Abortions prompt free birth-control plan

By Martin Johnston

One of New Zealand's largest primary health groups is offering free long-term birth control to high-need families, after a study found some women were having abortions while waiting to be sterilised.

Waikato Primary Health, which serves 305,000 people, provides a vasectomy for men or insertion of long-term contraceptive implants called Mirena for women.

Vasectomy costs $360 and Mirena $525, in contrast to female surgical sterilisation by tubal ligation which can cost $1500.

The offer to Maori, Pacific and low-income families was prompted by a study for the Waikato District Health Board which identified problems in women's access to publicly funded tubal ligation surgery for sterilisation.

The study found that two-thirds of women on the Waikato Hospital waiting list in 2003 waited more than the Government stipulation of six months for treatment and that the delays were contributing to the 160 abortions per month recorded in the area.

Six per cent of the women on the waiting list had an unplanned pregnancy: 2 per cent had abortions and 4 per cent had deliveries.

The study also found that many women on the waiting list cancelled appointments.

Arranging transport to hospital and childcare were barriers to having the surgery.

The Health and Justice Ministries said yesterday they held no national abortion statistics in relation to tubal ligation waiting lists.

The Health Ministry said that at last December, 414 women were waiting for tubal ligation and had been given certainty of treatment within six months.

Waikato Primary Health operations manager Erica Amon said its clinics had provided 120 free vasectomies and 240 free Mirena insertions. The numbers using the service showed it was addressing a community need.

The Family Planning Association's executive director, Jackie Edmond, praised the scheme.

She said tubal ligation waiting lists had in the past been a problem, noting that one district health board was providing free vasectomies or Mirenas as an alternative to tubal ligation and another was investigating doing so.

Women's health groups, however, have reservations about Mirena, citing side effects lasting several months including bleeding, depression and decreased libido.

"This is not a simple, uncomplicated method of contraception," said Auckland Women's Health Council co-ordinator Lynda Williams.

The T-shaped device is inserted into the uterus and releases a contraceptive drug for up to five years.

Women's Health Action director Jo Fitzpatrick said that since Mirena was impermanent, it did not give couples the peace of mind offered by vasectomy and tubal ligation.

Vasectomy deserved more promotion, she said, as it was one of the easiest permanent birth control operations and had the least side effects.

"The only problem is that men have to do it and there are huge issues with lots of men around vasectomies. People seem to hold it in a lot more fear than I think it warrants."

Birth control costs

A Waikato primary health organisation is offering free long-term birth control to many families, either:

* Vasectomy, worth $360, or

* Mirena long-term female contraceptive implant, worth $525 including three medical consultations.

It was motivated by research which found:

* 2 per cent of women on a public hospital waiting list for surgical sterilisation had an unplanned pregnancy and abortion.

* 4 per cent had an unplanned pregnancy and gave birth.

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