Monday, June 25, 2007

British News- Abortion Debate? Bring It On

Abortion debate? Bring it on
The law is anachronistic, out of date and in need of a comprehensive review - and those voting to change it need to be fully informed of the issues.
By Ann Furedi June 21, 2007

Since 1990, when the abortion law was last amended, the government and their civil servants have done their best to keep abortion out of parliamentary politics. It's easy to understand why. Abortion is a complex and polarising topic that confers no party political advantage; parliamentarians are, by tradition, allowed a free vote. Abortion is something that policy makers, like most people, accept but don't want to talk about.

This has been frustrating. The law is anachronistic, out of date and in need of a comprehensive review. Clinical practice, our expectations relating to family planning and parenting, the role of medical professionals and social opinion have changed fundamentally since the abortion law was first past in 1967 and even since it was amended in 1990. Science has moved on too. So a review of abortion legislation is long overdue.

Both houses will in all likelihood vote on abortion later this year when amendments to the bill that will replace the Human Fertilisation and Embryology Act are debated. This is the legislation that sets a 24-week time limit on most abortions. Those voting need to be fully informed about the issues, and so a balanced, evidence-based inquiry by the science and technology committee could not be more timely.

However, it is particularly welcome that the scope of the inquiry extends beyond consideration of fetal viability and the upper gestational limit to such issues as: the relative risks of early abortion versus pregnancy and delivery; the need for two doctors to confirm a woman meets the legal requirements; the practicalities and safety of allowing nurses or midwives to carry out abortions; regulations regarding where the "abortion pill" can be used; and evidence of long-term or acute adverse health outcomes from abortion or from the restriction of access to abortion.

It's interesting that the Pro Life Alliance have objected already that "the thrust of the inquiry appears to be geared towards gathering evidence in relation to measures that would further liberalise our current abortion law." Another way of looking at it might be that the scope of the inquiry is comprehensive.

BPAS is responsible for more than a quarter of all the abortions provided in England and Wales. We specialise in late abortion and look forward to explaining to the committee why we remain convinced that science has provided no reason to lower the time limit, while the circumstances of our clients provide compelling reasons for it to remain at 24 weeks.

Our experience of almost 12,000 "abortion pill" procedures each year in nurse-led services with minimal doctor involvement, means that we are well-placed to inform the committee as to how services could be developed to suit the needs of women if some of the legal restrictions (imposed when all abortions involved an invasive gynaecological intervention) were removed.

Data on complications and adverse outcomes of abortion is meticulously collected by providers and will confirm the published evidence that abortion at all gestations is extremely safe, but the earlier the procedure, the safer it is.

It is only right that parliament should periodically scrutinise the abortion law and services. Women rely on termination of pregnancy as a back up to their usual method of birth control. A third of women use an abortion service at some point in their life. They, and their elected representatives, should know that services are delivered to the highest clinical and ethical standards. If this inquiry is truly evidence-based we are confident it will confirm this - and it will facilitate an informed discussion on the floor of the house.

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