By Dr Nathan Hodson
The UK has introduced the world’s first bereavement leave for people bereaved by abortion. I have described this in my new article in BMJ Sexual and Reproductive Health, titled “The UK Government Created Statutory Bereavement Leave for Abortions After 24 Weeks and Should Acknowledge It”. In this blog I want to outline how this came about, and how New Zealand’s law ended up excluding abortion.
The Parental Leave and Pay Act was initially conceived to create bereavement leave for parents who lose children aged under 18 years. But as the law was debated, some MPs suggested it was unfair that those who lost children through stillbirth were excluded. Hence, an amendment was introduced to extend bereavement leave to those who lost a child through stillbirth. Will Quince sought to explain the details of this to colleagues: “For Members who are not aware, a stillbirth is defined as a child stillborn after the 24th week of pregnancy”. This comment is true, but neither Quince nor any other MP mentioned that abortions after 24 weeks result in the issuing of a stillbirth certificate. The amendment was popular and the law was passed. See the full article for more details, but essentially this means that in Great Britain women who have abortions after 24 weeks (and their partners) are entitled to two weeks of parental bereavement leave.
My view is that this is a good thing. Most abortions after 24 weeks are because of the discovery of a fetal anomaly. In these cases, the would-be parents lose out on a much-wanted future and their feelings are made more complicated by a sense of responsibility or choice. Any system which allows abortions on the grounds of fetal anomaly should also be prepared to provide adequate emotional care for parents. Leave with pay is part of (but not all of) that care, as I have argued before.
However, New Zealand also recently created a bereavement leave law which includes stillbirths and miscarriages. The law differs from the UK law. It only allows parents 3 days of leave following pregnancy loss, but covers more women because it extends back to conception.
Another striking difference is that the New Zealand law includes a clause specifically stating that pregnancy loss through abortion excluded parents from bereavement leave. Initially legislation simply stated that the law covered “unplanned end of a pregnancy”, but this was later changed to explicitly ruling out abortion following a report from the Education and Workforce Committee which stated: “We understand that the intent of this bill is to provide bereavement leave to those who experience a miscarriage or stillbirth, not an abortion.” Evidently the Committee overlooked the fact that abortions and stillbirths are not independent categories, just as UK legislators did.
Evidence from Hansard suggests that some in the New Zealand parliament were reluctant to use legislation to indicate that abortions cause distress. Jan Logie of the Green Party argued “this legislation is not to apply to abortion, because the point of difficulty around people’s mental health that can come up in relation to abortion—it’s not actually in relation to abortion, it’s about having an unplanned, unexpected pregnancy, and not the ending of it”. Understandably, Logie didn’t want to give an inch to anti-abortion campaigners, but her analysis overlooks the lived experience of many people having later abortions. Erica Stanford, a National Party MP, brought a different perspective: “The grief and anguish and trauma experienced during an abortion and the fact that it’s not included in this bill make me uncomfortable—personally uncomfortable.”
Ginny Andersen, the MP leading the bill through the New Zealand Parliament, said she excluded abortion because she pragmatically feared that the bill could get bogged down by it. The impetus to rapidly roll-out pregnancy loss bereavement leave to all makes sense. But exclusion has a cost borne by people who have abortions due to fetal abnormality: both a material loss of leave and the compounding of stigma. If we want to live in countries where people can have abortions following the shocking news of fetal anomaly or under any other difficult circumstances, we ought to treat abortion bereavement like other losses, not an exceptional situation undeserving of care.
To be sure, many people have no need for bereavement leave after abortions and there’s no single experience of abortion. But creating the option for bereavement leave for some people in Great Britain after abortion is a good start; not all will take it but hopefully it will benefit some.
Author: Dr Nathan Hodson, Academic Clinical Fellow, Warwick Medical School