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Thursday, January 28, 1999 Published at 09:50 GMT


Health

Abortion 'part of birth control'

Modern techniques mean abortions can be induced by pill

Abortion is an essential part of good birth control policy, according to a panel of specialists.

It said a review of NHS abortion practice and the law regarding the procedure is needed if the UK is to maintain a serious approach to family planning.

The pregnancy specialists delivered their proposals to the government on Thursday at a symposium organised by the British Pregnancy Advisory Service (BPAS) and the Birth Control Trust.

The symposium heard that abortions should be moved out of a specialist hospital setting and into the community.

However, anti-abortion campaigners said that access to abortion is already too easy.

And the government says there are no plans to change the law, but the new clinical standards agency may look at the matter.

Contraception failures

Ian Jones, a BPAS spokesman, said: "Contraception sometimes fails and sometimes we fail to use it effectively.

"If society believes that people should plan their families it must allow women to end unwanted pregnancies in abortion."

He said that "unnecessary, obstructive and out-of-date" abortion regulations sometimes made this difficult.

Only fertility treatment is as strongly regulated as abortion.

Mr David Paintin chaired the symposium. He expects it to result in a call to "demedicalise" abortion and remove the legal obstacles surrounding the procedure.

At the moment unwanted pregnancies are viewed by law as illnesses that have to be treated by a doctor, following the 1967 Abortion Act.

Two doctors must agree that a pregnancy would damage the woman's health.

To do this, they can use the World Health Organisation's definition, whereby health is not just defined by the absence of illness or infirmity - but by the complete physical, mental, and social well-being of the individual.

Abortions on demand

However, the current legal situation has been criticised for removing the power of choice from the women most affected.


[ image: Some experts say unwanted pregnancies damage women's health]
Some experts say unwanted pregnancies damage women's health
It means that women who want an abortion must find two doctors who interpret the law in this way.

It also means that there is no such thing as abortion on demand, unlike in other European countries.

Mr Paintin called for a change so that abortion is regarded as a "service healthy women need to regulate their fertility" rather than treatment for a gynaecological disease.

He said: "There is a bill that the Pro-Choice Alliance is hoping some MP will take the time to introduce as a private member's bill to provide abortion on request up to 14 weeks into pregnancy."

It would also place a duty on the NHS to provide such abortions.

Playing catch up

"It may be that it does no more than catch up with Europe," he said. "You can make a case for delegalising abortion completely, perhaps for the first half of pregnancy."

He added that abortion should be seen as a natural back-up to contraception.

"Sometimes measures fail," he said. "This is why abortion is necessary as a back-up.

"Without it the woman pays the price of the unwanted pregnancy and perhaps has a child at the wrong time in her life."

Figures show that the use of abortion has not changed since the increase in use of contraceptives during the 1960s.

Mr Paintin hopes to see abortions carried out in well-equipped GP surgeries and family planning clinics, as these are the settings in which birth control is initiated.

Modern techniques and the abortion pill mean that the procedure is easy and carries few risks of side effects.

The effects of taking a pill are "similar to a miscarriage", he said.

Uneven procedure

Dr Kate Paterson, a consultant community gynaecologist at St Mary's Hospital in London, addressed the symposium on how services can be better organised.

She said: "Reproductive control is absolutely essential. Birth control is the first line but it's no good without abortion as a back-up."

She said the most important points that needed to be addressed were the uneven provision of NHS abortions, the lack of understanding among health care professionals as to why a woman would want an abortion and women being denied the right to choose.

"There is very uneven provision across the country," she said. "And there is no real acceptance from health authorities or from the country as a whole that abortions are extremely cost-effective."

Doctors sometimes let their personal feelings about abortion lead them to deny one to a woman with an unwanted pregnancy when they would not let their feelings get in the way of other decisions, Dr Paterson said.

"It should be up to the woman to choose," she said. "Then the doctor should make sure she has access to an abortion on the health service.

"If they object to performing the procedure themselves, they should refer to another doctor."

Objections

A spokesman for anti-abortion charity Life said: "We are dismayed by this conference and the demands it is putting forward.

"We believe the rising number of abortions has already led to problems and we are counselling more and more women who are suffering trauma after having a termination.

"Making abortion easier is also causing problems among the younger generation because they don't see it as any big deal.

"They have an abortion and then afterwards start having problems coming to terms with what they have done."

A spokesman for the Department of Health said there were no plans to introduce abortion law reform.

"Equal access to services is something that the National Institute of Clinical Excellence might look at when it is up and running," he said.



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