Ben Roback: Overturning Roe vs Wade could supercharge the Midterms – but to what effect?

18 May

Ben Roback is Vice President of Public Affairs at Sard Verbinnen & Co.

As if domestic politics in the United States needed another reason to become even more split along partisan lines, a leaked draft Supreme Court opinion rocketed the abortion debate towards the very top of the political agenda once again.

There is a very realistic possibility that the highest court in the land, with a 6-3 conservative majority, will overturn the 1973 ruling that legalised abortion across the United States.

The Politico leak, a deeply controversial story in its own right, revealed the Court’s view that the Roe v Wade judgement is “egregiously wrong”.

If the Court follows the draft opinion this summer, at least 26 states would be set to ban abortion entirely with 13 of those prepared with “trigger laws.”

The Supreme Court is considering a case which challenges the state of Mississippi’s ban on abortion after 15 weeks. Should the Court rule in favour of Mississippi, it will in effect end the constitutional right to an abortion and make abortion rights a decision for individual states once again.

Deep red Republican states have not waited for the Supreme Court to deliberate. States like Mississippi, Oklahoma, Texas, Idaho, and Arkansas have been advancing the pro-life agenda for years. It is a regular reminder for Democrats of the importance of down-ballot elections and gubernatorial races.

Consider two examples. First, Mississippi has a trigger law if Roe vs Wade is overturned. The law would ban all abortions except when continuing the pregnancy puts the person’s life at risk or if the pregnancy is the result of a rape in which a formal charge is filed with the police.

Second, Oklahoma, where Governor Kevin Stitt (R) signed a recent bill into law that bans abortion after six weeks: when cardiac activity can be detected by clinicians in the embryo, but typically before a woman knows she is pregnant.

Public opinion remains broadly against overturning Roe. According to an SSRS poll conducted following the Supreme Court leak, 66 per cent say it should not be completely struck down and 59 per cent would support Congress passing legislation to establish a nationwide right to abortion – an impossibility, based on the current political composition of Capitol Hill.

The potential to energise both sides ahead of the 2022 midterms

The key question is what impact the turbocharging of abortion as an election issue will have on the November elections, and especially the extent to which it boosts turnout.

Republicans are comfortable getting on the front foot and advocating pro-life policies. Democrats will fight tooth and nail to defend a woman’s right to choose and recognise its central importance to their voter base. All that points to an intensely motivated voter base on both sides.

Two polls published either side of the leak reveal the potential for a knock-on effect. The share of registered voters who say they are “extremely” or “very” enthusiastic about voting rose six points between the first poll and the second.

There was only a negligible difference across party lines: 43 per cent of Democrats are now “extremely” or “very” enthusiastic. That figure is 56 per centamongst Republicans.

Furthermore, 47 per cent of younger adults say they would feel “angry” if Roe was overturned, but only nine per centof that age category are “extremely enthusiastic” about voting this November.

Can Joe Biden and Democrats across the country convert the anger of young people into votes? If they can, it holds the key to having a transformational impact on the outcome of at least the more marginal races later this year.

Despite abortion access being one of the most politically entrenched issues in US politics, uniformity is not guaranteed among party lines.

Joe Manchin, the Democratic senator representing the red state of West Virginia, is on the record as describing himself as “pro-life and proud of it”. Susan Collins and Lisa Murkowski are two rare Republican abortion rights supporters in the Senate.

A Senate vote last week exposed the fissures in party unity; independent-minded senators cannot be simply lumped in with the view of their party.

The debate around abortion rights has brought protestors to the streets in front of the Supreme Court and state legislatures across the country. But whilst Roe vs Wade feels instrumental right now, it would be remiss to lose sight of the fact that the economy is the issue most likely to be a driving force for voters come November as petrol, food and energy prices all continue to rise.

On the economy, 46 per cent of adults say the Republican Party’s positions are more aligned with their own, compared with 31 per cent for the Democratic Party.

The Supreme Court’s decision on Roe vs Wade matters, but it is more likely to be the state of the US economy that has the biggest impact on the November midterms.

Why are we so obsessed with America’s abortion debate?

4 May

George Orwell once claimed that the English intelligentsia are thoroughly Europeanized since they “take their cookery from Paris and their opinions from Moscow.” Whilst I’d imagine their culinary inclinations are (rightly) largely unchanged, the end of the Cold War has brought a new source of intellectual delight for our commentator class – Washington.

Today’s headlines are a perfect illustration of this. From the editorial of The Times cautiously approving  the abortion question being potentially handed back to the States, to pieces from The New Statesman informing the ‘birthing persons’ of North London of how to obtain an abortion in ‘post-Roe America’, yesterday’s leaked Supreme Court judgement reversing Roe v Wade has clearly excited that part of the cognoscenti minds most interested in affairs across the Pond.

There was a time, of course, where to be interested in American things was considered distinctly lowbrow. Whereas politicians grumbled in the 1920s that millions were becoming Americanised due to the newfound popularity of Hollywood movies, more recent snobbishness would prevent any self-respecting member of the literati from being seen dead in a KFC. The United States has been taken as everything wrong about decadent consumerism and intellectual petrification, a haven for the fat, the bigoted, and the stupid.

That element hasn’t entirely disappeared. When my fellow metropolitan liberal-types imagine the average Trump voter, they probably go for some pot-bellied, MAGA-hat wearing, rifle-toting redneck, with a fondness for Fascism, marrying his sister, and blaming Mexicans for stealing his job. His views on abortion, gun control, immigration, and the few other issues which he can comprehend are all directly opposite to those of any right-thinking, open-minded, decent person with a subscription to The Guardian and a penchant for Tuscan villa holidays.

The reason that our intelligentsia think like this, however, is because their social and intellectual equivalents across the Atlantic do so too. Of course, they may prefer The New York Times to The Guardian in the hip cafes of Manhattan, San Francisco, and Washington D.C. But that makes little difference (except, perhaps, that The New York Times loathes post-Brexit Britain even more), especially in the age of social media. The highly educated and self-consciously liberal in this country see their reflection in their American idols – and so download their opinions wholesale.

Hence why, despite this potential Supreme Court decision not changing the lives of anyone living 3,600 miles a way a jot, it can earn itself an Editorial in our paper of record, endless commentary on the BBC, and as much energy devoted to it on Twitter as the other vital question of whether the Prime Minister knows who Lorraine Kelly is or not. Like a chubby child stuffing in their umpteenth Chicken McNugget, we are hooked on America’s produce.

All of this comes at the expense of an interest in our neighbours. I imagine many of those of the most zealously #FBPE persuasion know more about the intricacies of the Supreme Court, voting infractions in Georgia, and what Kamala Harris likes for dinner than they do the names of most (far more impressive) female European leaders, or the structure of the European Council, or what the Customs Union actually is.

I am not innocent in all this. My Yanko-philia and Yanko-phobia have always worked against each other, with a childhood spent visiting Disneyland Florida – the English equivalent of the pilgrimage to Mecca – competing for precedence in my eight-year-old mind with Top Gear’s less-than-flattering portrait of the land of the free. And yet I have grown up (to an extent) to be both fascinated and repulsed by the United States, and have visited it much more than any European country.

So I am as much interested in yesterday’s leak as any Trump-hating Guardianista I hoped to lampoon. For one thing, I largely agree with the line The Times took this morning. The Roe v Wade ruling in 1973 was a clear act of judicial over-reach, stretching the Constitution to cover an issue beyond the comprehension of the Founding Fathers. In doing so, it has meant the issue has failed to be settled, and has caused endless political and legal wrangling for the last fifty years.

We have largely avoided this rancour and acrimony in Britain. Since the 1967 Abortion Act was passed, public opinion in Britain has settled into broad agreement on abortion’s status as a regrettable necessity. Although some debate exists over where time limits should be set – and it was adjusted down from 28 weeks to 24 in 1990 – the whole issue is largely free from controversy. Even if I occasionally wish it wasn’t.

Yet I wouldn’t go so far as The Times in offering advice to Americans in how to respond to the potential ruling. Remember The Guardian’s hilariously misguided mailing campaign in 2004 to the voters of Ohio? It was designed to prevent Bush Jr’s re-election. If I was an average member of that great state, I can’t imagine anything that would make me more likely to vote for the second-best President called George Bush. Or J. D. Vance, who last night took a step towards being the next U.S President but three.

Americans don’t care what we limey assholes think. That is the case now more than ever before. We may be doing sterling work leading the Western response to the Ukrainian crisis, but geography, economics, and plain common sense suggest that America’s future lies more towards the Pacific in the decades to come. The affection our commentariat have for their Yankee brethren only goes one way.

In which case, this is an excellent opportunity for them to educate themselves on our European friends and neighbours. In or out of the European Union, it is clearly Britain’s fate to be a leading force on the Continent. If we are to understand and flourish in that role, we should probably know what’s going on there. We could even discover that most European countries have abortion laws far more stringent than our own. Perish the thought.

Why I wish Britain’s abortion debate was more like America’s

1 Apr

It could be said that MPs voted on Wednesday to make it easier to murder babies. The Commons voted by 215 to 188 to retain the ‘pills by post’ service introduced at the pandemic’s start. This was despite the government’s wish to scrap it.

This service has enabled women to take both pills needed for an abortion at home, rather than, as previously, taking the first in the presence of a clinician. Once the bill is law, it shall always be possible to end the life of an unborn child within the first ten weeks of a pregnancy from the comfort of one’s own home. Taking a life has never been so cosy.

Of course, that isn’t how most will see it. It doesn’t summarise the general media opinion, or even my own. Polling suggests the British public support retaining these services, and retaining current abortion laws. Most do not consider abortion to be murder, but as a regrettable necessity required in specific and unfortunate circumstances.

The bulk of the coverage reflected this: from The Guardian to The Daily Mail, note was made of the most emotional speeches, and the warnings of various groups of potential dire consequences of not passing this amendment to the Health and Care Bill. Despite Conservative MPs voting by a margin of over 100 not to keep these measures in place, the Commons has said they shall remain.  

I am no zealot for either side of the abortion debate, being of traditional agnostic Anglican stock and mainstream Tory views. I therefore lack either the enthusiasm of my pro-life Catholic friends or my pro-choice liberal ones.

But I am distinctly uncomfortable about a practice that has seen over 125,000 abortions performed over the last two years being made permanent based on a few hours’ debate. We already have some of the most liberal abortion laws in Europe – they can be performed up to 24 weeks into a pregnancy, double what most of our continental neighbours allow. A quarter of all pregnancies end in abortions; over 200,000 pregnancies are legally aborted in England and Wales every year.

All this goes on with very little public debate. Our obsession with American politics ensures that we hear a lot about the perpetual Roe v. Wade row waged across the pond. Recent bills to restrict or ban abortion in Texas, Alabama, and Mississippi, have all received cries of foul from the BBC and The Guardian.

The Supreme Court vote last year on a bill from the Lone Star State restricting abortion beyond when a heartbeat could be heard was prominent in the BBC’s headlines. This must have been a bit bizarre for those viewers hoping to know what was going on this side of the Atlantic. It reflects the extent to which supporting abortion rights is as much a shibboleth of contemporary British liberalism as holidaying in Tuscany or enjoying Radio 4.

Why is this? The traditional British unwillingness to cause a fuss must play some part. Most find the bitterness and partisanship of American politics abhorrent. Our brief flirtation with it over Brexit was a profoundly depressing experience; although it may pain GB News to hear this, the prospect of a culture war fills voters more with dread than hope.

But it should also be acknowledged that our flexible, centralised constitution and liberal-leaning judiciary have greatly restricted the potential for abortion to become as much of a hot topic as it has across the pond. We have had Roe v. Wade by stealth.

When David Steel’s Abortion Act legalised the practice in 1967, abortion was allowed on the grounds of protecting the mother’s life, or as a kindness to a child that might be born with severe handicaps.

However, the liberality with which the law has been interpreted has allowed for it to be treated as another form of contraception. I am hardly able to get on a high-horse: I have friends who have had abortions, and partners who have used the morning after-pill. Personally, I’m rather keen not to be a father at 22. Nevertheless, as Ross Clark has pointed out, liberal judges and politicians have extended the law’s use in practice far beyond what it was ever intended to allow.

I may be, to quote a man with much more reason to be so than myself, afraid of Americans. But at least Uncle Sam debates these issues. At least the assumption isn’t always in the direction of greater liberality – as when MPs from England, Scotland, and Wales voted to legalise abortion in Northern Ireland whilst Stormont was suspended. At least pro-life students aren’t automatically treated as social pariahs when they make their case on campus, or politicians treated as bizarre for arguing a position that reflects their religion. At least we could argue that, with 90 per cent of abortions being performed before 12 weeks, British limits could be brought in line with the rest of Europe’s. That is a position held by a significant minority of the public, after all.

But no dice. That number will tick up past 250,000, and then past 300,000. Few will bat an eye-lid, and politicians will devote little time to debating it. And I can’t shift the feeling that that is wrong.

The vote on ‘pills by post’. 72 Conservative MPs voted to keep abortions at home – and 175 voted against.

31 Mar

The Ayes

  • Atkins, Victoria
  • Baillie, Siobhan
  • Bell, Aaron
  • Beresford, Paul
  • Blunt, Crispin
  • Bottomley, Peter
  • Buchan, Felicity
  • Butler, Rob
  • Chishti, Rehman
  • Clark, Greg

 

  • Clarke, Theo
  • Clarkson, Chris
  • Clifton-Brown, Geoffrey
  • Colburn, Elliot
  • Coutinho, Claire
  • Davison, Dehenna
  • Dinenage, Caroline
  • Djanogly, Jonathan
  • Duddridge, James
  • Eastwood, Mark

 

  • Edwards, Ruth
  • Evans, Luke
  • Everitt, Ben
  • Fabricant, Michael
  • Farris, Laura
  • Firth, Anna
  • Fletcher, Katherine
  • Ford, Vicky
  • Garnier, Mark
  • Graham, Richard

 

  • Halfon, Robert
  • Hall, Luke
  • Harrison, Trudy
  • Holden, Richard
  • Hollinrake, Kevin
  • Holmes, Paul
  • Howell, John
  • Jenrick, Robert
  • Jones, Andrew
  • Jones, Fay

 

  • Kearns, Alicia
  • Largan, Robert
  • Lewis, Brandon
  • Malthouse, Kit
  • Mangnall, Anthony
  • May, Theresa (pictured)
  • McCartney, Jason
  • Mercer, Johnny
  • Merriman, Huw
  • Miller, Maria

 

  • Mills, Nigel
  • Mordaunt, Penny
  • Mortimer, Jill
  • Mumby-Croft, Holly
  • Nokes, Caroline
  • Norman, Jesse
  • Penrose, John
  • Philp, Chris
  • Richardson, Angela
  • Shapps, Grant

 

  • Shelbrooke, Alec
  • Skidmore, Chris
  • Smith, Julian
  • Spencer, Mark
  • Trott, Laura
  • Vara, Shailesh
  • Wallis, Jamie
  • Warman, Matt
  • Watling, Giles
  • Webb, Suzanne

 

  • Whately, Helen
  • Williamson, Gavin

 

The Nos

  • Afolami, Bim
  • Afriyie, Adam
  • Aldous, Peter
  • Allan, Lucy
  • Anderson, Lee
  • Andrew, Stuart
  • Ansell, Caroline
  • Argar, Edward
  • Bacon, Gareth
  • Bacon, Richard

 

  • Badenoch, Kemi
  • Bailey, Shaun
  • Baker, Duncan
  • Baker, Steve
  • Baldwin, Harriett
  • Baron, John
  • Baynes, Simon
  • Bhatti, Saqib
  • Blackman, Bob
  • Bradley, Ben

 

  • Braverman, Suella
  • Brereton, Jack
  • Bridgen, Andrew
  • Brine, Steve
  • Bristow, Paul
  • Browne, Anthony
  • Buchan, Felicity
  • Burghart, Alex
  • Cairns, Alun
  • Carter, Andy

 

  • Cash, William
  • Cates, Miriam
  • Caulfield, Maria
  • Chishti, Rehman
  • Chope, Christopher
  • Clarke, Simon
  • Clarke-Smith, Brendan
  • Coffey, Thérèse
  • Collins, Damian
  • Courts, Robert

 

  • Cox, Geoffrey
  • Crosbie, Virginia
  • Daly, James
  • Davies, David T. C.
  • Davies, Gareth
  • Davies, James
  • Davies, Mims
  • Docherty, Leo
  • Donelan, Michelle
  • Dowden, Oliver

 

  • Drax, Richard
  • Drummond, Flick
  • Duncan Smith, Iain
  • Dunne, Philip
  • Elphicke, Natalie
  • Eustice, George
  • Fletcher, Mark
  • Fletcher, Nick
  • Foster, Kevin
  • Fox, Liam

 

  • Frazer, Lucy
  • Freeman, George
  • Fuller, Richard
  • Fysh, Marcus
  • Gale, Roger
  • Gibson, Peter
  • Gideon, Jo
  • Gray, James
  • Green, Chris
  • Green, Damian

 

  • Griffith, Andrew
  • Griffiths, Kate
  • Grundy, James
  • Gullis, Jonathan
  • Hammond, Stephen
  • Harper, Mark
  • Hayes, John
  • Heald, Oliver
  • Heaton-Harris, Chris
  • Higginbotham, Antony

 

  • Hollobone, Philip
  • Holloway, Adam
  • Huddleston, Nigel
  • Hughes, Eddie
  • Hunt, Jane
  • Hunt, Jeremy
  • Hunt, Tom
  • Javid, Sajid
  • Jayawardena, Ranil
  • Johnson, Caroline

 

  • Johnson, Gareth
  • Jones, David
  • Jones, Marcus
  • Jupp, Simon
  • Keegan, Gillian
  • Kruger, Danny
  • Latham, Pauline
  • Leadsom, Andrea
  • Leigh, Edward
  • Levy, Ian

 

  • Lewer, Andrew
  • Lewis, Julian
  • Liddell-Grainger, Ian
  • Loder, Chris
  • Logan, Mark
  • Longhi, Marco
  • Lopez, Julia
  • Lord, Jonathan
  • Loughton, Tim
  • Mackinlay, Craig

 

  • Mackrory, Cherilyn
  • Maclean, Rachel
  • Mayhew, Jerome
  • Maynard, Paul
  • McPartland, Stephen
  • Menzies, Mark
  • Metcalfe, Stephen
  • Millar, Robin
  • Mohindra, Gagan
  • Moore, Damien

 

  • Moore, Robbie
  • Morris, James
  • Morton, Wendy
  • Mullan, Kieran
  • Nici, Lia
  • O’Brien, Neil
  • Opperman, Guy
  • Pawsey, Mark
  • Penning, Mike
  • Pincher, Christopher

 

  • Prentis, Victoria
  • Pursglove, Tom
  • Quin, Jeremy
  • Randall, Tom
  • Redwood, John
  • Rees-Mogg, Jacob
  • Robertson, Laurence
  • Rosindell, Andrew
  • Rowley, Lee
  • Russell, Dean

 

  • Saxby, Selaine
  • Selous, Andrew
  • Smith, Chloe
  • Smith, Greg
  • Smith, Henry
  • Smith, Royston
  • Solloway, Amanda
  • Spencer, Ben
  • Stevenson, Jane
  • Stevenson, John

 

  • Stewart, Bob
  • Stewart, Iain
  • Stuart, Graham
  • Sunderland, James
  • Swayne, Desmond
  • Syms, Robert
  • Thomas, Derek
  • Throup, Maggie
  • Timpson, Edward
  • Tolhurst, Kelly

 

  • Tomlinson, Justin
  • Tomlinson, Michael
  • Trevelyan, Anne-Marie
  • Vickers, Matt
  • Villiers, Theresa
  • Walker, Robin
  • Webb, Suzanne
  • Wheeler, Heather
  • Whittaker, Craig
  • Whittingdale, John

 

  • Wiggin, Bill
  • Wild, James
  • Wood, Mike
  • Wright, Jeremy
  • Young, Jacob

That’s 175 MPs, plus two tellers: Fiona Bruce and Karl McCartney.

The total numbers were 215 for, and 188 against. 

Miriam Cates MP: The re-introduction of key abortion safeguards is a step towards tackling domestic abuse

18 Feb

Miriam Cates is MP for Penistone and Stocksbridge

Almost two years ago, suddenly and without scrutiny, the Department of Health and Social Care (DHSC) announced the biggest change to abortion law in this country since 1967.

At the start of the pandemic and ensuing lockdown, the DHSC granted emergency measures to allow medical abortions to be self-administered at home without any in-person consultation. Now, the Government is mulling over whether to end this temporary policy in line with the cessation of other Covid emergency measures.

In practical terms, the changes in March 2020 have meant that a single phonecall currently suffices for women and girls to be sent abortion pills. This was no small alteration to abortion provision. The knock-on effects of this ill-judged change have since emerged, with the experiences of women revealing concerning issues.

In removing the requirement for an in-person consultation prior to abortion, there is no guarantee that the woman requesting the pills is doing so for her own legal use within the medically accepted time limit (10 weeks gestation in England and Wales). Nor is there any guarantee that she is doing so freely, without coercion. There is no way to ensure that the patient is alone. Without a face to face consultation, there are fewer or no visual markers (such as eye contact or body language). This disjuncture of care is exacerbated in cases where the woman has limited English-speaking abilities and poor computer access.

The circumstances that surround a woman’s reasons to seek abortion are complex and individual. Often victims of domestic abuse do not even realise that what they are experiencing is, in fact, coercion. For example, pressure from well-meaning parents to abort so that a student finishes her studies, a partner citing economic pressures or threatening to walk out, or teenagers encouraging their friend to just do it and swallow the pills are all instances of pregnancy coercion. How can a healthcare professional possibly certify over the phone that a woman is making the decision to abort freely?

We have seen an appalling rise in domestic abuse during the pandemic. Over 40,000 calls and contacts were made to the National Domestic Abuse Helpline during the first three months of the lockdown alone. The charity Refuge reported a 61 per cent increase in calls to its 24-hour helpline and online chat service in the past year, and a shocking 81 per cent of callers in 2020 described being “controlled” by their partner. As Lisa King from Refuge summarised: “Lockdown measures, where women have been isolated and confined with their perpetrators more than ever, have compounded their exposure to violence and abuse.”

Moreover, Refuge’s figures show that domestic violence worsens during pregnancy; 20 per cent of women using the organisation’s services are pregnant or recently gave birth, whilst studies show that four to nine per cent of women experience abuse during their pregnancy or afterwards. The most common age bracket contacting Refuge’s helpline were women aged 30-39. It is no coincidence that they are women of childbearing age.

As such, parliamentarians should be doing all we can to prevent domestic abuse situations from escalating, and ensure the highest level of support services for women. I am certain the Government does not want to put women at risk from coercive control nor put in place measures that risk aiding their abusers.

As a 2019 article in a leading medical journal states, “Potential for misuse and coercion is high when there is no way to verify who is consuming the medication and whether she is doing so willingly. Sex traffickers, incestuous abusers, and coercive boyfriends will all welcome more easily available medical abortion.”

Notably, polling of clinicians supports these concerns. Around six in seven GPs were found to be concerned that the “at-home” abortion policy could see more women being coerced into abortion, whilst 87 per cent were concerned that women were at risk of unwanted abortion arising from domestic abuse by partners controlling or monitoring their actions.

The Conservative Party manifesto in 2019 pledged “to fight crime against women and girls” and provide support for “individuals, most often women, trapped with coercive partners.” Indeed, Home Office Ministers have reassured us that the Government has “remained resolute in our commitment to tackling abuse that takes place behind closed doors and out of sight”; a commitment which has been evident through the passage of the Domestic Abuse Act 2021.

As the Government makes its decision about the long-term future of  the home abortion policy, I urge the DHSC to prioritise the security and welfare of women facing unplanned pregnancies. Coerced abortion is widely held to be a “brutal form” of “discrimination”. It is our duty to prevent it.

Lynn Murray: MPs must stop abortion law discriminating against those with disabilities

23 Nov

Lynn Murray is a spokesperson for Don’t Screen Us Out.

This week, MPs must take a stand against discrimination towards babies with disabilities

As a mother of a daughter with Down’s syndrome and spokesperson for Don’t Screen Us Out – a group of over 17,000 people with Down’s syndrome, their families, and supporters who are working to build a United Kingdom where people with Down’s syndrome are valued and have an equal chance of being born – I strongly support the amendment, NC52, tabled to the Health and Care Bill by Carla Lockhart MP.

Supported by a cross-party alliance of MPs, it would introduce an upper gestational limit on abortion on the grounds of disability equal to the limit on most other abortions.

Our organisation works to help reform unfair legislation, policies and practice, alongside helping to build a more positive culture that accepts and embraces people with Down’s syndrome.

Our fundamental goal is equality, including equal treatment of both the unborn with disabilities and those without disabilities. The current abortion law, through its discriminatory time limits, dramatically fails to deliver this.

Unbeknownst to many members of the public, abortion is allowed up to birth in England and Wales if “there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.” This has been interpreted to include Down’s syndrome, cleft lip, cleft palate, and clubfoot, meaning abortion is legal up to birth based solely on a primary diagnosis of one of these entirely non-fatal conditions that are far from ‘serious handicaps’.

By contrast, in most other cases, abortion is only available until 24 weeks’ gestation for babies not found to have a congenital condition. Therefore, the law is inconsistent with disability-equality legislation by permitting abortion on the grounds of disability more widely than most abortions, without justification.

recent High Court case was brought against the Government for allowing disability discrimination in abortion by Heidi Crowter, 26, who has Down’s syndrome and Máire Lea-Wilson, whose son has Down’s syndrome. Crowter has consistently described how the current law “makes me feel that my life is not as valuable as anyone else’s”, whilst Lea-Wilson was “placed under intense pressure” to have an abortion after a 34-week scan revealed her son had Down’s syndrome.

Both Crowter and and Lea-Wilson are seeking permission for their case to be taken to the Court of Appeal.

As argued by the claimants in the recent case, section 1(1)(d) of the Abortion Act 1967, which allows for abortion on the grounds of disability without any upper gestational limit, is incompatible with Article 2 (Right to life) of the Universal Declaration of Human Rights (UDHR) by “permitting abortion in circumstances where, and at a time at which, it would not be permitted in the case of a non-disabled child.”

It is not just those living with those Down’s syndrome who have serious concerns about disability discrimination before birth. The Disability Rights Commission have said this aspect of the Abortion Act “is offensive to many people; it reinforces negative stereotypes of disability… [and] is incompatible with valuing disability and non-disability equally”.

Tragically, abortions on the grounds of disability after 24 weeks’ gestation continue to steadily increase, seeing around a 55 per cent increase since 2010 and an over 140 per cent increase over the past twenty years.

Surely, it is inconsistent for Parliament to pass laws (such as the Disability Discrimination Act 1995 and the Equality Act 2010 that expressly prohibit discrimination on grounds of disability after birth, yet allow another law to remain that expressly provides for lethal discrimination through termination on grounds of disability up to birth?

Parliamentarians should know that there is substantial public support for change to our laws in this area. Polling from Savanta ComRes shows that only one in three people think it is acceptable to ban abortion on the grounds of sex or race but allow it for disability.

On the last occasion that Parliament addressed abortion on the grounds of disability, they found that the “vast majority of those who gave written evidence believed allowing abortion up to birth on the grounds of disability is discriminatory, contrary to the spirit of the Equality Act and does affect wider public attitudes towards discrimination.”

Now, Parliament should heed the advice of those campaigning against disability discrimination and amend our abortion law to ensure our society can be a place of disability equality both before and after birth.”

Liz Sugg and Ritah Anindo Obonyo: At this week’s Global Education Summit, we need to talk about sex

29 Jul

Baroness Liz Sugg CBE is a Conservative peer and Ritah Anindo Obonyo is a member SheDecides Kenya.

When Boris Johnson co-hosts the Global Partnership for Education summit this week, we want him to talk about sex.

Why? Because comprehensive sexuality education (CSE) is absolutely vital to realising the UK’s commitment to ensuring 12 years of quality education for young people everywhere.

The Global Partnership for Education provides a vital opportunity for Boris Johnson and other world-leaders to commit funding to transforming education systems in the world’s poorest countries. That transformation must have CSE at its heart.

For girls in particular, access to comprehensive sexuality education gives them the tools and knowledge they need to understand their rights and to make decisions about their own bodies. Whether in Kent or Kenya, it helps to prevent gender-based violence and sexual exploitation. In fact, it is key to women’s and girls’ economic empowerment later on in life.

The benefits of CSE cannot be ignored. Girls who don’t receive sex education are more likely to drop out of school due to early marriage and pregnancy. In sub-Saharan Africa, four million girls leave school before finishing due to early pregnancy.

In contrast, when we provide CSE and information on reproductive choices, we can help girls stay in school. We know that girls who complete secondary education are five times more likely to be educated on HIV/AIDS, keeping them safer and giving them the tools they need to make decisions about their bodies.

Growing up in the Korogocho Slum in Kenya, I, Ritah Anindo Obonyo had no sex education. My two friends and I used to talk about what was happening to our bodies – both friends then dropped out of school as a result of early pregnancy.

Without sex education, young people access information from unreliable sources. They have poor reproductive health outcomes. They are more vulnerable to HIV/AIDS – in Sub-Saharan Africa six out of seven new HIV infections occur in young women aged 15-24. All of these issues have a profound effect on women’s life chances and equality and have been exacerbated by Covid-19.

We know that women’s economic and social equality is impossible to achieve when women don’t have ownership of their own bodies. Sex education is therefore key to sustainable development.

For many years now, the UK Government championed our belief that CSE is crucial to girls’ empowerment. The UK taxpayer should be proud that, via the international aid budget, we have collectively helped empower vulnerable women and girls around the world.

But when I, Baroness Sugg, resigned as Minister for Sustainable Development and Special Envoy on Girls’ Education last year, I did so because the progress we have made on supporting women’s and girls’ sexual and reproductive health faced a grave threat with a budget cut that broke both the Conservative Party manifesto promise and international commitments.

Two weeks before the launch of the Global Partnership for Education Summit the UK Parliament approved the fiscal circumstances needed before we return to spending 0.7 per cent of gross national income on international development.. This will unequivocally damage the rights of girls and risks rolling back decades of progress.

The cuts will force the closure of sexual and reproductive health services in some of the world’s poorest countries. It will lead to more women and girls being forced to access unsafe abortion. It risks more women dying in childbirth.

Simon Cooke, the Director of MSI Reproductive Choices and also a SheDecides Champion, has warned the cuts will “do more damage … than the global gag rule” – a US policy that denied federal funding to NGOs that offered abortion services or advice that resulted in 20,000 unnecessary maternal deaths and 1.8 million unsafe abortions between 2017 and 2000.

What will the UK Government’s record be?

The cut to international aid will end life-changing and life-saving programmes that deliver information and advice on sexual and reproductive health. We are deeply concerned about the long-term impact a lack of education about sex, respect, consent and bodies will have on girls in the Global South, particularly as they deal with the impacts of the Covid-19 pandemic.

Of course, we cannot change the past. But we can look to the future. As ministers prepare for this week’s Global Education summit, we ask them: are we going to leave women and girls behind as the world builds back better from Covid-19? Or are we ready to ensure girls’ rights are protected by investing in CSE?

The Chancellor has promised to work with parliamentarians to ensure the UK’s overseas development aid budget is spent in a way that has maximum impact. We know that ensuring every child has access to CSE will have a huge impact in the years and decades to come. It will create healthier and more equal communities. It will boost women’s economic empowerment. It will reduce maternal deaths, unsafe abortions, and rates of child marriage.

This week’s summit provides the UK with an important opportunity to raise its hand and recommit to quality education. We need to hear from the Prime Minister that he commits to funding education systems to include CSE, for every child in the world, no matter where they live.

So, Prime Minister, are you ready to talk about sex?

Jonathan Lord and Louise McCudden: We strongly reject claims about the dangers of at home abortions

23 Jul

Jonathan Lord is a consultant gynaecologist in the NHS and Medical Director of MSI Reproductive Choices UK, and Louise McCudden is an Advocacy and Public Affairs Adviser at MSI Reproductive Choices UK.

In March 2020, with Covid-19 limiting health service access, the Government made a bold but sensible decision: across England, Scotland, and Wales. It was agreed that both mifepristone and misoprostol, instead of only the latter, would be approved for home use.

These are the two medicines used in abortion care. In other words, early medical abortion could now be completed at home, following a telephone consultation with a clinician. This service, known as telemedicine, has now been running smoothly for over a year. Numerous peer-reviewed studies hail it as a success.

This week, Dr Melody Redman made a series of claims about the service on ConservativeHome: that clinicians oppose the service, that women don’t want it, and, perhaps most egregiously of all, that abortion providers are relaxed about offering a service which jeopardises safety. In all these assertions, Dr Redman is mistaken.

First of all, telemedicine wasn’t suggested by the sector merely as a response to Covid-19. This has long been the direction of travel in abortion care. Dr Redman cites 600 medics expressing concerns about telemedicine. But conspicuous by their absence from her article are the official views of bodies like the National Institute for Clinical Excellence (NICE), the Royal College of Obstetrics and Gynaecology,) and the Royal College of Midwives. These bodies recommend telemedicine. NICE calls it “an improvement” in abortion care.

Peer-reviewed studies show that telemedicine is safe, effective, and often preferred. As far as complications go, studies suggest that telemedicine, if anything, results in a small drop in complications. This could be because telemedicine reduces waiting times, so more treatments happen at an earlier gestation. Abortion is a common, safe procedure with a low complication rate in general, but it’s still true that the earlier the gestation, the safer it is.

It’s not only clinical bodies that back telemedicine. Dr Redman may well be sincere in her safeguarding concerns. But it’s no surprise to us, seeing the service operate up close, that End Violence Against Women Coalition, Rape Crisis England and Wales, and the Women’s Aid Federation of England agree telemedicine should stay.

Many vulnerable clients benefit from the option of telemedicine. For instance, there are women in abusive households who can safely receive discretely packaged abortion medicine at home but can’t safely attend a clinic. As predicted by safeguarding experts, the availability of telemedicine coincided with a drop in online pill sales from informal, unregulated providers – and during the pandemic, countries with no regulated “at home option saw a rise in these sales. Being forced to buy pills from these sources can mean abortion with no safeguarding, no counselling and no aftercare at all – and, shockingly, a risk of life imprisonment.

MSI UK’s safeguarding team members are deeply conscientious, highly skilled professionals. We would never support telemedicine if it hindered our ability to protect vulnerable clients. Dr Redman implies, by reminding readers that we are a “leading abortion provider”, that MSI isn’t an impartial voice in this debate. It’s true that as a provider, we’re not impartial on the question of abortion rights. We are unapologetically pro-choice, and we are proud to be a leading abortion provider. That doesn’t make us biased; it means we know what we are talking about.

Dr Redman is right to say that domestic abuse, including reproductive coercion, has risen during the pandemic. But she only mentions the dangers of forced abortion. It is more common to be coerced into keeping a pregnancy than ending one. As an unapologetically pro-choice organisation, we fight all reproductive coercion. No credible analysis of reproductive coercion or any other form of domestic abuse concludes that a sensible solution would be greater barriers to reproductive healthcare. The best way to fight reproductive coercion is more choice, more autonomy, more privacy, and more flexibility in access, not less.

As for the claim that 92 per cent of women want to be seen in person, this is not what peer-reviewed studies show, and nor is it what we hear from our clients. When those using the service were surveyed, two thirds said they preferred telemedicine, regardless of Covid-19 (when we factor in Covid-19, that rises to 80 per cent). But in any case, even if the figure were true, why remove the option? With nine in 10 adults describing themselves as pro-choice, this is, or should be, a clinical decision, not a political one. We don’t say telemedicine is right for everyone. We simply want to offer choice.

The truth is, theres consensus among clinicians and regulators that telemedicine is safe, compassionate, and it is often preferred. It’s more efficient for the health system as a whole, despite providers still offering a full pathway that includes safeguarding, counselling, and aftercare. No matter the obfuscations and rhetorical insinuations of those who disapprove of at home abortion, there are simply no clinical or safeguarding justifications for taking the choice away.

Melody Redman: Abortions at home must only be a temporary measure

17 Jul

Dr Melody Redman is a clinical genetics registrar, with a background in academic paediatrics.

In March 2020, temporary provisions were introduced to permit women in the first 9 weeks and 6 days of pregnancy to take both medical abortion pills at home. The pills are sent through the post, after a remote consultation with an abortion provider. Prior to this, the administering of the first of the two required pills for medical abortions could only take place in approved hospitals or abortion clinics.

This emergency ‘at-home’ abortion scheme was introduced because of fears about limited in-person access to clinics during the coronavirus pandemic, with the mantra at the time being ‘Stay Home and Protect the NHS’. The UK, Welsh, and Scottish Governments have recently undertaken consultations on whether to end these measures or make them permanent, and the publication of their respective decisions is imminent.

Unsurprisingly, this push to permanently permit ‘at-home’ abortion has been spearheaded by the UK’s two largest abortion providers: MSI Reproductive Choices (formerly Marie Stopes) and the British Pregnancy Advisory Service, who are lobbying for the scheme to be made permanent. Given that 59.3% of UK abortion clinics are rated by the Care Quality Commission as ‘Requires Improvement for Safety’, how then can we trust them to ensure the safety of women ‘at-home’?

Last month, I along with over 600 other medics signed an open letter demanding an end to the scheme. Our letter expressed grave concerns over examples of the pills being used beyond the 10-week limit for home medical abortions, and in some cases after the 24-week legal limit for surgical terminations. The letter also highlighted a string of other safety and safeguarding issues related to issuing abortion pills without a face-to-face consultation.

Indeed, ‘at-home’ abortions rely on women accurately remembering the first day of their last period, which only around 50% of us do. This date is then used to estimate how far through the pregnancy the woman is. The Department of Health & Social Care has confirmed that pregnancies beyond the legal limit for ‘at-home’ abortions are being terminated at home, putting women at higher risk of complications.

It appears that data on the effects of ‘at-home’ abortions is being significantly and systemically under-reported. A Freedom of Information (FOI) request to the Care Quality Commission revealed that between April and November 2020, 11 women using the scheme, who had a gestational date beyond the legal limit for early medical abortion, required hospital treatment for complications. FOI requests have similarly since shown women suffering from serious issues (including sepsis, haemorrhage, and trauma to pelvic organs) after taking the pills.

Worryingly, an undercover investigation (led by a former director of MSI Reproductive Choices) revealed the lack of basic checks carried out by abortion providers before issuing pills-by-post. The investigation saw volunteer clients being sent abortion pills despite using false identities and gestational dates, including a date that could only have led to an abortion beyond the legal limit for ‘at-home’ abortions.

The removal of a mandatory in-person consultation also hinders clinicians’ abilities to flag up signs of coercion and abuse. An alarming seven per cent of British women have been pressured into an abortion by their partner or husband, a figure that likely increased under lockdown, during which there was a 49% increase in calls to domestic abuse services.  This is a serious concern; 87% of GPs are worried about ‘unwanted abortion arising from domestic abuse’ when no in-person consultation is required.

As a doctor, I know that telephone consultations can work well for some things, but there are huge limitations. I cannot control the environment on the other side of the phone, unlike in a safe clinic space. I cannot tell if my patient is next to an intimidating partner. I cannot ‘eyeball’ them to see if they appear frightened, have a black eye, or are heavily pregnant. Abortion consultations are not as simple as phoning your GP for advice on your reflux. They are intimate and challenging discussions, with life-changing physical and psychological ramifications.

Savanta ComRes polling of the general public reveals a high number of serious concerns. We are so often told to simply ‘trust women’ when it comes to liberalising abortion laws. Why then should we ignore the 92% of women who agreed that a woman seeking an abortion should always be seen in person by a qualified doctor?

‘At-home’ abortions were a hasty, temporary measure, introduced at a time when it was feared women should not attend an abortion clinic. This should not be a permanent solution. When making the difficult decision to pursue an abortion, we must be sure that women get a face-to-face consultation. Let us give women the space, the safety and the specialist assessment they deserve. I therefore implore the Government to bring this temporary policy to an end with immediate effect.

Sally-Ann Hart: ‘DIY’ home abortion puts women and babies at risk, and ministers should end it

29 Jan

Sally-Ann Hart is the MP for Hastings and Rye and was a councillor in Rother.

The Department of Health and Social Care (DHSC) recently launched its public consultation on whether to make home use of both abortion pills a permanent measure in the UK.

‘At-home’ abortions – which the media and critics have termed ‘DIY’, or ‘do-it-yourself’ abortions – were introduced on 30th March 2020 in the most radical change to abortion law since 1967. After a phone call with an abortion provider, women can now be sent Mifepristone and Misoprostol pills to take at home without direct medical supervision in order to end their pregnancies.

Originally sanctioned as a temporary measure to reduce transmission of Covid-19 during the pandemic, abortion campaigners and providers are pushing to make ‘at-home’ abortions permanent.

But given the risk of serious complications, coercion from abusive partners, and inability to verify gestational age over the phone, the Government should immediately withdraw the temporary order. Should it and the consultation continue, however, I can only hope we see the concerns of those responding to the consultation taken seriously by our Government.

Before reviewing the serious complications that have occurred in relation to ‘DIY’ home abortion, it is prudent to refute recent claims in the New Statesman of a relative lack of medical complications for ‘DIY’ home abortion. Indeed, this article rather serves to highlight the serious problem of systemic underreporting of such issues.

DHSC data show only one complication following ‘DIY’ home abortion from April to June this year for the whole of England and Wales. Unbelievably, this would mean that the average rate of complication for medical abortions at a similar gestation over the past five years was over seventeen times higher than the complication rate for ‘DIY’ home abortions earlier this year. This is not only highly unlikely – that complications would radically reduce in a home setting versus a medical setting – but, some may say, ridiculous.

Indeed, evidence from a Freedom of Information (FOI) request demonstrates clearly the current issues related to reporting complications when abortions take place outside a clinical setting. The data from the FOI request shows seven women were admitted to University Hospital Lewisham alone for complications following medical abortion between the end of March and the beginning of September this year.

If both Departmental and hospital records were true, this is a shocking leap from just one complication nationwide in the three months from April to June to a further six complications in the same locality in the two months from July to September. There is either a serious problem with sharply rising complications in Lewisham since the end of June, or a substantial issue with the overall quality of reporting and recording the real impact of medical abortion on women’s health when abortions take place at home.

Serious complications can certainly arise when abortion is removed from a clinical environment. One Swedish study from 2018 of almost 5,000 induced abortions over eight years (from 2008 to 2015 inclusive) found that the complication rate for medical abortions before 12 weeks’ gestation almost doubled from 4.2 per cent in 2008 to 8.2 per cent in 2015, concluding that the significant surge in complications “may be associated with a shift from hospital to home medical abortions.”

Requiring the first pill to be administered in a clinic provided essential safeguards for women, not least as it allowed for an in-person examination or ultrasound to verify whether a woman was too far along in her pregnancy to be prescibed a medical abortion.

Tragically, we have already begun to see the effects of the absence of such safeguards. Police have been investigating the death of an unborn child who was aborted at 28 weeks – four weeks past the legal limit for surgical abortion and a shocking 18 weeks past the limit for abortions at home. Notably, abortion provider BPAS stated they were investigating the case along with eight other known incidents of babies who were aborted past the 10 week legal limit for ‘at-home’ abortions.

Only this year, a study (funded by NICE) found that for later gestational dates, greater dosage of misoprostol may be required to achieve a complete abortion. As such, there ‘may be more pain or bleeding associated with the expulsion of a larger/later pregnancy’. This clearly highlights a need for accuracy in determining gestational age, particularly if the woman expels the pregnancy at home.

Further concerns are highlighted by a leaked NHS email from a Regional Chief Midwife on the ‘escalating risk’ around the ‘pills by post’ service in May 2020, which revealed that a woman received abortion pills at 32 weeks of pregnancy. The email goes on to note that there were 13 incidents under investigation linked to ‘at-home’ abortions, and “3 police investigations”, one of which “is currently a murder investigation as there is a concern that the baby was live born.”

If such troubling incidents occurred within weeks of the ‘DIY’ home abortion ruling, making it a permanent feature of our healthcare system would clearly be a disservice to women in the UK.

In addition, many women in domestic abuse situations may be coerced by their partner into having an abortion. If we remove the requirement of a face-to-face consultation, there is no guarantee that a patient can speak freely without the coercive party listening in. Indeed, Health Minister Lord Bethell iterated these concerns on behalf of the Government when the Coronavirus Bill was brought to the House of Lords on 25 March, recognising that:

“If there is an abusive relationship and no legal requirement for a doctor’s involvement, it is far more likely that a vulnerable woman could be pressured into having an abortion by an abusive partner.”

Furthermore, if a woman is in a domestic abuse situation, leaving her to perform her own abortion at home only helps her abuser by enabling her to remain in an abusive situation.

Accounts from women of their experience of the ‘pills by post’ system should further compel the Government to immediately suspend this temporary order. For example, a nurse who suffered extreme complications from ‘DIY’ home abortion that left her needing life-changing surgery disclosed that she experienced ‘excruciating pain’, and heavy bleeding that continued for ten days after the abortion. Claiming Marie Stopes failed to provide follow up care, she also shares: “I’m actually quite shocked that the UK, with all of our research and expertise would approve this”.

In addition to physical complications, other women have expressed concern at the ease and speed with which they were able to acquire these life-changing pills. One woman describing her experience stated: “I wasn’t ready. It all seemed so fast. I was expecting to speak to lots of people, to be offered counselling.” Yet ‘greater capacity’ and ‘shorter waiting times’ have been lauded by proponents of ‘at-home’ abortion as prime reasons for extending the scheme, perhaps due to the notion that telemedical abortions free up NHS resources.

This is the kind of language used to discuss routine health appointments and hip replacements; that this narrative is currently being used to frame the life-changing decision to abort a child – the termination of a human life – is truly disturbing. Tragically, this same language is replicated in the newly launched UK public consultation, where participants are encouraged to reflect on ‘at-home’ abortion services in the context of ‘workforce flexibility, efficiency of service delivery’ and ‘value for money’.

Opposition to ‘DIY’ abortion schemes is widespread across the UK. Hundreds of healthcare professionals recently signed an open letter to the Health Minister of Northern Ireland to highlight the dangers of removing essential safeguards around abortion. Additionally following the launch of the Scottish Government consultation on ‘at-home’ abortion in October, Chairman of the Scottish Council on Bioethics Dr Antony Latham highlighted the increased health risk if ‘DIY’ home abortions are introduced on a permanent basis, stating ‘significant bleeding and sepsis are not uncommon.’ He further notes that the removal of in-person consultation opens the door for abortion coercion.

Finally, polling suggests that in-person assessment during the abortion process is highly valued by women in the UK; in one poll 77 per cent of women agreed that doctors should be legally required to verify in person that a patient seeking abortion is not being coerced, while another poll showed that 92 per cent of women agreed that a woman seeking an abortion should always be seen in person by a qualified doctor.

‘At-home’ abortions are not safe, and must not be euphemised as abortion ‘care’. Contrary to representation from abortion activists and providers, extending the ‘at-home’ abortion policy is not a given, and the public consultation has been launched with the option to ‘end immediately’.

Safe and effective healthcare is central to our British values: this irresponsible policy must be revoked before more lives are put at risk. I encourage all reading this to respond to the consultation – and select ‘end immediately.’