Abortion must always be about choice
Reported December 18, 2007
THOSE with moral objections to abortions should not have abortions. Neither should they be allowed in a free and democratic society to impose their particular moral beliefs on others, nor have those beliefs imposed through the law.
The fundamental point to remember in relation to medical practitioners is that they are regulated by law. They are entitled, and indeed obligated, to use their clinical judgement in consultation with their patient to determine what course of action is in the best interests of the patient. The late-term abortion case at the Royal Women’s Hospital was a tragic one, particularly for the woman involved, but there is no evidence that the medical professionals involved acted improperly or immorally.
It is well known that the vast bulk of the Australian public supports a woman’s right to choose. The Australian Survey of Social Attitudes undertaken in 1987, 1996 and 2004 indicates that support for a woman’s right to choose has grown. Even among religious groups, the majority favoured the right to choose.
In a perverse acknowledgement of public support for the right to choose, the religious right keep running a rearguard action by focusing attention on late-term abortions.
Nicholas Tonti-Filippini (Opinion, 14/12) is correct that many Australians are deeply conflicted over the issue of late-term abortions. But it is necessary to put the facts. Such terminations are extremely rare.
According to Jan Dickinson, who reviewed the outcomes for abortion beyond 20 weeks’ gestation in Western Australia, between May 1998 and December 31, 2002, only 219 women presented for late terminations. Dickinson found that all pregnancy terminations in these latter stages were for foetal abnormality and those requesting such terminations were statistically older women.
Likewise, associate dean and professor of obstetrics and gynaecology at ANU Medical School, David Ellwood, estimated that across Australia, late-term abortions are somewhere between 0.1% to 0.6% of all births each year. He found that nearly all are at less than 28 weeks’ gestation, with the majority less than 24 weeks, and the reason is for severe foetal abnormality that is likely to result in major handicap or perinatal death.
While opponents would like to see late-term abortions made illegal, Dr Lachlan de Crespigny is correct in his view that such laws would be an injustice to women. Because late-term abortions turn on the particular circumstances of the case and in the vast majority involve either a health risk to the mother or severe abnormality, such decisions should be left to the woman or couple and their doctors. It is not the business of third parties to intervene in what is already a highly emotive and stressful situation and inflict their desired outcome on the parents. To make such terminations illegal may in some cases endanger a woman’s life.
There is also a lot of mythology about the physical and mental health threats of abortion. Numerous studies in the United States and by the National Academy of Sciences over 20 years have found that there is no basis for supporting the argument that abortion causes severe physical or mental health threats. A two-year study on the psychological effects of abortion found that the majority of women do not experience any mental health problems or regrets two years after an abortion. A third study undertaken in 1991 found that up to 98% of women who had abortions had no regrets and would choose the same course of action again.
The American Psychiatric Association, despite the repeated assertions of anti-choice proponents, does not recognise the so-called “post-abortion syndrome”.
Similar research undertaken in Australia by Melbourne psychologist Dr Susie Allanson supports the conclusions of the international studies. It is misleading to suggest that the majority of women suffer harm as a result of having an abortion. The evidence does not support that position.
The insistence that women be required to undergo compulsory counselling is also a distraction. Mandatory counselling and waiting periods assume that all women are unable to reasonably determine what is best for them and are unable to rationally reflect on their decision. This assumption is demeaning to women and undermines their autonomy.
In addition, making counselling mandatory would achieve little, other than become a focus of anger and a cause of distress. Abortion providers and hospitals, private as well as public, already offer counselling services to women seeking terminations.
Criminalisation of abortion is an anachronism and needs to be repealed. If there is to be a law governing abortion, then it must start from the position of respecting women’s full human rights, including liberty and security of the person, and the right to determine when and if they have children.
Abortion law reform must also be backed up by a comprehensive sexual and reproductive health program that provides high-quality, professional and unbiased information on family planning, pregnancy and terminations, in a timely, affordable and accessible manner. This means that services should be localised; rural women need women’s medical centres in regional cities.
The Victorian Parliament should have the courage to follow the example set by the Australian Capital Territory Government and refrain from acting as a watchdog over women’s reproductive choices.
Anne O’Rourke is a vice-president of Liberty Victoria, a lawyer and a lecturer at Monash University. Liberty Victoria’s submission to the Victorian Law Reform Commission inquiry can be found at www.libertyvictoria.org.au