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Opinion, Comment & Reviews
Abortion law
  Don't mention the A-Word?
By Ellie Lee

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

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