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Don't
mention the A-Word?
By Ellie Lee
24/01/01
The comment by the shadow
Health Secretary, Liam Fox, that abortion should be an election
issue, and that there should be 'a huge restriction, if not
abolition' of the current law, has caused some consternation
for those a Tory Party Central Office. As Andrew Lansley,
Shadow Cabinet Office Minister, explained on the Today Programme
this morning, the last thing politicians want is for abortion
to become a focus for debate in the General Election.
As far as the Tory Party goes, nothing could be more true.
The prospect of the pro-life brigade being given the green
light to bang on about the need for bans on abortion, the
right to life of the unborn child, and to subject us all to
looking at pictures of developing fetuses, or even worse,
aborted ones, must send a chill down Conservative strategists'
spines. One look at American politics, and the consequences
become clear. The emergence of divisions in the party, as
there are in Republican ranks, and the branding of the Tories
as 'fundamentalist extremists', through their association
with the moral absolutism of the anti-choice lobby, is their
worst nightmare. If there is anything the Tories just don't
need, it's splits and accusations of extremism.
It is also true to say that there is no demand coming from
the public for abortion law reform, of even for a public debate
about the subject. Unlike the issue of fox-hunting, where
animal rights activists and blood sports defenders clash,
there are no sizeable lobbies currently active on the abortion
issue. The issue is truly depoliticised in Britain, and has
become considered by practitioners and in the public mind
as a medical matter, rather than a political one, best decided
on by the woman concerned and her doctor (1). Does this mean,
however, that there is no place for discussion of abortion
in relation to the election? This conclusion is not necessarily
the right one to draw.
One of the most irritating aspects of the discussion of abortion
at election times (this was the case in 1997 too) is the fact
that if it is raised at all, it is raised by those who want
to restrict access to abortion, rather than those who support
its availability.
The vast majority of current Labour MPs profess to support
access to abortion, and most argue privately that it should
be up to the pregnant woman to decide whether she wants to
bear and rear a child. Yet the notion that law and policy
should reflect this view is something they refuse to argue
in public. They are scared of the 'A' - word - but there is
no reason to be.
For the vast majority of people in Britain today, abortion
is accepted as a fact of life. There are around 180 000 abortions
carried out in Britain each year, and a quarter of all women
will have at least one abortion. As Ann Furedi, director of
communications for BPAS, has pointed out, 'Women may not intend
to rely on abortion as a means of family planning, but in
reality that is often the way it works out. Women today expect
to have control over their fertility and are expected to control
their fertility. The need for 'family planning' is almost
universally accepted even among the most conservative thinkers'
(2).
Today, in reality, abortion is no longer the stigmatised procedure
it once was. Rather, it has become accepted by most people
as an essential back-up to contraception. While, of course,
everyone would prefer it be the case that couples could regulate
their fertility through contraception alone, in practise it
is not the case that all can. A recent survey at BPAS found
that more than 60 per cent of women claimed to have been using
contraception when they became pregnant. Whilst this figure
may be inflated, since many women may feel uncomfortable admitted
they did not use contraception, it is simply a fact that contraception
often fails, and people fail to use it correctly or at all.
Pills are missed, or taken at the wrong time of day, condoms
split or are used wrongly. After a couple of glasses of wine,
and the onset of passionate feelings, inserting a cap may
go to the wall. This is the reality, and, unless we decide
that we want recreational sex to lead to the 'punishment'
of bearing a child, in the event of contraceptive failure,
then abortion is needed. The vast majority of health-care
professionals understand this (which is why the Royal College
of Obstetricians and Gynaecologists designated abortion a
health care need for women in their latest guideline on abortion
(3)).
Most policy makers also accept the need for abortion, because
it matches with, rather than contradicts, the overall current
direction of social policy. In policy, at the present time,
a high premium is placed on 'good parenting'. Policy is based
on the notion that children should be wanted, and well-cared
for and looked after by their parents. In this respect, the
prospect of the birth of thousands of unwanted children, which
would be the practical outcome of restrictive abortion law,
does not fit easily with current policy imperatives.
So if this is the case, why not make it clear that abortion
law and policy should make it easy for women to access abortion?
The notion that the law and policy arrangements should attempt
to place barriers in the way of women, who want to end unwanted
pregnancy being able to do so, is just nonsensical. Yet, formally
at least, this is the situation we have.
Whilst in practice, it has become ever easier for women to
get abortions, at least in the first three months of pregnancy,
the law still rests on the idea that it should not be so.
The current law was not designed (as anti-choice campaigners
never tire of pointing out) to lead to 'abortion on request'.
In fact, far from it. Its aim was to create a system of vetting,
where doctors assess women's case for abortion and decide
which women are 'deserving' cases, and which are not. Hence
the law demands that two doctors agree 'in good faith' that
women meet one of the four grounds specified in the Act, if
they are to have an abortion.
There is now, however, a substantial gap between the formal
terms of the law, and what currently happens in practice.
In reality, most doctors, rightly, judge it to be the case
that women who say they do not want to take a pregnancy to
term, and bear a child, should not be compelled to do so.
Hence, many now interpret the Act liberally, and concede to
women's requests for abortion, whatever their reason. This
is just how it should be, and, if we are to have a law at
all, we should have one that matches with current, very sensible
practise, not the anachronistic legislation we have at the
present time.
Policy should also aim to meet with women's abortion needs.
It would be simply unacceptable to people to have access to
maternity care in hospitals rationed: you can have medical
care and a bed if you fit out health authority criteria, but
not if you don't. Yet this is what happens with abortion.
In some local health authorities, women can get an abortion,
in others they cannot, and have to pay a charitable service
to get the operation they need. Abortion should, in contrast
to this practice, be treated as a central aspect of women's
healthcare needs, be properly funded, and should no more be
subject to rationing criteria than smear tests or maternity
care.
Given the gap that exists between current law and policy,
and a sensible approach to the regulation and provision of
abortion services, there is a strong case for abortion to
be a election issue, but from a pro-choice perspective. There
is no need to imagine that this means single issue politics.
Rather, New Labour, which after all does profess to stand
for women's needs, should simply make reform of abortion law,
and commitments to equalise access to abortion part of it
health policy agenda.
I have no doubt that it is more likely to rain frogs than
for New Labour to commit to abortion provision in this way.
But nevertheless it remains the case that abortion is not
an embarrassment or a problem - it is a solution to a problem
- and politicians should learn to not be so spineless, and
speak of it as such.
(1) For a detailed account
of the 'medicalisation' of abortion, see Sheldon, S. Beyond
Control, Medical Power and Abortion Law, Pluto Press 1997.
(2) Ann Furedi, 'Abortion is not a problem' www.prochoiceforum.org.uk,
www.bpas.org
(3) RCOG, The Care of Women Requesting Abortion. Summary
available at www.prochoiceforum.org.uk and copies can be
ordered from the RCOG bookshop, 27 Sussex Place, Regent's
Park, London NW1 4RG or via their website www.rcog.org.uk
The Liam Fox story was reported in: The Mirror, 24.01/01,
'Tories declare abortions war' PA News, 24/01/01, 'Senior
Tory Calls for Curb on Abortion' The Telegraph, 24.01/01,
'Pray for abolition of abortion, Fox tells
Christians'
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