Some international students, such as those from more conservative societies, may bring different perspectives on sexual behaviour. Some may opt to reaffirm their sexual ethics or they may find themselves exploring dating and sexual relations in a more liberal country. Hence, for some students, this may be the first time they engage in sexual relations. Unsurprisingly, many students are unaware of the risks and implications of having unprotected sex (Lim et al., 2022). Similarly, they may not consider using contraception, not know where to get it, feel unable to ask for it, or even think they don’t need to use it (e.g. due to common myths about pregnancy that are still prevalent).

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It is therefore critical that students fully understand prior to arriving that pregnancy will have serious consequences for their study programme, student visa and insurance policies. There are also significant financial implications for men who father children. In addition, students need to be prepared for experiencing an extremely stressful and life-changing event, should pregnancy happen, and to therefore seek mental health support alongside and after the pregnancy, regardless of what their decisions/outcomes may be.

1.1 Visa and study programme implications

Student visas do not allow for extended breaks from studying. The maximum time that international students can take time off studying without having to change to another visa is three months within a 12 month period. 

If the suspension of study lasts longer than three months, the student’s education provider notifies Immigration New Zealand and the student’s visa may be cancelled. If this happens, students will need to apply for a new visa to either remain in New Zealand to have the baby or return to New Zealand to continue studying once they have had the baby in their home country. 

Some education providers have their own policies that may be more limiting. Below is a quote from one of New Zealand’s tertiary institutes stipulating that their ‘special leave’ allowance is just one month. 

“Students who require more than one month of leave from their studies are in a position where it is highly unlikely they will be successful in completing their programme/qualification.  Furthermore, the student would not be meeting the requirements and conditions of their Student Visa. Therefore, [redacted] will have no option but to terminate the student’s enrolment and advise Immigration New Zealand.”

Note that the minimum recommended recovery time is six weeks for new mothers, and that midwives do not conclude post-partum care until the sixth week.

1.2 Financial implications

Immigration New Zealand has specific financial conditions for pregnant individuals applying for (or continuing on) a student visa:

“If you are pregnant and apply for a temporary visa to visit, study or work in NZ you must tell us how you will pay for your maternity care while you are here. Maternity care includes looking after you: before your baby is born, during labour and birth, and after your baby is born.”

According to the New Zealand Student and Immigration Advisers website, maternity services can cost at least NZ$9000. Similarly, abortion costs can vary between NZ$950 and $5,500 (see ‘Support for abortion’ under section 2.2 below for more details). 

However, international students are ineligible for publicly funded maternity or abortion services. In addition, neither maternity nor abortion services are covered by international student insurances, and international students are not eligible to take out private health insurances in New Zealand.

“Under Studentsafe and most international student insurance policies on the market, pregnancy is excluded. There is limited cover only if the pregnancy commenced during the period of insurance and only if there are complications or emergencies up until the 28th week of pregnancy. It is therefore really important that students are aware of this, since it means any pre-natal/birth costs will be self-funded. The other thing to consider is that abortions are also currently excluded in most international student policies.”
– Dominique, Studentsafe

Men also have serious financial consequences of pregnancy. Men who father a child face the possibility of paying child support for 18 years – regardless of whether they are in New Zealand or not. In addition, there are potential court fees around their rights to have access to the child if they wish to be involved in the child’s life but the mother does not want them to be. See the legal implications section below for more information.

1.3 Legal implications

There are various legal implications to consider, depending on the situation and the outcome. Citizen’s Advice Bureau (CAB) and Community Law (CL) are good resources for international students wanting to ask experts about legal aspects specific to their situation. There is no cost for using these services. Below are examples of some situations that can emerge from pregnancy, with links to relevant parts of the CAB or CL websites for more information where appropriate.

Men are not exempt from the legal consequences of pregnancy-related decisions. As indicated in some of the situations above, there are legal implications around paternity and a father’s right to have access to their child as they grow up, for example. See the Paternity section of the Community Law website for more information.

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2.1 Support for accessing contraception and pregnancy tests

Family Planning is one of the most informative resources for those wanting to prevent pregnancies and maintain good sexual health. Its services include contraception, pregnancy testing and advice. Family planning does charge for non-residents. 

NauMai NZ has information about sexual healthcare including contraception that is specifically for international students. It states that student insurance is unlikely to cover contraception as a healthcare cost.

Cultural considerations

It is important to consider the different cultural perspectives of international students. Westernised information about sex and pregnancy may be inappropriate for international students because of the social stigma that is often attached to sexual education or pre-marital sex  in more conservative countries. 

See the topic Supporting international students with sexual healthcare for more information.

Useful resources for students:

• Family Planning: Contraceptive (before/during sex)
• Family Planning: Emergency Contraceptive Pill (within 3-4 days of having sex)

2.2 Support for pregnancy and its outcomes

Support for pregnancy

Many students will not be familiar with New Zealand’s maternity health system and may find it hard to know where to start when they discover they are pregnant. 

Some students may prefer to ask student support staff for guidance over people they know personally. As a priority, make sure to inform students that what they tell support staff will always be considered and treated as completely confidential. 

Lisa’s story below is an example of how student support staff can provide effective guidance on pregnancy.

Also remind students that their education provider’s mental health support services exist for them to use fully for working through the emotions and stress that may surface as they experience pregnancy. Keep giving them plenty of opportunities for you to refer them to that service should they want/need it. 

Section 2.3 below contains pregnancy-specific counselling resources, and the toolkit topic Understand mental health and wellbeing principles and tools also has general mental health support tips.

Cultural and religious considerations

International students from more conservative countries may consider pregnancy ‘out of wedlock’ a taboo subject, since conservative traditions within various world religions (e.g., Christianity, Islam, Orthodox Judaism, conservative Hinduism, Sikhism ) view sex as something that should only happen in heterosexual marriages. This is a widely held conviction globally, with Christians and Muslims together making up more than half the world’s inhabitants. Students coming from religious majority countries may therefore be reluctant to seek help with pregnancy. Similarly, international students may be hesitant to seek help over fears that support staff are unfamiliar with their cultural beliefs or perspectives towards sex and pregnancy. 

When discussing pregnancy with students, three effective actions that can help create a safe space are to:

• ensure that the discussion is fully confidential;
• affirm that different cultures have a range of values and beliefs; and 
• avoid inserting your own beliefs or opinions into the conversation. 
  

The toolkit topic Intercultural competence in educational contexts can help you understand more about how to create a safe and open space for honest discussions.

Useful resources for students:

• Manatū Hauora Ministry of Health: Support for young pregnant women
• Family Planning: Pregnancy testing – They can immediately refer students with positive pregnancy tests to either a midwife or abortion provider (at a non-resident cost).
• Citizen’s Advice Bureau: I’m pregnant - what do I do? 
• Family Planning: What should I do if I am pregnant?
• Manatū Hauora Ministry of Health: Services and support during pregnancy
• Manatū Hauora Ministry of Health: Maternity Care – Note that while it says ‘all maternity care is free’, international students will pay non-resident costs.
• Find Your Midwife – This is the most important first step after a positive pregnancy test.

Support for abortion

Students will be able to get a referral for abortion from any local; Family Planning centre. Family Planning states that the costs of using abortion and aftercare services for non-residents (i.e. international students) vary between NZ$950 and $5,500, depending on the provider and type of abortion, plus the cost of any ultrasound scans and/or prescription fees. 

Cultural considerations

Abortion is considered taboo by many non-Western countries, cultures or religions. Similarly, there are discrepancies around the limit of how far along a pregnancy goes before abortion is morally unacceptable and/or forbidden by different cultures and relations.

For example, all groups/sects of Islam forbid aborting a pregnancy at 120 days (17 weeks), as this is when the foetus becomes ‘ensouled’ i.e. a person (Hedayat, Shooshtarizadeh & Raza, 2006). Some groups/sects, such as Maliki Muslims, forbid abortion at any stage after conception (Shapiro, 2013). The only exception is if the pregnancy threatens the life or health of the mother.

The taboo and time-sensitive aspects of abortion means that the longer some international students put off discussing abortion as a potential option, the less likely it is to be an option for them – and sometimes their final decision to go ahead with an abortion may even be too late. Hence, it is critical to provide culturally-safe information and support about abortion alongside general pregnancy information as early and effectively as possible, particularly for international students with more conservative beliefs and values.

For students who leave the decision too late to have an abortion (20 weeks in New Zealand, earlier for other cultures/countries), they can choose to adopt the baby out (see below) if they do not want to be a parent.

The toolkit topic Intercultural competence in educational contexts can help you understand more about how to talk about topics like abortion in a safe, open and inclusive and effective way.

Useful resources for students:

• Citizen’s Advice Bureau: I want to have an abortion – what do I do?
• Family Planning: Abortion
• DECIDE National Abortion Telehealth Service – 0800 DECIDE
• DECIDE: Frequently Asked Questions – This includes meanings to unfamiliar words about pregnancy and abortion, so could be useful to speakers of English as a second language.
• Abortion Services in New Zealand – This includes clearly outlined costs for non-residents.
• Abortion Services in New Zealand: Who to talk to – This provides counselling services for students who are unsure, need to talk through their decision, or need emotional support after termination.

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Support for adoption

Students who do not want to keep the baby but do not want (or it is too late) to terminate the pregnancy can consider adoption as an option. International students should be informed that adoption is an option with a student visa.

“You can place your baby for adoption even if you are not a permanent resident in New Zealand. Your baby would bear your nationality until it is placed for adoption. At that time of the adoption your baby takes the nationality of the adoptive parents.”
– Adoption Option website

There are two main conditions of adoption that international students considering this option need to be made aware of:

1. The student will need to get consent from the father/mother to continue with the adoption – unless their name is not on the birth certificate. 
2. The baby must be at least 12 days old before the student can sign a consent to the adoption. The student can take longer than 12 days to make the decision if they need it, as once they have signed consent it can be difficult to reverse it.
   

It can be helpful for the student to meet with local support groups that provide more information and support to adoptive or birth parents. They can do this via their local Citizen’s Advice Bureau.

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Cultural considerations - Julie’s story

Julie’s story on Adoption Option’s web archive points to a possible option when considering tailored support, if sought, for an unexpectedly pregnant student from a conservative society. Adoption may be viewed as a more acceptable option. Julie is a 20-year-old student from China with only the support of her homestay ‘mum’ to help her navigate the maternity healthcare system and the process of putting her baby up for adoption:

“I have a beautiful son and his adoptive family loves him very much. I gave him the chance of life and I chose the best family I could for him. I know he will have a happy life. I am going back to China but I will stay in touch with the adoptive parents by email and we will visit each other in the future.”

Other useful resources for students:

• Citizen’s Advice Bureau: I want to adopt out my baby after the birth. How do I do this?
• Oranga Tamariki: Placing your child for adoption
• Adoption Option – The FAQ section of their website may be particularly useful to pregnant students considering adoption.
  

2.3 Support for mental health concerns linked to pregnancy

Students going through pregnancy are likely to require significant mental health support as they navigate and recover from this major life event. This means that all students who are pregnant, regardless of their stage or what decision they make, should be referred to professional, culturally-inclusive counselling services as soon as possible. 

It is important to include students who have a miscarriage, as this event likely affects all those who experience it, regardless of where they are in their decision-making. Similarly, students who choose to continue the pregnancy to birth and then return to study may need continued mental health support to help them work through any postpartum depression or anxiety.

“To be honest it was the fact that I kept it to myself. I guess I was still making the decision to keep or let baby go. Then just like that, the decision was taken from me in the form of a miscarriage and I felt like the worst person in the world for even considering the things I did.”
– anonymous quote, Pregnancy Counselling website

Again, make sure to remind students that their education provider’s student mental health support service exists for them to use it as much as they need to, as it may be the best option for them. It's important to be clear what student health insurer provisions are for significant mental health episodes. Most face-to-face counselling services come at a cost for non-residents, and while there are free options for counselling run by charities, most are by phone rather than in-person. 

Below are two pregnancy-specific counselling resources that could supplement/be supplemented by student mental health support if needed:

• Pregnancy Counselling Service (PCS) provides free counselling services (including on miscarriage and abortion) to non-residents as well as residents. PCS also endeavours to “to help with any pregnancy related need where we can, such as baby clothes or equipment, as well as emergency accommodation or professional support (where possible)”.
• The Crisis Pregnancy Support page on the New Zealand Health Professionals Alliance website also has a comprehensive list of counselling services and other mental health support options.
  

The toolkit topic Understand mental health and wellbeing principles and tools also explains how to acknowledge and support the mental health concerns of international students in general.

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This topic covers how to support international students in making decisions relating to pregnancy. International education practitioners should now be able to inform students efficiently and effectively of the implications of pregnancy, how to prevent it, what decisions they need to make if pregnant, and which professional advice/support services to refer pregnant students to.

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Hedayat, K M; Shooshtarizadeh, P; Raza, M. (2006). Therapeutic abortion in Islam: contemporary views of Muslim Shiite scholars and effect of recent Iranian legislation. Journal of Medical Ethics. 32:11, 652–657. https://doi.org/10.1136/jme.2005.015289 

Lim, M. S. Y., Hocking, J. S., Sanci, L., & Temple-Smith, M. (2022). A systematic review of international students’ sexual health knowledge, behaviours, and attitudes. Sexual health, 19(1), 1–16. https://doi.org/10.1071/SH21073 

Shapiro, G. K. (2013). Abortion law in Muslim-majority countries: An overview of the Islamic discourse with policy implications. Health Policy and Planning. 29:4, 483–94. https://doi.org/10.1093/heapol/czt040 

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