spiked proposals: Abortion
Politicians who say they are pro-choice on abortion should argue that abortion is a fact of life, and for the reform of abortion law. Women should have access to abortion as early as possible and as late as necessary.
Political leaders committed to ‘women’s issues’ should:
- Make abortion part of political discussion
In the run up to the last election UK prime minister Tony Blair said that he would ‘do everything in [his] power to keep abortion out of politics’. Four years on, there are still significant changes that need to be made to existing law and policy. In order to make these changes, the provision of abortion, like other services women need if their lives are to be improved, should be discussed as part of politics. It is anomalous that at a time when ‘women’s issues’ are supposed to be central to politics, abortion is still exempted from political debate.
While contraception is now openly promoted as morally and socially acceptable, abortion is not. It is often portrayed as ‘responsible’ to avoid unwanted pregnancy through contraception, but problematic to seek an abortion where contraception fails or couples fail to use it.
Policy makers should recognise that, for women faced with unwanted pregnancy, abortion is not a problem, but a solution to a problem they face in their lives – and that it is as responsible to end that pregnancy as it is to continue it.
Policy makers should also promote the truth about why unplanned pregnancy happens. Contraceptive failure and even non-use is not a sign of irresponsibility, fecklessness or foolishness (1).
Money spent on public education about the causes of unwanted pregnancy, which aims to contextualise and explain truthfully why women have abortions, would be money well spent.
An abortion can still only be legally performed if two doctors agree that the woman has reasons for needing an abortion that meet one of the four criteria specified in the 1967 Abortion Act. This turns doctors into gatekeepers, responsible for ensuring the woman’s reason for abortion is a ‘good’ reason. This system benefits neither doctors nor women.
This 1967 Act was passed at a time when recreational sex was still taboo, when university education and career aspirations for women were the exception rather than the rule, and when women were still expected to sacrifice all for motherhood. Those who reformed the law in the UK parliament viewed the kind of woman who would need an abortion as a ‘distracted multi-child mother, often the wife of a drunken husband’ (2): a worn-down victim, who could not cope with bearing another child.
The context today is very different. Around one quarter of all British women will have an abortion. It represents a backup to failed contraception, necessary if women (and men) are to be able to enjoy recreational sex, and if women are to pursue careers and plan their families. Most people accept the need for abortion. For the majority of the general public, for the medical profession and for those involved in abortion care, it is a fact of life.
The principle of patient self-determination now has central importance in British medical law. A great deal of importance is placed upon the right of an individual to make decisions about their treatment (3). Even where the decision made might appear irrational or morally objectionable to others, as along as the patient understands what they are doing, their wishes come first. This approach should also apply to abortion.
In practice this would mean that as long as the doctor was confident that the woman concerned had consented to the abortion taking place (as the law demands of any medical procedure), then the abortion can go ahead. This should apply regardless of the gestation of the pregnancy.
From the point of view of women’s abortion needs, abortion must be provided as early as possible and as late as necessary.
Just as the legal framework on abortion suffers from being out of touch, so do policy guidelines. For example, guidelines issued in 1977 by the then Department of Health and Social Security advocate that a woman be counselled before her abortion about her decision ‘to ensure that [she] has had the full opportunity to make a reasoned assessment of her own wishes and circumstances’. Underlying this policy is the notion that women will find the decision to have an abortion sufficiently upsetting and difficult that they need special help from a counsellor.
Yet research indicates that many women find the assumption that they need counselling in order to make a ‘reasoned assessment’ of their wishes patronising or confusing. This approach is not taken if women decide to continue pregnancies to term, so why is it where they decide to end them? (4)
When abortion is more socially accepted than in the past, and where women largely find support and somebody to talk to about their decision from within their personal circle of family and friends, the policy imperative that women should be counselled is unnecessary and unhelpful. There does not need to a be specific policy that dictates what is psychologically best for women when they go through the process of choosing abortion.
Policy makers should take into account that most women who have abortion are adult enough to find ways for themselves of managing their feelings, and that service providers can be trusted to provide extra support for those women who make it clear they want it.
Ellie Lee is coordinator of the Pro-Choice Forum, and a research fellow in the Department of Sociology and Social Policy at the University of Southampton. She is the author of Abortion, Motherhood, and Mental Health: Medicalising Reproduction in the United States and Great Britain, Walter de Gruyter, 2004 (buy this book from Amazon (UK) or Amazon (USA)). She is also the editor of Abortion: Whose Right?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)); Designer Babies: Where Should We Draw the Line?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)); and Abortion Law and Politics Today, Palgrave Macmillan, 1998 (buy this book from Amazon (UK) or Amazon (USA)).
Give them enough rope, by Ann Furedi
Don’t mention the A-word, by Dr Ellie Lee
Defending abortion – in law and practice, a spiked-paper by Ann Furedi and Dr Ellie Lee
(1) Abortion is a fact of life, by Ann Furedi and Dr Ellie Lee
(2) Beyond Control, Medical Power and Abortion Law, Sally Sheldon, Pluto Press, 1997
(3) ‘Abortion, Autonomy and Prenatal Diagnosis’, Emily Jackson Social and Legal Studies (2000) Vol. 9 (4) 467-94
(4) Abortion, Between Freedom and Necessity, Janet Hadley, Virago, 1997
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