Tory health spokesman Liam Fox caused a storm in January 2001 by saying he wanted to see abortion banned. He backed off in an instant, admitted it was unrealistic, and instead declared a commitment to reducing the time limit governing at what stage of pregnancy a woman can have an abortion.

For those of us committed to women's reproductive choice, this concession is in some ways more worrying. The chance of a ban on abortion in the foreseeable future is non-existent. But restrictions on late abortions may well come.

A tiny proportion of people oppose abortion in all circumstances. Early abortion is accepted as a reasonable way to manage an unplanned pregnancy, especially when people consider the alternative - forcing a woman to have a child she doesn't want. But people feel much less comfortable about late abortion.

A fetus at 20 weeks is no more 'alive' than a fetus at eight weeks,- but most people find it harder to accept the ending of a life that so closely resembles a newborn baby. The UK Independent newspaper recently reported that many MPs and medical experts are pressing for a reduction in the time limit to as low as 18 weeks, 'because advances in medical science make it possible for younger fetuses to survive' (1).

In practice, however, it is not the law that keeps the number of late abortions low. Less than two percent of abortions are performed at, or after, 20 weeks. Women do not often request late abortions and fewer doctors are prepared to perform them. In the UK National Health Service, it is rare for hospitals to provide abortions after 14 weeks, unless there is evidence of fetal abnormality.

Even those with a relatively liberal attitude to abortion often question the acceptability of post-20-week procedures. In 2000, influential columnist and science writer Greg Easterbrook unsettled both pro- and anti-choice lobbies in the USA with an article in The New Republic, which argued that scientific advances make the case for liberalising early abortion and restricting late abortion.

Easterbrook argues that the case for liberal provision of early abortion is strengthened by evidence that the natural termination of potential life by spontaneous miscarriage is far more common than was previously assumed. But he also claims that discoveries about the brain activity of the more developed fetus stand as an argument against late abortion, and should lead to a reduction in the time limit.

This is not an argument that we should accept. We need a robust defence of women's access to late abortion in law and in practice - not some kind of trade-off.

Women do not request late abortions because they are ignorant of fetal development. Science may now be able to tell us more than ever before about the fetus, and there is clearly much more to learn. But it is often irrelevant to abortion decisions.

Scientists may need hi-tech developments in fetal monitoring to convince them that the fetus is 'a complex responsive organism that reacts to its intrauterine environment'. The experience of fetal movement has been telling women that for as long as they have been experiencing pregnancy. Nor, in these modern times, are women ignorant of the fact that a developed fetus looks like a small baby.

The few women who request late abortions do so because their specific circumstances lead them to believe that it is better if their pregnancy does not result in a child. Changed knowledge about the fetus does nothing to change these circumstances.

If you talk to nurses, doctors, counsellors - anybody involved in abortion care - they will tell you that there is always a story behind a woman's request for a late abortion. I asked a number of staff at the British Pregnancy Advisory Service about women they had recently seen, and was told about the woman who presented at 22 weeks because she had been 'saving up' for an abortion. She eventually realised she was not going to get the cash unless she borrowed it from her sister.

Then there was the woman who came too late to be helped (she was 25 weeks pregnant). Her pregnancy had been wanted until her husband left her; and she had put off the decision to have an abortion, week after week, in the hope that he was coming back.

A surprising number of women do not realise they are pregnant. If you are on the pill you do not expect to be pregnant, and you will probably still have a period-like bleed in your pill-free week. Teenagers put off telling mum and hope the problem will just 'go away'. And many women simply find it too hard to make up their minds whether or not to have the child.

The decision to end a pregnancy once you are visibly pregnant and can feel the fetus moving is difficult enough, without politicians trying to make political capital out of these women's circumstances. For a pregnant woman a late abortion is not just an abstract moral issue, but a decision that will be with her for the rest of her life.

A politician walks away from a vote, but a woman cannot walk away from a problem pregnancy.

(1) Independent 5 February 2001

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