Abortion

What is abortion?

Abortion describes the medical procedure for the premature termination of pregnancy.

Abortion procedures change according to the gestation (stage) of the pregnancy. The gestation is measured in weeks counting from the first day of the woman's last menstrual period. These methods range from the administration of drugs at early stages, through to 'vacuum aspiration' and medical induction at the latter stages of the pregnancy.

Abortion is legal in Great Britain, but not in Northern Ireland. However, it must be carried out in an authorised environment (usually an NHS hospital), and only after the certification of two registered medical practitioners, except in certain emergencies.

Background

The legal status of abortion has shifted considerably with social values. In the 18th Century, English common law allowed abortion, provided it was carried out before the mother felt the foetus move ('quickening').

The Offences Against the Person Act of 1861 made abortion a criminal offence punishable by imprisonment from three years to life. This was reversed by the Infant Life Preservation Act of 1929, which amended the law so that abortion would no longer be regarded as a criminal offence if it were proven to be carried out in "good faith for the sole purpose of preserving the life of the mother".

The Abortion Act 1967 (as amended) regulates the modern process of abortion. The Act provides a number of criteria to be fulfilled before a pregnancy can be terminated, although opponents argue the procedure is too simple.

In 2003, the Department of Health produced a Strategy Implementation Action Plan, identifying regional differences in service provision as a major problem.

Controversies

There is much controversy surrounding abortion. The debate may be simplified by dividing it into the opinions of those who support women's rights to abortion, who are called 'pro-choice', and those who oppose it, who are called 'pro-life'.

'Pro-choice' proponents centre their concerns on the rights of the woman. They argue that moves to abolish the right of pregnant mothers to opt for abortion are paternalistic and deny women control over their own bodies. They argue further that abortion is a permanent feature of society, thus the practical result of a ban would merely be to remove clinical guidelines from abortion and push it underground, placing women at serious risk.

'Pro-life' proponents focus the debate on the rights of the unborn child. To a greater or lesser degree, the pro-life party believes that life - as protected by the right to life - begins at conception.

In other countries, the debate is far more intense than in the UK: in the US, doctors prepared to carry out abortions have been attacked and even murdered by pro-life campaigners.

Between the positions at either end of the spectrum, there is a range of ethical, political and medical debate about how easy access to abortion should be, which interests and factors should prevail over others, and how late terminations may be carried out.

In recent years the issue of viability has been pushed to the forefront of debate. Advances in ultrasound technology have produced highly detailed images of foetuses in gestation. Most scientists argue we know nothing new or compelling about the development of foetuses, and therefore have no objective grounds to reducing the abortion time limit. However, the pictures provide an emotional argument for the rights of the foetus, appearing to show foetuses smiling or 'walking' in the womb.

Recent developments

By 2007 it appeared a concerted attempt was underway to recede abortion rights in the UK. A succession of private member's bills went before parliament but were rejected by MPs. Nadine Dorries had attempted to reduce the abortion time limit from 24 to 21 weeks. Pro-abortion campaigners argued late abortion is a rare procedure in the UK - and one often sought by women from overseas who have been forced to travel for treatment.

Ann Winterton put forward a bill to introduce a mandatory seven-day 'cooling off' period for any woman seeking an abortion. This was defeated by MPs, as was a private member's bill by Angela Watkinson, who said women under 16 should receive "parental guidance" before having an abortion.

At the other end of the scale, there was mounting pressure from doctors to liberalise abortion access in the early stages of pregnancy. British legislation does not allow for abortion on demand but requires the consent of two doctors. In 2007 the British Medical Association voted it should be treated as any other medical treatments and offered on the basis of the patient's informed consent.

In autumn 2007 a review of the Abortion Act 1967 by the Commons' science and technology committee re-opened the debate. MPs recommended dropping the requirement for two doctors' signatures, dismissing the precaution in safety terms.

The government agreed stating: "We were not presented with any good evidence that, at least in the first trimester, the requirement for two doctors' signatures serves to safeguard women or doctors in any meaningful way, or serves any other useful purpose." The government was also concerned that the requirement for two signatures "may be causing delays in access to abortion services."

The following year amendments were tabled during the final Commons debate on the Human Fertilisation and Embryology Bill which would have allowed one doctor to sanction an abortion, thereby ending the two signature rule. The amendments would also have allowed nurses to perform abortions and would have legalised abortions in Northern Ireland.

Initially MPs were to be allowed a free vote on the amendments. However, at the last minute Gordon Brown, instructed Leader of the Commons, Harriet Harman, to put forward a motion which effectively prevented the amendments from being voted upon and so the changes were not introduced. An earlier amendment to the bill, supported by Conservative leader David Cameron, which would have reduced the 24 week abortion time limit was also defeated by the government.

But the debate continues with the pro-choice groups still calling for the changes sought by the 2008 amendments and the pro-life groups still seeking a reduction in the abortion time limit. In an interview with the Catholic Herald in April 2010, David Cameron said he believed a review of the time limit was needed, suggesting that "an upper limit of 20 or 22 weeks would be sensible." However, he also stressed he felt it was "an issue of conscience" and that a free vote should be allowed on this issue.

Statistics

In 2010, for women resident in England and Wales:

The total number of abortions was 189,574, 0.3% more than in 2009 (189,100) and 8.0% more than in 2000 (175,542).
The age-standardised abortion rate was 17.5 per 1,000 resident women aged 15-44, the same as in 2009, but 3% higher than in 2000 (17.0) and more than double the rate of 8.0 recorded in 1970.
The abortion rate was highest at 33 per 1,000 for women aged 19 and 20, the same as in 2009 and slightly lower than the highest rates in the year 2000 (34 per 1,000 for both 19 and 20 year olds).
The under-16 abortion rate was 3.9 per 1,000 women and the under-18 rate was 16.5 per 1,000 women, both lower than in 2009 (4.0 and 17.6 per 1,000 women respectively) and in the year 2000 (3.9 and 18.3 per 1,000 women respectively).
96% of abortions were funded by the NHS. Over half (59%) took place in the independent sector under NHS contract, up from 2% in 1981.
91% of abortions were carried out at under 13 weeks gestation. 77% were at under 10 weeks, compared to 75% in 2009 and 58% in 2000.
Medical abortions accounted for 43% of the total, up from 12% in 2000.
2,290 abortions (1%) were carried out under ground E (risk that the child would be born handicapped),

Non-residents:

In 2010, there were 6,535 abortions for non-residents carried out in hospitals and clinics in England and Wales (6,643 in 2009). The 2010 total is the lowest in any year since 1969.

Source: Department of Health – May 2011
 

Quotes

"If a woman feels that an abortion is in her or her family's best interests, then she should have access to safe, supportive and non-judgmental advice and help from an expert clinic. No one else should pressure her into either continuing with the pregnancy or having an abortion."

Marie Stopes International - 2010

"No-one has the right to destroy the life of any innocent human being from fertilisation to natural death."

Oxford University Pro-Life Society - 2010