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 introduced 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 has been mounting pressure from doctors to liberalise abortion access in the early stages of pregnancy. British legislation does not allow for abortion in 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.


Statistics

In England and Wales, 186,400 abortions were performed on resident women in 2005.

The abortion rate was highest for women aged between 20 and 24 at 32 per 1,000 resident women.

The abortion rate for women aged under 16 was 3.7.

84 per cent of abortions were funded by the NHS. 52 per cent of these took place in independent clinics under an NHS contract.

89 per cent of abortions were carried out at under 13 weeks gestation.

7,900 abortions were carried out in England and Wales for non-resident women.

(Source: Department of Health Abortion Statistics, England and Wales: 2005)


Quotes

"The decision to continue with a pregnancy is one of the biggest and most life-changing decisions a woman will ever make. This is why we believe that all women should have the right to choose for themselves."

Marie Stopes International, 2003

"It was quite clear in the 1990 parliamentary debate on amending the Abortion Act that the clause on late abortion must not be used for such trivial things as a cleft palate."

Richard Nicholson, Editor of the Bulletin of Medical Ethics 2003

"An abortion may be approved providing two doctors agree in good faith that one or more of the following criteria apply:
A. The continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated;
B. The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman;
C. The continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman;
D. The continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing child(ren) of the family of the pregnant woman;
E. There is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped; or in an emergency, certified by the operating practitioner, as immediately necessary:
F. To save the life of the pregnant woman; or
G. To prevent grave permanent injury to the physical or mental health of the pregnant woman.
In relation to grounds C and D the doctor may take account of the pregnant woman's actual or reasonably foreseeable environment, including her social and economic circumstances."

Guidance issued by British Pregnancy Advisory Service, 2003

"Abortion is a complex issue, one that no woman takes lightly. We must continue to ensure that women and their needs always remain at the centre of the abortion debate. Forty years since abortion was legalised it's time to move forward for women - not back."

Anne Quesney, Abortion Rights director, commenting on science and technology's November 2007 report on 1967 Abortion Act

"The 1967 Act was intended to solve the problem of illegal abortion, on the basis that it was a major cause of death in pregnant women. Yet our countries now perform nearly 200,000 abortions every year. We have one of the most liberal abortion laws in Europe with abortion up to 24 weeks and abortion in the case of disability (and on some other grounds) up to birth. Whatever our religious creed or political conviction, abortion on this scale can only be a source of distress and profound anguish for us all."

Cardinal Keith O'Brien and Cardinal Cormac Murphy-O'Connor, heads of the Catholic church in Scotland and England and Wales respectively, in an October 2007 open letter