The journey of people accessing first trimester abortion in Aotearoa New Zealand: health consumers' perspectives.

INTRODUCTION

Aotearoa New Zealand (NZ) achieved abortion law reform in 2020, allowing people to choose abortion without legal restriction up to 20 weeks gestation. Abortion can now be provided by a range of health practitioners in a variety of settings. While some progress has been made, we are yet to see abortion care being provided within the full extent of the law.

AIM: To describe the journey of people accessing first-trimester abortion care in NZ to identify how abortion services can be developed to deliver optimal first-trimester abortion care.

METHODS

This was a qualitative study informed by phenomenology. Participants were recruited via a separate national survey to participate in in-depth interviews. Analysis was undertaken using a reflexive inductive approach to identify themes.

RESULTS

Seven people were recruited. Analysis revealed four themes: (1) decision making (to have an abortion, choice of method, and coercive contraceptive decision making); (2) barriers to access (abortion service navigation, lack of access in rural areas including requirement to travel, abortion requirements); (3) abortion as a societal issue (abortion is isolating, 'slut-shaming', abortion is the taking of a life); and (4) empathy and advocacy.

DISCUSSION: Despite decriminalisation of abortion in NZ, barriers remain. Work is required to improve access to accurate and non-judgemental information to inform decision-making. People value kind, non-judgemental clinicians and supportive whanau/friends play a major role in optimising the experience. Abortion stigma persists and has a negative impact on the abortion experience. Abortion services need support to ensure they are responsive to the needs of health consumers and reduce barriers to care.