Auckland: Difference between revisions

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'''OVERVIEW'''

As the largest city in New Zealand, you will find many health care resources in Auckland. You need a prescription for hormonal birth control, but there are low-cost options for consultations and prescription appointments. While you don't need a prescription for condoms, they are much cheaper if you do receive a condom prescription. Emergency contraception (the morning after pill) is now available without a prescription, which is a rather new development with NZ. You can get a free STD/STI test at a local sexual health clinic, and there are many support networks for people with STIs, including herpes, HPV and HIV. There is a nationwide HPV vaccination program. PrEP is currently not yet available in NZ (as of January 2017). Abortion is only legal in very specific circumstances and is not available upon request.  

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

In New Zealand, you need a prescription for the birth control a general practitioner or nurse. However, the laws will soon be changing to allow women (who are over 16 years old and already have taken birth control before) to obtain birth control pills without a prescription. To do this, they will need to pay a $45 fee at the chemist and, so far, this change only applies to birth control pills.<ref>[http://www.stuff.co.nz/national/health/89395698/oral-contraceptives-to-be-sold-over-the-counter Oral contraceptives to be sold over the counter - but not everyone happy]</ref> While the age of consent is 16 years old, there are no age restrictions for a birth control prescription and parental consent is not required. The birth control pill has been available in New Zealand since the 1960s, and it became widely available to NZ women in the 1970s. It is estimated that 71.3% of NZ women use some form of contraceptive and that 67.4% use a modern method.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref>

Check out this [http://www.familyplanning.org.nz/media/302862/fp_cyc-chart_dec2015.pdf helpful breakdown] of contraceptive methods available in New Zealand, provided by New Zealand Family Planning. You'll see methods like birth control, IUDs, shots and more. Click [http://www.health.govt.nz/new-zealand-health-system/eligibility-publicly-funded-health-services/guide-eligibility-publicly-funded-health-services here] to see if you're covered by New Zealand health care (and to learn more about coverage).

* 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 [http://www.familyplanning.org.nz/clinics/services/condoms here]. You can also get free condoms and lube at New Zealand AIDS Foundation - click [https://www.nzaf.org.nz/services-programmes/free-condoms-lube/ 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). 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.

* '''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.

Condoms cost $12-$20/pack (but they're much cheaper if you get a prescription). At New Zealand Family Planning, you can get birth control pills ranging from $5-100 for a 6-month supply, depending on the pills and your status (for example, if you have health care funding). For an IUD, you can get a copper one for free if you're from NZ (you'll need to pay if you don't have NZ health coverage). For non-copper IUDs, will pay for the cost of the device (for example, Mirena is $333). They also do Depo-Provera injections for free, which last for 3 months. You may also pay around $80-100 for a Depo-Provera injection at certain medical facilities. The Implanon implant costs $270 and the Jadelle implant costs $22. The contraceptive ring (Nuvaring) is about $90.

'''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 [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

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.  

* 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).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> 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.

* You can buy emergency contraception online, but it may be pricey since you may need to buy in bulk. At one [http://www.schickersunichem.co.nz/buy-plan-b-in-nz.html 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."

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.<ref>[https://en.wikipedia.org/wiki/Contraceptive_rights_in_New_Zealand Contraceptive rights in New Zealand]</ref> If you buy it online, you can expect to pay around $181 for an 8-pack package.

'''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 [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ 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 [http://www.whatisprep.org/ here].

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.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=133 NEW ZEALAND - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>

* [http://www.ashs.org.nz/ Auckland Sexual Health Service]: "We are a specialist service offering free and confidential sexual health care including: diagnosis and management of sexually transmitted infections and other related conditions including genital skin conditions, genital pain and sexual dysfunction, reproductive health including contraceptive advice, sexual health counselling, adult sexual abuse service including the care of related medical, nursing and social issues, sexual health education, including Peer Sexuality Support programmes for schools." They have four locations in Auckland (Greenlane, Glenfield, Henderson & Mangere). Check out this [http://www.ashs.org.nz/nz-sexual-health-clinics.html link] to see the locations.

* [https://www.nzaf.org.nz/services-programmes/hiv-sti-testing/ New Zealand AIDS Foundation]: Provides free HIV & STI testing. "We provide a rapid testing service for HIV, syphilis or hepatitis C which involves just one quick, painless finger prick to produce a single drop of blood which is placed in a sterile testing device. An accurate result is confirmed in just twenty minutes instead of the five to seven days it might take for a result from a standard blood test through your GP or local sexual health clinic. We also offer tests for gonorrhoea and chlamydia which involve a urine test and/or swab depending on your case. The results for these tests are available within five working days and you will only be contacted if you have a positive result." NZAF Burnett Centre. Phone: +64 9 309 5560. Email: contact.burnett@nzaf.org.nz ex 35. Address: Hargreaves Street, St Mary's bay, Auckland 1011

* [http://www.herpes.org.nz/ 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."

* [http://www.hpv.org.nz/ 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."

* [http://positivewomen.co.nz/home-2/ 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

* 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."<ref>[http://www.hpv.org.nz/hpv-vaccination-girls HPV vaccination for girls]</ref>

* 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."<ref>[https://www.nzaf.org.nz/hiv-aids-stis/hiv-prevention/prep/ Pre-exposure Prophylaxis (PrEP)]</ref>

'''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 [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

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 [http://www.tweedle.co.nz/ Tweedle] or [https://www.facebook.com/mothersinstinct/ Mother's Instinct]. For MoonCup, you can get it delivered from the UK to NZ. For Lunette, check out [http://www.ecomoon.co.nz/ Ecomoon]. There appears to be no official sellers of DivaCup in NZ so it should be purchased online.

Click [http://www.health.govt.nz/your-health/pregnancy-and-kids/services-and-support-during-pregnancy/maternity-care here] to learn about maternity care in New Zealand.

'''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 [https://www.plannedparenthood.org/learn/abortion here].

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.<ref>[http://www.abortion.gen.nz/abortion-procedures Abortion Procedures]</ref>

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.<ref>[http://www.familyplanning.org.nz/advice/abortion/the-law-around-abortion The Law Around Abortion]</ref>

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 [http://www.abortion.gen.nz/ Abortion Services in New Zealand] for more information.

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, here are the abortion providers in Auckland:

* [http://www.amac.org.nz AMAC (Auckland Medical Aid Centre)]: "AMAC is an independent not-for-profit clinic that provides first trimester (less than 13 weeks pregnant) terminations and related services. AMAC receives no government funding, so service fees..." Address: 283-289 Dominion Road, Mt Eden, Auckland 1030. P: (09) 638 6040, (09) 638 6041 W:. Email: reception@amac.org.nz

* Auckland Hospital - National Women's Hospital/Green Lane Hospital: "National Women's Hospital provides surgical termination between 13 and 18 weeks for women who reside in the Auckland District Health Board area."

* Epsom Day Unit: "Epsom Day Unit provides surgical abortion up to 13 weeks of pregnancy for patients from Auckland, Counties-Manukau and Waitemata DHBs." Address: Greenlane Clinical Centre, Greenlane West, Auckland 3. P: (09) 631 0740.

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.

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.

* [https://womensrefuge.org.nz/ 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.

* [http://www.2shine.org.nz/how-shine-helps/womens-refuge 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.

* [http://www.ashs.org.nz/pohutukawa.html 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.

* [http://www.womens-health.org.nz/ 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."

* [http://awc.org.nz/ Auckland Women's Centre]: "We provide affordable, quality welfare and support services, personal development educational opportunities, events and collective advocacy on women’s issues."

* [http://rpe.co.nz/ 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."

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