Abortion: how the 40-year-old law traps NHS patients

Guest post from Natalie Bennett

Abortion is sometimes presented as a marginal issue, something of concern only to feckless teenagers, the disorganised and unlucky woman. But that’s far from the case. One in three British women will have an abortion by the time they reach the age of 45. Contraceptive failure is the chief reason (and contraceptives are a great deal less reliable than the popular view would have it) – and many women having abortions already have one or more children.

Where women live – and who they are – will have a considerable impact on the provision of that abortion. In Scotland in 2002, 99.8% of abortions took place in NHS hospitals. In England and Wales only 42% were NHS facilities, while 22% were obtained privately. (The rest were funded by the NHS in private facilities.)

In some parts of England and Wales the waiting list for an NHS abortion is more than seven weeks; the average two to four weeks, although the official target maximum waiting time is 21 days.

That wait has two main impacts – there’s stress and distress, then there’s potential medical effects. While having an abortion is safer than continuing the pregnancy, the rate of complications does increase with the gestation period, and for a number of women may mean being forced to change from a medical abortion (i.e. taking hormone pills), to a surgical abortion.

When the current abortion law was passed 40 years ago, medical knowledge was considerably less advanced than it is now. The only method of abortion available was surgical, and the level of complications considerably higher. So the law at that time specified that the procedure could only be carried out by a doctor, in a specific facility. Also, the politics of the time led to a requirement being added, one needed for no other procedure, that the signatures of two doctors be obtained to authorise it.

Many organisations, the Royal College of Nurses and the British Medical Association among them, have formally backed the removal of some or all of those outdated provisions in the law.
In many other countries nurses and midwives provide abortions, with safety rates entirely comparable to those of doctors; in many countries women are able to complete medical abortions in the comfort and security of their own home. Making changes to the law in Britain would help the NHS to significant reduce waiting times. So too would the removal of the two-doctor rule.
These are issues now the subject of a significant campaign by women’s groups, which has been given new impetus by the drive by anti-abortion activists, such as Ann Widdicombe, to tack anti-abortion provisions on to the Human Embryology and Fertilisation bill now going through parliament.

And it is an issue being taken up by the Green Party. The party’s policy is already solid, stating that women’s access to abortion should not be less than it is under the current law, but a motion before the Reading party conference later this month, which I am proposing, backed by Caroline Lucas, MEP, and Sian Berry, our London mayoral candidate (and many others), calls for improvements to the law to remove the two-doctor rule, to allow appropriately trained nurses and midwives to carry out the procedure, and to remove unnecessary restrictions on where the procedure can be carried out.

What this can achieve is simple. By removing unnecessary barriers to provision, and unnecessary costs, the NHS should be able to greatly improve its provision of abortion services, without spending any extra money. And women using the NHS should be able to receive an appropriate, supportive service that does not force them to wait – eventually it could be hoped – more than a few days for the procedure once they have made the decision to have an abortion. It may never be possible to entirely remove the inequalities in NHS and private treatment, but changing the law as proposed by the Green Party motion would be a considerable step in the right direction.