‘Two doctor’ rule hits the headlines

The UK media responds to the Ipsos Mori poll on attitudes to abortion. 

The Ipsos Mori poll Attitudes to Abortion, commissioned by bpas and released on 28 November, was big news in the UK. ‘Abortions should be made easier on demand, says charity’, reported the front page of the Times (London), reporting bpas’ arguments that laws that require two doctors to approve an abortion should be dropped to allow women complete control over their family planning, and that abortions should also be made easier by allowing nurses rather than doctors to prescribe Early Medical Abortion (the abortion pill) to women within the first nine weeks.

Times science editor Mark Henderson endorsed bpas’ position. ‘It is a common misperception that British law allows abortion on demand,’ he wrote, before explaining that women seeking an abortion ‘must first jump through several medical and legal hoops’ - including obtaining the approval of two doctors, who must justify their decisions on medical grounds: ‘The usual one, cited in 96 per cent of cases, is that pregnancy poses a greater risk to the woman’s mental or physical health than an abortion.’

‘A single doctor is quite capable of assessing a woman’s suitability, and the two-doctor rule does little but waste medical time and resources,’ argued Henderson. ‘It certainly does nothing to protect women’s health. The double examination delays the procedure, when more timely abortions are less risky. It makes a decision that is always likely to be traumatic more stressful. Some women also find it humiliating to be declared at psychological risk when making a choice to end a pregnancy.’

Henderson concluded that ‘if society has decided that abortion should be permitted — as the latest polling suggests it has — there is a good case to be made that the State’s priority should be to ensure it is available in the safest possible form’ – through improved access to early medical abortion.

The Guardian led with the headline ‘Poll backs nurses being allowed to give abortion pills’. Its report discussed the role of contraceptive failure in about 40% of cases where women seek abortion, and the extent to which abortion has become a back-up to family planning.

The explanation given by Ann Furedi, chief executive of bpas, for the 20% rise in abortion between 1995 and 2005, was also discussed. The main reason for the rise, said Furedi, was that ‘people who are having sex don’t want children’. The fact that 20% of women today are childless at 45 means that many women in their early 20s, at the peak of fertility, were having sex regularly but did not want to have a child. Ten years ago many might have accepted pregnancy – today, says Furedi, ‘women are perhaps less tolerant of an unplanned pregnancy.’

The Daily Telegraph’s front-page news article was headlined ‘More women have abortions as it loses stigma’, and reported Ann Furedi’s argument that women are finding it more acceptable to have an abortion than to drift into an unplanned pregnancy. ‘Parenting is considered to be very important and is taken seriously these days,’ said Furedi. ‘The idea of just drifting into unplanned motherhood is seen not to be a good thing and you could argue that among many groups of people in society abortion is seen as a more responsible response to being a victim of uncontrolled fertility’.

The poll caused hackles to rise amongst the anti-abortion lobby. The Society for the Protection of the Unborn Child (SPUC) told the Guardian: ‘Bpas, for its own ideological reasons, is pushing for abortion to become even more prevalent, and that is why they are calling for changes in the law.’ Life said women should not make choices at the expense of unborn children. A spokesman told the Telegraph: ‘Society must respect the right to life of all human beings, even those who are small and vulnerable and possibly inconvenient.’ Julia Millington, of the Prolife Alliance, said the survey took no account of the fact many believed there should be ways of reducing the number of abortions being carried out each year and the mounting ‘concern about the psychological and physical harm to women’.

Writing in the Times, Dr Thomas Stuttaford worried that ‘the importance of pregnancy is trivialised by repeated abortions’, and raised the concern that we might ‘revert to the Eastern-bloc methods of the 1950s and 1960s’. Mary Kenny, writing on Guardian Unlimited, argued: ‘If we thought abortion was morally neutral, we would reward abortion doctors for destroying the unwanted pregnancy, as we admire fertility expert Lord Winston for enabling the wanted one. But nobody ever says at a dinner table, “Oh, I’m an abortionist"’.

At the release of the Attitudes to Abortion poll, Ann Furedi urged MPs to mark the 40th anniversary of the 1967 Abortion Act by updating the legislation. This call was backed by Dr Evan Harris, the Liberal Democrat MP for Oxford West and Abingdon. The current 24-week time limit for abortion was chosen ‘on the basis on viability’, he said, adding that he did not think the age at which a fetus was capable of surviving outside the mother had changed. But, he stressed, ‘I don’t think this is something we should be scared of debating.’

Dr Harris backed bpas’ calls to allow nurses to administer the abortion pill, saying that rules preventing them from doing so were ‘outdated and inappropriate’. Tony Kerridge, of Marie Stopes International, told the Times that his organisation would go even further by urging MPs to allow nurses to carry out simple surgical abortions.

Read on:

Poll shows majority support for legal abortion, Abortion Review, 28 November 2006

Attitudes to Abortion: summary of findings, Abortion Review, 28 November 2006