Pregnancy: your options

Parenting means continuing the pregnancy, giving birth, and raising the child. Some people parent with a partner. Some parent on their own. Some parent with strong support from whānau, friends or community.

If you continue the pregnancy, you are entitled to maternity care. In Aotearoa New Zealand, maternity care is usually provided by a Lead Maternity Carer, often called an LMC. This is usually a midwife, but may sometimes be a doctor or obstetrician. Your LMC provides care during pregnancy, labour and birth, and after the baby is born.

If you choose to parent, it can help to think about:

• Who can support you emotionally and practically
• Where you will live
• How study or work might be affected
• What financial support may be available
• What cultural, whānau or community support matters to you
• What kind of pregnancy and birth care you would like.

Some people continue a pregnancy but do not plan to parent the child themselves. Two possible pathways are whāngai and adoption.

Whāngai is a traditional Māori practice where a child is raised by other whānau members. Whāngai arrangements are usually made within whānau. They are culturally significant and may allow the child to maintain strong whakapapa and whānau connections. Whāngai is generally informal in New Zealand law, and birth parents usually remain the child’s legal guardians unless other legal steps are taken.

Adoption is a legal process where parental rights and responsibilities are permanently transferred to adoptive parents. Adoption involves legal steps through Oranga Tamariki and the Family Court. Many adoptions are open, meaning there may be some ongoing contact or information-sharing, but the legal relationship changes permanently.

If you are considering whāngai or adoption, it is important to get independent advice and support so you understand the emotional, cultural and legal implications.

Abortion is healthcare. It is legal in Aotearoa New Zealand.

You can contact an abortion provider directly yourself, or a health professional can refer you. You do not need to go through your GP if you would prefer not to.

Up to and including 20 weeks of pregnancy, a qualified health practitioner can provide abortion care if you request it. After 20 weeks, After 20 weeks, it requires assessment of your health and consultation with another practitioner.

There are two main types of abortion:

Early medical abortion
This uses medicines to end a pregnancy. It is usually available in the first 9–10 weeks of pregnancy, depending on the provider.

Surgical abortion
This is a procedure to remove the pregnancy tissue from the uterus. The type of anaesthetic and where it is provided depends on the pregnancy gestation, the provider and your clinical situation.

Most abortion services are free for most New Zealand citizens and residents. There may be some extra costs, such as ultrasound, prescriptions or blood tests, depending on the service and your situation.

You can ask for counselling before or after an abortion. Counselling should be non-judgemental and should support you to make your own decision.

You may want to:

• Take time to notice how you feel
• Talk with someone you trust
• Contact DECIDE or Sexual Wellbeing Aotearoa
• Book with a GP, nurse, nurse practitioner, school nurse or midwife
• Find out how many weeks pregnant you might be
• Ask about your options, including parenting, adoption/whāngai and abortion
• Ask about contraception if you do not want to become pregnant again soon.

This decision is yours. Other people may have feelings or opinions, but no one else gets to make the decision for you.

If you choose to continue the pregnancy, it is a good idea to arrange early pregnancy care.

You can:

• Contact a midwife directly
• Use Find Your Midwife to search by location and availability
• Talk with your GP, nurse practitioner or nurse
• Ask a clinic to help you find maternity care.

Early pregnancy care may include:

• Confirming the pregnancy
• Estimating your due date from your last period or an early scan
• Talking through your health history
• Reviewing any medicines, supplements or health conditions
• Checking blood pressure
• Urine testing
• Blood tests, such as blood group, iron levels, HIV, hepatitis B, syphilis, rubella immunity and other tests depending on your situation
• Screening for STIs if needed
• Discussing early ultrasound scans
• Talking about smoking, alcohol, vaping, other drugs, food safety, stress and support
• Discussing family violence or safety concerns if relevant
• Planning folic acid and iodine supplements.

Two supplements are recommended for most pregnant people in Aotearoa New Zealand:

Folic acid
Folic acid helps reduce the chance of neural tube defects such as spina bifida. It is best started before pregnancy, but if you have just found out you are pregnant, start as soon as possible. Some people need a higher dose, so check with your doctor, nurse practitioner, midwife or pharmacist.

Iodine
Iodine supports the baby’s brain and nervous system development. It is usually recommended during pregnancy and breastfeeding.

Your midwife, GP, nurse practitioner or pharmacist can advise the right dose for you.

Get urgent medical advice if you are pregnant or might be pregnant and you have:

• Heavy bleeding
• Severe lower abdominal or pelvic pain
• One-sided pelvic pain
• Shoulder-tip pain
• Fainting, dizziness or feeling very weak
• Fever or feeling very unwell
• Severe vomiting and not keeping fluids down
• Pain or burning when passing urine with fever or back pain.

Pain and bleeding in early pregnancy can happen for different reasons, and many people go on to have a healthy pregnancy. However, pain with bleeding can sometimes be a sign of miscarriage or ectopic pregnancy, which needs prompt medical assessment.