The re-politicisation of abortion in the UK

Recent attacks on abortion provision are part of a broader strategy aimed at eroding abortion rights, writes POLSIS PhD candidate Fran Amery.

In recent months, abortion has once again become a hot topic in British politics and in the media. In September last year, MPs debated a proposed amendment to the Health and Social Care Bill, sponsored by Conservative MP Nadine Dorries and Labour backbencher Frank Field, which would have required abortion providers to offer women seeking abortions ‘independent’ counselling. In February, the Telegraph exposed three doctors illegally offering to arrange abortions on the grounds that the foetuses were female, prompting an investigation by health officials. Most recently, the Health Secretary, Andrew Lansley, announced a wave of shock inspections on abortion clinics following claims that doctors were ‘pre-signing’ abortion paperwork without seeing patients. These actions on the part of politicians seem benign when taken in isolation – surely it is important to ensure that doctors are acting responsibly and the law is not being flouted – but they in fact represent attempts to chip away the foundations of the Abortion Act.

The 1967 Abortion Act did not technically decriminalise abortion for women who sought it. Instead, it achieved a ‘medicalisation’ of abortion regulation in which control over the abortion decision was handed to doctors rather than to pregnant women. Abortion is now legal only with the agreement of two doctors that to continue the pregnancy would involve ‘a risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman’ or there was ‘a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped’. Doctors are given considerable leeway in deciding what constitutes an injury to physical or mental health. (Nowadays doctors are generally inclined towards a liberal interpretation of the law, but can still obstruct access to abortion if they so choose.) The Act, at its core, therefore relies upon trust in doctors’ ability to interpret the law and manage abortion wisely.

It is this trust which recent political developments have challenged. The Dorries and Field amendment, described by its supporters as a ‘modest’ proposal aimed at providing women seeking abortion with more choice, rested on a depiction of doctors as untrustworthy and abortion providers as biased, or worse, as profiteering (this in spite of the fact that the largest abortion providers are not-for-profit organisations). The ‘sex selection scandal’, which surfaced (perhaps uncoincidentally) around the time of abortion’s repoliticisation, helped to further sow the seeds of mistrust of doctors – despite the Telegraph investigation uncovering only sparse evidence of the practice taking place. Similarly, while it is debateable whether pre-signing abortion forms is even illegal, the allegations and subsequent spot inspections on clinics have served to foster a climate in which abortion clinics are presumed to be acting irresponsibly.

We are told that these challenges to abortion providers are not meant as challenges to abortion rights. Rather, they are about improving services and enhancing the standard of care – even about protecting women. However, undermining confidence in doctors has long been a tactic of those seeking further restrictions to legal abortion. Bills introduced by MPs James White and John Corrie, in 1975 and 1979 respectively, attempted to amend the Abortion Act so that abortions could only be carried out if the pregnancy posed a ‘grave’ risk (rather than simply ‘a risk’) to the health of the pregnant woman – effectively rendering a huge proportion of abortions illegal. The Corrie Bill would also have reduced the time limit for legal abortion, then at 28 weeks’ gestation, to 20 weeks. White and Corrie justified their Bills by painting doctors as unscrupulous profiteers committed to abusing the Act. Both Bills met with trenchant opposition and eventually failed, but attempts to undermine the medical basis of the Abortion Act remained a stalwart feature of anti-choice activity. While the image of the ‘irresponsible’ doctor did for a while fade from public debate as lobbyists instead attempted to depict doctors as ‘victims’ of the Act, it has re-emerged in recent months thanks to the efforts of Nadine Dorries, Andrew Lansley and others.

There are good reasons to call for changes to abortion regulation. The Abortion Act has been critiqued by activists on the grounds that it does not allow for abortion ‘on demand’ and therefore does not safeguard women’s right to choose. The requirement for two doctors to agree that an abortion should be carried out infantilises women, and is opposed by the British Medical Association’s Medical Ethics Committee. Similarly, rules governing early medical abortion should be loosened – currently, women must make multiple trips to a clinic in order to take both sets of pills under medical supervision, meaning that many women experience the onset of an abortion as they are still travelling home. These unnecessary restrictions have been made possible by an abortion law which is overly medicalised. There is room to challenge the foundations of the Act from a pro-choice perspective, and pro-choice actors need to claim this terrain back from opponents of legal abortion.

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