BACKGROUND:The New Zealand government has made a commitment to reducing inequalities in health among its population through the New Zealand Health Strategy. Termination of Pregnancy (TOP) services are an important part of women's health services, and equity in access to services must be ensured. OBJECTIVE:Assess geographic accessibility to first trimester termination of pregnancy services in New Zealand, and discuss implications for equity in access to services. METHODS:TOP service information was obtained nationwide through online resources, and approximate driving distances between all major centres and the closest TOP service to which patients are referred to were calculated for each region. Census data and Statistics NZ data are used to compare population characteristics between regions with reduced geographic accessibility of TOP services. RESULTS:Women who live in regions that do not offer local TOP services must travel on average 221 km to access TOP services. This equates to an average return-trip distance of 442 km. Three of the five regions that do not have local TOP services available have a higher than average proportion of Maori population. CONCLUSIONS:The results of this study demonstrate that first-trimester TOP services are relatively difficult to access for over one-sixth of the women in New Zealand.