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Abortion and Viability

Andy Newman


 

There has been some controversy over the summer about the issue of late abortions. This started with images by Professor Stuart Cambell in the Evening Standard showing a 12 week foetus, and this has led some politicians, such as the Prime Minister, health minister John Reid and David Steel to consider that the current limit of 24 weeks is too late. The viability argument is an important one, and should not be ducked:

I think there are two principles at work:

i) that women have an absolute right of choice about their own fertility
Ii) there is a societal responsibility towards all human beings (everyone who has been born)

The first point is wider than the right to choose (or not) abortion. There should be free access to contraception for women of all ages. Women should be able to choose to have children when they want, whereas currently women are having children later because of financial pressures, housing crisis, etc. Women should have a right to free fertility treatment on the NHS (not only promoting equality of access but reducing the incidence of multiple births as private clinics literally over-egg). Women should be able to choose the birth experience of their choice, so there should be more midwife led units, state employed doolas, more support for home births. There should be state employed breast feeding councillors, much higher paid maternity/paternity leave, etc. Child allowance should be much higher so that no-one considers an abortion just because they cannot afford to have an otherwise wanted baby.

The status of motherhood and parent hood should be increased and there should be public support in the shape of nursery provision, workplace crèches, subsidised canteens for families, etc. (these are all reforms that could be brought in under capitalism, and with the private family intact. Who knows how a classless society would deal with child care?) All women should have a right to terminate their pregnancy on demand. (There must be safeguards to ensure this is their own choice not due to pressure from their family or the father, and that the choice is informed (aware of the risk to future fertility etc)

The time limit relates to the second responsibility, in that after a certain point the foetus, once removed from the womb, is actually a child. A foetus aborted before 28 weeks is effectively not a viable child, and there is no societal responsibility towards something that is only a potential person. A woman who has gone past 28 weeks should still have the right to an elective caesarean, but on medical and ethical grounds they should be strongly encouraged to carry the child to term.  Early elective caesareans are unfortunately sometimes necessary (pre-eclampsia, etc) but are bad for both the mother and child. Of course any mother can give up a baby for adoption, if they so wish, fortunately most people want their children.

There are of course grey areas around the time limit of whether a foetus is viable or not, but foetal development is quite deterministic and provided the dates are right (and this can be checked by ultrasound) the health professionals will be able to determine viability. There are already acknowledged ethical issues in obstetrics relating to (wanted) premature babies born after 24 weeks, many of whom are simply allowed to die, although they could theoretically be saved (at risk of ill -health, deformity, etc). I think late abortions are related to this known and relatively common ethical dilemma.

Finally it has never been put better than the demand: "every child a wanted child, every mother a willing mother"


 

 

December 2004

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