Day 2 | Session 5 | Concurrent | Access to abortion

Second trimester abortion access: addressing our patients’ needs

As patients enter the second trimester, options for abortion care drop dramatically. Patients outside of major cities are disproportionately impacted by the lack of available services. 

This talk will discuss the importance of offering choice in later abortion services, and highlight the need for additional training to meet patients’ needs. 


Dr Rachel Rapkin
Clinical Lead, Te Mahoe Unit

Rachel Rapkin is the clinical lead of Te Mahoe Unit and provides medical and procedural abortions to 20 weeks and beyond in Wellington Regional Hospital. In her role as clinical lead, she coordinates later abortions for patients throughout the region, including for those residing in Capital and Coast, Hutt Valley, Wairarapa and beyond, including Whanganui, Mid Central, Hawkes Bay, and Tairawhiti. She has also co-coordinated a feticide program in the hospital. 

Rachel completed her Obstetrics and Gynaecology and Complex Family Planning sub-specialty training, including surgical abortion provision to 24 weeks gestational age, in the US in 2011 and 2013, respectively.  o

Access to feticide integral to abortion care

Access to feticide (induced fetal demise) is a prerequisite for abortion care after 22 weeks’ gestation. Difficulties accessing feticidal injection can place significant strain on abortion providers and patients alike. Feticidal injection is also important for abortion care prior to 22 weeks’ gestation, although this has been significantly underutilised in the Australasian context.

We describe the importance of feticidal injection to comprehensive and holistic abortion care, explaining how access to this service has been improved over the last 3 years in New Zealand. 


Dr Richard Carpenter
Obstetrician Gynaecologist
Nelson Marlborough District

Richard is the Clinical Lead for Abortion Services at Nelson-Marlborough District, New Zealand, and works to expand access to abortion care alongside RANZCOG, APGANZ, NZCSRH, and most recently by partnering in training with the National Abortion Federation.   

Richard is heavily involved in research, holding Honorary Lecturer status at the University of Auckland, and is working towards a Master of Medical Law and Bioethics at the University of Otago. His current research includes peri-operative surgical technique and the practise and ethics of complex abortion care.  

A new abortion service in a rural setting (title TBC)

more information to come...

Access to abortion services for people with disability (title TBC)

more information to come...