Serious questions for the DoH on Abortion and Disability
Posted by Benjamin Portelli on 18 December 2017
We work for the recognition and respect for the human dignity of all children in the womb, regardless of (dis)ability
"Women considering an abortion must be provided with accurate information about the procedure and its possible effects on their health."
This is the opening line of Abortion and Women's Health: An evidence-based review for medical professionals of the impact of abortion on women's physical and mental health written by Dr Greg Pike the latest edition of which was published by SPUC in October 2017. The review concluded that abortion is "associated with a wide range of adverse physical and psychological outcomes", including substance abuse, PTSD and depression (psychological harm being particularly prevalent after an abortion following a diagnosis of foetal abnormality1).
Does the Government care?
Yet following such findings it remains unclear if complete and accurate information relating to pregnancy and abortion is unilaterally provided to women. It's not even certain that relevant information is collected by the Department of Health in the first place.
A series of Parliamentary Questions (PQs) were recently posed to Secretary of State for Health, Jeremy Hunt MP, by Jim Shannon MP and Martin Vickers MP, and responded to by Philip Dunne MP and Jackie Doyle-Price MP, on the subject of detection of foetal abnormality and abortion. The answers were revealing.
For example: according to the information provided by Ms Doyle-Price, 42 per cent of (pre-birth) diagnoses of congenital defects resulted in an abortion in 2015 (see figure2).
Crucially, when asked if the Department of Health holds statistics on the number of babies diagnosed pre-birth with a disability and subsequently born without that disability in each year since 2010 the response given was "this information is not collected centrally". That amounts to more than 800 unborn children being aborted on the grounds that they might be "severely disabled". This in light of the finding that "when an abortion is undertaken for reasons of foetal anomaly the after-effects can be particularly traumatic", and "if a woman is motivated to have an abortion because of foetal disability, her risk of psychological harm is higher than if motivated by other reasons"1. Apparently, this is of little to no concern to the Department of Health, who are unable to quantify the number of women traumatised.
Ms Doyle-Price's full response presents other issues. Mr Shannon and Mr Vickers both asked for statistics pertaining to "the number of women expecting a baby with a disability who (a) did and (b) did not have an abortion in each of the last three years". Ms Doyle-Price responded with reference to Ground E for abortion (risk that the child would be born 'seriously handicapped'"), which is problematic for a number of reasons:
a). Not all "disabilities" are qualified as "serious handicaps", and the expectant mother of a "disabled" but not "seriously handicapped" child can still claim a belief in significant potential risk to her mental health (Ground C), without consideration for the fact that proceeding with abortion also poses risks to her mental health. This is expanded on in Abortion Mis-certification: Mental health grounds as a pretext for therapeutic abortion3. The response might be more accurate for the question asked, if an attempt was made to present the number of abortions under any ground following the diagnosis of a disability.
b). The definition of "seriously handicapped" appears to include conditions that are not life-threatening, and are treatable within the earliest months of life, like cleft lip/palate. This too doesn't appear to be of concern to the Department of Health, which "does not record information on whether a disability is rectifiable". This was confirmed in a later PQ querying the number of women who have abortions when their unborn children having rectifiable conditions. To top it off "the information that is provided to women expecting a child with a disability is provided on a trust by trust basis", so one can't be sure that women are unilaterally informed that the condition is rectifiable in the first place.
c). Ms Doyle-Price fails to mention that statistics on the number of Ground E abortions in the report she provides are, as admitted in that very report, to "be treated with caution" as "almost half of Ground E notifications are missing". The statistics are incomplete.
The NHS is required to provide counselling and support to women when a foetal abnormality is detected, explained Mr Dunne in answer to a follow-up question. As part of his answer he provided a document (which pertains specifically to NHS England) which states: "Detailed counselling [is provided], including explanation of findings which may include specific diagnosis or differential diagnoses and the implications and prognosis for the baby". It is not clear how this differs between England, Wales, Scotland and NI, and whether or not counselling is also available to the father. Additionally, Mr Dunne continued, "evaluations of the counselling services are arranged on a trust by trust basis".
We, in the pro-life movement, work for the recognition and respect for the human dignity of all children in the womb, regardless of (dis)ability, and find that these answers present a particularly shocking and callous response to the disabled community and their families. This is, apparently, how our society treats its members who are most deserving of our compassion.
What is important?
A commenter and friend of SPUC, Jane Finigan de Villalobos, shared with us:
"It is difficult to understand governmental indifference towards statistics on abortion for reasons of disability. My husband and I adopted our son Damian, now aged 35, when we were still in our twenties, from a position of almost complete ignorance of the world of disability. Damian has Down's syndrome and is quite severely affected but his positive, funny, endearing character has brought us such happiness over the years. He has been the best of sons."
And the pregnant women? It seems that, for the Department of Health, eradicating children who might be disabled and are perhaps seen as burdensome and dispensable is more important than ensuring a good standard of information and counselling for women at risk of considering an abortion. It seems that information about the reality of abortion and disability is something the DoH isn't interested in being guided by.
1. White-Van Mourik MCA, Connor JM & Ferguson-Smith MA (1992) The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality. Prenatal Diagnosis 12:189-204.
Koponen K, Laaksonen K, Vehkakoski T & Vehmas S (2013) Parental and professional agency in terminations for fetal anomalies: analysis of Finnish women’s accounts. Scandinavian Journal of Disability Research 15(1): 33-44.
Lafarge C, Mitchell K & Fox P (2013) Women’s experiences of coping with pregnancy termination for fetal abnormality. Qualitative Health Research 23(7):924-936
Coleman PK (2015) Diagnosis of fetal anomaly and the increased maternal psychological toll associated with pregnancy termination. Issues in Law and Medicine 10(1):3-23.
(Quoted with references from Pike G, (2010) Abortion and Women’s Health: An evidence-based review for medical professionals of the impact of abortion on women’s physical and mental health, Society for the Protection of Unborn Children)
2. Public Health England (2017), Congenital anomaly statistics 2014/15, Prepared by National congenital anomaly and rare disease registration service, Retrieved from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/630736/Congenital_anomaly_statistics_2015.pdf on 30/11/2017
3. Retrieved from: https://www.spuc.org.uk/~/media/Files/Abortion-Miscertification-briefing.ashx?la=en on 30/11/17