Contraceptive rights in New Zealand

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Contraceptive rights in New Zealand are extensive. [1] There are many options available to women seeking contraception. There are also options for men. Government funding keeps the cost of most types of contraception low in most cases. Family planning options in New Zealand are generally in keeping with the United Nations stance towards sexual and reproductive rights although the country has received criticism in some aspects.

Contents

Contraception as a human right

The United Nations believes that access to family planning services, including contraception, is a human right. [2] The United Nations Population Fund states that 'to maintain one's sexual and reproductive health, people need access to accurate information and the safe, effective, affordable and acceptable contraception method of their choice. [3]

The Convention on the Elimination of All Forms of Discrimination Against Women was ratified by New Zealand in 1985. [4] Article 12 of the convention states that 'States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning.' [5]

New Zealand, as a state that has ratified the convention, is required to give periodic reports to a convention monitoring committee. The committee then replies with its concluding observations. New Zealand's most recent report was given to the committee at its 52nd session in July 2012. [4] The committee stated in its concluding observations that it 'commends the State party for its advocacy on the protection of women's sexual and reproductive health rights'. [6]

History of contraception in New Zealand

In the earlier part of the 20th century, 'New Zealand did not have laws against the use of contraception, but there were regulations that stopped people finding out about birth control methods – and sex in general.' [7] The first birth control clinic was opened in Auckland in 1953 by the New Zealand Family Planning Association. [8] The pill became available in New Zealand in 1961, although its prescription was regulated to married women only. [9]

Teenage girls were unlikely to be taking the pill, and did not seek doctors' prescriptions for it. This was because they knew doctors would be unlikely to provide them with it as it was against the policy of the New Zealand Medical Association to do so, and because it was expensive for young women likely to be earning a low wage, or even none at all. [10]

In the 1970s the Family Planning Association criticised the governments' refusal to give them funding, pointing out that the prime minister had signed the 1967 United Nations World Leaders Declaration on Population, which advocated for contraception. In December 1971 the New Zealand cabinet approved its first grant to the Association. [11]

A national survey in 1979 revealed that over 66% of fertile women were using contraception. [12] In the 1990s a study showed 87% of women surveyed in New Zealand were using some form of contraception, a higher percentage of women than many other countries surveyed. [13]

Funding and subsidies

The United Nations has stated that family planning is an essential component in reducing poverty. [2] This is also recognised in New Zealand. For women on various social security benefits, including girls who are dependent on a parent who receives a benefit, there is a contraceptive grant available which covers the cost of long-acting reversible contraception. [14]

The Pharmaceutical Management Agency (Pharmac) maintains the New Zealand Pharmaceutical Schedule, which lists all medication subsidised by the government in New Zealand. Fully subsidised medication listed on the schedule cost $5 every three months to cover dispensing costs.

The pill

The combined oral contraceptive pill is a common method of contraception in New Zealand alongside the progestogen-only pill (mini pill). In 2009 approximately 202,000 women in New Zealand were taking the pill. [15] The pill is not available over the counter in New Zealand. It is available by prescription by a health professional such as a general practitioner or a nurse. Nevertheless, the New Zealand Family Planning website states that 'the pill is easily accessible to all women in New Zealand'. [9]

Although the age of consent is 16 in New Zealand, those under 16 can still be given contraception. [16] Parental consent for the provision of contraceptives to their children is not required. Section 3 of the Contraception, Sterilisation, and Abortion Act 1977 regulating the provision of contraception to children was repealed in 1990. [17]

Subsidisation

As of February 2017, the government subsidised three formulations of the combined oral contraceptive pill (ethinyloestradiol with norethisterone, ethinyloestradiol with desogestrel, and ethinyloestradiol with levonorgestrel), [18] and two formulations of the progestogen-only pill (levonorgestrel and norethisterone). [19] A non-subsidised six-month supply could cost up to $100, depending on its type. [20] Appointment costs at family planning clinics may also be subsidised: appointments are free for women under 22 years of age. For women 22 and older, appointments are five dollars for a community services card holder and $27 for those without a community services card. [20]

Issues

The pill is currently classified as a prescription medicine in New Zealand. However, there is debate over whether it should be reclassified as restricted medicine, which would allow it to be sold over the counter in pharmacies throughout the country. The company Green Cross Health Ltd has lobbied to the Medicine Classifications Committee for reclassification since 2014. [21] The Classifications Committee has stated that it is concerned that sidelining the role of doctors in prescribing contraception may result in inadequate counselling and advice on sexual health. Green Cross has stated that pharmacists are 'well equipped to consult with women about their contraceptive needs' [21] and also claims that women would find it more convenient.

Other forms of contraception available

Condoms

Another common form of contraception in New Zealand is the condom. These are commonly available at supermarkets and pharmacies in New Zealand. There is no age restriction on buying condoms. These are also available on prescription from a doctor or family planning nurse. When purchased on prescription, they are subsidised for up to 144 condoms. This is significantly cheaper than buying condoms from a store, where the price can be up to $20 for one pack of 12 condoms. [20]

Implants

Levonorgestrel implants (Jadelle) are available in New Zealand. These implants are subsidised, although there is a $22 charge for dressing and prescription at family planning clinics. [20]

Etonogestrel contraceptive implants (Implanon) cost around $270 for New Zealand residents from a family planning clinic. They are not government subsidised. [20]

IUDs

The copper IUD has been available in New Zealand since the 1970s. [22] The New Zealand Family Planning website lists it as being available at no cost to New Zealand residents. [20]

The mirena Pharmac has agreed to fully fund Mirena and Jaydess contraceptives, from November 2019. [23] [20]

Sterilisation

Sterilization is a popular method of contraception in New Zealand. It has been claimed by academics that 'sterilization has become the preferred method of fertility regulation among women of older reproductive ages.' [24] Often one or the other partner in a relationship undergoes sterilization. Women undergo tubal ligation and men undergo a vasectomy. New Zealand Family Planning reports that the country has 'one of the highest rates of vasectomy in the world' with 18% of men and 25% of married men having undergone the procedure. Doctors may object to performing sterilisations on conscience grounds but must refer the patient to another practitioner. [25]

The emergency contraceptive pill

The emergency contraceptive pill is available in New Zealand. It is able to be purchased over the counter at pharmacies without a prescription for around $40–$80. Alternatively, they can be obtained for free from a family planning clinic, or at a cost of $5 for a three-pill prescription. [20]

See also

Related Research Articles

Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to ejaculation and then directs his ejaculate (semen) away from the vagina in an effort to avoid insemination.

<span class="mw-page-title-main">Emergency contraception</span> Birth control measures taken after sexual intercourse

Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy.

<span class="mw-page-title-main">Family planning</span> Planning when to have children

Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marital situation, career or work considerations, financial situations. If sexually active, family planning may involve the use of contraception and other techniques to control the timing of reproduction.

<span class="mw-page-title-main">Levonorgestrel</span> Hormonal medication used for birth control

Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand names Plan B One-Step and Julie, among others, it is useful within 72 hours of unprotected sex. The more time that has passed since sex, the less effective the medication becomes, and it does not work after pregnancy (implantation) has occurred. Levonorgestrel works by preventing ovulation or fertilization from occurring. It decreases the chances of pregnancy by 57 to 93%. In an intrauterine device (IUD), such as Mirena among others, it is effective for the long-term prevention of pregnancy. A levonorgestrel-releasing implant is also available in some countries.

<span class="mw-page-title-main">Hormonal contraception</span> Birth control methods that act on the endocrine system

Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive pill—was first marketed as a contraceptive in 1960. In the ensuing decades many other delivery methods have been developed, although the oral and injectable methods are by far the most popular. Hormonal contraception is highly effective: when taken on the prescribed schedule, users of steroid hormone methods experience pregnancy rates of less than 1% per year. Perfect-use pregnancy rates for most hormonal contraceptives are usually around the 0.3% rate or less. Currently available methods can only be used by women; the development of a male hormonal contraceptive is an active research area.

Contraception was illegal in Ireland from 1935 until 1980, when it was legalised with strong restrictions, later loosened. The ban reflected Catholic teachings on sexual morality.

<span class="mw-page-title-main">Comparison of birth control methods</span>

There are many methods of birth control that vary in requirements, side effects, and effectiveness. As the technology, education, and awareness about contraception has evolved, new contraception methods have been theorized and put in application. Although no method of birth control is ideal for every user, some methods remain more effective, affordable or intrusive than others. Outlined here are the different types of barrier methods, hormonal methods, various methods including spermicides, emergency contraceptives, and surgical methods and a comparison between them.

This table includes a list of countries by emergency contraceptive availability.

Contraceptive security is an individual's ability to reliably choose, obtain, and use quality contraceptives for family planning and the prevention of sexually transmitted diseases. The term refers primarily to efforts undertaken in low and middle-income countries to ensure contraceptive availability as an integral part of family planning programs. Even though there is a consistent increase in the use of contraceptives in low, middle, and high-income countries, the actual contraceptive use varies in different regions of the world. The World Health Organization recognizes the importance of contraception and describes all choices regarding family planning as human rights. Subsidized products, particularly condoms and oral contraceptives, may be provided to increase accessibility for low-income people. Measures taken to provide contraceptive security may include strengthening contraceptive supply chains, forming contraceptive security committees, product quality assurance, promoting supportive policy environments, and examining financing options.

<span class="mw-page-title-main">Birth control</span> Method of preventing human pregnancy

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<span class="mw-page-title-main">Family planning in India</span> Efforts to curb unintended pregnancies in India

Family planning in India is based on efforts largely sponsored by the Indian government. From 1965 to 2009, contraceptive usage has more than tripled and the fertility rate has more than halved, but the national fertility rate in absolute numbers remains high, causing concern for long-term population growth. India adds up to 1,000,000 people to its population every 20 days. Extensive family planning has become a priority in an effort to curb the projected population of two billion by the end of the twenty-first century.

<span class="mw-page-title-main">Birth control movement in the United States</span> Social reform campaign beginning in 1914

The birth control movement in the United States was a social reform campaign beginning in 1914 that aimed to increase the availability of contraception in the U.S. through education and legalization. The movement began in 1914 when a group of political radicals in New York City, led by Emma Goldman, Mary Dennett, and Margaret Sanger, became concerned about the hardships that childbirth and self-induced abortions brought to low-income women. Since contraception was considered to be obscene at the time, the activists targeted the Comstock laws, which prohibited distribution of any "obscene, lewd, and/or lascivious" materials through the mail. Hoping to provoke a favorable legal decision, Sanger deliberately broke the law by distributing The Woman Rebel, a newsletter containing a discussion of contraception. In 1916, Sanger opened the first birth control clinic in the United States, but the clinic was immediately shut down by police, and Sanger was sentenced to 30 days in jail.

<span class="mw-page-title-main">Birth control in the United States</span> History of birth control in the United States

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Reproductive coercion is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and control related to reproductive health by a current, former, or hopeful intimate or romantic partner, but they can also be perpetrated by parents or in-laws. Coercive behaviors infringe on individuals' reproductive rights and reduce their reproductive autonomy.

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<span class="mw-page-title-main">Margaret Sparrow</span> New Zealand medical doctor, activist and author

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<span class="mw-page-title-main">International Family Planning and Development</span>

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<span class="mw-page-title-main">Contraception in Francoist Spain and the democratic transition</span>

Contraception in Francoist Spain (1939–1975) and the democratic transition (1975–1985) was illegal. It could not be used, sold or covered in information for dissemination. This was partly a result of Hispanic Eugenics that drew on Catholicism and opposed abortion, euthanasia and contraception while trying to create an ideologically aligned population from birth. A law enacted in 1941 saw usage, distribution and sharing of information about contraception become a criminal offense. Midwives were persecuted because of their connections to sharing contraceptive and abortion information with other women. Condoms were somewhat accessible in the Francoist period despite prohibitions against them, though they were associated with men and prostitutes. Other birth control practices were used in the 1950s, 1960s and 1970s including diaphragms, coitus interruptus, the pill, and the rhythm method. Opposition to the decriminalization of contraception became much more earnest in the mid-1960s. By 1965, over 2 million units of the pill had been sold in Spain where it had been legal under certain medical conditions since the year before. Despite the Government welcoming the drop in the number of single mothers, they noted in 1975 that this was a result of more women using birth control and seeking abortions abroad.

References

  1. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 210. ISBN   1-877228-16-8.
  2. 1 2 "Family planning | UNFPA – United Nations Population Fund". www.unfpa.org. Retrieved 30 April 2016.
  3. "Sexual & reproductive health | UNFPA – United Nations Population Fund". www.unfpa.org. Retrieved 30 April 2016.
  4. 1 2 "CEDAW | National Council of Women of New Zealand". www.ncwnz.org.nz. Retrieved 30 April 2016.
  5. "CEDAW 29th Session 30 June to 25 July 2003". www.un.org. Retrieved 30 April 2016.
  6. "CEDAW Concluding Observations" (PDF). Retrieved 1 May 2016.
  7. Taonga, New Zealand Ministry for Culture and Heritage Te Manatu. "5. – Contraception and sterilisation – Te Ara Encyclopedia of New Zealand". www.teara.govt.nz. Retrieved 30 April 2016.
  8. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 81. ISBN   1-877228-16-8.
  9. 1 2 "The Pill – Family Planning". www.familyplanning.org.nz. Retrieved 30 April 2016.
  10. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 106. ISBN   1-877228-16-8.
  11. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 124. ISBN   1-877228-16-8.
  12. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 223. ISBN   1-877228-16-8.
  13. Pool, Ian (1999). New Zealand's contraceptive revolutions. Hamilton: Population Studies Centre, Univ. of Waikato. p. 122. ISBN   1-877149-99-3.
  14. "Special Needs Grant Long Acting Reversible Contraception – Work and Income". www.workandincome.govt.nz. Retrieved 30 April 2016.
  15. Taonga, New Zealand Ministry for Culture and Heritage Te Manatu. "3. – Contraception and sterilisation – Te Ara Encyclopedia of New Zealand". www.teara.govt.nz. Retrieved 30 April 2016.
  16. "Contraception For Young Women – Family Planning". www.familyplanning.org.nz. Retrieved 30 April 2016.
  17. "Contraception, Sterilisation, and Abortion Act 1977 No 112 (as at 01 July 2013), Public Act 3 Sale or disposal, etc, of contraceptives to children [Repealed] – New Zealand Legislation". www.legislation.govt.nz. Retrieved 30 April 2016.
  18. "Combined Oral Contraceptives – Pharmaceutical Schedule Online". Pharmaceutical Management Agency. Retrieved 29 January 2017.
  19. "Progestogen-only Contraceptives – Pharmaceutical Schedule Online". Pharmaceutical Management Agency. Retrieved 29 January 2017.
  20. 1 2 3 4 5 6 7 8 "Comparing The Cost of Contraception – Family Planning". www.familyplanning.org.nz. Archived from the original on 17 April 2016. Retrieved 30 April 2016.
  21. 1 2 "Pill may go over-the-counter". Stuff. Retrieved 30 April 2016.
  22. Smyth, Helen (2000). Rocking the cradle : contraception, sex, and politics in New Zealand. Wellington, N.Z.: Steele Roberts Ltd. p. 143. ISBN   1-877228-16-8.
  23. "Campaigner welcomes Mirena announcement".
  24. Pool, Ian (1999). New Zealand's contraceptive revolutions. Hamilton: Population Studies Centre, Univ. of Waikato. p. 87. ISBN   1-877149-99-3.
  25. Skegg, Peter; Paterson, Ron (2015). Health Law in New Zealand. Wellington: Thomson Reuters. p. 591. ISBN   978-0-86472-943-9.

Further reading