Guidelines and training for abortion service providers

This guideline provides best practice clinical guidance for health professionals on abortion care in Aotearoa New Zealand.

The guideline, published by Ministry of Health replaced the Interim Standards for Abortion Services and is intended for use by health practitioners who provide or are considering providing abortion care and covers pre-, during and post-abortion specific content.

New Zealand Abortion Clinical Guideline — Ministry of Health (external link)

Abortion counselling is no longer mandatory. People seeking an abortion, however must be made aware that counselling is available, both before and after receiving abortion services. Abortion related counselling must be in line with the standard as outlined in this document.

The standard is grounded in Te Tiriti and health equity practice and describes what the Ministry of Health expects of those delivering abortion related counselling.

The standard also outlines what abortion counselling is, the principles, and who can provide abortion counselling and the principles. It sets out the connection with Ngā Paerewa Health and Disability Services Standard NZS 8134:2021 and sets out the rights of people receiving abortion counselling.

Standard for Abortion Counselling Aotearoa New Zealand — Ministry of Health (external link)

Ngā Paerewa Health and Disability Services Standard — Ministry of Health (external link)

The Ngā Paerewa Health and Disability Services Standard NZS 8134:2021 defines updates to the quality and safety requirements for the provision of included services in Aotearoa New Zealand. Ngā Paerewa reflects the shift towards more person- and whānau-centred health and disability services. People are empowered to make decisions about their care and support in order to achieve their goals, with a stronger focus on outcomes for people receiving support.

Ngā Paerewa and the corresponding Sector Guidance for Abortion Services provide a suite of information about the best practices for abortion services.

• Ngā Paerewa Health and Disability Services Standard — Ministry of Health (external link)
• Sector Guidance for Ngā Paerewa Health and Disability Services Standard — Ministry of Health (external link)

Online training is available to health practitioners through Ko Awatea LEARN and healthLearn. These resources include:

• webinar recordings about abortion data regulations and reporting for those providing abortion services
• an e-learning module about changes to the abortion legislation for all health practitioners.

Ko Awatea LEARN (external link)

healthLearn (external link)

Accessing this training

When healthcare staff create a Ko Awatea LEARN or healthLearn account to access this training, we may collect and use the information provided to develop further workforce training and learning.

If information about the training is published, it will be done so anonymously. You have the right to ask for a copy of any personal information we hold about you related to this, and to ask for it to be corrected if you think it is wrong. For any queries email AbortionServices@tewhatuora.govt.nz

First-trimester abortion training modules

The New Zealand College of Sexual and Reproductive Health (NZCSRH) has developed free training modules for abortion service providers with cultural safety at its core. The training is suitable for:

• those not currently providing services, but wishing to start
• current abortion providers wishing to upskill in culturally safe practice
• current abortion providers wishing to further develop additional skills, such as surgical abortion provision or point of care ultrasound.

This training aims to increase the availability of, and access to, abortion services by growing a diverse abortion workforce in primary and community care settings.

The training is focused on delivering abortion care that better meets the needs of Māori, Pasifika, gender diverse and disabled people, who experience greater inequity when accessing health services like abortion services.

The training includes an early medical abortion (EMA) module, an early surgical module (ESA), a triage and communication skills module and an early pregnancy point-of-care ultrasound (POCUS) module. Further modules for later term abortion services are currently developed.

New Zealand College of Sexual and Reproductive Health (NZCSRH) (external link)

Abortion training — NZCSRH (external link)

No requirement for pharmacies to supply EMA medicines

There is no requirement for a pharmacy to provide medicines used for medical abortion. Pharmacists may hold a conscientious objection to supplying these medicines and a pharmacy may decide not to supply these medicines.

Pharmacists can refer to the Pharmacy Council’s Code of Ethics 2018 which details obligations on them and acknowledges a pharmacist’s right to hold a conscientious objection. For pharmacist's who hold such an objection, their requirement to ‘refer patients to alternative providers if personal moral or religious beliefs prevents them from providing a professional service and appropriately facilitates continuity of care’ are explained (Principle 2: H).

Pharmacy Council Code of Ethics — Pharmacy Council (external link)

Pharmacists who choose to supply EMA medicines

If a pharmacy chooses to supply medicines for EMA, the pharmacy meets the legal (but not clinical) definition of an abortion provider under the legislation,and so must be registered on a list held by the Ministry. All abortion providers care can apply for a Safe Area, designed to protect the safety of individuals accessing or providing services.

Abortion Safe areas — Ministry of Health (external link)

Pharmacists dispensing EMA medicines are not required to submit reports to the Ministry of Health. It is the prescriber's responsibility (such as the health practitioner who provided the abortion consultation and prescription), to submit the relevant reports.

Alternatively, you can speak with a trained counselor by calling or text 1737 for free.