Contribution
My Lords, until recently I was head of the Royal College of GPs. Our college is fully in favour of decriminalisation of abortion. As Professor Hawthorne said:
“No woman should face prosecution under antiquated laws that were created before women were even allowed to vote. This change in the law is a vital piece of protection for the reproductive and health rights of women”.
I would like to pick up a few issues. I have been fortunate enough to work in the NHS, in a legal state in terms of abortion, which has been absolutely fabulous, because I have seen many young women and girls and older women coming and needing terminations of pregnancy and I have guided them through it. I want to talk about a few things—for a start, telemedicine and “medicines by post” and the assumption that this is somehow a bad thing. I would like to turn it all round and say that this is a patient-centric initiative. Imagine having to travel far and to have to go past your abusive husband or abusive partner to say where you have been all day. This is humane and patient-centric and about 50% of women choose this option.
It does not mean that they do not get a proper assessment. Many people are assuming yet again that it is a sort of tick box. It is an hour-long consultation with pre- and post-termination counselling and at any point the woman can be seen face to face. I have also been hearing an assumption that it is an unsafe procedure. I think that I heard—I may have misheard—that one in 17 women end up having complications from having had a medical termination. That is not the figures from the Royal College of Obstetricians and Gynaecologists. It says that, under 10 weeks, one in 1,000 women have heavy bleeds and at, over 20 weeks, four in 1,000 do. Those women are in hospital. Clearly it is very different. It is nothing like one in 17. You also have to compare that—we have the comparator—with women who miscarry at home without having an abortion, who probably end up in hospital, as I did twice as a young woman when I had miscarriages. I also want to pick up the issue that somehow telemedicine is a process without any legal requirements. Of course it has legal requirements. It is currently, and will continue to be, regulated under the abortion law. What we are doing is decriminalising it.
I then want to talk about foeticide or foetal sex selection. Foetal sex can be determined as early as 10 weeks and many women choose, for one reason or another, to know the sex of their child. Both my daughters-in-law—I was going say my sons but, of course, for the purpose of this, boys cannot become pregnant—chose to determine the sex of their child, just as many people do. It is perfectly legal to determine the sex of your child—at the 20-week scan, anyway, you can choose to determine the sex. Women can then choose to have a legal termination if they so wish, though I am struck by the noble Lord, Lord Winston, saying that there are legal implications. This is conflating the issue of decriminalisation and sex selection. I personally am against sex selection, but it is not part of this argument about decriminalisation.
I would also just like to address the under-16s and compulsory safeguarding assessments under what I assume would be a multi-agency assessment, including the police and social workers. As the law stands, women under 16 can obtain an abortion and obtain sexual health advice and contraception without safeguarding implications—clearly noble Lords all know about Gillick competence and Fraser guidelines. This would be a retrograde step. These young girls would not come to see us. They would probably end up like one patient who I saw very late in pregnancy. She presented with a rash on her abdomen, which is the rash with stretch marks; she was 32-weeks pregnant. She was so terrified—and this was before the law changed—of admitting that she had had unprotected sex and had not had her period. Compulsory safeguarding is a retrograde step and has nothing to do with this decriminalisation, which I fully support.