Outright opposition to all abortion is today a minority view. Most condemnation of, or debate about abortion, now focuses not on the issue of abortion per se but on specific types of abortion, or on the reasons women give for wanting an abortion that are regarded as particularly problematic.

Here we examine why opposition to all abortion has become an outlook held by few people.

We then discuss examples where abortion remains controversial, and put forward arguments in support of a woman's right to choose in even these instances.

Finally we consider, and refute, the case made mainly by opponents of abortion, that abortion constitutes a risk to women's health.

Key points:

On the place of abortion in British society today....

·         For many women, abortion currently acts as an essential back-up to contraception, necessary to enable them to regulate their fertility and plan their families. Since individuals are expected to plan their families, abortion is now considered by most sections of society as a 'fact of life'. In early pregnancy at least, abortion is viewed by most as preferable to unwanted childbirth. 

·         In this context, it is inappropriate for abortion to be considered as a problem - rather it is a solution to a problem.

The most contentious areas of discussion are:

Abortion at later gestations of pregnancy

Abortion on grounds of fetal abnormality

There are also concerns raised about the health risks of abortion

On 'late' abortion....

·         While most people have no difficulty accepting the legality of abortion at early stages of pregnancy, fewer are so sure about their position as pregnancy progresses – especially when the fetus is perceived to be ‘viable’. In the UK Parliament, the most frequent kind of measure proposed to reform abortion law has been to reduce the legal time limit.

·         It is incorrect to assume that the need for late abortion could be removed by expanding access to early abortion. Most abortions in the second trimester take place for reasons that could not have been anticipated earlier in the pregnancy.

·         In practice the law plays little role in preventing late abortions. There are few requests for abortion in the later stages of pregnancy because women do not request them and doctors are not prepared to perform them.

On abortion for fetal abnormality....

·         In 1967, when abortion was made legal in the UK, fetal abnormality was construed a 'good' reason for abortion. Today the opposite seems the case. This kind of abortion is now considered at best ethically difficult, at worst a manifestation of anti-disability views.

·         Abortion for abnormality does not encourage discrimination against disabled people. It is possible to make a judgement or express an attitude towards a particular condition, without in any way imputing an attitude towards the value of people who suffer from that condition.

·         A woman who opts for this kind of abortion is not making a social or political statement about the abnormality, or about born people with that disability. She is making a statement about herself; what she feels she can cope with and what she wants.

On the 'health risks' of abortion....

·         The recent Royal College of Obstetricians and Gynaecologists guideline, The Care of Women Requesting Induced Abortion (1), provides evidence based on systematic literature reviews that abortion cannot be considered a serious risk to women's physical or mental health.

·         Claims by opponents of abortion that abortion leads to breast cancer, future infertility, or mental ill-health can be understood as a political strategy, not an objective evaluation of the likely effects of abortion for a woman's health.

For basic facts and statistics on abortion, refer to the British Pregnancy Advisory Service www.bpas.org

Further comment about the issues discussed in this paper can be found on the following sites:

www.prochoiceforum.org.uk (research papers and comment)

www.bpas.org (facts/statistics and comment)

www.statistics.gov.uk (key tables)

www.rcog.org.uk (policy and research papers)

These days, abortion has an accepted place in fertility regulation. It is a method of family planning, in the sense that women use abortion to control whether or when they have children.

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.

But the evidence shows that women cannot manage their fertility by means of contraception alone. Contraception fails, and couples sometimes fail to use it effectively (2). A recent survey of more than 2,000 women requesting abortion at clinics run by BPAS, Britain's largest specialist abortion provider, found that almost 60 per cent claimed to have been using contraception at the time they became pregnant, and nearly 20 per cent said they were on the pill. Other studies have shown similar results (3).

The number of women who claim they experienced a split or slipped condom, or missed just a couple of pills, is undoubtedly inflated. Unprotected sex is stigmatised and some women requesting abortion may falsely claim to have used contraception, believing that they will be treated more sympathetically if the pregnancy is ‘not their fault’. But even so, it is clear that contraceptives let couples down.

All methods of contraception have a recognised failure rate (4). Whether the pregnancy occurred because the condom split or because the couple failed to get it out of the packet is not very important. The simple truth is that the tens of thousands of women who seek abortion each year are not ignorant of contraception – most have tried to use it and, indeed, may have used it and become pregnant regardless.

Women’s need for abortion is implicitly understood by policy makers and legislators. This is why abortion is provided at NHS hospitals throughout the country. Most societies hold that women should expect, and be expected, to make a broader contribution to society than bearing and caring for the next generation. Motherhood is still regarded as ‘natural’ at some time in a woman’s life, but most people assume that motherhood will be an interval sandwiched on both sides by an income-generating ‘job’ if not a ‘career’. Girls from appropriate (middle class) backgrounds are expected to progress to a university education.

Society currently places a high premium on ‘planned parenthood’. The belief prevails that children should be wanted, that parents should be able to support them, and be willing to make sacrifices for them. Growing social concern about ‘unfit’ or ‘problem’ parents does not easily co-exist with a disposition to force people to bear children they do not want and by their own admission cannot care for. This ethos creates a framework whereby abortion can in some circumstances be perceived as a ‘responsible choice’ even by social conservatives who would disapprove of abortion in principle.

Surveys of public opinion suggest widespread tolerance of legal abortion. A national opinion poll carried out three years ago by the UK’s main polling agency MORI found that 64 per cent of those asked agreed that: abortion should be legally available to all who want it. 25 per cent disagreed. The remainder neither agreed nor disagreed or said they did not know. The proportion of those who agreed had increased by 10 per cent since 1980 (5). Birth Control Trust, for whom the poll was commissioned, suggested that this demonstrated a growing acceptance of legal abortion and a widespread belief that belief that the law should not be used to prevent women ending pregnancies.

Women today are at particular risk of unplanned pregnancy. Sex is an accepted part of an adult relationship for which we do not expect to suffer unwanted consequences. Pregnancy is seen by an increasing number of women as an unwanted consequence that they are not prepared to adapt to. The fact that more women are delaying starting a family until they are in their thirties, that many are deciding to opt out of parenthood altogether, suggests increased numbers of sexually active women who do not want a child. Is it any wonder then that the number of abortions remains high?

A relatively high abortion rate is not necessarily a sign of the failure of sex education and family planning programmes. It may be a symptom of a society where women wish to combine a sex life with ambition. Of course it is preferable for unwanted pregnancies to be prevented rather than ended. Abortion is safe, but contraception is safer and more convenient. Nevertheless, today abortion is an essential method of family planning and should be accepted it as such.