Abortion debate in UK fails to change upper time limits

Sandra Ryan looks at the debate and vote that took place last week in Westminster and the reasons why MPs voted to keep the abortion status quo.
Last week, MPs in Britain voted to reject attempts to reduce the upper time limit for abortions from 24 to 20 weeks, as part of the lengthy debate on the controversial Human Fertilisation and Embryology Bill. The abortion ‘free vote’ was the first time in nearly 20 years that the issue has been so hotly debated by politicians in the UK — unlike Ireland, which has had almost 20 years of controversy on the subject.

Also unlike Ireland, the debate was mostly focused on the available scientific evidence rather than the religious or moral implications of abortion — and what seemed to sway the majority of MPs was the insistence that there is no evidence that the abortion law needs to change. The last time abortion law in the UK changed was 1990, when the upper gestational limit for abortions was set at 24 weeks, down from 28, because there was evidence showing a foetus could survive outside the body at that point.
Recent amendments to the UK Bill had suggested the time limit for abortions should now be decreased to anything between 12 and 22 weeks. To many (including, clearly, the majority of MPs), the issue is simple enough.
A statement from the British Medical Association (BMA) and several other medical organisations stressed the importance of ‘evidence-based factual information’ leading the parliamentary debate on abortion.
h4. No evidence
“There is no evidence of a significant improvement in the survival of pre-term infants below 24 weeks’ gestation, in the UK, in the last 18 years. The major development since 1990 has been an improvement in the survival of babies born at 24 weeks and over, but not below this gestation,” the statement said.
According to the Chairman of the BMA’s Medical Ethics Committee, Dr Tony Calland, recent research published a few weeks ago in the British Medical Journal adds evidence to their opinion that there is no scientific justification for lowering the limit.
“This is the most up-to-date research in the UK investigating the survival of very premature babies,” he said. “Although the vast majority of abortions take place in the first trimester, there are still young women who need abortion services later on in pregnancy, particularly very young women or those close to the menopause who may not realise they are pregnant. Lowering the abortion limit would leave a number of women in dire circumstances.”
This research was done by Prof David Field and colleagues in the University of Leicester. Survival of extremely premature babies in a geographically defined population showed that over the past 12 years, there has been no improvement in survival of babies born before 24 weeks’ gestation.
Prof Fields concluded that the limits of viability for the survival of premature babies have been reached. He examined the survival of all babies born before 26 weeks’ gestation who were alive at the onset of labour, in the Trent health region of the UK, between 1994-’99 and 2000–’05.
The study involved 16 hospitals with over 55,000 births a year. The researchers found that despite over half the babies born at 23 weeks being admitted to intensive care, there was no improvement in their survival over the 12 years of the study, and only 18 per cent survived the stay in hospital.
The Royal College of Obstetricians and Gynaecol-ogists (RCOG) has also pointed out the tenuous link between the issue of viability — a baby’s ability to survive outside the womb — and the time limit for abortions. “The time-limit is the cut-off time for an abortion to take place… These are pregnancies that are unplanned and/or unwanted.”
To others it’s not so simple, however. Those pushing for a lower limit quote another large study, Epicure 2, that analysed all severely premature births in England in 2006 and compared their survival outcomes to babies born in 1995.
The study states that the 2006 babies born after 24 weeks and admitted to neonatal units were more likely to live than those from ‘95 (47 per cent survived in 2006 compared to 35 per cent in 1995). But the increase in survival rates at 23 weeks from 19 per cent in ‘06 to 26 per cent in ‘95 was deemed statistically insignificant because only a small number of babies were studied.
h4. Feeling pain
Some argue that a foetus can feel pain at around 20 weeks. One of them is ultrasound specialist Prof Stuart Campbell, King’s College London — famous for scans a number of years ago that show a 12-week old foetus apparently walking in the womb — who has said that, although he supports women having choice, between 20-25 weeks, a foetus is ‘quite advanced’.
“It can open its eyes, it will react to a needle being put on its skin,” he said. “It is developing in such a way that it deserves to keep its hold on life.”
In a document prepared by the RCOG, it states that there is also no evidence that lowering the time-limit for abortions will actually reduce the number of abortions carried out.
“Some individuals and groups associate the lowering of the time limit with a lowering in the number of abortions carried out each year. Currently, only two per cent of all abortions in the UK occur between 20 and 23 weeks, and these are carried out in instances where the woman’s or baby’s health is at risk. Lowering the time limit will not lower the abortion rate. Women who are desperate to have an abortion will look for the means to have one, and this includes having an illegal and unsafe abortion in their own countries or travelling to a country where late abortions are carried out.”