Abortion rights - convince your MP: this could be a very close vote

More anti-choice work from the usual suspects, in the continuing attempt to gradually introduce US-style "you can only have an abortion if the moon is full on a Tuesday with the agreement of three doctors, two vicars, and a greengrocer, with a 32-hour waiting period" restrictions to the UK.

More information at Abortion Rights and The F-Word.

If you are a UK citizen or resident please write to your MP and ask them to vote against these amendments if they are discussed at Report Stage.

Initial assessments in the press suggest that the amendment might pass but by a very narrow margin. It is therefore crucial that pro-choice MPs are reminded that they need to turn up and vote against it, that wavering MPs are convinced to vote against it, and that anti-choice MPs are given sufficient doubts that they abstain.

You can get a rough idea of how MPs are likely to vote at Public Whip - anyone who voted 'No' on that vote will likely vote 'No' on the amendment too. However, it's quite possible that many of those who voted 'Yes' can also be convinced to vote 'No' this time. If your MP isn't newly-elected, then you may be able to use this information to tailor your letter to their views.

Also potentially in our favour is that the Health and Social Care Bill itself is highly controversial - it has already been returned to Committee for a massive rewrite once, after major public objections and serious Lib Dem uneasiness with its content. Adding an entirely separate controversial issue to it has the potential to wreck the whole Bill, and this may explain the news that the government is now unlikely to support the amendment.

Nevertheless, we can't take any votes for granted.

Here's my letter.

I am writing concerning the amendments proposed by Nadine Dorries MP and Frank Field MP to the Health and Social Care Bill.

The amendments would prevent any non-NHS body that provides termination of pregnancy (including those providing those services on behalf of the NHS) from also offering counselling to women considering abortion.

This principle - that advice should be given by someone entirely unrelated to the provider - is not demanded, and nor should it be, for any other medical procedure.

Furthermore, women seeking abortions who feel that they would like counselling already have the choice to go to any provider that they wish to, and can already choose a separate provider if they feel this would be beneficial.

These amendments act to reduce their available choices, but also - by requiring women who would not otherwise do so to seek out a separate provider for advice and counselling - will increase the time between a woman deciding to obtain an abortion and actually being provided with one. Since the earlier an abortion can be carried out, the easier and safer it is for the woman concerned, this is extremely unhelpful.

Field disingenuously portrays this as being similar to advice on pensions, where there is a conflict of interest if the company selling the pensions is also advising customers on their choice of pensions. However, this reveals more about the mindset of the amendment's sponsors than about the real situation:

• medical care is not a commercial product, and it is considered beneficial for all other medical procedures for advice to be given by the provider of the procedure. Termination of pregnancy is no different.
• counselling is explicitly not about giving advice, but about allowing a client to come to their own decisions.
• neither the NHS nor non-governmental abortion providers have an interest in maximising the number of abortions carried out (unlike a pension company which does have an interest in increasing the number of pensions it sells)

The amendment is based on a transparently false caricature of the motivations of medical professionals, and a massive underestimation of the ability of women to make decisions about their own bodies.

I ask you to please vote against these amendments if they are discussed at Report Stage on the 6th and 7th September, and to encourage your colleagues in all parties to do likewise. It is also rumoured that the Department of Health intends to implement some or all of the measures set out in these amendments without the need for legislation, and I therefore also ask you to put pressure on the Department not to do so against the will of Parliament.

Thank you

Inevitably, rights need to be defended

Well, it was obvious this was coming sometime during this Parliament. The Telegraph reports that amendments to further restrict access to abortion will be tabled to the Health and Social Care Bill by MPs including Nadine Dorries MP (Conservative, Mid Bedfordshire) and Frank Field MP (Labour, Birkenhead).

[trigger warning]

The amendments haven't yet been filed, but the Telegraph reports that the first will:

[...] create a new precondition for any women having an abortion to receive advice and counselling from an organisation that does not itself carry out terminations.

...and the second will transfer responsibility for setting clinical guidance for abortions to the National Institute for Health and Clinical Excellence (away from the Royal College of Obstetricians and Gynaecologists).

The second appears to be more symbolic than anything else, at an initial glance: they don't like the recommendations that the RCOG is likely to produce, so they'll give the job to someone else less specialised. Given that two doctors are required to agree for an abortion to happen - one or two more than any other medical treatment - this may cause problems with finding doctors if the guidelines NIHCE comes up with are significantly more anti-abortion than the ones RCOG would have written, but there will still be plenty of doctors who believe that forcing someone to go through with an unwanted and/or dangerous pregnancy is sufficiently harmful in its own right.

The first comes right out of the USA anti-choice book, though. It's full of typical anti-choice assumptions:

• People in possession of a uterus automatically lose all their critical thinking skills and therefore, by force of law, must be required to be take advice and counselling whether they want or need it or not. No-one ever thinks about whether or not they should have an abortion before they walk into their GP's office.

  Unsurprisingly, this isn't applied to most other life decisions. Perhaps, given that - according to Science! - 99.81% of decisions on who to heterosexually marry are non-optimal, there should be mandatory advice and counselling for anyone wanting to get married. Religious organisations would not be allowed to provide this advice, since that would be a conflict of interest.

• The pro-choice side want to maximise the number of abortions performed. Therefore it's a major conflict of interest for advice to be provided by an organisation (such as the NHS) which also provides abortions.

  Claire Murphy of BPAS is quoted in the Telegraph article for the obvious reality:

  On average, 20 per cent of women who approach BPAS initially seeking an abortion eventually chose not to have a termination, [Murphy] said.

  “The bottom line is that like any other medical procedure, women have to consent before they receive abortion treatment,” she said. “We have no interest in pushing women into procedures they do not want. We are about giving women choices.”

• Reducing the number of abortions, in and of itself, would be a social good. The means taken to do this are irrelevant.

  The social problems resulting from a vast increase in the number of unwanted children - it's not as if our foster care and adoption services are keeping up with demand as it is; the health problems caused by carrying on with unwanted or dangerous pregnancies; the problems caused for families who neither want nor can cope with an extra child - all quietly ignored.

It's unfortunate, because there are several largely uncontroversially good actions which could be taken, one side effect of which would be to reduce the number of abortions. "Cheating" and just making abortions illegal or harder to get¹ doesn't have the same effect.

For instance:

• Researching - and not restricted to one form of reproductive anatomy, either - cheap, fully reliable contraception without side effects or the possibility of sabotage, and making this widely advertised and available to everyone in the country.
• Significantly increasing the level and range of support available to parents - especially those without much money, and those with disabilities, and single parents, and everyone else who differs from society's default parenting model.
• Major improvements in the coverage and availability of sex education for children - and, indeed, if we don't want to take most of a century to catch up, for adults too - especially on coercion issues (which often include coercion over contraception). Dismantling as much of rape culture as possible would help.
• Far more efficiency and effectiveness in dealing with domestic violence and rape.

All of these would - as a side effect - reduce the number of abortions that were needed annually, either by making it less likely that people would become pregnant unexpectely, or by making it more likely that people who became pregnant would be able to support a child for the following decades.

Of course, helping people is not really what these MPs go in for (both are well to the right of their party as a whole) - far easier to punish them for not doing exactly what those MPs would have done.

Aside on Parliamentary Procedure

Votes concerning abortion in the Commons are generally "free" or "conscience" votes on which none of the parties take a particular line. As far as I can tell, none of the major parties currently represented in the Commons have any official policy on abortion.

In practice, most Labour MPs will vote against restrictions, most Conservative MPs and most Northern Ireland MPs will vote for restrictions, and the Lib Dems will split roughly equally on both sides. When there was a Labour majority in the Commons, this wasn't too bad. At the moment, however, the odds are not good (though, with around a third of MPs being new, they may be better than it looks).

It's not clear yet whether the amendments will be submitted at committee stage, report stage, or for third reading, which affects who will be able to vote on them.

Footnote

¹ In Northern Ireland, abortion is almost entirely illegal. Middle-class people who are pregnant there can quietly get on a ferry to Great Britain, have an abortion, and return home. Poorer people need to rely on the services of groups like the Abortion Support Network to cover their travel costs, hotel bills, and so on. (ASN is always in need of donations to cover its costs, if you have some spare cash)

Quite a few of the suggested restrictions are heavily class-based. Outlawing abortion entirely would cause too much opposition from the middle-classes and their swing votes. Restricting it won't inconvenience them too much and "who cares about poor people anyway?".

Fighting red herrings on abortion

In the news recently has been Cameron's statement that the time limit for abortion should be cut to 20 or 22 weeks. This is not surprising news - he voted for 22 weeks the last time (2008) the question came up in the Commons, and many Conservative MPs (as well as some from other parties) favour larger cuts.

He claims as the reason "the way medical science and technology have developed in the past few decades". Unsurprisingly, the general response has been the same as last time, to point out that the evidence he's using for that claim is wrong.

This is not the full story.

The problem is that currently the way the debate has been framed is that the time limit on abortions¹ in the UK is set with reference to the survival chances of premature babies born after an equivalent length of gestation.

Cameron and others claim that the survival rate of premature babies born in the 20-24 week period has improved significantly. Numerous doctors and scientists claim - with the support of the scientific literature - that this is not the case, although the proportion surviving who are born after 24 weeks has improved considerably.

It's a concern, definitely, if the leader of a political party is misinterpreting or unaware of the relevant research, and people are absolutely right to point this out.

The problem is that relatively few people are also pointing out that the entire basis of the argument is flawed. There is no good reason - historical inertia from the original legalisation I'd view as an "accurate" rather than "good" reason - why the survival of premature babies once born should be at all related to the time limit for abortion.

The original argument may have been to set a distinction between "alive" and "not alive" that wasn't fertilisation, conception, or birth - and if that was what was needed to get the original legalisation passed, that's fair enough. The distinction is absurd, though, and I think it's necessary to also point this out.

If medical science was to develop an incubator environment that could duplicate the uterus so well that not only did the survival rate for premature babies at any stage of development increase massively, but that babies could develop right from the embryo stage in this environment (which would be a massive boost for some branches of fertility treatment) this would hardly mean that abortion for non-medical reasons should be banned. Almost all the reasons why someone might want an abortion would still apply despite this technology existing.

Conversely, assuming that Parliament and scientific research could move rapidly enough, what about the case where a war or natural disaster significantly reduced the UK's medical and scientific resources and capabilities, to the point where survival of premature babies in the 24-30 week range became highly improbable. I doubt those now calling for a lower limit would support it being raised anyway, but it would be slightly absurd to do so even if they did.

Basing the abortion time limits on - effectively - how good the local health service is seems logically indefensible. It may have been a necessary thing to do politically at the time, and it's fortunate that the limit it provided then was a high one, but continuing to accept it as a correct way of deciding the limit will eventually be a very bad strategy. (While the reduction from 28 to 24 weeks in 1990 probably could not have been avoided in practice due to the size of the Conservative majority, it was done under exactly these grounds)

It's quite clear from the votes on 12-week and 16-week limits that some MPs would rather it was reduced significantly below any plausible limit this argument could provide, and would probably have voted for 0-week if the option had been there. If they don't accept it as a dividing line, I don't see why I should either when opposing them. The time limits at which abortion is available should be related to when it is necessary for the woman involved, not to what another woman's premature baby's chances of survival are.

So Cameron is wrong on the science, but he's even more wrong that the science is relevant in the first place.

¹ Excluding Northern Ireland, where abortion remains illegal and the government refuses to do anything about it, and excluding those medically necessary to save the mother's life or prevent serious (but not less serious) injury to her which can occur at any time.
Technically those within the 24 week period must be justified by the prevention of harm to the mother or her existing child(ren)'s health (physical or mental) but the majority of doctors correctly interpret this broadly.

Postscript

Other things that are infuriating about the way that the political debate over abortion is conducted in the UK:

• Northern Ireland. The UK Parliament has the authority to legalise abortion there (which in practice means legalising abortion for poor women there, rich women being able to afford the ferry/plane trip to one of the other UK countries) but not the courage to do so.
• "Free votes". All three major political parties give their MPs a "free vote" on abortion. I don't object to free votes as such, but this means that none of the three will ever include anything explicitly pro-choice in their manifesto, because this custom would stop them being able to require their MPs to follow it. They don't have to follow the custom, but for now they'll continue to do so. On other so-called "moral issues" the parties have quite happily set an official line. This seems to be a case where they're secretly happy to be bound by a pointless Westminster tradition.
• Parliamentary timing. The amendments to the HFE Act that would have reduced the time limit to 12, 16, 20 or 22 weeks all got debated and voted on. Two pro-choice amendments (one to remove the requirement for two doctors to agree, which is not required for any other medical procedure; one to bring Northern Ireland into line with the rest of the UK) were scheduled later and didn't make it to a vote. That hardly seems balanced, and if that pattern - with a Labour government mostly in control of the timing - continues, any erosions are going to be very hard to reverse.

Sceptical Intersections

This guest post at Liberal Conspiracy, is in many ways an excellent example of the "Sexism in the atheist community" described by Amy Clare.

It describes the "Skeptical Voter" project, which is asking MPs the following questions:

1. Do you support the use of public funds to provide unproven alternative "treatments" such as homeopathy?
2. Should schools be allowed to teach creationism as an equivalent theory to evolution?
3. Do you believe that religious belief should be legally protected from ridicule?
4. Should an independent government adviser whose views in their area of expertise conflict with government policy be able to express those views publicly without fear of being sacked?
5. Should Sharia law be allowed as an alternative system within UK law?
6. Do you agree that testing on animals (within strict criteria) is a necessary part of the development of medicines?
7. Should policy-makers trust scientific evidence even when it appears counter-intuitive?
8. Do you think that abortion time limits should always be determined by the current scientific and medical consensus?
9. Should religious leaders be entitled to vote in the House of Lords?
10. Do you support the reform of English and Welsh libel law to allow a stronger 'public interest' defence?

Presumably the answers an MP totally in line with their views would give are "Yes" to 4, 6, 7, 8 and 10, and "No" to the others.

Here we have the example, because some of these questions could quite easily be given an answer other than the expected one by someone who was nevertheless in favour of science-based policy and a secular society. There seems both to be an anti-religious attitude (rather than a secular one) and (at best) a lack of understanding of privilege.

Question 3 is not completely clear, because of the way this question is sometimes tied to similar questions about sexuality, and might end up tied to similar questions about other axes of oppression should the Public Order Act be extended further. An MP might reasonably conclude that such a provision was a compromise worth making in exchange for similar provisions on gender, appearance, sexuality, disability, and so on. If removing the "avoidance of doubt" clause in 29J was the price to remove the far more problematic one in 29JA, it might well be worth paying.

Question 5 is extremely worrying. The group seems (from comments at the LC post) to be in favour of banning faith-based arbitration. I really don't see what it has to do with them if two people mutually agree to arbitration under particular terms, even if those terms are religious. Furthermore, while the group seems to be in favour of banning faith-based arbitration generally, the question and most of their efforts are towards Sharia-based tribunals rather than the longer standing (but less subject to recent tabloid panic) Beth Din.

Even without the discriminatory notes of singling out a particular religion's method of arbitration, the whole question seems more anti-religion than secular. With the focus on Sharia specifically, it seems to tie in to the general Islamaphobic racism present in the UK today.

Question 8 is another extremely worrying one. The recent debate on the time limits for abortion provision (England, Wales and Scotland only, with two doctors approving) was mostly framed around how likely it was that premature babies born after X weeks gestation would survive, with '24 weeks' being "reasonable chance" with current technology, and '20 weeks' being "extremely unlikely indeed" with current technology (but claimed to be "also a reasonable chance" by many of those pushing for a lower limit).

While it's true that those in favour of reducing the limit were misrepresenting the science, I don't think an answer of "Yes" to this question is a particularly pro-choice stance either, because it accepts a very dangerous - and inevitably losing - frame for the argument. At some point medical science will probably advance to the stage where the "uterine replicators" of science fiction are possible. Their existence will not be a good reason to ban abortion. Closer to the present, when medical science does advance to the point where a baby born after only 20 weeks gestation does have a reasonable chance of survival, this won't be a reason that abortion of an unwanted fetus shouldn't be allowed to 24 weeks (though, it will probably be used as one).

Viability of premature babies provides another (slightly fuzzy) dividing line to go along with conception and birth, and being currently somewhere in the middle, it's an obvious one to use for many people (including myself, before I actually thought about it a bit more). That doesn't mean it's the right line to use.

Question 9 is not as clear as they seem to think, either. Yes, the appearance in the House of Lords of the Anglican bishops is a historical anomaly and not a desirable one (but then, the appearance of people in the House of Lords whose sole qualification for membership is that their great grandfather was there too is also an undesirable anomaly).

However, several proposals for reforming the House of Lords involve making a chamber of representatives from various sectors of society. It wouldn't be unreasonable in that case to have a few representatives from the major UK religions (and of course in that case there should be some form of representation for atheists and agnostics too). Religion is a major part of many people's lives, and some representation for it in government seems fair (especially for those of religions other than Christianity, who in the UK at least are subject to more discrimination than atheists)

Any other problems I've missed?