Report Stage, House of Commons

Amendments relating to the Abortion Act

Forty years on from the enactment of the Abortion Act 1967, too many women seeking an abortion face distressing obstruction and delay, resulting in abortions taking place at a later gestation than is necessary or in some cases women being forced to bear a child against their will.

Abortion Rights urges MPs of all parties to support amendments tabled by pro-choice MPs, which would improve access to abortion and bring the law into line with developments in medical practice and social attitudes.

We urge MPs to support New Clauses 1,2, 7, 9-14 which are based on recommendations by the cross-party Science and Technology Committee and which carry broad support from organisations including: The Royal College of Obstetricians and Gynaecologists, The Royal College of Nurses, The Faculty of Sexual and Reproductive Healthcare, Family Planning Association, Antenatal Results and Choices, British Pregnancy Advisory Service, Marie Stopes International, Doctors for a Woman’s Choice on Abortion, Brook, women’s groups and trade unions.

On the other hand we urge MPs to vote against:
· New Clauses 4, 5 and 17 which would lead to damaging delays for the small numbers of women who need abortion post 24 weeks and lead to them having terminations at ever later gestations.
· New Clauses 6 and 15, which pointlessly alter the definition of foetal abnormality.
· New Clause 16 which is in opposition to NC1 and NC13 and makes a baseless distinction between abortion before and after 13 weeks

Ending distressing obstruction and unnecessary delays

New Clauses 1 and 13: Removing the need for 2 doctor’s signatures
Government guidelines say a woman should not have to wait longer than three weeks for an abortion but there is widespread evidence that women frequently face delays of six weeks or more because the law facilitates unfair obstruction by anti-abortion doctors and requires outdated medical practices. There is a postcode lottery of services in Britain, causing women great distress at a difficult time and forcing those who can afford to, to pay hundreds of pounds in fees for an abortion in the independent sector. An estimated 23 per cent of women seeking abortion in the second trimester wait longer than three weeks.

New Clauses 1 and 13 would end the current legal requirement for a woman to seek two doctor’s approval for an abortion performed up to 24 weeks. Instead, once a woman has made her own careful decision, only one doctor would be required to certify that the abortion will be undertaken in line with ‘the conditions and principles of good medical practice’. Abortion is currently the only medical procedure except involuntary treatment under the Mental Health Act that requires two doctors’ authorisation.

The cross-party Science and Technology Committee called for the requirement for two doctors’ signatures to be removed arguing that it may be causing delays in access to abortion services and that it services no useful purpose (either in terms of safeguarding women or doctors). These amendments would not increase the number of women requiring an abortion but would speed up access to abortion services once a woman has made her decision and would remove a pretext for obstruction.

New Clauses 2 and 14: Enabling suitably trained healthcare professionals to carry out early abortions
New Clauses 2 and 14 would enable suitably trained nurses to carry out abortions. Nurses are increasingly skilled in abortion care and performing common gynaecological procedures. Nurses commonly administer and carry out early medical and surgical abortion in the USA and South Africa. The medical consensus is that this will extend women’s access without compromising safety or quality of care.

New Clauses 7 and 10: Locations where abortions can take place
New Clauses 7 and 10 would broaden the criteria for approved premises where abortion can take place to include suitable medical settings such as GP surgeries and family planning clinics rather than just hospitals and specialist abortion clinics. This would help speed up access to early abortion and updates the law in line with existing government trials and developments in medical practice. Providing abortions in these settings could also facilitate better contraceptive follow-up, which would reduce the likelihood of further unintended pregnancies.

New Clause 9: Home administration of Misoprostol
The Royal College of Obstetricians and Gynaecologists (RCOG) states that abortion is safer than continuing pregnancy. Amongst abortion methods, early medical abortion is particularly safe. New Clause 9 would give women the option of being at home to complete an early medical abortion with appropriate follow-up and care. Already women in Britain commonly choose to take the second abortion pill at a clinic and travel home immediately for it to have effect. Removing the requirement for two clinic visits, for which there is no clinical need, would increase capacity of abortion services, helping to reduce distressing delays for women.

New Clause 11: Banning deliberately misleading advertising
We believe women must have the right to clear, non-directional, evidence based information to make decisions on unwanted pregnancies. New Clause 11 would safeguard women from unlicensed and unregulated ‘crisis pregnancy counselling’ centres which are anti-choice and provide misleading, directional information. These organisations deliberately target vulnerable women and young women. They rarely make it clear to women seeking counselling that they do not support abortion and will not refer them on. They then mislead women about the ‘risks’ involved in an abortion and may encourage them to believe (wrongly) they will become mentally ill, get cancer or become infertile should they decide to end their pregnancy. Women then feel guilty and distressed. For some, treatment is delayed as a result; others may end up having a child they do not want. To stamp out such abuse, this amendment would make it an offence for an organisation to seek to mislead women with biased information and direct them into making a decision they would not otherwise have made.

New Clause 12: Protecting women seeking referral for abortion
According to the Family Planning Association, 18–24% of medical practitioners describe themselves as broadly anti-abortion and do not refer women. We believe there should be tougher rules on anti-choice doctors alerting patients to the fact that they do not consult on abortions and referring to another doctor. Doctors with a genuine conscientious objection should not be expected to consult on abortion and women should be clearly signposted to GPs who are willing to refer. This would bring practice into line with current professional guidelines.

New Clause to extend 1967 Act to Northern Ireland
We hope a further amendment will be tabled extending access to safe, legal abortion to women in Northern Ireland. This would right an historic injustice that has resulted in huge suffering for women there, please support it. Women in Northern Ireland must travel abroad and pay hundreds of pounds for a safe termination causing great distress, and often resulting in much later abortion than women would prefer. Since 1967, the Family Planning Association in Northern Ireland estimate that 50,000 -70,000 women have travelled to England for a termination. There have been at least five known deaths due to unsafe abortion practices and countless women have been forced to continue a pregnancy against their will.

Amendments to oppose

New Clauses 4,5 and 17: Amendments increasing delays post 24 weeks
Increasing the number of doctors required to approve abortions post 24 weeks from 2 to 3 as in New Clauses 4, 5 and 17 would be a deeply retrograde step. Very few women need an abortion after 24 weeks. Those who do are often in very vulnerable and exceptionally distressing circumstances. These amendments would create damaging delays and added stress for women leading to abortions at ever later gestations. There is no medical precedent for any medical procedure requiring three doctor’s signature. Please vote against these proposals.

New Clauses 6 and 15: Amendments to the definition of foetal abnormality
New Clause 6 would amend the definition of ‘foetal abnormality’ to explicitly exclude cases where a foetus has club foot, cleft lip, cleft palate or cleft lip and palate. While New Clause 15 would amend the definition to specify that seriously handicapped means the child would be incapable of having or achieving a recognisable quality of life.

Neither of these amendments are advanced from a pro-choice or disability equality perspective; both are unnecessary. Abortion Rights believe women – including disabled women - need to be free to make their own decisions about continuing with or ending a pregnancy, regardless of the status of the foetus. Abortions on grounds of foetal abnormality are rare and often have more to do with families’ perception of their ability to cope than any value judgement made about the foetus or the potential quality of life of any resulting child. From a disability equality perspective what matters is to create a context in which impairment or non-impairment become irrelevant to a woman’s decision. This will not be achieved by tinkering with abortion law, it will only be achieved by improving disabled people’s rights to participate in society as equal citizens and changing public attitudes towards impairment.

The Science and Technology Committee warned against attempting further definition of serious handicap or inserting lists of abnormalities that should or should not be deemed to be serious. In the light of all the evidence they received they concluded this was neither desirable nor feasible. The Government agreed and commissioned the RCOG to review its 1996 guidance for medical practitioners on the Termination of pregnancy for fetal abnormality.

New Clause 16: In opposition to NC1 and NC13
New Clause 16 changes the current requirement for two doctor’s approval for abortion to one doctor up to thirteen weeks of gestation and two thereafter. There is no medical, practical, ethical or ideological logic to introducing a distinction in practice at thirteen weeks. The amendment is in opposition to NC1 and NC13 which would require 1 doctor’s approval for an abortion up to 24 weeks and would be a significant advance for women.

For more information please contact: Louise Hutchins, Abortion Rights Campaign Coordinator. Tel: 020 7923 9792 www.abortionrights.org.uk choice@abortionrights.org.uk