“A woman s right to choose; a child’s right to life; pro-choice; pro-life” — the debate about abortion is too often conducted using slogans that set one group’s “rights” against those of another. No doubt we will hear the same old arguments for and against abortion as David Alton’s
private member’s Bill passes through Parliament. Alton, a devout Roman Catholic opposed to all abortion, wants to amend existing laws so that the time limit for legal abortions is reduced from 28 weeks to 18 weeks. Those in favour of the new time limit argue that recent advances in medical technology now mean it is possible, in some cases, for doctors to keep a baby alive that is born after just 23 weeks gestation. In other words at the moment abortions are permitted beyond the time at which a foetus could be said to be “viable”.The arguments for and against abortion should be re-examined in the light of the facts, not only about abortion but also about the circumstances in which women seek abortion.
Abortion on demand
Despite the anti-abortion lobby’s propaganda and the pro-abortion lobby’s demand, there is no “free abortion on demand” in this country. In order to obtain a legal abortion on the NHS a woman must first convince two doctors that there are good reasons why her pregnancy should be terminated. The most common reason given by doctors is that to continue with the pregnancy would be a “risk to the woman’s physical or mental health”. Some doctors who are anyway predisposed to be guided by the woman’s wishes, use this as a convenient catch-all reason for agreeing to an abortion. But this is by no means the case in all parts of the country. There are huge disparities between regions in the proportion of abortions carried out by the NHS which is evidence of the extent of consultant gynaecologists’ discretionary powers. Around 50 per cent of all abortions in Britain are carried out privately. Money can buy a way round NHS doctors’ objections providing a substantial profit for those practitioners who are more enlightened or less principled depending on your point of view.
But to all intents and purposes the arguments this time around are not about whether abortion is ever justified but about whether abortion after 18 weeks pregnancy is justified. Given that “late” abortions are undoubtedly traumatic for both the pregnant woman and medical staff carrying out the operation — they often involve inducing labour and the “delivery” of the foetus — we need to ask why any woman would seek an abortion this far into the pregnancy.
Some “late” terminations occur precisely because abortion is not available “on demand”. It may take some time to get an appointment with a consultant, to get him or her to agree to the abortion and then to be allocated a NHS bed. One survey discovered that as many as one in five women seeking “late” abortions had first sought medical advice before they were 12 weeks into the pregnancy. As a result, some who oppose the Alton amendment argue that if he is serious about eliminating “late” abortions then the way to do it is not to make them illegal but to make it then easier to obtain by removing delays in the NHS. This strategy would, no doubt, reduce the number of “late” abortions but would not eliminate the need for them altogether.
Of the 5,865 abortions carried out last year after 18 weeks, 550 were because tests had shown that the baby was likely to be born handicapped. If Alton’s bill becomes law then there will be more handicapped children born because many of the tests for foetal abnormality cannot be carried out until after 18 weeks. For example, most pregnant women cannot be tested for Down’s Syndrome until 17 weeks at the earliest. They then have to wait several weeks for the results of the test and if the decision is to terminate the pregnancy, they must wait again for a hospital bed to become available. There is a new test for Down’s Syndrome which can be carried out earlier in the pregnancy but it is only available in a few well-equipped hospitals.
Most women seeking late abortion are from countries outside England and Wales where abortion is illegal. This figure is beginning to decrease as other countries liberalise their abortion laws, but there are still significant numbers of women arriving from Ireland, Spain and Portugal to seek abortions. Again there is an irony in the fact that the number of late abortions performed in this country which Alton is so anxious to reduce is largely made up of women from countries which impose the same Catholic morality that Alton believes in.
The final group of women likely to seek late abortions are very young or older women. In the latter case women who think they are past child-bearing age may not discover they are pregnant until they are more than 18 weeks into the pregnancy, having mistaken physiological changes for the menopause.
But perhaps the group most likely to be adversely affected by the proposed change are teenage girls. Again, they may not at first realise they are pregnant or if they do they may be too scared to tell anyone until they can no longer conceal the fact.
Teenagers reach sexual maturity at a young age and are encouraged by the persuasive glamorisation of sex by the media to engage in sexual activity. Unfortunately this glossy portrayal of sex tends to leave out (or at least did so prior to AIDS) the considerably less glamorous issue of contraception. A DHSS survey of pregnant schoolgirls in 1986 revealed that although 65 per cent of them had their first sexual experience before they were 16, 51 per cent had never been given any information about contraception. In 1985 the result of this ignorance was 38,000 babies born to single girls aged between 13 and 19 and 1.500 babies born to girls under the age of 14.
If the Alton bill becomes law then those people who. on any assessment are likely to be considered most in need of an abortion — very young girls, older women and those carrying an impaired foetus — are also the people most likely to be adversely affected.
The arguments for and against abortion so often take on a high moral tone that they frequently fail to answer the most important question: why are there unwanted pregnancies?
As we have already seen, ignorance must be to blame in some cases. It is estimated that one in ten teenagers who reach the age of 15 this year will have an abortion before they are 20. Many of these unwanted pregnancies will be the result of an appalling lack of knowledge about sex and contraception among sexually active teenagers. So why is it that young people are not given the information they need to enable them to take responsibility for their own actions? Once again we are confronted with the fact that it is the morality of Alton and others like him who ignore the fact that teenagers do engage in sexual activity at a young age and insist instead that they should not. It is doubly perverse for the same moralists to then condemn abortion — an inevitable consequence of their own moralism. Clearly the first practical step that needs to be taken to reduce the number of abortions is to reduce the number of unwanted pregnancies by providing proper sex education and information about contraception and encouraging free discussion among teenagers in an atmosphere free from repressive moralism.
Unwanted pregnancies may also result from “accidents” — no method of contraception is 100 per cent effective. While in some cases an unplanned pregnancy will be accepted and the child welcomed, this is by no means always so. For some women another child will be a burden that they and their families cannot cope with for financial, social or psychological reasons. To go ahead with the pregnancy in such circumstances could cause tremendous damage to all concerned. In a society which is not concerned about meeting human needs such situations will continually arise.
Doubts about whether human needs will be met must be even greater in cases involving a handicapped child. No woman who is already 18 weeks or more into a pregnancy is going to take lightly the decision to go through the trauma of a late abortion even where there is evidence that the baby will be born handicapped. The fact that many women in such a situation do opt for abortion is evidence of the difficulties faced by parents trying to care for a handicapped child. Similarly in a 1983 survey conducted by the Journal of Medical Ethics, parents of Down’s Syndrome children were asked what they would do if they knew that they were expecting a severely mentally handicapped child. 78 per cent said they would request a termination. No doubt these parents loved and cared for their own handicapped children but the difficulties they face are such that the majority would not willingly take on such a responsibility again. David Alton argues that the certainty of a baby being born handicapped should not be grounds for abortion and that if parents themselves do not want to keep the handicapped child then they should arrange for it to be adopted. This completely ignores the difficulties not only of finding adoptive parents for handicapped children but also of providing for their needs in a society that does not give any human needs priority let alone special needs.
David Alton’s bill offers no answers to any of these questions and the arguments of most of his opponents also fail to address the most fundamental issues. Because until we face up to the fact that we live in a society which routinely fails to provide for the needs of a majority of its members — parents and children, handicapped or not — then there will continue to be a demand for abortion. Anyone who is seriously concerned to reduce or eliminate abortion might do well to consider what kind of society would first have to be created in order to achieve that objective. For pious sentiment about the sanctity of human life has a hollow ring when each and every day brings fresh evidence of the lack of respect for human life. And moralistic cant about “rights” will do nothing to change the material circumstances that cause women to seek abortions. Only in a society in which human needs are paramount — the needs of women to control their own fertility, the needs of parents to have creative work besides looking after their children, the needs of children to grow up in a secure, loving environment free from want and deprivation. the needs of the handicapped to be respected and useful members of the community — is it possible to imagine a situation where all babies are wanted and abortion redundant.