumstances, rather than being dictated by a narrow, strictly medical definition. In 1939 Justice MacNaughton ruled that abortion was lawful if continuing the pregnancy would, in the doctor's opinion, make the woman a ‘physical and mental wreck’. While the interpretation of ‘mental wreck’ was still entirely in the hands of the doctor, it was the first formal acknowledgement that emotional stress was an important component in a woman's decision to seek an abortion.

Doctors' willingness to perform an abortion on the grounds of mental health changed very slowly however. Up to the beginning of the 1970s women continued to seek illegal, non-medical operations with considerable risks involved.

When the 1961 Crimes Act was being drafted, the New Zealand Branch of the British Medical Association submitted to the Statutes Revision Committee that no provision to legalise specifically therapeutic abortion on social or economic grounds was necessary, nor in cases of pregnancy as the result of rape or illegal intercourse. The only change the Association wanted was to allow for abortion ‘to avoid grave injury to the future health of the mother’, but the Committee refused even this concession.

The sections on abortion that were incorporated into the 1961 Crimes Act remained simply the 1893 legislation substantially unchanged. By this time it was a law that was half a century out of date and bore no relationship to the modern concept of therapeutic abortion. Section 182 made provision for up to fourteen years' imprisonment for intentionally killing an unborn child except where the act was in good faith to preserve the life of the mother.

By the late 1960s the idea that motherhood was a compulsory service to the country, which had been so prevalent even into the 1950s, was being widely challenged. Family planning clinics were no longer on the fringes of social respectability, but were recognised as a necessary service used by unmarried women as well. The release of the contraceptive pill offered women more control over their own fertility than ever before and child-bearing was increasingly seen as a matter of choice, not a biological inevitability. Although not everyone consciously identified with the burgeoning feminist movement, few were untouched by the wider social changes in which feminism was rooted. Women were widening their horizons, and looking at increased education and job opportunities.

When the 1967 Abortion Act was passed in the United Kingdom, greatly extending the grounds for abortion in that country, lurid stories were printed in the New Zealand press of crying foetuses being rescued from the incinerator, and unscrupulous operators touting for business. Women responded with personal accounts of illegal abortions, making experiences public that had previously been clouded with fear and shame. A new argument began to surface in this changing climate of social opinion - that abortion was a right. Some claimed it was about the right to control our bodies; others the right for every child to be loved and wanted. But the net effect was growing criticism of abortion laws that were increasingly seen to be inequitable and unworkable.

At National Women's Hospital in Auckland a group of staff members and other interested individuals had begun meeting to discuss a strategy for preventing reform of the abortion laws in New Zealand. On 8 March 1970 they called a public meeting and formed the Society for the Protection of the Unborn Child (SPUC). About 400 people attended, listening to a recording of a foetal heart-beat and looking at magnified photographs of foetuses aborted at a late stage. SPUC was to become the foremost opponent of abortion law reform in New Zealand, maintaining that the existing law on abortion was quite adequate to cover cases of genuine need and that the rights of the foetus needed to be recognised as well. They were fighting against a turning tide of worldwide change, but they were highly organised and numbered prominent individuals, particularly from the medical and legal professions, among their ranks. The fight to establish a safe, legal abortion service in New Zealand was to be long and bitter, with SPUC opposing reform all the way.

Initially SPUC was very successful, especially in gaining the support of Members of Parliament, where it was able to wield a great deal of influence. By October 1971, 13 MPs were members. By February 1973, this had increased to 24, including five Cabinet Ministers. By 1976, 32 MPs were also members of SPUC, including three who held the vital portfolios of Health, Justice and Social Welfare.

SPUC's extremist stand eventually prompted a public reaction. the Abortion Law Reform Association of New Zealand (ALRANZ) was officially formed in Auckland at a public meeting on 17 March 1971 and in Wellington a week later.

ALRANZ considered that foetal development takes place on a continuum, so that the pregnant woman's rights are gradually diminished by the developing child. They campaigned for a change in the law to make the decision the woman's in consultation with her doctor, up to the twelfth week of pregnancy, with increasing restrictions up to the time of viability. Once viability had been reached (at between 20 and 24 weeks) abortion should be carried out only in exceptional circumstances, to save the mother's life. Unlike SPUC, they actively promoted the use of contraception as a practical measure to reduce the incidence of unwanted pregnancies.

In January 1972 ALRANZ commissioned a major survey from the National Research Bureau, a reputable marketing and social research firm that used a sample selected by random probability from throughout New Zealand, in proportion to the distribution of the population. 1,200 women over 15 years of age were asked if they had attempted an illegal abortion. From this sample the NRB estimated that there were about 11,000 attempts each year, with 6,500 successes.

A variety of methods were being used in private hospitals, some of them out-dated and dangerous. Hysterotomies - the surgical removal of the foetus through an incision in the uterus - were being routinely performed for pregnancies as early as six weeks. Other women were booked in ostensibly for a dilation and curette operation, creating an atmosphere of secrecy and guilt.

The number of therapeutic abortions being performed in public hospitals increased exponentially between 1950 and the mid-1970s. From 1950 to 1957, the official number remained constant at under 100 a year but had increased to 212 in 1969 and doubled again to 470 in 1971. In 1973, 988 abortions were performed in public hospitals, and the numbers remained at about this level for the next two years, when the Auckland Medical Aid Centre began operating.

Doctors who were making crucial abortion decisions did not always have a sound understanding of the law in the first place. Clearly the law was being interpreted liberally in some parts of the country while an abortion was all but impossible to obtain in others. The outcome of any request in a public hospital depended on where a woman lived and who happened to hear her case. Women also flew out of the country to Australian states where abortions were more readily available. The exact numbers who did so in the early 1970s are at best only estimates. The most accurate survey at this time was carried out by Jacqueline Steincamp who contacted all Australian clinics, hospitals and doctors to whom New Zealand women were known to have been referred. She found a total of around 900 women in twelve months had obtained a termination in this way. New Zealand women comprised 10 per cent of the total patients seen in a Melbourne clinic over two years in the early 1970s.

In April 1972, the first National Women's Liberation Conference in Wellington called for the repeal of the abortion laws and the right of individual choice for all women. Following this gathering, an ad hoc group known as the May Abortion Action Committee was formed in Wellington to organise activities for International Abortion Action Week. Members of ALRANZ, the University Students Association and the New Zealand Medical Association (founded by Dr Eric Geiringer as a radical alternative to the Medical Association of New Zealand) joined activists from the Women's Liberation Movement in arranging marches and public educational seminars. Similar committees formed in Christchurch, Auckland, Nelson and Hamilton at the same time continued to work for the repeal of all abortion laws as `Women's Abortion Action Committees'.

The close association between women's liberationists and the professional, middle-class members of ALRANZ did not last. Whereas ALRANZ held that abortion reform had to be a matter of co-operation between women and the medical profession, for feminists the right to abortion was part of a wider movement to dismantle male professional control over all aspects of women's health. ALRANZ was aiming to win over middle-of-the road opinion on the abortion issue and had no wish to alienate potential support. It deliberately divorced itself from the blunt, provocative image that many people associated with women's liberation, which was being reinforced by the media's representation of feminists who visited from abroad, such as Germaine Greer's highly publicised tour in 1972.

The split was formalised in July 1973 with the launch of a separate national body called the Woman's National Abortion Action Campaign (WONAAC) to co-ordinate the Women's Abortion Action Committees already in existence. Members of the Socialist Action League were centrally involved in setting up WONAAC which provoked criticism from other feminists who questioned whether the League was using the abortion issue as a platform for its own political ends. WONAAC's uncompromising style certainly alienated many politicians, and over the next few years public support for the repeal of all abortion laws actually declined in favour of making abortion a shared decision between a woman and her doctor, which was the stand taken by ALRANZ.

The Medical Association of New Zealand (MANZ) did not have an official policy on abortion because its members were deeply divided over the issue, but the most conservative element tended to hold sway. This group opposed extending the legal grounds for abortion, particularly in the light of reports on the apparent abuses of the liberal United Kingdom Act. In 1968, MANZ claimed that only a handful of doctors wanted minor changes and that none were in favour of major reforms. In May 1969, MANZ emphatically opposed a submission to the Minister of Justice by the Canterbury Branch of the New Zealand Medical Women's Association which advocated extending the law to include socio-economic grounds.

In August 1973, ALRANZ organised a panel discussion at which a number of prominent doctors publicly supported liberalisation of the abortion laws. The occasion was especially significant because previously public attention had been focussed on anti-abortion doctors, giving the impression that the medical profession was opposed to reform. Doctors who were less certain of their role in the decision-making process or confused by the law, hid their ambivalence behind a cold or even hostile manner which increased their patients' distress. Others who came to be known as sympathetic risked being inundated with requests.

A National Research Bureau survey commissioned by ALRANZ in 1972 showed that 65 per cent of New Zealanders supported abortion on the grounds of danger to the mother's mental health; 64 per cent if the pregnancy was the result of incest and 70 per cent if it was the result of rape; 71 percent for foetal abnormality and 65 per cent if the woman and her doctor agreed it was inadvisable to continue the pregnancy. 25 per cent supported abortion being legal under any circumstances and 14 per cent believed it should never be legal.

A second poll in 1974 showed similar results with a noticeable increase in the proportion who supported abortion if the pregnancy was the result of a criminal act (74 per cent) and a shift away from the two most extreme positions: support for abortion under any circumstances fell to 16 per cent and for the total prohibition of legal abortion to 11 per cent.

The publication of these survey results along with other material researched by ALRANZ stimulated much public debate particularly in newspapers. In 1972 television also picked up the cue and an entire Gallery programme was devoted to interviews with women who had obtained abortions both legally and illegally, and the following year David Frost fronted a talkback programme on abortion. Both of these excited a great deal of general comment and criticism.

Three of the four major Protestant churches also formed policy on abortion that reflected concern for the quality of the mother's life and the general welfare of her family. In November 1970 the Baptist church declared its support for abortion to avoid serious risk to the life, mental or physical health of the mother, and in cases of incest, rape, and foetal deformity. In 1971 the Public Questions Committee reported to the Presbyterian Church that the foetus in the earliest stages of development did not have the status of a human being and accepted the necessity for abortion in some circumstances to protect the existing family unit. The most liberal stand at this time was taken by the Methodist church which in 1974 adopted an earlier report that recommended that abortion should be available on the request of the patient in consultation with her doctor, with the opportunity for further professional counselling, and that free contraception should be available to all.

By now there was overwhelming evidence that New Zealand's abortion laws were quite inadequate, causing untold misery for thousands of women every year and confusion and frustration among the doctors whom they approached for help. As well, the majority of New Zealanders supported some kind of reform. In spite of this, neither the National nor the Labour Party were prepared to confront what had become an urgent social issue.

In 1970 the Labour Party's annual conference passed a remit that a Labour government would establish a Commission to clarify the law ‘with a view to reform’. In 1971, the National Party's annual conference also passed a remit calling for a committee of inquiry into the law. But neither party was prepared to accept further remits from their youth wings at subsequent conferences recommending abortion at the woman's request. After the third Labour Government took office in December 1972, it became obvious that in spite of the support of prominent individuals such as the new Minister of Justice, Dr Martin Finlay, the Parliamentary party had no intention of dealing further with an issue that promised to be highly contentious and divisive. The 1974 Labour Party conference ignored altogether resolutions in reports from the Labour Youth and Women's conferences. The Prime Minister and Minister of Health refused to be pressured into following through the earlier remits in favour of an official investigation, making ambiguous statements instead that ‘information was being collected’.

The whole situation appeared to have reached a stalemate: the discrepancy between the law and actual practice was clear to all but an entrenched minority, but few organisations were prepared to lobby actively for reform, and both Parliamentary parties continued to stall for time. Then early in 1974, The Dominion published an article that hinted at the possibility of a major change, stating that an un-named group of Auckland doctors was considering the possibility of establishing a special clinic to provide professional counselling, contraception advice and ‘a legal standard termination procedure’ for unhappily pregnant women. According to one of the doctors, ‘the question is not whether abortions will take place or how many .. but how the medical community of Auckland can face the challenge of providing full-scale humane services available to all in need regardless of socio-economic status ...’

This was almost the only warning the general public had. The clinic was the Auckland Medical Aid Centre which opened three months later on 17 May 1974 - ‘one of Auckland's best-kept secrets’ as one newspaper later described it. Over the following years it offered hope to thousands of women and also transformed the abortion debate by providing it with a concrete focus which could no longer be ignored.

Auckland Medical Aid Centre now operates from a modern premises on Dominion Road in Mt Eden. It is a charitable company and provides an option for women seeking an alternative to the public hospital system.

Extracted and edited from an unpublished manuscript commissioned by the Auckland Medical Aid Trust. Original unfinished manuscript by Charlotte Parkes.

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