Module 4: Point of care ultrasound in first trimester abortion (POCUS)
3. Tikanga in abortion care
Tikanga Māori: Living by Māori values (Mead, 2016) states that:
Generally speaking, tikanga are Māori customary practices or behaviours. The concept is derived from the Māori word ‘tika’ which means ‘right’ or ‘correct’ so, in Māori terms, to act in accordance with tikanga is to behave in a way that is culturally principled and appropriate. According to Mead (2016) “it is difficult to imagine any social situation where tikanga Māori has no place. Ceremonies relating to life itself – birth, marriage, sickness and death – are firmly embedded in tikanga Māori”. Furthermore, “tikanga comes out of the accumulated knowledge of generations of Māori and is part of the intellectual property of Māori”.
Physical and practical approaches to upholding Tikanga within abortion care include:
- The physical transition from waiting areas to areas where consultation/ abortion occur. Separating Noa (ordinariness) from Tapu (sacredness)
- The right to Karakia (prayer) should be offered
- The ability to offer whānau support throughout the process, whilst maintaining confidentiality. Always ask the patient as to their wish/need for whānau involvement.
- Be respectful of Taonga (valuables worn with spiritual significance)
- The ability to wash after the procedure
- Support of Kai Atawhai (return of pregnancy tissue to cultural land) and facilitation of this if the patient is unable
The Abortion Legislation Act 2020, in combination with the principles of Te Tiriti o Waitangi, provides whānau, hapū and iwi with the opportunity to revitalise their older knowledges and practices for abortion. The intention is for Māori, in the context of abortion, to enact their rangatiratanga or self-determining rights over tikanga and mana motuhake or autonomy over their bodies and their reproductive health and wellbeing. For this reason, health practitioners should be very careful not to impose their understanding of tikanga or mātauranga Māori on Māori through the abortion process. Nor should they assume that all Māori are familiar with terms such as tikanga, mātauranga and Te Tiriti o Waitangi. Unfamiliarity with such terms can be experienced by Māori as a diminishment of their mana as expressed by Te Tiriti o Waitangi; an outcome that is antithetical to Te Tiriti, the Abortion Clinical Guideline and Ngā Paerewa.
As a health practitioner providing abortion care please refer to "The New Zealand Aotearoa Abortion Clinical Guideline 2021". This document provides the framework for abortion providers and health practitioners providing abortion services to Māori while upholding the principles of Te Tiriti o Waitangi and was developed with the support of - Ngā Paerewa Health and Disability Services Standard.
For further information, see “Māori women and abortion: A Kaupapa Māori literature review”.