Module 2: Early Medical Abortion
2. Tikanga in abortion care
Abortion provider staff should complete a Te Tiriti o Waitangi-focused course that will assist them to reflect
upon their own cultural assumptions about Māori and how these influence their capacity to provide culturally
safe services to Māori, and indeed to all people.
Cultural competence should be incorporated into abortion providers’ continuing education. With respect to
cultural competence and Māori, this should include an awareness of Māori understandings and approaches to
good health and wellbeing. Te Whare Tapa Whā conceptualises Māori health and wellbeing as incorporating
four domains:
- Te taha hinengaro (mental health)
- Te taha tinana (physical health
- Te taha wairua (spiritual health)
- Te taha whānau (family health)
Consideration of each of domain should be used to inform the practices of clinicians, social workers and others
involved with Māori undergoing a medical abortion. In keeping with Te Whare Tapa Whā model and in particular
the principle of te taha whānau, abortion services should ensure that whānau members who have come along
to support a Māori person considering a medical abortion are made to feel welcome and are treated with
respect. For some Māori people and whānau, having a karakia led by the patient or a whānau member at any
stage of the EMA process may feel appropriate. However, not all Māori people and whānau will deem karakia
necessary, and their right to choose the path that best suits their requirements must be respected.
Click here for more information about Te Whare Tapa Whā.
EMA management of the products of conception or kukune
New Zealand Aotearoa Abortion Clinical Guideline 2021, recommendation 5.2.3 is: “Disposal of any
products of conception must consider the person’s individual choice as required by criteria 1.7.8 in
Section 1.7 Kua whai mōhio ahau, ā, ka taea e au te mahi whiringa | I am informed and able to make
choices”
Patients have the right to retain the products of conception or kukune following their EMA procedure if they
choose. As part of the EMA information process, abortion provider staff might suggest in advance that people
undergoing an EMA may wish to bring a container to carry the kukune home. If the EMA procedure happens
at home, Māori people may wish to place the kukune (and sanitary pads) into a container to dispense with as
they see fit.
