Nouvelle-Zélande

INTRODUCTION

En Nouvelle-Zélande, vous trouverez de nombreux services de santé. Il vous faudra une ordonnance pour obtenir une contraception hormonale, mais il existe des options peu onéreuses pour les consultations et les prescriptions. Même si une ordonnance n'est pas nécessaire pour obtenir des préservatifs, ils sont beaucoup moins chers si vous en présentez une. La contraception d'urgence (pilule du lendemain) est désormais disponible sans ordonnance, ce qui est un développement plutôt nouveau pour la NZ. Vous pouvez obtenir gratuitement un dépistage MST au centre de santé sexuelle local, et il y a de nombreux réseaux pour les personnes atteintes de MST, y compris l'hérpès, le papillomavirus et le SIDA. Il existe un programme de vaccination national contre le papillomavirus. Le PrEP n'est pas encore disponible en NZ (en Janvier 2017). L'avortement est légal uniquement sous certaines circonstances spécifiques et n'est pas disponible sur demande.

Contraception

Note générale : il existe de nombreux moyens de contraception, comme les DIU (dispositifs intra-utérins ou stérilets), les contraceptions orales, les patchs, les injections, les préservatifs, etc. Pour une liste complète, cliquez here.

Lois et stigmatisation sociale

En Nouvelle-Zélande, il vous faut une ordonnance d'un médecin général ou d'un infirmier pour obtenir un contraceptif. Pourtant, les lois vont bientôt changer pour permettre aux femmes (de plus de 16ans et ayant pris une contraception par le passé) d'en obtenir sans ordonnance. Pour ce faire, elles devront payer 45€ de frais à leur pharmacie, et jusqu'ici, ces changements ne s'appliquent qu'aux pilules contraceptives Si'âge du consentement légal est de 16ans, il n'y a pas d'âge pour obtenir une contraception et l'accord parental n'est pas recquis. La pilule contraceptive est disponible en NZ depuis les années 1960, et est devenue largement disponible pour les Néo-zélandaises dans les années 1970. Il est estimé que 71.3% des NZaises utilisent une contraception et que 67.4% d'entre elles utilisent une méthode moderne.

Que prendre et où

Regardez helpful breakdown de méthodes contraceptives disponibles en NZ, fourni par le planning family Néo-Zélandais. Vous y trouverez des méthodes commes la pilule contraceptive, les stérilets, les injections, et d'autres. Cliquez here Pour savoir si vous êtes couverte par le système de santé Néo-zélandais (et en apprendre plus sur les couvertures sociales).

• You can find condoms in grocery stores, pharmacies, dairies, pubs public toilets, petrol stations, nightclubs and sex shops in New Zealand. There are no age restrictions to purchase condoms. They typically cost $12-$20/pack. However, if you get a condom prescription (which is not required), the cost can go down to $5 for 144 condoms. For more details on getting a condom prescription, click here. You can also get free condoms and lube at New Zealand AIDS Foundation - click here for details.
• If you want birth control pills, you'll need a prescription from a general practitioner or nurse. If you go to New Zealand Family Planning, the consultation will cost $27 if you're not covered by NZ medical care. If you don't go to NZ Family Planning, you can expect a doctor's appointments to range from $10-$60. Once you have the prescription, you will be able to buy your pills. There are many birth control pill brands available in New Zealand (both progestin-only and combined progestin-estrogen combined). Some brands you can expect to see are Alesse, Desogen, Duphaston, Mircette, Microlut, Microval, Nordiol, Ortho Tri-Cyclen, Ovral, Levlen ED, Microgynon 30 ED, Microgynon-30, Monofeme 28, Nordette, Loette, Microgynon 20 ED, Miranova and Yasmin.
• The contraceptive ring, like Nuvaring, is available in New Zealand. You can get it at New Zealand Family Planning for about $90.
• If you want an IUD, you can call New Zealand Family Planning to have a consultation and determine next steps. Here's the link to their page on IUDs. If you're a New Zealander, you can get the copper IUD at no cost. If you're a foreigner, there will be some extra costs. If you want a non-hormonal IUD (Mirena), you'll need to pay $333, regardless of whether you're from NZ or not.
• You can get the contraceptive shot (Depo-Provera) at a local medical center. You'll explain that you need a shot and then book an appointment. If you're a foreigner (and potentially if you're an NZ national), you'll have to pay a consultation fee. It normally cost around $80-100 and lasts for 3 months. If you to to the same medical center for the second injection, it will be much cheaper.
• If you want to get the contraceptive implant, you can get Implanon (costs about $270 and lasts for 3 years) or Jadelle (costs about $22 and lasts for 5 years). Jadelle is cheaper because it "is fully funded. However, there is a small dressing and prescription fee. This is $22.00 at Family Planning clinics."
• Sterilization is a fairly common contraceptive practice in New Zealand. Women get tubal ligation and men get vasectomies. According to New Zealand Family Planning, New Zealand has one of the highest vasectomy rates in the world.

Coûts

Les préservatifs coûtent 12-20$ le paquet (mais sont beaucoup moins chers si vous avez une ordonnance). Au planning familial NZais, vous obtenir des pilules contraceptives de 5 à 100$ pour 6 mois de soins, selon la pilule et votre statut (par exemle, si percevez des cotisations santé). Pour un stérilet, vous pourrez gratuitement en obtenir un financé par l'état si vous êtes de NZaise (vous devrez payer si vous n'êtes pas couverte par le système NZais). Pour un stérilet non financé par l'état, vous devrez payer les coûts (par exemple, Mirena est à 333$). Ils vous fourniront également des injections Depo-Provera gratuitement, qui durent 3mois. Vous pourrez aussi payer 80 à 100$ pour les injections Depo-Provera dans certains centres de santé. L'implan Implanon coûte 270$ et l'implant jadelle coûte 22$. L'anneau contraceptif (Nuvaring) coùte 90$.

Contraception d'urgence (pilule du lendemain)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

Emergency contraception (the morning after pill) is available in NZ. At some pharmacies, you can buy it over-the-counter without a prescription. At other clinics and facilities, you will need a prescription.

What to Get & Where to Get It

• You can purchase dedicated emergency contraception in NZ at pharmacies or clinics. Some brands you can expect to see are Postinor 1 (take 1 pill within 120 hours after unprotected sex), Levonelle and Postinor 2 (take 2 pills within 120 hours after unprotected sex for these brands). You can generally purchase them at pharmacies without a prescription.
• You can have an IUD inserted to prevent pregnancy. Please refer to the "Contraception" section for details.
• If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Nordiol or Orval (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Levlen ED, Microgynon 30 ed, Microgynon-30, Monofeme 28 or Nordette (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Loette, Microgynon 20ED or Miravona (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).
• You can buy emergency contraception online, but it may be pricey since you may need to buy in bulk. At one online pharmacy, you'll find an 8-pill pack for $123 and a 12-pill pack for $181."Medication will be shipped in anonymous discreet package without disclosing its content."

Costs

If you go to a Family Planning clinic, you can probably get emergency contraception for free. At the clinic, you may also be able to get a prescription of 3 pills for $5. If you purchase emergency contraception at a pharmacy without a prescription, it will cost around $40-$80. If you buy it online, you can expect to pay around $181 for an 8-pack package.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

There are no travel restrictions related to HIV or STI status in New Zealand. However, if you want to stay over one year in New Zealand, there may be some restrictions, according to HIVTravel. We'll need more information on this to confirm the legal requirements.

Testing Facilities

Please visit the city pages, like the Auckland page, for local recommendations.

Support

• New Zealand Herpes Foundation: "Founded in 1994 by an alliance of patients, doctors and health professionals, we provide accurate information, improved management and support for people affected by the herpes simplex virus."
• New Zealand HPV Project: "HPV is probably the most common STI there is, affecting most people at some point in their lives. In this site you’ll find nearly everything you need to know about HPV."
• New Zealand AIDS Foundation: "We’re here to answer all your questions about HIV in New Zealand. Our services include prevention, testing, counselling and support."
• Body Positive: "Body Positive Inc. is a group founded by and run for people with HIV/AIDS. We welcome all people living with HIV and AIDS in New Zealand."
• INA (Māori, Indigenous & South Pacific) HIV/AIDS Foundation: "We operate under the auspices of Tikanga Māori, Ethical cultural values and principles. We are all responsible and we all will have the solution." Phone: (+64) (0)27 2991535. Email: info@ina.maori.nz. Address: , PO Box 1, Tirau, South Waikato, New Zealand.
• Positive Women: "We aim to provide a support network for women and families living with HIV or AIDS. We also strive to raise awareness of HIV and AIDS in the community through educational programmes with a focus on prevention and de-stigmatisation." E-mail: positivewomen@xtra.co.nz

Medications & Vaccines

What to Get & Where to Get It

• New Zealand has an HPV vaccination program: "Girls and young women aged from 12 to their 20th birthday can receive Gardasil free under the Ministry of Health’s HPV Immunisation Programme. HPV vaccination involves three doses by injection, usually spread over six months. Your Family Doctor and Primary Health Care Nurse will be able to give you more information on the cost of this vaccination."
• Pre-exposure Prophylaxis (PrEP) is currently not available in New Zealand but will probably will be in the future. This is the update from the NZ AIDS Foundation (August 2016): "Truvada is not currently approved by Medsafe for use as PrEP in New Zealand, nor is it funded by Pharmac for this use. We are pleased to see that Gilead Sciences Inc., the manufacturer, submitted the application to Medsafe in July 2016. It could take some time for Medsafe to process the application but we expect it will be fast-tracked because it recently received approval in Australia. After Medsafe has approved Truvada for use as PrEP, it would then need to be approved for funding by Pharmac."

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In New Zealand, you can find pads, tampons and menstrual cups. You can find pads and tampons at most supermarkets, convenience stores and pharmacies. The tampons come without applicators (heavy and light absorbency) and with applicators (typically, heavier absorbency). Some common tampon brands are Libra and Carefree. As for menstrual cups, you can purchase LadyCup from Tweedle or Mother's Instinct. For MoonCup, you can get it delivered from the UK to NZ. For Lunette, check out Ecomoon. There appears to be no official sellers of DivaCup in NZ so it should be purchased online.

Organizations that work on menstrual issues in New Zealand:

• Days for Girls New Zealand: "Days for Girls empowers girls and women worldwide with more dignity, health and safety through access to quality sustainable menstrual health management and education. Volunteers all over the globe work toward the day when every women in the world has access to quality feminine hygiene. Every Girl. Everywhere. Period." Email: daysforgirlsnz@gmail.com.

Pregnancy

Laws & Social Stigmas

Click here to learn about maternity care in New Zealand.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In New Zealand, abortion is only permitted in certain circumstances, as outlined by the Crimes Act 1961. During the first twenty weeks of gestation, an abortion can be legally performed if the woman's life is seriously endangered by the pregnancy, if a woman's physical or mental health is seriously endangered by the pregnancy, if the woman can be classified as possessing "mental sub normality," if the pregnancy is due to incest of any sort, or if there is risk of fetal impairment. Factors that are not grounds for abortion (but may be taken into consideration) are sexual violation (rape) or extremes of age (either very young or very old for the pregnancy). After 20 weeks of gestation, an abortion can only be performed if the pregnancy threatens the woman's life or if the pregnancy brings risk of permanent injury to the physical or mental health of the mothers. After twenty weeks of gestation, the risk of fetal abnormality in itself is not grounds for abortion.

The abortion pill is only permitted during the first 9 weeks of pregnancy. If you're 9-14 weeks of pregnant, you will need to have a surgical abortion. This is considered a minor procedure and you'll usually be awake. If you're 14-19 weeks pregnant, you can have a surgical abortion under general anesthesia (asleep). If you are more than 14 weeks pregnant and there is a fetal abnormality, doctors can do an early induction of labor. If you're 20-24 weeks pregnant, you probably need to travel to Australia to receive an abortion, unless you fit under the criteria for up to 20 weeks.

For an abortion to be legally performed, the pregnant woman needs a referral from her doctor. She also needs blood tests and ultrasounds. Furthermore, the abortion must be approved by two doctors, which are called "certifying consultants" in New Zealand. One of these doctors must be a gynecologist or obstetrician. Counseling is not mandatory (just optional). After 12 weeks of gestation, the abortion must be performed in a "licensed institution," which generally means a hospital. It's important to know that doctors are legally allowed to conscientiously object to performing or assisting in an abortion. They can also refuse to refer you for assessment.

While there is no statutory definition of a fetus or embryo as "an unborn child" in New Zealand, abortion law is notably more conservative than other major Commonwealth countries, such as Australia or Canada. If a NZ woman wishes to obtain an abortion, she may travel to Australia, where abortion policy is more lax.

You can visit Abortion Services in New Zealand for more information.

What to Get & Where to Get It

If you're a pregnant teenager or young person, you may want to call Youthline (0800 37 66 33), send a free text to 234 or email talk@youthline.co.nz for assistance.

If you are legally entitled to an abortion in New Zealand, visit Abortion Services in New Zealand for local providers.

If you are not legally entitled to an abortion in New Zealand, you have a few options. Some women find doctors that declare them possessing "mental sub normality," thereby enabling them to obtain a legal abortion in NZ. There also probably some women who purchase the abortion pill via mail, but this is illegal in NZ and you may you get in trouble. If you are pregnant and wish to obtain an abortion, your best option is probably to seek an abortion outside New Zealand. While there is an underground illegal abortion industry, it's not safe and not recommended. Rather, you may consider traveling to Australia, where you can legally obtain an abortion upon request.

Costs

If you legally obtain an abortion in an NZ hospital and you are covered by NZ health care, the abortion will be free. If you're not on NZ health care but your pregnancy is due to rape, ACC is obligated to pay for your treatment. If you are pregnant and considering getting an abortion outside NZ (like in Australia, for example), you will need to consider the following costs: transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling

What to Get & Where to Get It

• Women's Refuge New Zealand: Call our free Crisisline on 0800 REFUGE or 0800 733 843. "We are a women’s organisation for women and their children, here to help prevent and stop family violence in New Zealand. If you are experiencing any form of abuse in your family or your relationship, or know someone who is, there are many ways we can help you – for free, and confidentially." Email: info@awrefuge.org.nz.
• Shine Women's Refuges: National Helpline: call free 0508 744 633 (9am to 11pm, 7 days a week). "Shine operates two women’s refuges in Auckland, offering short-term accommodation for women and their children who are at risk of further harm from domestic abuse. Having two refuges means that Shine is now able to provide access to refuge at most times of day and night, including on weekends." Email: enquiries@2shine.org.nz.
• Outline: This confidential service has been provided to the LGBTQI+ community, their friends and families since 1972. Call us on 0800 688 5463.
• Counselling @ Auckland Sexual Health Service: "Counselling team comprises a male and a female therapist, plus one psychotherapy student. We provide counselling for individuals and couples, for up to 6-10 sessions where necessary. Issues we cover include : sexual functioning, sexuality and gender issues, STI and HIV counselling, non-ACC covered sexual abuse, sexual compulsion. The service is free of charge." They have four locations in Auckland (Greenlane, Glenfield, Henderson & Mangere). Check out this link to see the locations.
• Sexual assault (Pohutukawa) @ Auckland Sexual Health Service: "Pohutukawa is a free specialist medical and forensic service for adult women and men who have been sexually assaulted or abused. We are committed to providing the highest quality health service that is sensitive, appropriate, accessible and that acknowledges social and cultural differences." How to get an appointment: After hours: If your request is urgent, contact the local police, or crisis counselling agencies below: Auckland Sexual Abuse HELP - Tel:(09) 623 1700. Counselling Services Centre - Tel: (09) 277 9324. In hours: Self referral by phone, email, fax or sending a text message and we will ring you back. Referral by your GP, counsellor, Family Planning clinic, HELP, Police etc.

List of Additional Resources

• Women's Health Action: "Women’s Health Action is a social change organisation, working to improve the health and wellbeing of women, their families and whanau, and communities."
• Auckland Women's Centre: "We provide affordable, quality welfare and support services, personal development educational opportunities, events and collective advocacy on women’s issues."
• Working Women's Resource Centre: We provide advice on problems at work: Dismissal, Minimum pay rates, Parental leave, Discrimination, Work-related injuries and illnesses, Sexual Harassment, Community Groups, Which Union you could belong to."
• Shakti New Zealand: "Shakti is a national not-for-profit community organisation specialised in the area of women’s development, empowerment and domestic/ family violence intervention, prevention and awareness. We are a specialist provider of culturally competent support services for women, children and families of Asian, African and Middle Eastern origin."
• RainbowYOUTH: "RainbowYOUTH (est.1989) is a charitable organisation dedicated to helping young queer and gender diverse (LGBTIQ) people up to the ages of 27, as well as their wider communities."
• Agender NZ: "Agender New Zealand Incorporated is a Non-Profit Organization, which has been supporting Transgender people and their families throughout New Zealand since 1996."
• Intersex Awareness New Zealand: "ITANZ is a New Zealand registered charitable trust and provides information, education and training for organisations and professionals who provide services to intersex people and their families."
• Rape Prevention Education: "RPE’s mission is to work in relationship with Tangata Whenua to develop partnerships and evidence-based prevention activities in community services, education, health promotion, research and advocacy that effectively promote respectful relating and eliminate perpetration and experience of sexual violence in Aotearoa, New Zealand."