In the pro-choice movement, it is fairly common to be told that we are promoting murder, eugenics, racism and social ills of all kinds. In some ways it’s easy to dismiss this kind of accusation: most reasonable people, in the UK at least, broadly support a woman’s right to choose abortion and are able to distinguish between extremist viewpoints and rational debate on the subject.
That’s why the abortion-related amendments to the Health and Social Care bill recently tabled by Nadine Dorries and Frank Field are more problematic – because superficially they sound reasonable.
The amendments propose that women seeking abortion should receive counselling from an organisation that does not itself provide terminations, and that the body charged with drawing up clinical guidelines for abortion care should not itself be linked to abortion-providers. Counselling for women with unplanned pregnancy? Good idea. Unbiased clinical guidelines? Of course.
Anti-choice campaigners aren’t stupid. They know from the experience of their American counterparts that hardline anti-abortion measures couched in moderate language have greater resonance with the public. Later term abortion in the US? Re-christened ‘partial-birth abortion’ and promptly banned.
So Nadine Dorries tells us she is neither pro-choice nor ‘pro-life’ but simply ‘pro-woman’. Her campaign around these amendments is called Right to Know. Women have a right to know the ‘real risks’, both physical and mental, associated with abortion which, it is claimed, are currently being deliberately withheld from them by the abortion-industry. The Royal College of Obstetricians and Gynaecologists’ clinical guidelines on the care of women seeking abortion cannot be trusted because it too is part of this ‘industry’. Everyone, it seems, has a vested interest in encouraging more women to have more abortions.
But the boring fact of the matter is that none of this is actually true. Informed consent from the patient is required before any medical procedure, including abortion, can be carried out. Clinicians are required to discuss all potential risks and complications, both physical and psychological. Abortion in the UK is already thoroughly regulated – let’s not forget, it’s the only procedure that requires the permission of two doctors before it can go ahead.
Bpas (the British Pregnancy Advisory Service), which is one of the UK’s largest abortion-providers and therefore the main target of Ms Dorries ire, reports that around 20% of women decide not to go ahead with termination following the counselling they receive. It’s also a registered charity which carries out 90% of its procedures under contract to the NHS, and is licensed by the Secretary of State for Health to do so.
The problem facing anti-choice campaigners such as Dorries is that the clinical facts about the ‘real risks’ of abortion do not accord with their view of what women should be told about the procedure. When carried out legally in a clinical setting, as it is the in the UK, abortion is a very safe procedure; the risks of complication are small, but women are still informed about them, as they should be. In terms of mental health, the Royal College of Obstetricians and Gynaecologists finds (in its new draft guidelines) that “the great majority of women who have abortions do not experience adverse psychological [consequences]”.
It is not unreasonable to trust the members of the RCOG to have used the most up-to-date evidence at their disposal and to have the best interests of their patients at heart. Nor is it unreasonable for those drawing up such guidelines to themselves be involved with the provision of abortion. In fact, I rather hope that they would be involved.
Advice provided by medical bodies about other types of procedure does not attract this kind of criticism. Private healthcare providers in other areas of medicine are accepted as offering unbiased opinion, although they most certainly do so in a for-profit capacity (in fact the Conservative Party actually seems quite keen on seeing more of this).
Requiring women to undergo further mandatory counselling, is both unnecessary and insulting to women. It presumes that women are incapable of making up their own minds when presented with the clinically relevant facts and ultimately seeks to delay and deter women from having abortion.
What does ‘independent advice and counselling’ as sought by Dorries et al actually mean? Where will it come from? In the United States, compulsory counselling means that in some areas women are given grossly inaccurate information about abortion’s links to breast cancer and infertility, some are required to listen to a detailed description of the foetus or view ultrasound pictures before they are allowed to proceed. Counselling at the hands of anti-choice Crisis Pregnancy Centres most certainly will not result in genuinely ‘informed’ consent.
Debate on abortion is not solely driven by scientific evidence on either side. The pro-choice movement deals with human and gender rights, bodily autonomy, need and circumstance. But here we are talking simply about what women should be told before having an abortion, and if we ignore mainstream medical opinion because it does not tally with our personal ideological viewpoint, and then seek to enact those views into law, then we are in dangerous, and not at all reasonable, territory.