I’ve helped perform abortions but these ‘no limits’ zealots chill my blood
When I first saw the headline, I thought I must have misread it. The Royal College of Midwives was calling for the 24-week cut-off for abortions to be scrapped, effectively legalising terminations until birth. no, surely, surely, that can’t be right. But it was. Chief executive Cathy Warwick — who also happens to be chairman of the country’s biggest abortion provider, the British Pregnancy Advisory service — had signed up the college to a campaign to repeal all legal limitations on abortion.
she hadn’t consulted her members or put it to a vote. she’d just breezily committed all midwives to joining a tiny handful of countries such as China and Vietnam where abortion is legal on demand until birth.
now, I don’t know about you, but when it comes to human rights, I’m never one to feel comfortable following China’s lead.
And I can’t understand how anyone who knows the full facts about abortion could countenance such a grotesque idea.
Cards on the table. I have no moral issue with abortion in the early stages of pregnancy and unreservedly support a woman’s right to choose.
I am aware that not everyone will agree with me, but I have thought long and hard about it. Indeed, while I was a medical student I assisted in terminations as part of my training. This was not compulsory. I volunteered.
Many of my fellow students opted out. But I felt that if I was going to say I was comfortable with abortion — and refer patients for it when asked — then I had to face the reality.
so what was it like? Frankly, not what I expected at all.
In my naivety, I’d assumed there’d be some special, sombre mood as a little life was snuffed out. hushed voices. Perhaps a tear in a nurse’s eye. A sorrowful reverence as the remains of the foetus were removed.
NoT a bit of it. It was all as emotionless, routine, and — after a while — boring as any other gynaecological procedure. Like cutting out a cyst.
After doing one abortion, we’d move on to a patient with endometriosis. Then, perhaps, another termination. There’d be worries about falling behind with our schedule, or someone dropping an instrument, but that was as dramatic as it got.
I’d expected an epiphany, but I just felt detached. It was only later that I realised this lack of emotion was precisely what made the experience so salutary.
The fact that ending a life can feel so routine is the most compelling reason of all to be very, very careful about the limits we place on it.
It’s so chillingly easy to treat abortions as being like any other operation — and the longer a pregnancy progresses, the more dangerous that becomes. In the developing foetus, each week of gestation brings a host of anatomical and physiological changes. But the only factor relevant to existing abortion legislation is when the foetus is capable of independent existence.
The current legal limit for terminating a pregnancy is 24 weeks. Most terminations occur at 13 weeks or earlier, with only a fraction — less than 2 per cent — carried out after 20 weeks. even so, that still means about 3,000 terminations a year at 20 weeks or later. That’s about ten a day.
If truth be told, many doctors are uncomfortable about the current cut- off. It’s not something we openly discuss because we know it’s so emotive. But, privately, many express discomfort that the current law is inherently inconsistent.
In the same hospital where we are trying to save a premature baby born at 23 weeks, a woman down the corridor is legally allowed to undergo a late-stage abortion on a foetus of the same gestation.
so on the one hand we throw money, resources and skill at trying to save a baby’s life, while on the other we sanction its destruction.
As medicine stands, babies can’t survive outside the womb at 21 weeks. At 22 weeks, there’s a 1 per cent chance of life. But just seven days later, at 23 weeks, this rises to between 11 and 40 per cent.
The fact that a small number of babies can survive at this stage — and that the chances are good enough for doctors to try to save them — undermines the basis on which the 24-week limit rests.
For a libertarian such as me, this is difficult. Any suggestion that the limit should be reduced is vociferously denounced as anti-choice.
TheRe’s a feeling that the right for women to determine what happens to their body when they are pregnant has been hard won, and that any change to the rules risks an insidious erosion of women’s reproductive freedom.
But that understandable concern shouldn’t be allowed to silence discussion. And it seems to me — from a purely logical perspective based on current premature survival rates — that a cut- off of 22 weeks would make more sense.
If we wanted to be cautious, 20 weeks would give a clear gap between the upper limit for termination and the lowest biologically plausible age for a premature baby to survive.
But that’s up for debate. What the medical evidence doesn’t even begin to suggest is that the upper limit should be scrapped entirely.
Cathy Warwick’s proposals chill my blood. If I were a midwife, she would be the last woman on earth I’d want to speak in my name.