During my first degree course, I studied medical ethics in the Law Department at King’s College in London. At the time, one could describe me as somewhat idealistic. I was firmly in what was described then as the ‘Rights-Based’ group. To me, a woman’s right to choose was paramount. Later on, as part of my medical training at St. Mary’s Hospital in London, I opted to attend a TOP (Termination of Pregnancy) list. I say opted as it was not a requirement of the medical course. I did so because I felt it was appropriate to see first-hand the realities of the abortion service. Appropriate because in the future it was to be my signature on the ‘blue form’ referring my ‘patient’ for an abortion. Not only did I closely observe the actual procedures, I also watched the staff. I asked questions of them throughout. I did not attend a further list after that.
Most GP’s undertake a six-month Obstetrics & Gynaecology attachment as part of their post-graduate training. I chose not to take part in the abortion service provided by the District General hospital I worked at. I did this because of both my previous experience at St. Mary’s, and further contemplation of my own moral framework within which I worked as a doctor. I now work as a GP and do not sign the forms required for abortion. I do, however, see it as my professional responsibility to inform my patients immediately of where they can seek an abortion. I recognise the implicit moral inconsistencies of that approach.
I have outlined the above so as to give some sense of how I have arrived at my view on abortion and its provision.
Today, Nadine Dorries is introducing a Ten Minute Rule Bill in which a reduction in the legal limit of abortion from 24 weeks gestation to 21 weeks is proposed. Fortunately, in this country such questions of conscience are left to each individual MP to make a decision. I would not want abortion, or indeed any other moral dilemma, to become a political issue. Hence, it is the responsibility of politicians to legislate sensitively on these issues.
There are approximately 200,000 abortions each year in this country. Relatively few of these occur after 20 weeks gestation. The majority occur before 12 weeks. Since the introduction of the abortion service in 1967, there have been annual increases in its rates year on year. Contrary to popular belief, the majority of women involved are not teenage girls on sink estates. Over 50% of abortions are to women over 24 years old. They are often women who have either already had children or feel that it is not the right time for them to be starting a family. I have professionally encountered a number of cases of women having abortions between pregnancies they choose to continue. Another statistic that I encountered in my training was the ‘repeat factor’, that is the number of women having more than one abortion. To my knowledge, this figure is also increasing. This is a worrying development, as it suggests an ‘acceptance’ of abortion as a form of contraception. Clearly, we are now have ‘abortion-on-demand’ in this country. To suggest otherwise would be disingenuous.
How does the country feel about this?
I still believe that the majority feel that an abortion service is necessary. We can all think of appalling situations where for the woman (or girl) to be forced to carry the baby to term would be wrong. If I had a teenage daughter and she had been raped I would not want her to continue that pregnancy. For this reason, in this context I do not believe in a moral absolute. In saying all this, however, it does not mean I agree with the way in which abortion is provided in this country.
With further inprovements in reproductive and neonatal techniques, babies are living from earlier gestations. This throws up problems of determining viability. I am fully aware of the morally inconsistency of choosing a time limit for abortion. How can a baby have a different moral value depending upon the decade in which it was conceived? This is where the strength of the ‘Pro-Life’ argument resonates most. By drawing the line at conception, they have a position that is defensible through the ages. Those of us wrestling with our own morals within the imperfect world in which we live are less fortunate. I wish abortion was not necessary, but as I have outlined above, for me to support that position would require at least a world without rapists and paedophiles. That, rather sadly, is not going to happen anytime soon. What I do believe, however, is that one measure of our society is the way in which we value life. Consequently, to have increasing abortion rates does not reflect well on our society. Change is needed.
What are we then to do? What would be acceptable in Britain today?
Ms Dorries’ Bill is a step in the right direction. She has presented it in terms of viability and highlighted the recent advances in 3D imagery made by Professor Campbell at UCH in London. Personally, I would lower the limit further, perhaps even to twelve weeks. Three months should be enough time for any woman to come to a decision. Exceptions could be made where rare congenital malformations present late, however determining the degree of malformation needed to warrant termination would be a difficult area to supervise.
If I was an MP I would be voting to support the Bill. In order to take the issue further and successfully reduce abortion rates in this country we are left with education and social stigma. Evidence of education’s effectiveness is thin on the ground and social stigmatisation is not an area politicians should get into. I suspect this is a problem society and government will have to re-visit every decade.