Background

Abortion has been used throughout the world for thousands of years.

In the UK abortion became illegal in the 19th Century when the penalty for 'procuring a miscarriage' was life imprisonment. Women trying to escape the burden of an unwanted pregnancy were forced to use unreliable and dangerous methods, including poisonous drugs, knitting needles, soap or lead solutions inserted through syringes, and blows to the abdomen.

However many people were appalled by the number of women suffering and dying as a result of illegal abortion. Pressure for reform finally resulted in Liberal MP David Steel's Abortion Law Reform Bill, which became law on 27 October 1967 and took effect on 27 April 1968.

This was amended in 1990 by the Human Fertilisation and Embryology Act which changed the upper limit from 28 to 24 weeks for most abortions, due to the fact that advances in medicine mean it is now possible to keep some babies alive born after about 24 weeks of pregnancy.

Since 1967, there have been at over 20 unsuccessful attempts in Parliament to restrict the law, prompted by pressure groups opposed to legal abortion. However, recent polls show more than 80% of adults are in favour of abortion on request.

Ethics

The subject of abortion arouses fierce debate. People who are against abortion describe it as murder because they believe that a fertilised egg is a human being which possesses a soul from the moment of conception, and has the right to life under all circumstances. Pro-choice supporters see the fertilised egg as potential life, based on medical and scientific evidence that the fetus is not viable (ie capable of independent life) in the early stages of pregnancy and is still a part of its mother. In fact nature chooses not to allow all fertilised eggs to develop: it is estimated that as many as 25% of pregnancies end in spontaneous abortion or miscarriage.

Abortion has existed throughout history and making it illegal or socially unacceptable does not drive it away - it merely adds to the pain and danger which women are prepared to face to avoid carrying on with an unwanted pregnancy. People who have a moral or religious objection to abortion should not be forced to have or to participate in an abortion against their will. Should they be allowed to use the law to impose their views on those who do not share their beliefs?

If women are to enjoy a healthy, happy life and to offer the same to any children they may have, they need to be able to exercise control over their reproductive lives. Not all women are able to use contraception effectively at all times. Surely a request for an abortion is a responsible decision when faced with the prospect of a child that she is not able to love or care for? Why should a woman seeking abortion be accused of having no respect for life when her prime concern has been the future quality of life for herself, the potential child, her partner and her family?

Although it is women whose health and well-being are most affected by the availability of abortion, it is often men who have the power to decide. That is why pro-choice groups continue to press for a woman's right to decide for herself, believing that society should recognise that women are trustworthy, responsible people who are capable of making valid judgements for themselves on moral issues.

Religion

The Roman Catholic Church is the only major world religion to rule that abortion is absolutely unacceptable in all circumstances (including the probable death of the mother). However it is only since 1869, when Pope Pius VI declared that 'ensoulment' (gaining a soul) happened at conception, that Catholics have been taught that abortion is always morally evil.

The Church of England and the Church of Scotland teach that abortion is wrong because it denies the fetus the right to life but there are certain extreme circumstances (ie serious risk to the health of the mother) when her needs override the rights of the fetus.

Judaism teaches that life begins at the moment of birth, however abortion is discouraged except where the mother's life is at risk. Hindu scriptures also only allow abortion under these circumstances.

Islam also teaches that abortion is permitted only in extreme circumstances in which case the actual life of the mother takes precedence over the probable life of the fetus. Some scholars also sanction abortion if the pregnancy resulted from rape. As it is believed that the fetus becomes 'ensouled' at 120 days, early abortion is preferred.

The Free Churches (Baptist, Methodist and Evangelical) hold that abortion is a matter for the individual to decide. The Methodists in particular have been outspoken in their view that personal and social factors need to be considered in each case.

However there are many people whose attitude towards abortion differs from those of their religious leaders. They believe that individuals have the right to follow their own consciences, and women from all religions continue to seek abortions.

Who?

Since it became legal in 1968, more than three million British women - about 4 out of 10 women now aged between 16 and 60 - have had an abortion. The annual number of abortions in Britain (not UK) has risen from just over 100,000 in 1971 to 163,600 in 1995, mainly because there are more women of childbearing age but also because it has become more acceptable. About one in five (20%) of all pregnancies ends in abortion.

In 1991, nearly 90% of British abortions were carried out in the first 12 weeks of pregnancy. More than half of the women were in their 20s, while teenagers accounted for just under one fifth. Nearly 90% had an abortion on the grounds of risk to their physical or mental health.

The number of women travelling to Britain for abortions has fallen dramatically since it has become legal in most Western countries. Of the 9,300 non-resident women having an abortion in 1995, 6,750 were from other parts of the British Isles (including the Irish Republic).

Why?

Unplanned pregnancies are not necessarily unwanted but the news can come as a terrible shock. Although contraception is freely accessible in this country, no contraceptive has yet been developed which is 100% safe and effective, and contraceptive failure is currently a major reason for women requesting abortion.

There are many reasons for not wishing to continue a pregnancy: the woman may be too young or too old; it is the wrong time in her life; she is single and lacks financial and emotional support; she has too many other responsibilities; her baby is likely to be born with serious disabilities; she is pregnant as a result of rape or incest; she has no home or secure base; she has a serious disease which would be made worse by pregnancy; there is a hereditary disease in her or her partner's family; she has a large family already; she has relationship or marriage problems.

Law

In the UK (except for Northern Ireland), legal termination of pregnancy may be carried out IF two doctors agree that the woman is less than 24 weeks pregnant AND that continuing with the pregnancy would involve risk to her physical or mental health greater than if the pregnancy was terminated OR that continuing with the pregnancy would involve risk to the physical or mental health of any existing children in her family.

The 24 week limit does not apply IF the woman's life would be at risk if the pregnancy continued OR if there is a risk of grave permanent injury to the physical or mental health of the pregnant woman if the pregnancy continues OR if there is substantial risk that the child would be born with a serious disability.

Abortion is not available on request. Two doctors must agree and those with religious or moral objections are not legally obliged to help. Even a woman pregnant as a result of rape or incest does not automatically qualify for an abortion.

Many late abortions (towards the 24-week time limit) occur because the woman has experienced difficulty in obtaining an NHS abortion. Pro-choice organisations are currently campaigning for abortion on request in the first three months of pregnancy to minimise the increased medical risks and emotional distress associated with late abortion.

In England and Wales only 70% of abortions are provided free by the NHS (in Scotland more than 95% of abortions are free). Local services vary considerably - some districts carry out less than 50% of local abortions. A woman may have to pay £200 - £500 at a private clinic simply because of where she lives.

Methods

Early abortion (up to 12 weeks) most commonly involves 'vacuum aspiration', which means that the contents of the uterus are sucked out by an electric pump. This procedure takes about 10-15 minutes and is usually done under general anaesthetic. In some cases 'dilation and curettage (D&C)' or 'dilation and evacuation (D&E)' is also carried out to remove the contents of lining of the womb with an instrument. At 12 weeks, the fetus is only 50 mm long, and most of the tissue is made up of placenta and blood, rather like a heavy period.

A non-surgical method was introduced in 1991. Mifepristone or RU486 ( also known as the "Abortion Pill") can now be used by women before the ninth week and between the 13th and 20th weeks of pregnancy. As with all abortions, these must take place in an NHS hospital or a licensed clinic.

In the later stages of pregnancy, a form of labour is induced by the use of prostaglandins, a kind of hormone which causes miscarriage. This takes several hours and can be more distressing for both the woman and the medical staff involved.

After the abortion most women experience a huge feeling of relief, which may be tinged with sadness or guilt. Some women blame the abortion for their depression, instead of the crisis of the unwanted pregnancy.

It is important to seek reliable contraceptive advice: abortion is not an alternative to contraception. There are also two emergency methods of contraception: the so-called 'morning after pill' which can be taken up to 72 hours (three days) after intercourse, and the intra-uterine device (also known as an IUD or coil), which can be fitted by a doctor up to five days after unprotected sex.

Opinion

Public opinion has shown consistent support for a woman's right to choose abortion.

In 1964, when abortion was illegal, 44% of those asked said that abortion should be legal 'if the pregnant woman is unable to cope with any more children' (49% were against this). In 1965 two thirds of those questioned believed that abortion should be legal 'in some cases'.

In 1976, after the 1967 Abortion Act, 55% agreed that 'abortion should be legally available for all who want it'. Between 1979-1987, between 76-80% consistently supported the woman's right to choose; in consultation with her doctor.

Other polls, help to show whether sex, age and religion make any difference to people's opinions on abortion.

In 1988, a poll asked 'Do you think that women should have the right to choose abortion in the first few months of pregnancy?'. 86% of the Church of England members were in favour, as were over two thirds of the Roman Catholics. Of the non-Christians, 7 out of 8 Jews, all 3 Sikhs, 4 out of 6 Hindus, and 2 out of 6 Muslims favoured free choice. Of those with no religious beliefs, 85% supported the right to choose.

An April 1991 poll showed the highest ever support for abortion on request. In response to 'Do you think that women should or should not have the right to choose an abortion in the first three months of pregnancy?' 81.2% were in favour of the right to choose. More women (84%) than men (78%) were pro-choice, and the youngest age group (18-24) was most in favour, with 90% of them in support.

More recent polls have continued to show this level of support for abortion on request.

Safety

Access to safe abortion can dramatically improve the quality of life and general health of women throughout the world.

The World Health Organisation (WHO) estimates that worldwide 40-60 million abortions take place each year, ie between one third and one fifth of all pregnancies are terminated. Twenty million of these abortions take place in countries where abortion is illegal, forcing women to turn to back-street abortionists. These unsafe abortions kill an estimated 100,000 women each year, while many others are permanently injured. Before abortion became legal in Britain, reliable estimates put the number of illegal abortions at 100,000 a year, with many resulting deaths.

However legal abortion is very safe, particularly when carried out in the first 12 weeks of pregnancy. In fact, continuing with a pregnancy is eight times more risky than having a legal abortion. Each year, 500,000 women in developing countries die from pregnancy or pregnancy-related illnesses (including illegal abortion) and even in Britain about 40 women a year die while pregnant or shortly after giving birth - only one of these deaths is due to abortion.

Carrying on with an unwanted pregnancy can cause more long-term stress and suffering than having an abortion. Being refused an abortion has been shown to cause ongoing resentment towards the unwanted child which can last for years, with the child itself being more likely to experience a wide range of emotional and social problems.