Abortion care is healthcare. It is central to women’s health and bodily autonomy and restricting access to it harms women. This shouldn’t need stating. We thought that progress had been made, especially when Ireland voted to legalise abortion last summer. But recent events in America have shown how quickly these hard fought changes can be lost. Last weekend, Jeremy Hunt, who is one of the candidates to be our next prime minister, publicly stated that he is in favour of restricting women’s access to abortion. Within the wider attack on reproductive rights across the world, this is concerning and cannot be ignored.
Hunt stated that he believes that the time limits on abortion should be reduced from 24 weeks to 12 weeks. He said this is a matter of “personal conscience” and that he wouldn’t seek to make any changes if he became prime minister. The comments have been widely criticised, coming as they do at a time when the government is under pressure to give women in Northern Ireland access to abortion.
There will always be situations where women find themselves needing abortion care after 12 weeks of pregnancy. Diagnoses of fetal abnormality are often not made until the 20 week scan, and maternal health problems can make a pregnancy dangerous and even life-threatening. Women with addictions or mental health problems or learning disabilities may not realise they are pregnant until later in their pregnancy. Teenagers and women in abusive relationships may feel the need to conceal their pregnancy or struggle to access care. Complex personal and social factors can result in late recognition of pregnancy or a delay in accessing services, while gaps in service provision as a result of a shortage of skilled providers can also delay women’s access to services.
Reducing abortion time limits would harm vulnerable women who should be supported to access care, not criminalised. Hunt, who was the secretary of state for health for eight years, should be aware of these issues.
The focus of the current narrative is concerning. Instead of fighting to maintain women’s existing reproductive healthcare rights we should be highlighting how the law as it stands (which criminalises women and clinicians) is archaic, paternalistic, and not-fit-for-purpose. We should be insisting that potential leaders address the question of whether they will pursue evidence-based policy and take abortion out of criminal law as advocated by Doctors for Choice UK, and many other medical organisations. Decriminalisation would not only improve services in Great Britain, but would also end the unacceptable infringement of women’s rights in Northern Ireland.
Hunt made clear that his views on restricting access to abortion were personal and that he would not pursue this as government policy were he to become prime minister. However, his anti-choice sentiments are greatly at odds with the British public as the latest British Social Attitudes survey shows that 70% of the population are pro choice. These views are reflected by MPs. In the most recent attempt by Diana Johnson to decriminalise abortion (along with a cross-party coalition of MPs from five UK political parties), the House of Commons voted 208-123 in favour.
We cannot afford to be complacent about politician’s anti-abortion views, particularly in the current global political climate. In 2016, I argued that Trump’s rise to power posed a serious threat to reproductive rights globally. The worst of our fears are coming to play. In the US, the speed and ease with which hard-won reproductive rights are being rolled-back is terrifying. The impact of Trump’s policies are not limited to the US. In his first 100 days, he signed the Mexico City policy, the so-called “global-gag” order, which denies US funds to any overseas organization that provides or counsels on abortion. Every time the global-gag is imposed rates of unsafe and backstreet abortions rise alongside unwanted pregnancies and maternal deaths.
Furthermore, across the world we are seeing the rise of far-right politics with entrenched misogyny, anti-science, and anti-choice policies. The Vox party in Spain has stated “gender ideology” is a threat to white family values and has called for abortion laws to be abolished. The AFD in Germany wants to abolish abortion and promote “traditional roles for women”. Victor Orban in Hungary promotes debt-free education only for women who have at least three children.
Playing political football with women’s rights is nothing new, but given the global attacks on reproductive rights, it is deeply concerning. As clinicians, we have a duty to speak out when politicians advocate policies that are detrimental to women’s rights, health, and wellbeing.