By Joyce Arthur
(published by Abortion Review in the UK in June 2014 but may no longer be online)
For 25 years, Canada has had no legal restrictions on abortion whatsoever – not even any gestational limits. From my perspective as a Canadian, the UK’s current debate over the proposed reduction in its legal time limit for an abortion is way off-base. Politicians and the media seem trapped by the assumption that some kind of abortion law is necessary and they just need to decide what the limits are. In reality, the best solution is full decriminalization, because all anti-abortion laws are unjust, harmful, and useless – including the UK’s 1967 Abortion Act.
Every single legal restriction on abortion in the world today is a violation of women’s rights and dignity, and too often a threat to their health and survival. Laws don’t stop abortion. They only drive it underground, forcing women to rely on the illegal black market or attempt their own self-abortions. In developing countries, anti-abortion laws kill 47,000 women a year and injure over 8 million. Anti-abortion laws rest on traditional religious and patriarchal foundations that definitely do not have the best interests of women or their children at heart. Instead, these laws treat half the world’s women as criminals, ban and stigmatize a medical treatment that only women need, prevent or delay access to life-saving care, obstruct healthcare professionals, and expose doctors to harassment and criminal prosecution.
Canada is the first country in the world to prove that abortion care can be ethically and successfully managed as part of standard healthcare practice, without being controlled by any civil or criminal law. (Two Australian states have also successfully decriminalized abortion in recent years.) Since 1988, when the Supreme Court of Canada threw out our abortion law as unconstitutional, the sky has not fallen, but our abortion rates have – we’ve witnessed a decline since 2000 and now have a relatively low abortion rate compared to many other developed countries – about 14 abortions per 1000 women of childbearing age per year. That rate is still a bit higher than some western European countries, which reflects the need to further decrease the number of unwanted pregnancies. Nevertheless, Canada’s teen birth and abortion rate declined 37% between 1996 and 2006, primarily because of better access to effective contraception. In other words, declines in abortion rates are not related to anti-abortion laws, but mostly to the availability of contraception in a country. The only effective and just strategy for reducing abortion is to help women avoid unwanted pregnancy.
Despite the lack of a gestational limit law in Canada, 90% abortions occur during the first trimester, and less than half a percent after 20 weeks. The latter are all for compelling reasons, such as fetal abnormalities incompatible with life or a serious threat to the woman’s health or life. Sound familiar? That’s because the same pattern of abortion practice repeats itself naturally in any country where services are reasonably accessible – independently of any laws. The majority of women present as early as they can for an abortion, and a tiny number of women will always need later abortions because of dire circumstances. Banning later abortions in the UK would do nothing to prevent the need for them – but it would be profoundly cruel and endanger women’s health and survival. (Dr. Ellie Lee, a sociologist at the University of Kent, is one of the few public voices in the UK recognizing the harms of such restrictions and calling for full decriminalization of abortion.)
The notion that a legal gestational limit is required to stop later abortions is not just untrue, it’s also moralistic and patronizing. Anti-choice groups in Canada claim that women can have abortions right up to the ninth month of pregnancy for any reason, on the apparent assumption that women are stupid and doctors are irresponsible. But Canada’s abortion practice is not an unregulated free-for-all – it’s properly governed by policies of the Canadian Medical Association, codes of ethics, clinical protocols, and the medical discretion of healthcare professionals – just as it is for all healthcare. Criminal or civil law is inappropriate in medicine because it puts legislators in the operating room and gives them veto power over medical decisions made by doctors and patients. No other healthcare treatment is subject to such dangerous political interference, and abortion should not be either.
The UK debate over reducing the time limit is a perennial one that will keep coming back over and over again, because an abortion law – even a so-called liberal one – is a gift to anti-choice politicians. Not only does it provide a solid anchor from which to lobby for and pass more restrictions, it’s often used as a weapon against providers and women. The recent “sting” operations against abortion clinics and providers in the UK are a case in point. Examples abound from other countries, such as in New Zealand, where the anti-choice movement has gone to court with accusations that the two “certifying consultants,” required under that country’s law to approve abortions, have been illegally rubber-stamping almost all requests. But the problem is not whether the consultants are interpreting the law too broadly, the problem is the law itself – just as in the UK with its pointless legal requirement for two doctors’ permission. Women have a fundamental right to abortion on request without having to state a reason or obtain approval from anyone.
A couple of UK politicians have expressed concern for the impact of late abortion on women, but that just covers up a paternalistic belief that women are unable to make their own responsible and informed decisions, especially difficult ones. Too many people – even women unfortunately – still hold onto archaic assumptions about the motherhood role of women and see women’s control over their fertility as a threat to the patriarchal status quo. Let’s not forget that the main reason for banning abortion in the past was to ensure sufficient cannon fodder for wars. We are still not far removed from that reason today.
Much of the debate in the UK media has focused on the science of fetal viability and at what gestation they can survive on their own. This issue is totally irrelevant to women who need abortion care, as the survival ability of premature babies applies only to fetuses being carried to term. If a woman needs an abortion, then by definition, her fetus is not viable. Abortion care must be focused solely on the woman’s health and needs, because without a willing and able pregnant woman, the fetus has no standing – and there is nothing the state can or should do about it.
When we focus on the fetus, we forget about the woman and her reasons for an abortion. Women don’t ask for an abortion because it’s their “right to choose,” or because they don’t understand what’s inside of them. They request abortion because they can’t provide responsibly for a child (or another child) at this point in their lives. A woman’s abortion decision is about ensuring her future and that of her family, not about the current legal or moral status of her fetus. It’s about being the best mother possible when she’s ready – or maybe not becoming a mother at all if she knows she’s not suited to it. That is the very definition of conscientious decision-making. We can trust women to know what’s best for themselves and their families, without imposing punitive criminal laws against their private decisions.