Abortion: how late is ‘too late’?

At the Battle of Ideas festival in London at the end of October, Ann Furedi, chief executive of the British Pregnancy Advisory Service, debated the issue of late abortion with Will Saletan, a writer for Slate magazine. A transcript of Furedi’s opening comments is published below.

I think the reason we are having this debate is because there has been a strong argument put forward, particularly in the US, that support for later abortions is a problem. Apparently it is undermining public support for early abortions, and therefore it is becoming a burden and a barrier for the pro-choice movement. I think Will [Saletan] gave an indication of this in his final remarks, where he was kind of making the point that, well, abortion’s okay – just about – but if women are going to do it then they have a responsibility to make sure they do it earlier.

I think this raises some important questions. Because where Will is absolutely right is that public opinion on late abortion is very shaky. It is something that all of us who are involved in abortion care and abortion advocacy find quite difficult, because people look at pictures of the developed fetus and they perceive it as something fundamentally different to a very early embryo. And it is different, in some ways. It looks different; it looks like a baby, and for that reason it can provoke a more visceral response in people than early abortion does. Early abortion is looked upon by many as being more like inducing a period a bit late.

Also, there is a strong understanding in British public opinion that planning parenthood is a good thing and that sometimes contraception fails, and therefore women do need some access to abortion. But because abortion can be done early on, some believe there’s no excuse for women who, as Will indicated, are delaying because they’re having difficulty making up their mind. So I think we can all see that there is a problem when it comes to the debate about late abortion.

What we have to ask ourselves is whether there needs to be any policy intervention or social intervention to change or regulate what is going on at the moment. And I don’t think there does. There is no evidence to suggest that we need to restrict later abortions in any way, by enforcing legal time limits. And I certainly don’t see any reason to think that doctors are abusing the current situation, or indeed that women are abusing the current situation.

It is interesting that on a sentimental level, on an emotional level, women’s attitudes towards their pregnancy changes as the pregnancy progresses. There are many women who say they would have an early abortion but they wouldn’t have a late abortion. The number of women who request late abortions is very small. The number of late abortions that doctors carry out is very small. So consequently, I don’t get any sense that people have a coarsened view or an irrelevant view to the developing life in the womb.

Therefore, what we need to look at is whether there is a moral or a social reason why we should seek to restrict the number of late abortions. Is late abortion having some other impact, other than that on the individual women, which means we should make changes to the present law? I think this is where Will and I profoundly disagree.

I am very pleased that Will passed around a handout, which identifies the developments that take place during gestation, each week. Because for Will, what this does is indicate that there are firm points at which things morally and practically change in the abortion debate. But for me, what this does is actually illustrate my argument that there isn’t any profound point at which you can say there is a difference between one kind of fetus and another.

I accept that abortion stops a beating heart and I accept that abortion ends a potential human life, even in the very earliest weeks of pregnancy. So if we think it’s a morally wrong or morally coarsening thing to do, then I think we should oppose abortion right from the very earliest weeks. If we don’t think that, then we have to ask ourselves, very clearly, who decides when late is too late? Who has the capacity to make that decision, and who has the right to intervene in this area of women’s lives? Because late abortion is a very shaded thing, and it is determined very much by people’s circumstances.

This is a decision that must be taken by the people who are most involved – not by policymakers, not by journalists and not even by people like me, who run services. Women make decisions about abortion in the context of their own lives, and there are some women who would feel that 11 weeks is too late for them, or that 10 weeks is too late for them, because of their personal circumstances. There are other women who, faced with the decision quite late in their pregnancy, will feel that they can no longer bear to carry a child to term.

I would really question why, if there is no objective reason, no objective sudden value change, we need to intervene and create a point at which we apparently have the right to override a woman’s own subjective decision-making process. Because actually, any definition of late abortion is arbitrary and subjective.

The only time at which I am prepared to say that there is a difference in terms of the fetus is at the point of viability at 24 weeks. Because I think then we can say there is something which, in public opinion, represents a visceral stepping over the line. But my only reason for saying this is to do with public policy and what would be publicly acceptable – it is not that I personally think there is a particular difference at 24 weeks.

Does late abortion have a detrimental effect on society? No, I really don’t think it does. There is no evidence that the number of women requesting late abortions is increasing. The figures remain very much the same. However, does the idea that we can override who makes these decisions about late abortion have a detrimental effect on society? Yes, I really believe it does. Because what we’re really saying when we argue that an earlier time limit needs to be imposed is that we don’t trust women’s decisions, and we don’t trust doctor’s decisions.

What struck me about the 32 women who, in the space of a month, came to my organisation to request a late abortion, was that each of them had a compelling reason in their own way. And the idea of compelling those women to continue a pregnancy felt really beyond the pale. Because I think we have to remember that that is the alternative: when we turn around and say to a woman who is requesting an abortion at 20 weeks that she should have requested it earlier, we are still basically saying that we get to decide whether or not to deny her an abortion.

We should trust women to make decisions, because they will look at themselves in the mirror every day for the rest of their lives knowing the decision that they have made. We should trust doctors to make decisions about what they think is safe and acceptable. And as far as possible, we should keep policymakers away from it, and we should try and inform public opinion rather than be swayed by what I think is often ill-informed public opinion.

Ann Furedi is chief executive of BPAS, the British Pregnancy Advisory Service. The above is an edited transcript of a speech at the Battle of Ideas.