Abortion Law Reform Act 2019

The Act organises its regime around a small set of interlocking legal concepts: prescribed health practitioner; specialist medical practitioner; informed consent; approved health facility; guidelines issued by the Secretary; limitations by gestational age (22 weeks threshold); conscientious objection; assistance; data reporting; and administrative powers for government oversight.

• Prescribed health practitioner and gestational threshold: Section 5 creates a bright-line rule for terminations "not more than 22 weeks" where a “prescribed health practitioner” may perform the termination (s 5(1)). The legislated list in s 5(4) and Sch 1 identifies who is prescribed: medical practitioners, endorsed midwives (as defined in s 5(4)), and nurse practitioners (Sch 1). The 22-week line is a statutory threshold that determines both the permissible provider types and procedural safeguards.

• Specialist control after 22 weeks: Section 6 shifts decision-making and institutional control after 22 weeks. Only a “specialist medical practitioner” may perform such terminations (s 6(1)). The specialist must consider specified matters (s 6(3)), obtain a second specialist’s concurrence (s 6(1)(b)), obtain informed consent (s 6(1)(c)), and have the procedure performed at an appropriate facility (s 6(1)(d)). The definition of “specialist medical practitioner” in Sch 1 includes obstetrics and gynaecology specialists and other practitioners with relevant expertise, for example a GP with added experience (Sch 1).

• Informed consent: The Act repeatedly conditions lawful performance on informed consent (s 5(2); s 6(1)(c)). Sch 1 defines “informed consent” as consent that is freely and voluntarily given and in accordance with any applicable guidelines. The Act therefore links legal permissibility to clinical and administrative guidance issued by the Secretary (s 14), and to professional standards (s 5(5), s 6(3)(c), s 10(3)).

• Assistance and scope: Section 8 permits a roster of registered health practitioners to assist in terminations in the practice of their profession, subject to not assisting in procedures they know or ought reasonably to know are unauthorised (s 8(1)-(2)). The statutory term “assist” explicitly covers dispensing or administering termination drugs on instruction (s 8(3)). Section 5(5) preserves scope-of-practice and other regulatory law (for example, medicines and poisons Acts referred to in s 5(5)(c)).

• Conscientious objection and referral: Section 9 prescribes a practitioner’s procedural obligations if they conscientiously object: prompt disclosure (s 9(2)); and, where the request is for performance or advice for the person themselves, giving information on how to locate a non-objecting practitioner or transferring care (s 9(3)). The Secretary may approve the information content (s 9(4)). Emergency duties are preserved (s 9(5)).

• Administrative oversight: The Secretary has multiple powers: approving facilities (s 13); issuing guidelines that practitioners must follow (s 14(1), (3)); setting forms and methods for data submission (s 15(2)); and producing annual reports to Parliament (s 15A). The Secretary also must conduct a review and report on sex-selection terminations (s 16) and the Minister must review the Act within five years (s 17).

• Data collection and confidentiality: Section 15 obliges practitioners performing terminations to provide Secretary-decided information within 28 days and bars identifying particulars (s 15(1)-(3)). Section 15A requires the Secretary to report annually on service availability, waiting times, clinical performance, adverse events, and regional performance (s 15A(a)(i)-(v)).

• Emergency carve-outs and continuity of care: The Act repeatedly allows emergency departures from ordinary procedures (s 5(3) for consent; s 6(5) emergency performance after 22 weeks; s 7(3) information duties; s 9(5) duties despite objection). Section 11 preserves duties to provide clinically appropriate care to a person born following a termination.

These concepts create a framework where lawful practice is a function of gestational age, practitioner credentials, facility approval, informed consent consistent with guidelines, and adherence to Secretary-issued guidelines. Many operative rules refer practitioners and administrators to the Secretary’s further rules and decisions, making the Secretary a pivot of operational detail.

The Act affects several clearly identified groups through direct legal obligations and through indirect regulatory and data-collection effects:

• Persons seeking terminations: The Act directly affects people who seek termination services by removing criminal liability for self-termination (s 12) and by setting the procedural route for accessing services (s 5-6, s 7). It conditions services on informed consent (s 5(2); s 6(1)(c)) and requires practitioners to provide counselling information where appropriate (s 7). Persons seeking post-22-week terminations must access a specialist and an approved facility (s 6(1)(d); s 13).

• Prescribed health practitioners: The Act creates statutory authority and limits for those who may perform terminations up to 22 weeks (s 5(1), s 5(4); Sch 1). These practitioners must obtain informed consent (s 5(2)) and comply with guidelines (s 14(3)) and professional standards (s 5(5), s 10(3)). Practitioners who assist are covered by s 8, except where they know or ought reasonably to know the termination is unauthorised (s 8(2)). Registered practitioners with conscientious objections face disclosure and referral/transfer obligations (s 9).

• Specialist medical practitioners: For terminations after 22 weeks, specialist medical practitioners shoulder additional duties: substantive consideration of clinical, psychological and social factors (s 6(3)); consulting another specialist (s 6(1)(b)); obtaining informed consent (s 6(1)(c)); consulting multidisciplinary teams or committees if sought (s 6(4)); and performing procedures at approved facilities or statutory hospitals (s 6(1)(d)). Emergency powers are available to any medical practitioner (s 6(5)).

• Health service providers and hospital organisations: Hospitals and approved health facilities are relevant institutions: s 6(1)(d) mandates location requirements for post-22-week terminations. The Secretary may approve facilities (s 13). Hospital advisory committees and multidisciplinary teams are explicitly contemplated in s 14 and s 6(4).

• The Secretary of the Ministry of Health and the Minister: Administrative functions and regulatory discretion are concentrated with the Secretary: issuing guidelines that are binding on practitioners (s 14(1), (3)); setting reporting requirements and forms (s 15(1)-(2)); approving information for referral purposes (s 9(4)); approving facilities (s 13); preparing annual reports (s 15A); and conducting a sex-selection review (s 16). The Minister must arrange a statutory review of the Act within five years (s 17).

• Regulatory bodies and complaints processes: Professional conduct regulators and complaint mechanisms are implicated by s 10, which allows contraventions of the Act to be considered as part of regulatory and disciplinary matters, and notes applicability to notifications under the Health Practitioner Regulation National Law and complaints under the Health Care Complaints Act 1993.

• Pharmacists and those handling termination drugs: Section 8(3) explicitly includes pharmacists in the list of practitioners who may assist and defines assistance to include dispensing, supplying or administering termination drugs on instruction. Section 5(5)(c) cross-references medicines, poisons and therapeutic goods Acts, which remain applicable to prescribing, supply and administration.

• Aboriginal and Torres Strait Islander health practitioners: The Act recognises this profession in Sch 1 and includes them in the list of practitioners permitted to assist under s 8(1).

• Parliament and public: The Secretary must produce and table an annual parliamentary report (s 15A), creating transparency obligations and providing Parliament with data on availability, waiting times and clinical performance.

Financially, the Act imposes administrative costs on health services and the Ministry of Health for data systems, facility approvals, guideline development and production of annual reports. Practitioners absorb compliance costs for consent-taking, counselling information provision, record-keeping and reporting (s 15). The Secretary’s discretionary choices on guidelines, datasets, approved forms and facility approvals directly affect the operational burden on providers and the information available to the public and Parliament.

The Act imposes precise duties on practitioners and the Secretary and recognises rights that alter criminal liability. Key duties and rights are as follows, with section citations:

Duties on practitioners

• Duty to obtain informed consent for terminations up to 22 weeks (s 5(2)): A prescribed health practitioner must obtain informed consent from the person or a lawful surrogate, except where emergency circumstances make obtaining consent impracticable (s 5(3)). Sch 1 defines “informed consent” as freely and voluntarily given and consistent with any applicable guidelines.

• Duty to follow scope-of-practice and professional standards (s 5(5)): Section 5(5) expressly prohibits acting outside a practitioner’s scope and affirms obligation to relevant professional standards and other laws (including medicines/poisons Acts).

• Duty for specialist decision-making for post-22-week terminations (s 6(1)-(4)): A specialist medical practitioner must consider all relevant medical circumstances, the person's current and future physical, psychological and social circumstances, and applicable professional standards and guidelines (s 6(3)). They may seek advice from multidisciplinary teams or hospital advisory committees (s 6(4)). They must also consult another specialist who also considers sufficient grounds exist (s 6(1)(b)). Performance location is limited to statutory health organisation hospitals or approved health facilities (s 6(1)(d)).

• Duty to provide information about counselling (s 7): For up-to-22-week terminations, a registered health practitioner must assess benefit of counselling and, if beneficial and the person is interested, provide necessary information including details of publicly-funded counselling (s 7(1)). For post-22-week terminations a specialist must provide all necessary information about access to counselling (s 7(2)).

• Duty to disclose conscientious objection and effect timely referral (s 9): Practitioners who conscientiously object must disclose that objection to the requesting person as soon as practicable (s 9(2)). If the request is to perform or advise about a termination for the person, the objecting practitioner must either give information on how to locate/contact a non-objecting medical practitioner, or transfer care to a non-objecting registered health practitioner or health service provider they reasonably believe can provide the service (s 9(3)). Use of Secretary-approved information satisfies s 9(3)(a) (s 9(4)).

• Duty to report termination information to the Secretary (s 15): Practitioners who perform a termination must give the Secretary the information decided by the Secretary within 28 days and must not include identifying particulars (s 15(1)-(3)). The Secretary decides the content and manner of reporting (s 15(2)).

• Duty to comply with Secretary-issued guidelines (s 14(3)): If the Secretary issues guidelines about the performance of terminations, practitioners performing or assisting in terminations must act in accordance with the guidelines.

Rights and protections

• Removal of criminal liability for self-termination (s 12): A person who consents to, assists in, or performs a termination on themselves does not commit an offence despite any other Act. The Act therefore creates a statutory protection from criminal liability for self-managed terminations.

• Emergency exceptions: Multiple sections carve out emergency powers permitting departures from ordinary procedural duties where necessary to save life or where consent cannot practicably be obtained (s 5(3); s 6(5); s 7(3); s 9(5)).

• Protection from disclosure: Section 15(3) mandates that information provided to the Secretary must not include particulars that would identify the person on whom a termination was performed, creating a statutory patient confidentiality floor for the reporting regime.

Administrative powers and duties

• Secretary’s guideline power and binding effect: The Secretary may issue guidelines under s 14(1); s 14(3) makes adherence to those guidelines mandatory for registered health practitioners performing or assisting in terminations.

• Facility approval: The Secretary may approve hospitals or other facilities as places where post-22-week terminations may occur (s 13).

• Secretary’s reporting and review duties: The Secretary must annualise reporting to Parliament on service availability, waiting times, clinical performance and adverse events (s 15A) and must review and report on sex-selection terminations within 12 months (s 16(2)).

• Ministerial review: The Minister must conduct a review of the Act within five years and report to Parliament (s 17).

Regulatory interaction and enforcement

• Professional regulatory consequences: Regulatory bodies and complaint processes can take account of whether a practitioner performed or assisted in an unauthorised termination or contravened the conscientious objection provisions (s 10(1)-(2)). The Act explicitly allows its contraventions to inform notifications and complaints under health professional regulatory regimes.

These duties and rights create compliance obligations that bind practitioners’ clinical judgment to statutory processes, Secretary-issued guidance and professional regulation. The key compliance levers are consent processes, counselling information, cross-specialist consulting for later-term terminations, mandatory reporting, and adherence to Secretary guidelines and facility approvals.

The Act’s enforcement framework is predominantly administrative and professional rather than criminal. The Act contains the following enforcement mechanisms and implications:

• Removal of criminal offences for self-termination (s 12) reduces criminal enforcement in that domain. The Act’s note in s 3 indicates consequential amendments to the Crimes Act 1900 were made to repeal provisions relating to abortions and to abolish common law offences relating to abortion, which shifts enforcement away from criminal law. The text provided here records that as a note to s 3; the Act itself: s 12 provides a statutory non-offence for self-termination.

• Professional and regulatory oversight: Section 10 makes contraventions of the Act relevant to consideration under Acts governing registered health practitioners’ professional conduct or performance. Specifically, s 10(1) permits regulatory bodies considering professional conduct or performance matters to have regard to whether a practitioner performed or assisted in an unauthorised termination under ss 5-6 and 8, or contravened s 9. Section 10(2) lists matters to which this applies, including notifications under the Health Practitioner Regulation National Law (NSW) and complaints under the Health Care Complaints Act 1993. Section 10(3) expressly preserves duties to comply with professional standards and guidelines.

• Indirect enforcement via guidelines and facility approvals: The Secretary’s power to issue guidelines under s 14, and the mandatory compliance requirement in s 14(3), gives the Secretary administrative leverage to shape practice and create enforceable standards. Non-compliance with binding guidelines breaches professional obligations and may be treated as professional misconduct or poor performance by regulators. The Secretary’s facility approval power in s 13 identifies institutions where post-22-week terminations may lawfully occur; performing such terminations outside approved sites may be treated as unauthorised and therefore as a matter for professional regulation under s 10.

• Reporting requirements as compliance and monitoring tools: Section 15 obliges practitioners to report termination information to the Secretary within 28 days in a format determined by the Secretary; s 15(3) protects de-identification. Section 15A requires an annual report to Parliament, which publicly documents availability, waiting times, clinical performance and adverse events. These reporting obligations support administrative monitoring and can inform regulatory action, policy changes and public oversight.

• Emergency and conscience exceptions preserved: Sections 5(3), 6(5), 7(3), and 9(5) create statutory exceptions for emergencies and preserve obligations to act in emergencies despite conscientious objection, which constrains enforcement in urgent clinical contexts.

• No express monetary fines or criminal penalties in this Act text: The Act as presented does not set out express fines, imprisonment or criminal penalties for contraventions. Instead enforcement is channelled through professional regulation, Secretary-issued guidelines and administrative oversight. Any criminal rules removed are noted in the s 3 comment.

• Regulations: Section 18 authorises the Governor to make regulations for carrying out the Act’s purposes. Regulations could prescribe offences, penalties or enforcement procedures not contained in the primary Act, subject to the requirement they be consistent with the Act. The Act’s enforcement architecture therefore permits further regulatory elaboration.

In practice, enforcement will be a combination of regulatory discipline by professional bodies, compliance with Secretary frameworks (guidelines, facility approvals, data reporting), and public or parliamentary scrutiny informed by the annual report (s 15A). The Act ties unauthorised practice to professional misconduct pathways (s 10), rather than setting out new criminal offences within this statute. The Secretary’s discretion over guidelines, forms and approvals becomes an instrumental enforcement mechanism. Any further prescriptive sanctions would need to be found in either regulation under s 18 or in existing professional regulation statutes referenced in s 10.

The Act is written to operate alongside and to modify the application of other statutes and professional regulatory instruments. The text itself references interactions and limits; these are the concrete touchpoints and mechanisms by which it integrates with existing legal regimes:

• Health Practitioner Regulation National Law (NSW) and professional regulation: The Act repeatedly ties registered health practitioner status and obligations to the Health Practitioner Regulation National Law (NSW). Definitions in Sch 1 (for example, “medical practitioner”, “nurse”, “midwife”, “pharmacist”, “nurse practitioner”, “Aboriginal and Torres Strait Islander health practitioner”) are expressly linked to registration under that law. Section 10 expressly contemplates notifications under the Health Practitioner Regulation National Law and allows professional conduct or performance bodies to consider whether practitioners performed terminations in contravention of the Act. Section 5(5)(b) and s 6(3)(c) reference professional standards and guidelines, preserving duties under those regulatory instruments.

• Crimes Act 1900 and common law: Section 3 contains a note that consequential amendments were made to the Crimes Act 1900 to repeal abortion-related provisions and to abolish common law offences related to abortion. The Act also contains s 12, which provides that a person does not commit an offence for self-termination "despite any other Act", indicating a statutory preclusion of criminal liability in the specific context of self-termination.

• Medicines, poisons and therapeutic goods laws: Section 5(5)(c) cross-references the Poisons and Therapeutic Goods Act 1966 and the Medicines, Poisons and Therapeutic Goods Act 2022, and any other laws governing practitioner practice. These references indicate that prescribing, dispensing and use of medications for termination remain subject to medicines regulation. Section 8(3) explicitly includes dispensing, supplying or administering termination drugs on a medical practitioner’s instruction in the definition of “assisting”.

• Health Services Act 1997: Section 6(1)(d)(i) uses the concept of a hospital controlled by a statutory health organisation within the meaning of the Health Services Act 1997 as a class of approved location for post-22-week terminations. Section 14 contemplates hospital advisory committees established by statutory health organisations (s 14(2)(a)) and hospital advisory committees are defined in Sch 1.

• Health Care Complaints Act 1993: Section 10(2)(b) lists the Health Care Complaints Act 1993 as a regime where matters arising from potential contraventions of this Act may be considered.

• Privacy and confidentiality regimes: Section 15(3) imposes a statutory prohibition on including particulars that would allow identification of the person who underwent a termination in reports to the Secretary. That interacts with broader privacy and health information laws in practice, though the Act itself sets a specific floor.

• Administrative law: The Secretary’s functions (ss 13-16, s 15A) interact with public administration law. Decisions by the Secretary to approve facilities, issue guidelines, set reporting obligations, and produce public reports are administrative acts; such acts will be subject to judicial review principles and public law obligations (not expressed in this Act but present in the administrative law framework).

• Regulations and subordinate legislation: Section 18 allows the Governor to make regulations necessary or convenient to administer the Act. Those regulations may specify further operational detail, including potentially definitions, facility standards, data requirements or offences consistent with the Act. Any such regulations must be read alongside the primary law.

• Emergency practice and other laws: The Act’s emergency exceptions are expressed in clinical, not criminal, terms. Practitioners acting in emergencies remain subject to professional standards and other laws (s 5(5)(b) and s 11(2)). The Act explicitly preserves duties to provide clinically appropriate care (s 11).

Overall, the Act modifies the criminal law landscape by removing criminal sanctions for abortion (s 3 note; s 12) and anchors practice regulation within the existing professional and medicines regulatory framework. The Secretary’s guideline and approval powers interact with health services governance instruments. Practitioners remain subject to the Health Practitioner Regulation National Law and to medicines and poisons Acts for prescribing and supply. The Act cross-references and preserves these external legal constraints rather than displacing them.

The statute text includes internal amendment notes indicating legislative changes up to 2025. The Act as presented shows the following recorded amendments within the text and Schedule 1:

• Section 5: The text of s 5 concludes with the editorial note “s 5: Am 2025 No 26, Sch 1[1]-[3].” That indicates s 5 was amended by an Act cited as 2025 No 26, Schedule 1, paragraphs 1-3. The specific content of those amendments is incorporated in the current text; no further detail is in the source beyond the amendment citation.

• Section 7: The end of s 7 is annotated with “s 7: Am 2025 No 26, Sch 1[4] [5].” That records amendments made by the same 2025 instrument to s 7 (Schedule 1 paras 4 and 5).

• Section 8: The end of s 8 is annotated “s 8: Am 2025 No 26, Sch 1[6].” That records an amendment incorporated into s 8.

• Section 14: The text of s 14 ends with “s 14: Am 2025 No 26, Sch 1[7].” That records an amendment to the Secretary’s power to issue guidelines and the binding effect (s 14(3)).

• Section 15: The end of s 15 shows “s 15: Am 2025 No 26, Sch 1[8] [9].” That signals amendments to s 15’s reporting duties by the 2025 instrument.

• Section 15A: This section is followed by “s 15A: Ins 2025 No 26, Sch 1[10].” That indicates s 15A was inserted by the 2025 Act (Schedule 1 para 10).

• Schedule 1: The dictionary entries carry the note “sch 1: Am 2025 No 26, Sch 1[11] [12].” That shows amendments to Schedule 1 definitions effected by the 2025 Act.

• Schedule 2: The Schedule is marked “Schedule 2 (Repealed)” with a citation “sch 2: Rep 1987 No 15, sec 30C.” This indicates Schedule 2 was repealed historically in 1987, with the citation provided.

The source text does not include the primary instrument 2025 No 26 itself nor the explanatory material for those amendments. The internal amendment annotations are the only explicit amendment history contained in the provided text. They show that the Act has been amended and expanded with additional reporting and guideline obligations and possibly further clarifications to who may perform or assist, consistent with the 2025 legislative instrument.

Where the Act refers to consequential amendments to the Crimes Act 1900 and abolition of common law offences, that change is recorded as a legislative consequence in the note to s 3; the specific amendments to the Crimes Act are not reproduced in the text provided here. The Act’s commencement is immediate on assent (s 2), and the Minister must arrange a statutory review within five years of the commencement of s 17, which will itself generate an official review and likely further amendment proposals.

For operational and compliance planning, practitioners and health services should treat the Secretary’s guideline-making power and the regulations power (s 14 and s 18) as likely sources of further operational detail that may be enacted after, and pursuant to, these recorded amendments.

The Act text supplied does not include or reference any judicial determinations interpreting it. The Act contains cross-references to existing statutes and notes about legislative repeal of criminal provisions (s 3 note), but it does not list or summarise any cases that have construed its provisions. The Schedule and sections include amendment annotations and references to other Acts, but no litigation history is recorded in the Statute text provided.

Consequently, from the source text alone:

• There are no cases cited in the Act text that construe or test its provisions.

• There is no recorded judicial interpretation of the new Secretary guideline powers (s 14), reporting obligations (s 15; s 15A), facility approval processes (s 13), conscientious objection duties (s 9), or the thresholds in ss 5-6. For legal advice or contested matters, practitioners should assume that the Act’s provisions are subject to normal processes of judicial interpretation, administrative review and professional regulatory adjudication, but there is no statutory litigation record to rely on in this text.

• Where the Act indicates that consequential amendments were made to the Crimes Act 1900 and common law offences abolished (s 3 note), the source text does not reproduce any litigation that may have arisen from those changes.

Because the Act channels potential enforcement through professional regulation (s 10) and administrative powers vested in the Secretary (ss 13-15), practical litigation is more likely to arise in professional disciplinary proceedings, administrative review of Secretary decisions (for example facility approvals or guideline content), or privacy/data disputes arising from reporting. None of those proceedings are recorded in the provided statute text.

If litigation history is material to a specific compliance or advisory task, practitioners must search judicial and tribunal databases for decisions after commencement and for any challenges to Secretary guidelines, facility approvals, or reporting arrangements established under s 14, s 13 and s 15. The statute as provided gives the legal framework but contains no adjudicative history.

This section flags concrete pitfalls, ambiguous decision points and implementation risks that derive directly from the Act’s text. Each “gotcha” is grounded in the statutory mechanics and cites the relevant sections.

• Secretary discretion with binding effect: The Secretary may issue guidelines and once issued, practitioners "must perform the termination in accordance with the guidelines" (s 14(1), (3)). That gives the Secretary substantial discretion to define operational detail that becomes mandatory. Practitioners may assume professional standards govern practice; however, Secretary guidelines can impose additional procedural or evidentiary requirements with potential professional consequences (s 10). The risk: operational practice could change significantly by administrative instrument rather than primary legislation, increasing regulatory uncertainty.

• Reporting requirements are Secretary-determined and may be operationalised any way the Secretary decides (s 15(1)-(2)). The Secretary also prohibits identifying particulars (s 15(3)). The “gotcha” is that the Secretary controls both the content and the format (including forms) of reports; therefore compliance systems must be adaptable to Secretary-issued forms and data fields, and data governance systems must align with the statutory de-identification requirement.

• Facility approvals and continuum of care: Section 6(1)(d) requires post-22-week terminations to be performed at statutory health organisation hospitals or approved health facilities. Section 13 gives the Secretary sole authority to approve facilities. The practical risks: if few facilities are approved, access may concentrate geographically; if approval processes are slow or opaque, providers and patients may face delays. The text does not set approval criteria or timelines, leaving those details to Secretary practice or regulations (s 13; s 18).

• Conscientious objection obligations are immediate and operational (s 9). The objecting practitioner must disclose objection “as soon as practicable” (s 9(2)) and, if the request is for care for the person themselves, must provide referral information or transfer care “without delay” (s 9(3)). The standard “reasonable belief” appears in s 9(3)(b) when transferring or designating another service, and the Secretary may pre-approve information that satisfies s 9(3)(a) (s 9(4)). The “gotcha” is that the objecting practitioner’s duties are procedural: failure to disclose or to provide prompt referral/transfer may be treated as a professional conduct matter under s 10.

• “Assisting” includes dispensing and administering termination drugs on instruction (s 8(3)). For pharmacists and nurses, this attachment to a third-party instruction means that compliance risks arise if the prescribing or performing practitioner has not met the Act’s authorisation conditions. Section 8(2) excludes assistance where the assisting practitioner knows, or ought reasonably to know, the termination is unauthorised. This creates a knowledge/constructive knowledge test for assistants; establishing what an assisting practitioner ought reasonably to know is a practical compliance challenge.

• Informed consent is defined to require conformity with “any guidelines applicable to the registered health practitioner” (Sch 1). Because guidelines are Secretary-issued and binding (s 14), the legal content of informed consent may vary over time depending on administrative guidance. Practitioners must therefore track Secretary guidelines closely; failure to obtain consent consistent with those guidelines could render a procedure unauthorised for professional regulatory purposes (s 10).

• Emergency exceptions are fact-dependent and untethered to an external standard: the Act allows departures for emergencies (s 5(3), s 6(5), s 7(3), s 9(5)). The “gotcha” is that medical practitioners must reasonably be able to justify emergency departures; professional regulators will likely assess such decisions against professional standards and guidelines (s 6(3)(c); s 5(5)(b); s 10(3)), and retrospective assessment of “necessity” can raise legal exposure.

• Data confidentiality vs. parliamentary reporting: Section 15(3) bars identifying particulars in reports to the Secretary, but s 15A requires the Secretary to prepare a public annual report containing detailed information about access, waiting times, clinical performance and adverse events by region and district (s 15A(a)(i)-(v)). The “gotcha” is balancing non-identifying data submissions against the public reporting requirement; small-region or low-volume data sets may risk re-identification unless handled carefully. The Act does not prescribe statistical disclosure control methods.

• Overlap with medicines and poisons regulation: Section 5(5)(c) and s 8(3) cross-reference medicines/poisons law. Practitioners must comply with those regimes alongside the Act. The practical pitfall is assuming the Act alone authorises prescribing, dispensing or administration of termination drugs; it does not displace medicines or poisons law requirements.

• Broad definition of “termination”: Sch 1 defines termination as “an intentional termination of a pregnancy in any way” and gives examples including administering a drug or using an instrument. This is an intentionally wide definition that may sweep within its scope many clinical acts. Practitioners must consider whether a specific intervention fits that definition and whether the Act’s authorisation framework applies.

• Potential mismatch between professional standards and Secretary guidelines: Section 5(5)(b) and s 10(3) preserve professional standards and guidelines; s 14(3) requires compliance with Secretary guidelines. A potential conflict could arise where Secretary guidelines impose obligations that differ from professional regulator guidance. The Act does not specify how to resolve such conflicts; however, s 5(5) and s 10(3) preserve both strands, creating a practical compliance need to satisfy both.

• Ambiguity in definition of “specialist medical practitioner”: Sch 1 includes obstetrics and gynaecology specialists and “a medical practitioner who has other expertise that is relevant”, with an example of a GP with additional experience. The lack of objective licensing criteria for “other expertise” may create discretion for regulators and uncertainty for providers about who qualifies to perform late-term terminations (Sch 1).

Those “gotchas” are direct consequences of delegations to the Secretary, the interaction with professional law, open definitions and emergency-based exceptions. They highlight areas where administrative detail, Secretary guidelines and professional standards will determine practical compliance and risk exposure.

This section synthesises actionable compliance steps derived from the statutory text. Compliance obligations fall on practitioners, health service providers and the Secretary. The following steps are grounded in specific sections.

For registered health practitioners who may perform terminations (ss 5-6, Sch 1)

• Confirm credentialed status and scope: Ensure registration under the Health Practitioner Regulation National Law in the relevant profession. For up-to-22-week terminations confirm you are within the defined “prescribed health practitioner” group (s 5(4); Sch 1). For post-22-week terminations, ensure you meet the “specialist medical practitioner” definition in Sch 1.

• Follow scope-of-practice and professional standards: Do not act outside your scope of practice (s 5(5)(a)). Ensure your practice is consistent with professional standards and guidelines applicable to your profession (s 5(5)(b); s 6(3)(c); s 10(3)).

• Obtain and document informed consent: Obtain informed consent as required by s 5(2) for up-to-22-week terminations and by s 6(1)(c) for post-22-week terminations. Sch 1 defines informed consent to be freely and voluntarily given and in accordance with any applicable guidelines. Keep contemporaneous records documenting the information given and the person’s voluntary decision. In emergencies where consent is impracticable, document the circumstances justifying the departure (s 5(3)).

• Provide counselling information where required: For up-to-22-week terminations, assess whether counselling would be beneficial and, if so and the person is interested, provide all necessary information including publicly-funded counselling (s 7(1)). For post-22-week terminations, provide all necessary counselling access information (s 7(2)). Document the assessment and any information provided. Emergency exceptions (s 7(3)) should be documented.

• Consult appropriately for post-22-week terminations: For terminations after 22 weeks, undertake the multi-factorial consideration required by s 6(3) (medical, physical, psychological and social circumstances) and consult another specialist who also considers sufficient grounds exist (s 6(1)(b)). If seeking multidisciplinary advice, record who was consulted and the advice given (s 6(4)). Ensure the facility is approved (s 6(1)(d); s 13).

• Use approved facilities for late-term terminations: Arrange performance at a hospital controlled by a statutory health organisation or an approved health facility (s 6(1)(d); s 13). Verify the facility’s approval status with the Secretary before scheduling care.

• Ensure assistants are authorised and informed: If instructing nurses, midwives or pharmacists to assist (including dispensing termination drugs), confirm they are registered and understand their duty not to assist in unauthorised procedures (s 8(1)-(3)). Assistants should be trained to recognise situations where they “know or ought reasonably to know” a termination is unauthorised (s 8(2)).

• Maintain medicine/poisons compliance: For termination drugs, comply with the Poisons and Therapeutic Goods Act 1966, Medicines, Poisons and Therapeutic Goods Act 2022 and other applicable drug laws referenced in s 5(5)(c). Ensure prescriptions, dispensing and administration meet those legal frameworks.

For practitioners with conscientious objections (s 9)

• Disclosure and timely referral: If you have a conscientious objection, disclose it promptly to any person who asks for performance, assistance, decision-making under s 6, or advice about performance (s 9(1)-(2)). If the person requests performance or advice for themselves, give information on how to locate/contact a non-objecting practitioner or transfer care without delay (s 9(3)). Where available, use Secretary-approved information to satisfy the obligation to provide contact details (s 9(4)). Document the disclosure and the steps taken to provide information or transfer care.

• Emergency duties: Be prepared to act in emergencies despite conscientious objection (s 9(5)). Document the medical necessity if you perform or assist in an emergency.

For health service providers and administrators

• Liaise with the Secretary on facility approvals and guidelines: If seeking to offer post-22-week terminations, apply to the Secretary for facility approval (s 13) and ensure the facility meets any conditions set. Track and implement Secretary guidelines (s 14) and align hospital advisory committee processes with s 14(2).

• Build data systems for reporting: Implement data capture that will allow practitioners to provide the Secretary the information decided by the Secretary within 28 days (s 15(1)-(2)). Ensure systems do not capture identifying particulars in reports to the Secretary and have robust de-identification and disclosure controls to meet s 15(3). Prepare to provide the Secretary with datasets that support the annual report obligations (s 15A), including regional breakdowns.

• Integrate counselling pathways: Develop referral pathways for counselling services, including publicly-funded counselling, and ensure front-line staff can provide necessary information when requested (s 7).

• Update policies and training: Update workplace policies to reflect the Act’s requirements on informed consent, counselling information, conscientious objection disclosure and transfer, and emergency practice. Train clinical, administrative and pharmacy staff in the “assisting” definition and in identifying potentially unauthorised procedures (s 8).

For the Secretary and Ministry of Health

• Issue clear and detailed guidelines: Use s 14 to issue guidelines that practitioners must follow. Because guidelines are binding (s 14(3)), draft them with clarity on consent content, documentation requirements, multidisciplinary team procedures, facility standards, and data reporting formats to reduce practitioner uncertainty.

• Set reporting standards and forms: Under s 15 set the required information and the approved reporting method, and ensure data collection tools preserve non-identification (s 15(3)). Coordinate between clinical and data privacy teams to ensure the annual report’s regional detail (s 15A) is statistically disclosive-safe.

• Publish approved referral information for conscientious objectors: To assist practitioners and ensure compliance with s 9(3)(a), publish and periodically update contact details for services and non-objecting practitioners as authorised information.

• Define facility approval criteria and timelines: For s 13 approvals, publish transparent criteria, inspection protocols and processing timelines to reduce access bottlenecks and legal uncertainty for providers.

• Coordinate with professional regulators and medicines authorities: Engage the Health Practitioner Regulation National Board(s) and medicines/poisons regulators to harmonise guidance and enforcement expectations, particularly where professional standards and Secretary guidelines converge (s 5(5)(b), s 10(3)).

Record-keeping and documentation

• Keep contemporaneous clinical records supporting informed consent, counselling discussions, consultations with other specialists, multidisciplinary advice and facility approvals. For emergencies, document the medical rationale and urgency that justified any departure from ordinary processes (ss 5(3), 6(5), 7(3)).

• Maintain logs of conscientious objection disclosures and steps taken to transfer care or provide approved information, and retain proof of any referral or transfer arrangements (s 9(3)).

• Ensure reporting compliance: Set internal protocols to prepare Secretary-required reports within 28 days of a termination (s 15(1)). Verify that submitted reports do not include identifying particulars (s 15(3)). Prepare for audits or regulatory inquiries that may use this data in s 15A public reporting and regulatory oversight.

Contingency planning

• Emergency protocols: Establish clinical escalation procedures for emergency terminations where usual consent or referral processes cannot be followed, including documentation templates to capture justification (ss 5(3), 6(5), 7(3), 9(5)).

• Regulatory disputes and professional review: Anticipate that alleged non-compliance (for example, performing unauthorised terminations or failing to comply with conscientious objection procedures) will be addressed through professional regulatory channels (s 10). Have legal counsel or compliance leads familiar with the Health Practitioner Regulation National Law and the Health Care Complaints Act 1993.

By treating Secretary guidance, facility approvals and reporting rules as primary operational inputs and embedding those requirements into clinical, pharmacy and administrative workflows, practitioners and providers can align day-to-day practice with the Act’s statutory obligations. Documentation and data governance are central to demonstrating compliance.