Memorandum 46
Submission from LIFE
EXECUTIVE SUMMARY—(NUMBERS
REFER TO
PARAGRAPHS)
1. LIFE is one of the UK's leading provider of
crisis pregnancy and post-abortion counselling and supported accommodation
for pregnant women and mothers of small children.
2. Our charitable work gives us some unique insights
into women's experiences both pre and post abortion.
3-4. We are concerned, however, by the limited
scope of the inquiry. A consideration of abortion cannot solely
be based upon scientific evidence.
5: In discussions of survival rates following
premature delivery, the 1995 EPICURE study is quoted as authoritative;
however, more recent research indicates that the results of this
study are outdated.
6-7. Although there is a disproportionate incidence
of certain disabilities among those born prematurely, LIFE believes
that this should not influence discussion of the significance
of survival rates.
8. The proposal to scrap the two doctors' signatures
requirement ignores the intention of the original Act. UK abortion
law does not sanction a right to abortion but permits the practice
in specific circumstances.
9. The proposal to allow medical abortions to
take place outside of the clinic is one which trades expediency
with the needs of women.
10. Regarding psychological problems, the weight
of such evidence has led the American Psychological Association
to remove and review their guidance on the subject.
11. Considering that the majority of abortions
in the UK are performed on women aged 18-25, we would suggest
that the link with premature delivery should be of great concern
to parliament and the committee should give it serious consideration
in this inquiry.
12. There is evidence to suggest that the rise
in breast cancer rates may be associated with a corresponding
increase in abortions being performed on nulliparous women.
13. Even if, as some have argued, abortion in
the first trimester has fewer health implications, we do not feel
that this is the way to tackle the existing problems around crisis
pregnancy and sexual health.
14. In conclusion, LIFE welcomes the opportunity
to submit evidence on this topic and hope that the deliberations
of the committee will result in a report that is of assistance
to MPs and the general public.
LIFE: OUR PROFESSIONAL
EXPERIENCE
1. LIFE is one of the UK's leading provider
of crisis pregnancy and post-abortion counselling and supported
accommodation for pregnant women and mothers of small children.
We offer counselling, information and support on abortion and
pregnancy related issues via our free phone national helpline
or our nationwide network of pregnancy care centres. We also run
a supported housing programme for pregnant women and mothers of
small children.
2. Our charitable work gives us some unique
insights into women's experiences both pre and post abortion.
From our work with women, it is evident that abortion is often
not freely chosen but regarded as the only option. The professional
support that LIFE offers to women in crisis pregnancy and those
who experience psychological problems related to abortion is provided
in different areas of the UK. Our counsellors' experience of the
effects that abortion can have on different aspects of women's
health is wide-ranging and they are willing to appear before the
Committee to give oral evidence if invited.
CONCERNS ABOUT
THE INQUIRY
3. LIFE welcomes the Committee's decision
to reconsider this issue. We are concerned, however, by the limited
scope of the inquiry. The decision to exclude any ethical debate
on abortion seems curious, to say the least, when figures from
every side of the debate on abortion have been calling for a vigorous
and exhaustive public debate. In areas of legislation like abortion
and embryo research, public confidence is vital. Abortion remains
a contentious issue and there are a great number of people with
important things to say on the topic. The exclusion of ethical
debate might easily be construed as the Committee seeking to avoid
a proper debate.
4. A consideration of abortion cannot solely
be based upon scientific evidence. The interpretation of evidence
is influenced by ethical principles and in failing to discuss
these principles the committee's conclusions will be limited in
scope and far from comprehensive.
PREMATURE DELIVERY
AND VIABILITY
5. In discussions of survival rates following
premature delivery, the 1995 EPICURE study[363]
is quoted as authoritative; however, more recent research indicates
that the results of this study are outdated. The research published
in the journal Paediatrics by Hoekstra et al[364]
demonstrates a marked year on year improvement in survival rates.
The data gathered was the result of a 15 year study at a single
neonatal intensive care unit in the United States. In contrast
to the EPICURE study which found that the average survival rate
was 11% for babies born at 23 weeks, the more recent findings
revealed a survival rate of 66%; a significant increase. At 24
weeks, the EPICURE study showed that 26% survived; however, a
2004 study conducted at University College Hospital[365],
London, produced a survival rate of 72%.
DISABILITY
6. Although there is a disproportionate
incidence of certain disabilities among those born prematurely,
LIFE believes that this should not influence discussion of the
significance of survival rates. Such a position is shared by many
disability rights groups who rightly argue that abortion on the
ground of disability is prejudiced and creates negative stereotypes
of the disabled in society. The support that LIFE offers pregnant
women extends to providing them with information about the services
they can access for assistance in bringing up a disabled son or
daughter.
7. On these grounds, LIFE would recommend
both that there is a substantial reduction in the upper time limit
for abortions and that abortion on the ground of disability should
be outlawed.
TWO DOCTORS'
SIGNATURES
8. In considering scientific developments
relevant to abortion the committee acknowledges the original intentions
behind the Abortion Act 1967 (as amended) that foetal viability
determines the law. In contrast, the proposal to scrap the two
doctors' signatures requirement ignores the intention of the original
Act. UK abortion law does not sanction a right to abortion but
permits the practice in specific circumstances. The removal of
the two doctors' requirement would allow for easier access to
early abortion and undermine the significance of the procedure.
This would be a contradiction of the law as originally intended
and arguably encourage an increase in abortions; we would oppose
such a move for this reason.
UNSUPERVISED MEDICAL
ABORTION
9. The proposal to allow medical abortions
to take place outside of the clinic is one which trades expediency
with the needs of women. A recent review[366]
has shown that complications requiring hospital treatment are
twice as likely to occur with a medical abortion as with a surgical
abortion. It is instructive to note that the BMA has opposed the
proposal for at-home abortions. Abortion is a particularly traumatic
procedure to go through and can be a very isolating experience.
LIFE counsellors have been contacted by many women whose abortions
have occurred outside of the clinic. The psychological effects
of having to undergo an abortion without any immediate medical
or personal support can be harrowing and harmful and should be
rejected as a proposal.
WOMEN'S
HEALTH—PSYCHOLOGICAL
EFFECTS
10. There is a growing body of rigorous
peer reviewed, academic evidence on the consequences of abortion
for women's long term health. Regarding psychological problems,
the weight of such evidence has led the American Psychological
Association to remove and review their guidance on the subject.
Studies have documented increased death rates from injury, suicide
and homicide[367]
and, most significantly, a study referred to in a letter by 15
senior obstetricians and psychiatrists to The Times newspaper,
[368]suggests
these problems are not related to a patient's psychiatric history.
[369]The
recent paper from Fergusson et al. in New Zealand[370]
showed that there were serious repercussions for many post-abortive
women's mental health. This research was written and conducted
by a largely pro-abortion research team and was not originally
focused on abortion. However, the conclusions about abortion reached
by the team encouraged them to investigate further.
WOMEN'S
HEALTH—PHYSICAL
EFFECTS
11. While it is accepted that minor physical
complications can arise as a result of surgical abortion, the
evidence for more serious physical effects has only recently come
to light. Rooney and Calhoun's 2003 review[371]
of 49 studies relating abortion and pre-term delivery revealed
that 41 of these demonstrated an increased risk and none showed
that abortion had any protective effect. Such a connection is
strengthened by the evidence from the EPIPAGE[372]
and EUROPOP[373]
studies which highlights the economic cost of pre-term delivery
in terms of care for the children born who are more likely to
suffer from permanent brain damage. Considering that the majority
of abortions in the UK are performed on women aged 18-25, we would
suggest that the link with premature delivery should be of great
concern to parliament and the committee should give it serious
consideration in this inquiry.
12. There is evidence to suggest that the
rise in breast cancer rates may be associated with a corresponding
increase in abortions being performed on nulliparous women. It
is impossible to explain this evidence in such a short submission,
however, the meta-analysis conducted by Joel Brind[374]
is deserving of serious attention. A review of the recent scientific
evidence would seem appropriate to this inquiry and a matter of
great importance because of the potential impact on cancer death
rates worldwide. At the very least, women should be made aware
that there is no consensus on the subject and not that such a
link does not exist as some would claim.
FINAL CONCERNS
13. Even if, as some have argued, abortion
in the first trimester has fewer health implications, we do not
feel that this is the way to tackle the existing problems around
crisis pregnancy and sexual health. We are concerned by any proposals
that trivialise the procedure of abortion. Whatever position an
individual might take on the issue, it is undeniably a momentous
procedure.
CONCLUSION
14. In conclusion, LIFE welcomes the opportunity
to submit evidence on this topic and hope that the deliberations
of the committee will result in a report that is of assistance
to MPs and the general public. We would be keen to give evidence
in view of our involvement with women who are considering abortion
or have experienced abortion and trust that our evidence will
be given due consideration.
October 2006
363 Wood NS et al. Neurological and developmental
disability after extremely preterm birth. EPICure Study Group:
New England Journal of Medicine. 2000; 343: 378-384. Back
364
Hoekstra RE et al. Survival and long-term neurodevelopmental
outcome of extremely premature infants born at 23-26 weeks gestational
age at a tertiary centre. Pediatrics. 2004; 113: e1-e6. Back
365
Riley K et al. Changes in survival and neurodevelopmental
outcome in 22-25 weeks gestation infants over a 20 year period
(abstract). European Society for Pediatric Research, Annual
Scientific Meeting. 2004. Back
366
Goodyear-Smith F. First trimester medical termination of pregnancy:
an alternative for New Zealand women. Aust N Z J Obstet Gynaecol.
2006; 46(3):193-8. Back
367
Gissler M et al. European Journal of Public Health.
2005; 15, 5: 459-463. Back
368
"Risks of abortion", The Times 27 October 2006:
http://www.timesonline.co.uk/tol/comment/debate/letters/article614555.ece Back
369
Fergusson D et al. Journal of Child Psychology and Psychiatry.
2006; 47(1): 16-24. Back
370
See Fergusson D et al. Journal of Child Psychology
and Psychiatry. 2006; 47(1): 16-24. Back
371
Rooney B, Calhoun BC. Induced abortion and risk of later premature
births. Journal of American Physicians & Surgeons.
2003; 8: 46-49. Back
372
Moreau C et al. Previous induced abortion and the risk
of very preterm delivery: results of the EPIPAGE study. BJOG.
2005; 112: 430-437. Back
373
Ancel PY et al. History of induced abortion as a risk factor
for preterm birth in European countries: results of the EUROPOP
survey. Human Reproduction. 2004; 19: 734-740. Back
374
Brind J et al. Induced abortion as an independent risk
factor for breast cancer: a comprehensive review and meta-analysis.
J. Epidemiology and Community Health. 1997; 50: 465-467. Back
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