Abortion: get out the vote

The UK Human Fertilisation and Embryology Bill is currently being debated in parliament. On Tuesday next week, a series of amendments will be tabled with the aim of reducing the current abortion time limit from 24 weeks gestation to 22, 20 or even 13 weeks. Spearheading part of this campaign is Nadine Dorries, former nurse and current Conservative member of parliament for Mid-Bedfordshire (1). Her campaign has the tag line ‘20 reasons for 20 weeks’ and has received supportive coverage from the Daily Mail as well as a deserved lampooning from others (2).

The essential truth is that no good reason exists for reducing the time limit from 24 weeks, and there are lots of good reasons for getting rid of the time limit altogether. Of the 20 reasons Dorries presents, only two make any kind of sense: the possibility for survival if born before 24 weeks and the possibility of the fetus feeling pain during a late abortion. Both of these reasons are factually incorrect and irrelevant to the debate.

A major study published in the British Medical Journal this week reports that survival before 24 weeks has not improved during the past 10 years (3). Babies born before 23 weeks do not survive and those born at 23 weeks have about a 1 in 5 chance of survival. Such premature babies very rarely survive because, amongst a host of other problems, their lungs cannot take in oxygen and their brains are simply too immature. Even for those babies that do survive, serious complications and disability remain very likely.

I have written elsewhere about the misguided notion of fetal pain (4). Before 24 weeks, the fetus is not mature enough to support an experience of pain. Opponents of this view argue that brain regions generally considered necessary for survival are actually necessary and sufficient for thoughts and feelings. They dismiss about two-thirds of the brain as unimportant to the experience of pain.

Alternatively they argue that temporary brain structures, which appear in the fetal brain to support maturation, actually appear to support pain. Suggesting that structures appear in the fetal brain to provide the fetus with pain and then disappear before birth is quite peculiar. What possible reason could there be for the fetus to experience pain while buffeted inside the womb? The fetus cannot hide or run and so pain will merely use resources to no good effect. Before and after 24 weeks, the womb is a good place to sleep and grow but anything more is likely to be detrimental. Birth provides the moment for a true psychological life, including feelings and thoughts, to begin.

Viability and pain, however, are irrelevant to the debate about abortion. Whether a baby can survive after birth doesn’t really matter because we all know that babies can readily survive if the pregnancy is allowed to progress. Someone seeking an abortion does not want the pregnancy to continue to a live birth, which is the point of an abortion. Similarly, it is not impossible that the fetus might experience some kind of primitive sentience after a certain developmental point in the womb, but the woman seeking an abortion is more than primitive sentience. Her very real, very definite experience takes precedence over any potential the fetus might have. If the potential for fetal pain is a concern then a fetal anaesthetic might be included in the termination procedure.

Abortion is not about the fetus or the potential for babies to survive prematurely; it is about women making decisions about how to lead and control their lives. Restricting abortion to a 20 weeks’ time limit means witholding from women who discover a late abnormality the option for a legal abortion. It means forcing a woman who has just lost her job, or partner, or both, to face further hardship for herself and her other children. It means denying women the option to continue their lives on the same trajectory when, for whatever reason, they discover that they are pregnant late in the second trimester. It means increasing the social problem of involuntary parenthood and undermining the rights of women to decide about their lives and futures.

There is no reason for the abortion limit to come down and opposition to a lower limit is widespread. Any lowering of the time limit is opposed by the British Medical Association, the Royal College of Obstetricians and Gynaecologists, the British Association of Perinatal Medicine, the Royal College of Nursing, the Department of Health, the Commons Science and Technology Committee, and MPs from all three main parties. But the possibility of the limit being lowered is real because the vote on Tuesday is a free vote and MPs might decide it is not important enough to be there. One way to make it important is to write, call or visit your MP. You can find out who your MP is by using the Up My Street website and you can find model letters here at Abortion Rights.

Of course, if your local MP is Nadine Dorries, then you might better spend your time ensuring you are eligible to vote in the next General Election.

Stuart Derbyshire is senior lecturer in psychology at the University of Birmingham, England.

(1) Nadine Dorries MP

(2) As a young nurse, Nadine witnessed the horror of late abortions. Now an MP, she says the law MUST be changed, Daily Mail, 6 March 2008; Fact, fiction and foetuses, Guardian, 7 May 2008

(3) Survival of extremely premature babies in a geographically defined population: prospective cohort study of 1994-9 compared with 2000-5, BMJ, 9 May 2008

(4) Can fetuses feel pain?, BMJ, 2006; 332(7546): 909-12