In late March in the midst of the Covid-19 pandemic, the UK Government suddenly decided, without debate or scrutiny, to allow home abortions for pregnancies up to 10 weeks. This despite a government minister having said days before, "We believe that it is an essential safeguard that a woman attends a clinic, to ensure that she has an opportunity to be seen alone and to ensure that there are no issues."
On Monday night (July 6), the UK's House of Commons voted through the final Commons stage of the much-discussed Domestic Abuse Bill. Earlier, MPs keen to push for liberalisation of abortion had put forward amendments designed to decriminalise abortion before 28 weeks and also to make "home abortions" legal where domestic abuse was claimed.
Only the latter amendment was allowed to be debated, much to the disappointment of those who sought decriminalisation. Evidently fearing that this amendment would not be passed, Diana Johnson MP withdrew it after hearing the debate in the House. There will now be an inquiry into the issue of home abortion, and what has been learnt on this subject over the past few months.
It is to be hoped that the enquiry will be serious; certainly it comes none too soon. Such concerns were parked by a Government which had pushed ahead regardless of obvious safety concerns. It should have been clear, for example, that it would be difficult to check the stage of gestation at a distance. Already we have seen the still-birth during lockdown of a 28 week baby: a case currently being investigated by the police, as other cases of advanced gestation are being investigated by the abortion provider itself. Abortion providers have hardly been making things difficult: a sting operation found recently that pills by post were obtained by volunteers with frightening ease.
The Royal College of Obstetricians and Gynaecologists, until very recently headed by a woman who believes abortions should be treated no differently from other minor procedures like bunion removal, strongly supported the amendment on home abortions. Yet the same RCOG has recommended that healthcare services should identify issues such as domestic abuse among women seeking abortions and refer them to appropriate support services.
All sources indicate that the Covid 19 lockdown has led to an increase in domestic abuse. It was in this context that the Government brought in home abortions, in full knowledge that there was likely to be a higher prevalence of abuse and coercive control, but with the apparent assumption that such control would only go one way.
During the course of the debate on the Bill and amendments we heard much about abuse and coercive control, though analysis of these concepts was largely lacking. The definitions of abuse and coercion in the Bill are wide in scope – in, we are told, an attempt to capture unjust and harmful behaviour which might otherwise go unchecked. Whatever one makes of the definitions, it is striking that what is a matter of concern when it comes to coercive control in some areas becomes effectively irrelevant in other areas, suggesting that these terms should be treated with some caution by honest legislators.
There is at present insufficient evidence to show whether screening increases uptake of assistance or reduces harm. What we do know, from numerous studies, is that women seeking termination of pregnancy are generally far more likely to have suffered physical or emotional abuse compared to those seeking antenatal care
Women in the most vulnerable situations are not currently given the guaranteed protection of a proper, face-to-face and genuinely private assessment of their situation by a medical practitioner who can explore why they might be asking for an abortion. Sensitivity to a wide range of forms of coercion expressed during the Bill's debate was, by some, suddenly cast aside when it came to abortion decisions – or perhaps, contrary to the research, it was assumed that emotional or other coercion to end pregnancies does not exist. However, nothing is in place to safeguard against an abuser standing over a woman in lockdown while she phones and asks for abortion pills or perhaps persuading a female relative to do so.
Thankfully, the amendment was withdrawn. There is however great irony in the fact that a Bill aimed at protecting women especially from coercive control came so close to co-option of a kind that would have removed an obstacle to the great wrong of coerced abortion.
That obstacle is both legal and medical, and it is telling that certain well-placed medics and legislators seem determined to undermine the very protections that their institutions are supposed to/designed to offer the most vulnerable women in our society.