Britain - A bigoted offensive against women's right to abortion

Sep/Oct 2005

The call to reduce the present 24-week legal time limit for abortions has been getting a lot of publicity again this summer. On this occasion, largely thanks to the latest phase of an on-going campaign by the conservative newspaper, the Daily Telegraph. It claims there is now powerful public support for an "overhaul of Britain's 40-year-old abortion laws", having commissioned a YouGov opinion poll in August on British attitudes to "key ethical and moral issues of the day".

According to their poll, 58% thought the abortion time limit should be cut to 20 weeks and 27% that it should remain as it is. Of course, that still means that 85% of those polled (in this single small survey) are in favour of abortion, at least at some stage, but that is not the point this newspaper wishes to make.

No, the right-wing Daily Telegraph is obviously playing a tune which will appeal to those who wish, for all kinds of reasons, to turn back the clock on women's rights.

Given the general rightward political shift, as well as the increased role of religion in politics, all kinds of bigotry is being given a higher public profile today, and this is especially so on the question of women's rights, even if bigots do not represent more than a tiny minority in society. It was only a few months ago, in the run-up to the general election, that Tory leader, Michael Howard thought that he might win a few votes from the so-called "Catholic electorate" over the abortion issue if he called for the 24-week limit to be cut to 22 weeks, or even to 20 weeks. Blair's response at the time was not to dismiss this out of hand, but predictably, to register his own personal misgivings over abortion and to say that at some point "foetal rights" needed to be considered, even if there was no government plan at present to change the law. Blair also stated that he thought that it would be a pity if abortion became a party-political issue.

In fact, there has always been a consensus among the main parties that abortion should be a "personal matter" and not party-political, which only reflects the hypocrisy of politicians when it comes to confronting prejudice and religious institutions over the issue of women's rights. This hypocrisy is highlighted by the existence of a militant pro-life group within the Commons uniting supposedly irreconcilable political enemies - from Labour MPs and peers to Northern Ireland's Rev Martin Smyth from the Ulster Unionist Party, via the right-wing Tory, Ann Widdecombe - in order to impose the misery of unwanted pregnancies on working class women in the name of "morality"!

Former health minister and now defence secretary, John Reid, should have kept quiet, but he could not allow himself to be outdone by Howard, and claimed he had, in the past, taken an even stronger pro-life stance than Howard had, voting for a restriction to 16 weeks and to 18 weeks, even if there have never actually been votes on such restrictions! Labour MPs Peter Kilfoyle and Geraldine Smith also let it be known that they were in favour of abortion restrictions. Smith put in a Commons motion for a cut to 18 weeks.

After all of this, however, abortion as an issue in the election was more or less laid aside, with the government saying that it was not opposed to a future debate on the 1967 Abortion Act, in the light of the latest medical and scientific developments. However with the already agreed review of the 1990 Human Fertilization and Embryology (HFE) Act this year, the issue of abortion time limits will be raised in parliament one way or another, anyway.

Politicians promote pseudoscience

It should be said that the 1967 Act was already amended in 1990, on the back of the HFE Act at that time, to cut the time limit from 28 weeks to 24 weeks, except in cases of severe foetal abnormality or life-threatening danger to the pregnant woman.

Ever since then, but particularly over the last few years, the idea that 24 weeks is no longer a valid limit has been simmering under the surface, fuelled by statements from politicians and of course, all the anti-abortion groups who have always said that the "rights of the unborn child" supercede a woman's rights.

Modern developments in neonatal care are cited to support this reactionary view, because 50% of the few foetuses who emerge at 24 weeks today can be kept alive (with the help of highly sophisticated technology and vigorous medical intervention), even if half of these soon die - and of those who carry on living at least half again will suffer from severe disabilities.

This kind of dubious "viability" was apparently what prompted Liberal Democrat peer, David Steel, the self-styled architect of the 1967 Abortion Act (when leader of what was then the Liberal Party), to call for a review of "his" Act last year, helping to open the door to a debate which is, from the point of view of the defence of women's rights, completely beside the point.

But this is, of course, precisely the problem, because the 1967 Act did not take the defence of women's rights as its starting point, putting, as it did, the decision to abort in the hands of 2 doctors. So from the start the law was designed to keep women out of control of their lives, even if it was vague enough to allow the social and economic circumstances of the woman seeking an abortion to be taken into account. Sympathetic doctors were able, under the legal provision that "continuance of the pregnancy would involve risk...of injury to the physical or mental health of the pregnant woman or any existing children of her family" to agree to "social" abortions without fear of prosecution. However, the Act explicitly allowed doctors to refuse to carry out abortions (except to save the life of the woman) on the grounds of conscientious objection. At least 10% of general practitioners, usually a woman's first or only possible port of call, refuse to offer abortion advice, despite breaching General Medical Council guidelines.

Indeed, the 1990 Amendment further undermined what was already an ambiguous "right" to abortion, by cutting the time limit to 24 weeks, but thus made the "right" actually hinge on foetal viability. It was obvious at the time that this opened the way to cutting the time limit further in the future, on the same "viability" grounds, no matter how this affected the lives of women or indeed the right of the born child to a decent life.

Now there is another Liberal Democrat who is trying to make a name for himself in politics over the abortion issue - Dr Evan Harris - who is a member of the House of Commons Science Committee. He has used the Daily Telegraph poll as evidence that the "debate" on the "scientific basis" of 24 week limit is overdue and is calling for a parliamentary enquiry into the failure of the government to review the abortion laws.

This, just when the British Medical Association's 77% majority vote at its June 2005 conference, against any reduction in the time limit from 24 weeks - as well as a similar endorsement from the Royal College of Obstetricians and Gynaecologists - could have closed the debate. In fact doctors were also calling for better access to abortion, pointing out that 11% of Primary Care Trusts have waits of 5 to 8 weeks for the procedure to be carried out and stating that this was "disgusting".

In 1989, the BMA actually also voted against changing the law to reduce the abortion time limit to 24 weeks, as in practice, abortions after this time already took place only in "extreme cases" (the figure today for abortions after 24 weeks is 0.1% of the total), but politicians disregarded their advice.

And yet if the majority of doctors, who have the job of carrying out abortions and of looking after newly-born babies, do not feel that the "scientific" viability argument is valid and are convinced the needs of women should come first, shouldn't politicians keep their mouths shut and stop pretending they are acting in the name of "science"?

From pseudoscience to murder

David Davies, one of the main contenders for the Conservative Party leadership, nevertheless, has also just jumped on the bandwagon. He has accused the government of covering up the results of an investigation into last year's allegations by the Sunday Telegraph that the British Pregnancy Advisory Service (BPAS) helped women get illegal abortions after the 24 week limit, by referring them to a clinic in Spain.

In 2004, the Telegraph sent an "undercover" reporter who was 26 weeks pregnant to BPAS to request an abortion and then published its story that October, in order to try to implicate BPAS. It claimed that since BPAS is NHS funded, public money was being used for "illegal" (and immoral, of course!) purposes. (BPAS is indeed "NHS-funded", because it carries out NHS pregnancy terminations under contract, including many late abortions up to the legal limit, since most NHS facilities cannot and/or will not provide these.) All that BPAS had done was to provide the woman concerned with information as to where she could go to seek help. At the time then health minister John Reid said there would be an "investigation" into BPAS - but so far the results have not been made public.

All this, however, plays into the hands of the anti-abortion, "pro-life" lobby, including religious fundamentalists. In a way, however, anti-abortion organisations like "LIFE" and "SPUC" (Society for the Protection of the Unborn Child) are a lot more consistent than most politicians. Since they are against the killing of life in the womb from conception and therefore would argue that viability starts from that time, it does not matter at what stage abortion is done, to them it is still murder. Thus LIFE refers to the foetal embryo as a "child": "A child is as human at 10, 14, 18 weeks as he/she is at 22,24 or 28. Bigger is not better. To say that a child of 20 weeks should not be killed but one of 10 weeks may is as muddle-headed as saying it is permissible to kill a three-year old but not a nine-year old." They see behind Evan Harris' call for a review of the abortion laws a way for the "abortionists" to change the law to allow "complete freedom of supply up to 10 or 12 weeks". Unfortunately for women, however, this is highly unlikely, even if it is an aim of the "pro-choice" organisations here in Britain, who use the example of countries like France, the Netherlands and Sweden, where women can to all intents and purposes obtain an abortion "on demand" before the 13th week of pregnancy.

Of course, while apparently respecting the right to life of "children" the more extreme "pro-life" protagonists do not have similar principles when it comes to the "right to life" of adults who carry out abortions, as the countless examples from the USA show. The latest case being the conviction in July this year of the right-wing terrorist Eric Rudolph, who had bombed the 1996 Atlanta Olympic Games and then lived in hiding until he decided to bomb an abortion clinic in 1998, maiming one person and killing another. "What they did was participate in the murder of 50 children a week. Abortion is murder and because it is murder I believe deadly force is needed to stop it", said Rudolph. It is not impossible that when, as is likely, it comes to "reviewing" the 1967 Abortion Act, that irrational and pseudoscientific arguments, which are likely also to be promoted by Blair and some of his ministers, could create a climate in which such extremist behaviour could be seen in Britain, which so far has not been the case.

A social question, not a moral one

Of course, as socialists, we do not consider abortion as an ideal procedure for women. Despite medical progress, is still emotionally traumatic and usually also physically traumatic. But those who regard it with horror, from a moral point of view, are merely looking at a reflection of the barbaric society in which we live. Because in this class society, based on injustices, resorting to an abortion is very often the only means whereby a woman can assert some control over her life in order to make it more bearable, for herself but also for the rest of her family, if she has one. It is often also the only way for working class women, who may have no room for manoeuvre, unlike their middle class counterparts, to protect the "unborn child" from a life of poverty on the margins of society. And this is why in our society abortion cannot be considered a moral issue. It is a social issue.

No wonder the vast majority of bigots and reactionaries wish to deny this simple right to women, since for them, social inequalities are taken as a "given" - which cannot and should not be put into question.

Ever since the 1967 Act was passed, the implementation of abortion "rights" can be said to have been a yardstick by which the rolling back of the NHS and welfare provision could be measured. In this respect, the government's policies over the past two decades have helped to advance the cause of the anti-abortion lobby.

In the absence of general practitioner willingness and/or expertise, contraception and abortion have for a long time been relegated to charitable or other agencies - in fact much before "private contracting out" of NHS responsibilities became government policy.

This has meant that in practice, men and women requiring contraception, women needing "morning after" pills and those needing abortions have not had the free, expert and efficient NHS service they required - whatever the 1967 Abortion Act (and the granting of free contraception in 1974) might or might not have allowed in theory. GPs have been unable to offer such a comprehensive service and NHS family planning clinics never had the funding they needed. It was left to the charitable sector to fill the gap, which it could not do.

And the dire state of the NHS today - more and more pushed into dependency on the private sector - threatens to become yet another justification for reducing women's rights further.

Why? Because NHS provision of sexual health services as a whole is still in crisis, despite government assertions that more money is being put into this area under its 2001 "National Strategy for Sexual Health and HIV". In fact this crisis is actually illustrated by the increase in abortions, which directly reflect a deficiency in contraception and other allied services. The figures for abortions carried out in 2004 show an increase of 2.1% to an all time high of 185,400.

World Health Organisation researchers have shown that the worse the provision of contraception and preventive services, the higher the abortion rate - as if "research" was needed to prove such an obvious point! But for this reason, all indications are that the number of abortions carried out in Britain might be even higher, if access to abortion itself was not so fraught with difficulty and delay, and a victim of the "regional NHS lottery" as so many health needs are.

The crisis is born out too, by the increase in sexually transmitted infections like chlamydia (in females under 20 years these tripled to 18,674 cases in 2003), as well as the increase in infection by the "old nasties" like gonorrhoea and syphilis and, of course, HIV. But perhaps the worst symptom of this crisis is the high rate of teenage pregnancies, which remains four times greater than the European average, despite the government's 1999 "Teenage Pregnancy Strategy", which is meant to halve these by 2010.

Teenagers targeted

There is unequivocal evidence that there are more teenage pregnancies in deprived communities. Middle class girls are less likely to get pregnant than working class girls and twice as likely to choose abortion. A recent study showed that 69% of under 18s from Kensington and Chelsea chose abortion compared to 25% in Merthyr Tydfil, the extremely depressed ex-mining and ex-manufacturing area in Wales. And where there is more non-NHS provision, a higher proportion of pregnancies are aborted than in areas where the NHS is the main "provider" of abortions. It just so happens that "independent" providers are more likely to be located in affluent areas, because, although they are now contracted to do over 50% of NHS abortions, they also provide abortions for a fee to those who can pay.

Compared to other European countries, like France and the Netherlands, fewer teenage girls opt for abortion in Britain, and according to researchers, the direct correlation to social deprivation (more from families reliant on family credit), is not only a reflection of their perception of their futures and what alternatives face them, but also the fact that the more progressively minded advice clinics are few and far between where they live. Such girls, when asked about their choice to keep their babies say, for instance:"...if I hadn't had the baby I'm sure I would've been in jail." or, "They're all off on drugs and drinking every night [her friends] ...I can see if I didn't have her I'd have ended up going that way." This says something about the social environment and the "choices" available in places like the run-down areas of South Wales.

Anyway, the 15% annual target to cut teenage pregnancy has been missed so far. Last year saw a decrease of just over 9%. Some would say this is largely down to lack of sex education in schools, pointing to the fact that as Education Minister, David Blunkett refused to make SRE (sex and relationship education) compulsory. In fact the curriculum only compulsorily requires a basic lesson in biology, as if what children need to be taught is just where babies come from and not how to be in control of their own sex lives!

The government's own "independent advisory group" has criticised the lack of SRE. Ofsted found one in 10 schools poor on this score. This year's report of the Teenage Pregnancy Unit on the progress of its strategy to cut teenage pregnancy has to admit that under two-thirds of young people received SRE lessons and only 30% of girls felt that by year 4 these SRE lessons had met their needs. This percentage has not increased over the past 4 years.

Yet it is precisely these SRE lessons which are meant to explain about condom use and availability, for instance. Only around one third of boys from deprived backgrounds felt they had learnt what they needed from SRE. And while the number of teenagers knowing that condoms are available free of charge has increased over the last four years, 20% of girls and 40% of boys still do not know that this is the case! At the same time the number of young people getting contraceptive advice before having sexual intercourse has actually decreased over the past 4 years.

The real "bad news" is that in 2006 the "ring-fenced" funding for the Teenage Pregnancy Strategy Local Implementation Grant will end. The Unit itself complacently claims that since local authorities are obliged to develop broad "Children and Young People's Plans" in liaison with Primary Care Trusts (PCTs), that this will ensure that the strategy continues. But what about the fact that a large number of Trusts are already overspending every year on their budgets and are unable to meet many of their existing service requirements as a result?

What today's "streetwise" youth, really need, is immediate and easy access at all schools to free condoms (as was proposed, but not implemented), free "morning after" pills, as well as the possibility of arranging for an abortion at school, rather than being bombarded with yet more counselling and advice. They are often a lot less "hung up" and a lot more clued up than those who are appointed to counsel them, or indeed "survey" their attitudes. It has also been shown that just the fact of clinics or GP surgeries putting up a notice to say that under 16s can get contraception and abortion in complete confidence (without parental consent) increases the number of young people seeking such services. But only two thirds of GPs actually do so. In fact, it may even be more appropriate to target "education" at GPs, who, it should remembered, officially "provide" 80% of contraceptive care. It was only the 2004 GP's General Medical Services Contract which stipulated that these GP surgeries should offer a full range of contraception methods!

In fact the extent of services providing "family planning" as it is euphemistically called, is only just being made subject to government audit this year. There is no precise national data on the "availability" of such services, although it is officially acknowledged that this is deficient.

The 1997 initiative to start contraception clinics in schools, re-iterated in 2002, seemed to fade into thin air - and although some schools do provide some form of "clinic" these are few and far between. It remains to be seen what Blair's new Education Minister, "self- confessed" Roman Catholic, Ruth Kelly, will do next in this regard.

It is unlikely that there will be any attempt to address the gross injustice that Northern Ireland's 863,818 women have faced all these years, since the 1967 Abortion Act was never extended to them, thanks to the British government's pandering to the religious establishment over there. Although a small number of abortions are carried out in Northern Ireland, it is significant that there is no official data available! Women from the north of Ireland are thus not in a very different situation from their sisters in the south, having to travel to another country and usually pay private rates for the procedure. This, despite repeated calls since the 1970s, from the Family Planning Association and even from the BMA, that the law be extended to the six counties. Up to 9,000 abortions are carried out annually in England and Wales on women giving addresses from both sides of the Irish border.

Improving? Yes, for potential profiteers and the privileged

Oh yes, there have been some "improvements", in "sexual health services" for women.

In 1994, only 67% of all abortions in England and Wales were NHS-funded. Today, 82% are NHS-funded. But in fact this does not reflect an improvement in NHS provision in England and Wales. It is due to the transformation of the unofficial policy of contracting out abortion procedures to other agencies into official government policy. Only 40% of abortions last year were carried out by the NHS itself and 42% were done under contract by "NHS Agencies" like BPAS and Marie Stopes Clinics. 18% of the total were paid for privately.

This means that the "charities" are guaranteed a certain income from the Treasury, which they could not rely on before and have therefore actually been able to expand their services at the expense of the NHS. As the government's statistical service explains, the proportion of abortions performed under NHS contract has been rising steadily since 1992, while the proportion of NHS hospital and private abortions has been falling. No wonder organisations like BPAS which have thus benefited, are prepared to praise "New Labour's" initiatives!

There is plenty of scope for a private profitable sector to develop and nothing to stop it from doing so, on the back of NHS decline. It can only be helped by growing "NHS backwardness", well documented by researchers, which allows medical staff to refuse to have anything to do with abortion, but which is also failing to train junior doctors in abortion techniques, because in at least 20 health authorities very few abortions - and no late abortions - are carried out by the NHS anymore.

What is more, according to the latest data available, though 75% of Primary Care Trusts set a "target" of 21 days maximum waiting time for an abortion only 52% met this target consistently. 27% had waiting times of more than 21 days, and 11% had waits of 5-8 weeks. This is an additional pressure on those who can ill afford it to "go private", to do just that, given the fact that waiting for an abortion can mean the difference between a relatively simple medical procedure (taking pills) and surgical abortion - or even worse, "induction" of labour and actually having to give birth to a small foetus. But it also makes a farce of the sanctimonious pseudo-scientific arguments about legislating on a time-limit for late abortions!

So even without any formal change to curtail further the 1967 Act, the obstacles to abortion today are first and foremost those of material resources. And current NHS policy, favouring yet more contracting out, is unlikely to iron out regional variation in provision. Why should contractors set up premises in deprived areas, of most need, when there is little scope for offering privately funded abortions in these areas? The "more money" that is being allocated for these kinds of services (as well as "family planning") is channelled into such contractors' expensive overheads, even if they are "charities" and not profiteers, rather than allowing the real increase in the service which is needed.

It also opens the way for cutting spending on later abortions (after 16 weeks) - most of which are done at inflated cost to the NHS budget, by the charitable or private agencies. This is another reason why any attempt to reduce the 24 weeks limit or further water down the 1967 Act is unacceptable.

That said, a law which requires 2 doctors to agree to a woman's abortion request and which was never even extended to include the women of Northern Ireland should definitely be "overhauled", or maybe the correct word should be "overthrown", along with a whole social system which is intrinsically unjust! However, until this happens, free abortion on demand, at any stage up to birth should be a right for women, because this is the only way in which a woman's right to control her life and her body can be defended. But of course nothing short of a revolution in society to get rid of the class system and the social inequalities which come with it, is needed. Only then will we be able to address the denial of women's equal place alongside men in society, which is compounded by the lack of control women have over their own biology, despite scientific and medical advances which could have facilitated women's autonomy decades ago. And only then will real "choice" prevail.