Heated debate results in BMA conference voting to decriminalise abortion
Abortion should be decriminalised, medics at the British Medical Association (BMA) have said.
Delegates at the BMA’s annual meeting in Bournemouth voted in favour of a motion calling for a change in the law.
This means the BMA will adopt this stance as formal policy and lobby ministers for a change in legislation.
At present the law permits abortion up to 24 weeks of pregnancy. But if there is a substantial risk to the woman’s life or foetal abnormalities, there is no time limit.
Two doctors must ensure that the requirements of the Abortion Act are met before an abortion can take place.
The topic received heated debate among the 500 medics at the meeting.
Some medics said that abortion is a medical decision and not a criminal one. They said a change in policy supports the rights of women.
But others raised concerns about decriminalisation putting vulnerable women at risk, sex-selective abortion and professional regulation.
Dr John Chisholm, chairman of the BMA’s medical ethics committee, said that the motion was not about time limits, saying that the BMA supports current time limits on abortion.
Dr Coral Jones, who presented the motion, said: “We must respect women and have trust in women to make decisions for themselves and their families.”
The BMA said criminal sanctions for abortion should be abandoned but it should be regulated in the same way as other health procedures.
One delegate, Sarah Johnson, questioned whether it would be regulated in the same way as hip replacement or lip fillers – a cosmetic procedure not subject to stringent medical regulation.
The BMA said limits could still be set, but subject to professional and regulatory sanctions.
Other criminal laws which apply to other aspects of care would continue to apply to abortion – for instance supplying abortion drugs without a prescription would be a criminal offence under the UK-wide Human Medicines Regulation 2012.
Dr Chisholm added: “Abortion is currently a crime, with exceptions, throughout the UK. Following the debate the majority of doctors were clear that abortion should be treated as a medical issue rather than a criminal one.
“What must be clear is that decriminalisation does not mean deregulation. The debate today and the BMA’s new policy only relate to whether abortion should or should not be a criminal offence; the policy does not address the broader issue of when and how abortion should be available.”
Speaking after the debate, Dr Clare Gerada, former chairwoman of the Royal College of GPs who is also a trustee of the British Pregnancy Advisory Service (bpas), said: “Abortion is never an easy thing to do for any woman or for any man. But for abortion to be governed by criminal law rather than governed by healthcare regulation is nonsense.
“I think this is as powerful and as important as the 1967 Abortion Act. This will start now putting abortion where it really should be, which is regulated by healthcare and then improving women’s access to it, improving contraception and removing sanctions for women who might or might not buy their medicines online.
“BMA doesn’t make law but the BMA is a very powerful voice for doctors and it’s a very powerful voice for people of this country.
“And to be able to say that the BMA fully supports the decriminalisation of abortion I think is a very, very, very powerful voice to have.
“For the BMA to be coming out absolutely overwhelmingly for the decriminalisation of abortion, I think now politicians will have to stand up and listen and actually take action.”
She said she suspects that following the vote there would be a Private Member’s Bill put to the House of Commons.
In March, a Bill was introduced at the Commons calling for abortion to be decriminalised up to 24 weeks.
Former shadow health minister Diana Johnson introduced the Reproductive Health (Access to Terminations) Bill in a bid to get rid of “Victorian” abortion laws which contain criminal sanctions for both women and doctors if they do not meet certain requirements.
The Bill, which called to remove criminal sanctions in England and Wales and place regulation with professional bodies, received its first reading in March.
After gaining traction among MPs, it was scheduled for a second reading in May but Parliament was dissolved ahead of the General Election so the Bill fell.
Last year the Royal College of Midwives came out in favour of abortion being removed from criminal law.
Presenting the motion, GP Dr Jones said: “Decriminalisation is the removal of abortion from the penal code.
“Doctors and women will no longer face the threat of imprisonment for procuring or performing abortions.
“Following decriminalisation, abortion providers would be regulated by the General Medical Council standards of good medical practice including consent and confidentiality.
“And health providers would have a statutory right to conscientious objection.
“Malicious attempts to procure abortion or illegal supply of abortion would be subject to existing criminal law.
“So why push for decriminalisation when we have the 1967 Act? In the UK, women have been imprisoned for up to seven years and doctors have restrictions placed on their practice due to the penal code in the 1861 Act.
“Fear of prosecution can prevent doctors from making decisions where the health of their patients is their first consideration.”
She said 80% of abortions that occurred last year took place before the woman was 10 weeks pregnant.
Dr Jones added: “People have expressed concerns that Motion 50 will result in abortion on demand carried out in any location by non-medical practitioners up to term and that the right to conscientious objection would be removed
“Decriminalisation with regulation will not lead to these outcomes.”
But pro-life organisations have reacted with dismay to the news, saying that the decision had brought “medical profession into disrepute”.
Some staged a protest outside the meeting, displaying graphic images on 6ft posters.
The news comes as retailer Superdrug announced that it was launching a cut-price morning-after pill.
It is offering a generic emergency hormonal contraceptive (EHC) pill for £13.49 – about half the price usually paid for branded EHC.
Arguments for and against decriminalisation of abortion
Medics at the British Medical Association’s annual meeting in Bournemouth have debated the concept of the decriminalisation of abortion for almost two hours.
Around two thirds voted in favour of a change in the law.
With many doctors on either side of the argument, here are some examples from the debate:
Against decriminalisation.
Medical student Sarah Johnson said the motion did not provide evidence that a change in the law would be beneficial for women and it did not address “coercion of women”.
“Abortion isn’t usually an easy decision, but if policy were to change as described, women in abusive relationships would no longer be protected,” she said.
“The current system has mechanisms which aim to safeguard women being pressurised into an abortion that they do not want.
“Furthermore, women will be at an increased risk if they procure abortions at home.
“I couldn’t imagine going through a process like that at home without a medical professional, even being aware that it was happening. If a woman has felt so unable to seek medical advice prior to an abortion, do we think she will seek help if something has gone wrong? Are we not just telling women to keep it hidden and behind closed doors?
“Repealing the current law would allow abortion to be done anywhere. This motion states that it will be regulated like other medical procedures, but which ones? Hip replacements or lip fillers?”
Trainee medic Dr Amy Watson told delegates: “Let’s not trivialise abortion into a postal DIY service, removing the need for discussion and assessment.
“The rise in online abortion pills is a concerning challenge. But do we remove laws because people are breaking them? The risk of prosecution is an important deterrent.
“Admittedly, online pills can be a desirable option for women who wish to try and solve the problem of their unwanted pregnancy in secret, but should we encourage women to deal with this on their own? That’s not safe, that’s not compassionate. It’s isolating.
“A woman may not feel she can talk to her friends and family, but she should feel able to talk to her doctor.”
On two doctors signing off on abortion she added: “Let’s show women that they matter enough that despite the current ethos of medical austerity they warrant the attention of two medical minds.
“Women need time to think. After all, you wouldn’t have a procedure without any face-to-face pre-op would you?
“The number of prosecutions is already very small. These cases are extreme and well into the third trimester. How is aborting a healthy, viable baby not criminal?”
For decriminalisation
Professor Wendy Savage, coordinator for Doctors for a Woman’s Choice on Abortion, told the conference: “A lot of doctors have understood that it is the woman who makes the decision to have an abortion.
“Fifty-nine years ago, as a medical student, I saw a woman die from abortion. She was 35, married and had three children and objectively one could say ‘well why does she need to have an abortion?’ She felt so strongly that she could not carry on with a pregnancy in her circumstance and she took the law into her own hands. This is something that women will continue to do whatever the law says.
“To say that women are going to abort up to term is completely over the top.
“In my experience of 30 years of providing abortions and approximately 10,000 abortions that I have performed, women do not present after 24 weeks to have an abortion unless they’re mentally handicapped, have learning disabilities or are extremely young and their parents haven’t notices that they were showing signs of pregnancy.
“Last year, there were only 226 abortions after 24 weeks and those were on the grounds of foetal abnormality.
“The way that women are treated is really important and it has changed.”
Urging member to pass the motion, she added: “Send a message to the women of Britain that we trust women and we know that you are capable of making up your own minds about your own lives and your own bodies.”
Dr Megan Brown, a junior doctor, said: “A third of women in the UK will receive an abortion in their lifetimes, making it one of the most common gynaecological procedures. Yet we insist on regulating this with a legal framework routed in the conservative values of the Victorian era.
“Granted, the Abortion Act is only 50 years old – but it did not and does not go far enough to liberate women from patriarchal and traditionalist law.”
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