Thursday 20 June 2013

US House of Representatives vote for 20 week abortion limit raises the issue again for the UK

The Republican-controlled US House of Representatives has passed a bill that would reduce late abortions.

The plan to restrict terminations to the first 20 weeks after conception was approved by 228 votes to 196, largely along party lines.

The Pain-Capable Unborn Child Protection Act, which was based on research showing that the unborn child can experience pain by at least 20 weeks gestation, marks the first time that the United States’ Congress have voted to give affirmative protection to unborn children.

The debate followed polls showing that 64% of the American public would support legislation prohibiting abortion after 20 weeks (more detail is in Parliamentary Network for Critical Issues article).  

But the bill has no chance of becoming law as Democrats control the Senate and the White House has threatened a veto.

Most US states allow abortions to when a baby becomes viable outside the womb, considered to be some 24 weeks.

The Republican leadership pressed ahead with the abortion bill after the case of Kermit Gosnell, a Philadelphia abortion doctor who was recently sentenced to life in prison after being convicted of killing three babies delivered alive.

There has also been a lot of support for lowering the upper limit amongst UK politicians.

Health Secretary Jeremy Hunt came in for criticism last year  for saying that he believes the upper abortion limit should be lowered from 24 to 12 weeks. 

However he is not alone. Of the 16 Conservative MPs in Cabinet, 13 actually voted for a decrease in the abortion upper limit during the passage of the Human Fertilisation and Embryology Bill in 2008. 

Of these, three, including Mr Hunt, 
voted for 12 weeks, two voted for 16 weeks, seven voted for 20 weeks and one, the Prime Minister David Cameron, voted for 22 weeks. 

They are not alone in this conviction.

Nearly two thirds of the British public and more than three-quarters of women support a reduction in the 24-week upper age limit. 76% of the public think that aborting a baby at six months is cruel. Furthermore a 2007 poll by Marie Stopes International found that two thirds of GPs wanted a reduction from 24 weeks.

Why has public opinion changed on late abortion? There are five main reasons: 4D ultrasound, babies surviving below 24 weeks, stories of babies born alive after abortion, fetal sentience, and European precedent.

We have all seen Professor Stuart Campbell's high resolution 4D ultrasound images of babies 'walking’, swallowing, coughing, hiccupping from 12 weeks gestation and experienced how mothers bond emotionally to their babies as a result of these scans. We have also seen photographs of babies alive in the womb at 20 weeks (left).

The public also know about individual high profile cases like Manchester'sMillie McDonagh, born after a 22-week pregnancy and the world's most premature baby, Amillia Taylor, who was born a week younger in the US. Experts may argue about survival figures and about comparisons between population-based studies like EPICure and those from top neonatal units but the fact remains that some babies do actually survive below 24 weeks.

Stories of babies born alive after failed abortions are also not uncommon. In a 2007 West Midlands study of 3,189 cases of termination for fetal anomaly, 102 (3.2%) babies were born alive. This included 65.7% of those between 20 and 24 weeks. Accounts such as these understandably upset people.

And then there is the question of whether fetuses feel pain. The general public intuitively concludes that they do when they hear that from 16 weeks babies will recoil from a noxious stimulus in the womb and that premature babies born earlier than 24 weeks, if stabbed in the heel with a needle, will withdraw and cry. The RCOG wheels out its experts to tell us that babies below 24 weeks do not have the neurological apparatus to sense pain but fail to tell us that this is a controversial view not shared by other experts who regard it as being based on an outdated understanding of physiology.

Which of us, honestly, can imagine telling the mother who feels her baby kick at 20 weeks that it is not a sentient being?

Finally, Britain is out of touch with most of Europe in this matter. Most countries in the EU, 16 out of 27, have a gestational limit of 12 weeks or less. These include Germany, France, Spain, Portugal, Italy, Belgium and Austria plus most countries in Eastern and Central Europe who once had far more liberal laws. At 24 weeks Britain is up there with former Soviet States Lithuania and Latvia.

In 2010 there were 792 disabled babies and 1,936 able-bodied babies aborted in Britain between 20 and 24 weeks. Every single one of the latter group was aborted under ground C of the Abortion Act, which in 98% of cases means protecting the mental health of the mother.

Lowering the abortion limit to 20 weeks for able-bodied babies (as Miller and many other MPs would support) would give more legal protection to about 2,000 babies a year; just 1% of the total. It would put clear blue water between the upper abortion limit and the lower threshold of viability and it also would show that parliament is beginning to listen.

Of course it would also raise the question of whether we should be doing the same for disabled babies, who can currently be aborted up until the moment of birth, a question evaluated by a recent parliamentary inquiry which is due to report soon. 

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