5 July 2019 – The full judgement outlining Justice Lieven’s decision to order a 24 year old woman with a “moderate learning disability” who was 22 weeks pregnant to have an abortion has been released. The hearing took place in the Court of Protection on 21st June, however the ruling was later challenged in the Court of Appeal on the 24th June and was successfully overturned.
Justice Lieven’s judgement from the Court of Protection has now been released. The ruling discusses the woman’s ‘best interests’, her capacity to consent to abortion, as well as the role the grandmother, a former midwife, might play in raising the child. In all 63 paragraphs of the ruling however, no consideration or weight is given to the rights of the 22-week-old unborn baby.
The court judgement noted:
Paragraph 18 – The pregnant woman (referred to as AB for reasons of anonymity) understood that she “has a baby inside her, and that it will be born”. She could see her stomach grow and could feel the baby move.
Paragraph 22 – NHS Trust witnesses thought that the late-term abortion would be “less traumatic for her than the baby being taken away” however the AB’s mother, who the Justice Lieven noted “knows her best”, thought that AB would potentially be “very upset about the loss of the baby”.
Paragraph 35 – Previous case law is cited concerning an abortion for a 14 year old girl. The judge in that case writes that such an “immensely invasive procedure” as a forced abortion, could not be justified to be ordered by the court “unless there was powerful evidence that allowing the pregnancy to continue would put the mother’s life or long-term health at very grave risk.” The ruling states that AB is “young and physically healthy” (p.48) and any risk to postpartum psychosis was speculative and it would be “almost impossible to assess the likelihood of this happening” (p. 24).
Paragraph 43 – AB’s social worker said that she believed it was in “AB’s best interests to have the baby”. Paragraph 46 – Justice Lieven notes that she is “acutely conscious of the fact that for the state to order someone to have a termination, where it appears that they do not want it, is immensely intrusive”. Paragraph 52 – Despite the fact that Justice Lieven accepts that AB “probably will suffer some trauma or upset from the termination” she thinks that it “will be a lesser impact than having the baby”. Paragraph 56 – Justice Lieven makes a differentiation between a “pregnancy” of 22 weeks gestation and a “real baby”, saying that if AB gives birth, it will be a “real baby” but while she is still pregnant it is a “pregnancy”, seemingly not a “physical presence”. Paragraph 60 – Justice Lieven believed that AB “would like to have a baby in the same way she would like to have a nice doll”.
Spokesperson for Right To Life UK, Clare McCarthy has said:
“A few very worrying things ring through from this judgement, one especially resounding thing was that the rights of the 22-week-old baby in the case were not considered in any way, or carried no weight at all in the judgement. A baby this late in gestation would in some cases be able to survive outside of the womb and yet Justice Lieven dismisses the baby as “not a physical presence”.
“Despite the fact that the woman, supported by her mother and her social worker, made clear that she wanted the baby (p.26), and that Justice Lieven admitted that a court-ordered abortion is “immensely intrusive”, Lieven nonetheless imposed her pro-abortion agenda on this woman by overriding her wishes and ruling that she should be forced to have an abortion. It is a major relief that this ruling has been overturned but it should never have happened in the first instance.
“This ruling was a gross invasion not only on the rights of the pregnant woman but also on the right to life of the unborn child who the mother could feel growing and moving inside her womb.
Over 137,000 people signed a petition launched on the afternoon of Saturday (22 June) calling on the Secretary of State for Health, Matt Hancock, urging him to intervene in this case and doing all within his power to ensure this woman is not forced to have an abortion.
With Parliamentarians from all major parties, and an audience representing many organisations and professions in attendance, the Ceremony held in Committee Room 5 heard the powerful contribution of MacFarlane-Barrow and his organisation, Mary’s Meals, to the humanitarian effort to feed and educate children in some of the poorest parts of the world.
Lord Bates, the Minister of State at the Department for International Development, paid tribute to MacFarlane-Barrow and the work of Mary’s Meals at the beginning of the Ceremony, noting its importance as a part of civil society helping the world’s poorest people, and the example it gives of effective charitable and development efforts at a time when international aid by Government is under serious scrutiny and criticism.
Magnus MacFarlane-Barrow, with his brother Fergus, started his charity efforts in 1992 during the conflict in the Balkans after the breakup of the state of Yugoslavia. The two brothers were both fish-farmers in their mid-to-late-twenties when, touched by the plight of those affected by the conflict, they began a local appeal for food and blankets. They then drove to Bosnia with a jeep filled with the cargo they received and kept in their parents’ shed, and delivered it to those in need.
When they returned, they found that more donations had come in, and so Magnus took a year out from his job to continue delivering the aid. The donations never stopped however, and so Magnus took on his project full time, turning it into a charity initially named ‘Scottish International Relief’ and recently renamed ‘Mary’s Meals’.
In the 25 years that the charity will have been going by the end of 2017, it has become a school feeding charity, working with some of the world’s poorest communities to set up school feeding programmes, which enable children to come to school and gain an education that can offer a route out of poverty. In 2015, the number of children served by Mary’s Meals reached the milestone of 1,000,000.
The Westminster Award recognises extraordinary and notable work and achievements that safeguard the dignity and right to life of human beings. Its recipient is chosen by the Chair of the All-Party Parliamentary Pro-Life Group and the Trustees of Right To Life, having taken advice from senior Parliamentarians in both Houses. This year, a person has been chosen due to his hard work, over more than two decades, to make sure that the necessities of life are provided to those suffering from some of the worst deprivation in the world today.
Fiona Bruce MP, Chair of the All-Party Parliamentary Pro-Life Group and a Patron of Right To Life, said:
By Magnus’s efforts leading Mary’s Meals, many people have been delivered from hunger and malnutrition, and so Magnus has by these compassionate charitable accomplishments safeguarded the most fundamental right to life of the most vulnerable people in the world. Mary’s Meals is a triumph of humane and compassionate moral endeavour. This deserves our praise and richly merits the Westminster Award for Human Life, Human Rights, and Human Dignity.
Magnus MacFarlane-Barrow, Recipient of the Westminster Award, said:
I am deeply honoured and moved to receive this award and so very grateful for this recognition of Mary’s Meals as a mission focused on the right of each child to life – and life to the full. Without enough food to eat or the chance of at least a basic education, a child is denied the chance to grow and become the person they are meant to be. Our daily meal in a place of education helps meet those most basic needs of every child and helps set them free that they might live with dignity. I thank sincerely those who decided to recognise our work in this special way.
Councillor Chris Whitehouse KSG, a Trustee of Right To Life, said:
At Right To Life, we generally campaign against direct violations of the human right to life, and the dignity of the human person itself, in the law’s refusal to protect the vulnerable or attempts to remove vital protections. This Award to Magnus helps to illustrate that the very same ethic that drives our efforts for the elderly, the disabled, the terminally-ill, and the unborn child, amongst others, is one that also brings concern for a broader respect for humanity, and a celebration of the charitable efforts he has led that show true solidarity to those members of the human family who most need assistance to live.
Lord Alton, senior member of the All-Party Parliamentary Pro-Life Group, and a Patron of Right To Life, said:
Magnus MacFarlane-Barrow has a passion for human rights, human life, and human dignity and his work and beliefs demonstrate how this trinity of concerns come together as one. An extraordinary humanitarian, on a daily basis, Magnus saves lives – believing that, from the womb to the tomb, we must honour, respect and uphold the sanctity and worth of every human life. He’s incredibly inspiring and we can all learn a great deal from him.
RTL Executive Officer Peter D. Williams is available for further comment and media interviews about this and other right-to-life issues. For examples of previous RTL public appearances, see our website.
BPAS has launched a new campaign, Just Say Non, which seeks to attempt to lower the cost of levonorgestrel, an ‘emergency’ contraceptive colloquially known as the ‘morning after pill’ (MAP). The reason for the ‘Non’ is that their fairly well-produced campaign video tries to argue that the £30 it costs to buy this pill at the counter is the same as a very cheap trip to France, where one can buy the MAP for €7, allegedly with change to spare:
As arguments go, this is a fairly fun if flippant way to illustrate their point, but it only works if you don’t give it five minutes serious thought. After all, this is ‘emergency’ contraception we’re talking here; there’s a 72 hour window for a woman to get the drug and use it. Given this, I can’t quite work out whether the calculation argument is more batty or puritanical.
I mean, we would all love to live in an alternative reality where you can get a last minute plane ticket to Paris for €20. (“While free movement still applies!” – nudge nudge, wink wink, for the Remainers in the audience.) And maybe that is the sole transport cost if you actually live in an airport and fancy walking from Charles de Gaulle to Kilometre Zero and back. Frankly however, if your idea of a fun holiday in Paris is staying an hour to buy a contraceptive and have a cheap coffee and croissant, then La Ville Lumière is quite simply wasted on you.
Anyway, as enjoyable as pointing out the holes in BPAS propaganda is, you might be wondering why I should be bringing this up at all. After all, this is a blog about life issues; what has emergency contraceptive usage got to do with the right-to-life movement? Admittedly, this is not immediately obvious. A recent discussion helpfully illustrates its relevance however, and helps us clarify what has often been a confused and under-informed controversy.
The other day, Sky News hosted a segment debate between Ann Furedi and Aisling (pronounced ‘Ash-ling’) Hubert, a member of the Evangelical Protestant pressure group Christian Concern, on the BPAS proposals. Hubert has become known in the last year on the issue of abortion due to her attempted private prosecution of two doctors whom a Daily Telegraph investigation in 2012 exposed for sanctioning illegal sex-selective abortions. Her attempt was quashed by the Crown Prosecution Service (CPS), as they shamefully took it over, promptly dropped it, and left her with a legal debt of £47,000. You can see the exchange, here:
If you know the issues at stake here, you’ll have found it a very frustrating discussion. Aside from Hubert’s initial raising of concerns surrounding the taking of powerful synthetic hormones by minors and wider health concerns, elements that were too little touched upon, the rest of the discussion was taken up by both Furedi and Hubert’s disagreement on the nature of the MAP. Unfortunately, both their comments muddied the waters.
In order to see this, and before we go into what they said, it will help first to establish some basic embryological and biochemical facts.
As human beings, we begin to exist as biological entities at conception, when our father’s sperm and our mother’s egg fuse together to become a new entity: the unique embryonic individual that is you or me. This is elementary stuff, and should be obvious to anyone who was paying attention in Year 7 Biology, but I have nonetheless laid out the scientific evidence before and for an excellent written account I recommend the website of the brilliant HEAR campaign on the Isle of Man. In any case, whilst this point marks the beginning of our existence, it is not taken by the consensus of medical science as defining the beginning of pregnancy.
That may seem odd, as we are used to thinking in terms of pregnancy as the period in which a baby, whether at the embryonic or fetal stages of her development, is in her mother’s womb. This initial instinct makes sense, linguistically. The word ‘Pregnant’ is derived from the Latin praegnant-, probably from prae (before) and gnasci (be born). So, our normal idea of pregnancy is that it is the entire period of a child’s existence before birth.
The colloquial understanding does not correspond however, to what the British Medical Association (scroll to page 1, and sub-section What is abortion?) and indeed the courts have said. These define ‘pregnancy’ as beginning at implantation, when the already conceived human being forms a biological connection with her mother and begins to be given nutrients from her.
Such a definition has its own understandable reasoning. After all, the biological reality is that conception takes place not in the uterus, but in one of the two fallopian tubes. The newly conceived unborn child must then pass down into the uterus, and attach to the endometrium, the uterine wall of her mother’s womb. It is at this point that ‘gestation’ begins (that is, ‘[t]he process or period of developing inside the womb between conception and birth’; from gestationemvia similar words meaning ‘to carry’), and this is also when the current consensus defines ‘pregnancy’ to have begun.
I say ‘consensus’, because the established understanding is not due to some magisterial statement from a medical authority, but has come about as responses to the political debate around abortion. Perhaps partially due to this, and the more common – and you might argue, common sensical – understanding of what pregnancy entails, this is all a matter of some legitimate controversy. Nonetheless, this is the established state of things, and there seems little point arguing the toss: the human being begins at conception, and pregnancy (the carrying or gestation of a new human being) begins at implantation.
What is the relevant consequence of this? Quite simply, it determines the language we use when we talk about drugs that are used to ‘prevent pregnancy’, based on the different potential effects they may cause. There are three distinctions we must make:
Contraception: Derived from ‘contra-’ (against), and a shortened form of ‘conception’, this is any method that prevents conception from occurring (i.e. prevent sperm from meeting an egg).
Abortifacience: This describes drugs (‘abortifacients’) that cause a miscarriage through causing the degradation of the endometrium or womb lining that develops in pregnancy, and which gives nutrients to the unborn child. One example of this is RU-486, also known as the ‘abortion pill’. This is an anti-progestin, which means that it blocks progesterone, a hormone necessary for the maintenance of the womb lining. This causes the lining to break down, and starves to death the developing embryonic or fetal human being.
Contragestion: This is the third much lesser known action. The word ‘contragestion’ is derived from ‘contra-’ and gestation, so ‘against gestation’, and was coined in 1985 by the French biochemist and endocrinologist Étienne-Émile Baulieu, who concluded that a technical term was needed to describe the prevention of implantation, which did not fit the traditional definitions of either ‘contraception’ or ‘abortion’. What contragestives do is prevent the already conceived child from implantingin the mother’s womb by disrupting the development of the womb lining, which is necessary for the embryo to implant in her mother’s womb. This as with abortifacience prevents her from receiving the nutrients she needs to survive, and so she perishes.
What distinguishes abortifacients and contragestives is therefore their biological effect: abortifacients end the gestation [pregnancy] of an already implanted unborn child, whilst contragestives prevent the implantation (and thus gestation) of an already conceived child. This is what leads to the medical and legal distinction: what is seen to be ‘aborted’ in abortion is a pregnancy, and thus if implantation has already happened, then pregnancy has begun, and the disruption of this is the aborting of a pregnancy. If implantation has not yet occurred however, then the prevention of this taking place is a ‘contra-gestion’ (an action against the beginning of pregnancy). So, since contragestives do not end an already beginning pregnancy, they are not counted as abortifacients, but as a distinct chemical agent.
This is a neat distinction, but of course what should be immediately obvious is that contragestion is essentially morally equivalent to abortifacience. In both cases, the already-conceived unborn child is killed by being starved of the nutrients she needs to survive, either by the ending of a gestation that is already taking place or of one which is about to take place.
Given the neatness of the biological distinction, and the consequential moral equivalence, it isn’t difficult to see why language in this area is so frequently confused. Even Baulieu, the aforementioned coiner of ‘contragestive’, used it in reference to RU-486, a drug that is properly speaking abortifacient in the way it works. Worse, even though as we have seen the word ‘contraception’ classically refers to the preventing of conception, it is colloquially used to describe:
“The deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse. The major forms of artificial contraception are: barrier methods, of which the commonest is the condom or sheath; the contraceptive pill, which contains synthetic sex hormones which prevent ovulation in the female; intrauterine devices, such as the coil, which prevent the fertilised ovum from implanting in the uterus; and male or female sterilisation”.
So, the irrationally and unhelpfully wide semantic domain of ‘contraception’ now effectively conflates both contraceptive and contragestive agency, even though these are biologically distinct chemical effects.
Given how careless our language is on these issues, it’s little surprise that the concept of contragestion is relatively unknown, and that so many people on either side of the abortion debate see only a strict dichotomy between contraceptives and abortifacients. On the one hand, right-to-lifers can often assume that when we talk of abortion, we mean any action from conception onwards that kills an unborn child, and so they label drugs that have contragestive effects as abortifacients. On the other, abortion lobbyists, seeing that contragestives are not defined as abortifacients, assert blindly that they are therefore purely contraceptives.
Further, and coming to the nub of the issue, this linguistic problem is compounded by chemical reality: there are no pure contragestives, because chemicals with contragestive qualities are always primarily meant as ‘emergency contraceptives’.
Ulipristal acetate (Ella) for example, like RU-486, is an anti-progestin. It blocks progesterone, and works mainly by stopping or delaying the ovaries from releasing an egg. Since (again, as with RU-486) the blocking of progesterone retards the womb lining, this means that it carries the potential to be contragestive. Consequently, the U.S. Food and Drug Administration (FDA), which regulates all chemicals that act to prevent or to end pregnancy, states that:
“[Ulipristal Acetate] works mainly by stopping or delaying the ovaries from releasing an egg. It may also work by changing the lining of the womb (uterus) that may affect attachment (implantation)”.
That is, whilst it is primarily a contraceptive, it can have a secondary contragestive effect. Crucially for the Sky News exchange between Furedi and Hubert, the same is true of levonorgestrel, the MAP. This does not block progesterone, but is a pill with a progestin hormone (a synthetic version of progesterone). Contrary to what Hubert claimed, there is no NHS statement of the contragestive effect of the drug (in fact, both national and local information I have looked at is entirely silent on that specific issue). The Family Planning Association (FPA) does admit it however, and the FDA states in the same page as previously linked to that:
“[Levonorgestrel] works mainly by stopping the release of an egg from the ovary. It may also work by preventing fertilisation of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the womb (uterus)”.
Consequently, both Hubert and Furedi were quite right, and quite wrong. In her beginning comments, Hubert was absolutely correct to point out that:
“[T]his is also about preventing implantation, which is when the sperm and the egg [have] already met, and you’ve got a unique, whole, alive, human being, and it’s going to be prevented from implanting inside the womb… It is actually causing the end of a unique, whole, human life”.
“[I]t is really that everybody understands that… this pill cannot cause an abortion. If you’re already pregnant, it doesn’t work”.
As we can see, however, these two statements are not mutually exclusive. Levonorgestrel cannot cause an abortion, but it does end the life of a unique human being, and regardless of what we call it this is (as Hubert points out) a human rights concern.
Unfortunately however, this point was obscured by Hubert’s claim that “this isn’t just preventing pregnancy”, and that “it has abortifacient qualities”. In fact, the MAP is just about preventing pregnancy, as defined by the current medical and legal consensus, and is therefore not an abortifacient. By repeatedly and erroneously insisting that it is, as well as unfairly calling the denial of this a ‘lie’, Hubert enabled Furedi to employ the medico-legal consensus in her favour by again correctly stating that:
“If this Pill were a method of abortion, it could only be used in an abortion clinic. It could not be issued by pharmacists at all because the abortion law regulates abortion”.
This gave Furedi quite a bit of cover whilst she herself mischaracterised the nature of levonorgestrel. Just as Hubert wrongly insisted that the MAP is an abortifacient, so Furedi misleadingly asserted that the MAP is a contraceptive on the grounds that that “[t]echnically, contraception stops a pregnancy from being established”. We have seen that as a matter of definition this is true, but it is not the whole story, since the normal meaning of ‘contraception’ wrongly includes the distinct concept of contragestion.
It also allowed Furedi to undermine Hubert’s intellectual trustworthiness by caricaturing her as having:
“[A] completely fundamentalist attitude to what contraception is… [and] a perverse and very unscientific notion of what abortion is and what pregnancy is”.
This was false, as Hubert rightly accounted the embryological facts and the potential biological effect of levonorgestrel, even if she mistakenly cast it as abortifacient. Still, this followed on from Furedi’s adoption earlier in the discussion of a very typical abortion lobby trope. Whilst Hubert later unfairly accused Furedi of lying, earlier Furedi similarly imputed a degree of mendacity to Hubert, when she exhorted her to:
“… [b]e honest and say that [you oppose the MAP] for moral reasons, it’s that “we don’t think that these young people should be having sex”, because there is absolutely no other reason why it shouldn’t be available…”
The common abortion lobby slur here is that right-to-lifers are less interested in human rights than they are controlling the bodies or sexuality of others. That Furedi should genuinely employ this silly instance of the abortion lobby’s deluded demonology only illustrates the confusion and incomprehension of her appreciation of this topic. Yes, the MAP is a contraceptive, but it is also a contragestive, which is why Hubert was crucially correct in stating that, “of course this is a moral issue”: that distinct effect kills an innocent unborn human being at one of the earliest stages of their existence.
If you know, as Furedi certainly does, the case for the humanity and personhood of the unborn child, and that this necessarily applies after the human being begins to exist at conception, then there is no way you can claim that “there is absolutely no other reason why” someone might oppose the availability of contragestive drugs. Unless, that is, you are unaware of this element of the MAP’s biological effect. Only this charitably explains how she can straight-facedly paper over this distinct effect and search for alternative explanations as to why someone else would oppose it.
The Furedi/Hubert Sky News segment was hugely flawed then, but also very helpfully illustrative. One thing it shows is the importance of care and precision for right-to-lifers in our use of language. It might be tempting for some to consider the terminological consensus fundamentally broken, or even deliberately biased, and insist on referring to contragestives as abortifacients because there is no moral difference between them. All such people will achieve, however, is their effective exclusion from the primary discussion, or else an undermining of their advocacy, as they allow themselves to be presented as unscientific rubes, or dishonest peddlars of crypto-religiose woo. The current language is largely rational; a better tack would be to use it well enough so as to be able to bring out the ill-informed and irrational arguments of our opponents.
This is quite literally vital, because of what else was illustrated by the segment: the confused and ill-informed public awareness regarding the science and ethics of emergency contraception. A lot of time was wasted in what was a conversation spoilt by a failure to note important distinctions. And I say ‘important’ for good reason. These nuances aren’t just matters of pedantry, but inform the way that ordinary right-to-lifers morally live their own lives in consistency with their own principles. It isn’t just Levonelle and Ella, but according to the NHS also IUDs, and according to the American College of Obstetricians and Gynaecologists (ACOG) and the FPA, even progestin-only pills and injections, that have contragestive effects.
Much can be debated about whether various forms of contraception are contragestive, and we should be open-minded and throughly evidence-based in considering such matters. By knowing as best we currently can the full effects of these drugs and devices however, and carefully describing them according to the accepted terminology, not only can right-to-lifers be better informed and able to live out their conscientious principles, we can more effectively advocate for them in the public square, and show that it is our position that is most in keeping with physical and moral reality.
Last night, reports were published in the media about a study published in the Lancet which, it was claimed, contains data which shows that “criminalising abortion does not make it any less frequent”. If this provokes a sensation of déjà vu, it’s because we’ve been here before.
As I’ve had occasion to point out, the attempted argument that right-to-life protections do not, in fact, succeed in protecting unborn children from being destroyed, and indeed only causes deaths due to ‘unsafe’ abortions, is a hackneyed meme that has been popular both sides of the Atlantic. It’s not difficult to see why this should be the case. After all, why go through all the bother of attempting to morally justify the killing of innocent unborn children, when you can just argue that protections of the right to life of all human beings fail anyway? It seems to have the perceived virtue of sounding common-sensical, whilst requiring as little effort as possible.
Little wonder then, that studies which try (and seem) to support this apparent dialectical shortcut for abortion advocacy are promoted and spun with alacrity. As the Guardian summarised the new Lancet paper’s findings:
The abortion rate was similar regardless of the legal status of the procedure. It was 37 per 1,000 women in countries where it was prohibited altogether or only permitted to save the woman’s life and 34 where abortion was available on request.
The difference was in the matter of safety. No one knows how many clandestine, unsafe abortions are carried out, but it is known that between six million and nine million [sic] women are treated every year as a result of an unsafe abortion, which can end in death.
So, the claim here is that paper shows that right-to-life protections have ultimately no effect on the abortion rate (the number of abortions that occur), they only prevent abortion from being medically regulated and ‘safe’. Looking more closely however, we see it fails to do anything of the sort, but that it simply repeats the same error as past studies: it generalises so widely that it fails to make meaningful comparisons that would allow a real illustration of the efficacy of legal safeguards for unborn children, or the effects that these have on levels of deaths due to illegal abortions.
With regards to abortion rates, whilst there is relatively greater information about the levels of abortion in countries where the practice is legal and where there are more developed medical systems, where such systems are not so developed and where abortion is not legal, there is unsurprisingly little information to go on. Due to this, the authors of the Lancet study have to attempt to estimate abortion rates based on modelling, and various indicative statistics such as contraceptive failure rates. As the authors of the study themselves admit within it (pg. 8):
Our estimates have several limitations. Information about abortion incidence in the developing world is scarce. The quantity and precision of data in developing regions are reflected in the wide uncertainty intervals around estimates for these regions. Empirical evidence to inform and validate the estimated rates for subgroups of married women is also lacking, and research on abortion incidence in these subgroups is needed.
This is not hard data, then, but informed prediction. Even accepting the verisimilitude of such estimates, however, they fail to tell us anything truly meaningful about the effects of right-to-life safeguards on either abortion rates or illegal abortion deaths. The study itself argues:
When countries were grouped according to the grounds under which abortion was legal, we did not find evidence that abortion rates for 2010–14 were associated with the legal status of abortion (table 4). The rate was 37 abortions per 1000 women (34–51) where abortion is prohibited altogether or allowed only to save a woman’s life, and 34 (29–46) where it is available on request.
This is ‘table 4’ referred to in that text:
As we can see, there is a major flaw with the claim being made, and it is the same flaw of previous such attempts: it generalises absurdly, and fails to make more careful comparisons. The world is a diverse place, made up of countries that have very different societies, cultures, and economies. To group together all countries that have specific kinds of law regarding abortion, but regardless of the state of their medical system, levels of poverty, and other factors that would be relevant to the incidence of abortion and the level of maternal mortalities (including those due to illegal abortions) fails to control for these realities, and therefore tells us nothing.
It is meaningless to compare Sri Lanka with France, or Ethiopia with Norway. Rather, it is only when we compare countries that are relatively socio-economically and culturally similar, that we can properly try to control for important differences between them, and see the real difference that particular kinds of laws can make.
This is something the Lancet study never does. Rather than look at specific countries, it generalises in its estimates about abortion rates according to whole regions, without any concern for the diversity within them. This contributes little if anything to the debate. So, it still remains the case that to really begin to discern the effects of the right-to-life laws on either abortion rates or deaths due to illegal abortion, we need to engage in much more careful and specific studies and statistics.
As I argued before:
Whilst many of the countries that have permissive abortion laws are in richer areas such as Europe or North America, countries that have greater protections for the right to life of unborn children are located in places like Latin America or Asia that have higher rates and incidences of the sorts of social problems that lead to a higher perceived need for abortion. Yet when we compare countries that are similar – that is, countries or parts of countries that are socially and economically similar and in the same region, we find a different picture is painted.
Let’s start with illegal abortions. Deaths due to this are recorded by the reported incidence of ‘maternal mortalities’. These figures are published annually by the World Health Organisation (WHO), and can be found here (go to ‘Annex 19. Trends in estimates of maternal mortality ratio (maternal deaths per 100,000 live births), by country, 1990–2015’, pp. 92-98). If we compare the relatively lower maternal mortality rate (MMR) of 30 deaths per 100,000 in Sri Lanka (which has profound restrictions on abortion), compared with the 258 deaths per 100,000 births in Nepal (which has a de facto permissive abortion system), we seem to see a fairer comparison of countries with different abortion laws.
We see a similar situation when we compare Guyana to Chile. Guyana significantly liberalised its laws in the mid-1990s precisely citing concern over maternal deaths, and has now a higher rate of 229 maternal deaths per 100,000 births. Chile meanwhile, has uncompromising protections for the unborn child in its constitution, and has one of the lowest rates of maternal mortality, having seen its MMR decline from 275 maternal deaths per 100,000 live births in 1960 to 22 in 2015, possibly the largest reduction in any Latin country.
As for abortion rates, this is more difficult to ascertain from country to country by sheer definition: when abortion is illegal its incidence is harder to track as with any illegal activity. There is profound evidence, however, of the efficacy of right-to-life laws in reducing the incidence of abortion in jurisdictions that pass such legislation.
In the U.S., a 2014 study published in the State Politics & Policy Quarterly has showed that right-to-life protections at the state level have practically succeeded. The study was a meta-analysis of research based on data from the pro-abortion Guttmacher Institute and the U.S. Centres for Disease Control and Prevention from nearly all 50 states for every year from 1985 to 2005. It found that public funding restrictions, parental involvement laws (which mandate that parents be notified when their child tries to access abortion, and require their consent), informed consent laws (which mandate women be informed in various ways about abortion prior to being allowed to go through with the procedure), and laws that limited abortion by other means, all reduced the incidence of abortion.
When public money for abortion was not available, abortion rates were reduced by 10-15%. Parental involvement laws led to a statistically significant decline ranging from 13%-42% in the abortion rate for under-18s, with most declines being between 15%-20%. Informed consent laws that specifically required women to have the chance to view colour photos of fetal development that reduced the abortion rate by 3%-7%, whilst those that required in-person counselling the day before the procedure saw a fall of 7-12%.
One study that the meta-analysis looked at found that a law in the state of Texas which requires all abortions at or after 16 weeks of gestation to be performed in either a hospital or premises designated as ‘ambulatory surgical centres’ led to a reduction in the abortion rate by an astonishing 88%.
Additionally, two studies looked at by the meta-analysis found that when abortion was prohibited its incidence fell, and conversely when legalised, its incidence rose. One of these studies analysed changes in abortion policy in Eastern Europe after the fall of communism, and found that abortion restrictions reduced abortion rates by about 25%. The other study found that in 1971 and 1972, after the state of New York legalised abortion in 1970, abortion rates were significantly higher not only in that state but also in surrounding states.
This latter figure confirms what we know from our own experience in the UK. Since the Abortion Act 1967 passed, the abortion rate has gone up profoundly, compared to what it was estimated to have been in the 1960s (even if you use the higher rate historically estimated by the abortion lobby of 100,000 abortions prior to legalisation).
Like bad gifts, some errors are never properly junked even after they are debunked. They just keep on getting repackaged and sold again. In defending the very enterprise of the campaign for the right to life of unborn children, those who advocate for human dignity have to be willing and able to refute the abortion lobby’s falsehoods, even ad nauseam, until they are put to bed once and for all.
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