Midwives can carry out abortions, the Daily Mail declares in an outraged fashion on its front page today. The news is in fact not news, confirmed by a legal case more than 30 years ago, and at Bpas we have long employed midwives across our service. But let's not worry about details for the moment and focus on the central issue. Midwives and nurses can certainly help carry out abortions if they wish, and why on earth shouldn't they?
The Mail asks whether it isn't "a grotesque conflict of roles to ask midwives to snuff out the lives of unborn babies they would normally be using all their skills to protect?" Well, frankly, no it isn't. In fact it is entirely in keeping with a profession for whom the needs and wishes of the pregnant woman are put first and whose members strive everyday to deliver woman-centred care.
For a paper usually keen on old-fashioned ways, in principle that's exactly what this is. Before the criminalisation of abortion, midwives were traditionally exactly who women turned to when pregnant with a child they knew they could not carry to term. Today, most early abortions in the UK are effectively miscarriages induced by two sets of medication. Once a woman has had her request for an abortion approved by two doctors (a legal hurdle unheard of for any other medical procedure) midwives, or more often nurses, can dispense that medication and provide the clinical and emotional support she needs. They are often the people best placed to do this.
The Mail writers clearly not only see abortion and childbirth as entirely unrelated, but the women who undergo these as entirely separate categories of women. How wrong they are. More than half of women who have abortions are already mothers. They have abortions because they understand exactly the meaning of pregnancy, childbearing and rearing. They understand the implications a further child might have for their existing children, and they make the choice that is right for them and their families.
Abortion care will not be for all midwives, and the right to opt out of providing that care must always remain. It will not be something that most midwives will be regularly exposed to, as abortion and miscarriage care is generally provided away from maternity settings. However even here, many midwives will care for women undergoing abortion because a problem has been found with a much wanted pregnancy.
In old English, "midwif" means being with woman. The Mail may find it shocking, but there will be midwives who wish to support women make the pregnancy choice that is right for them at that stage in their reproductive life, whatever that choice may be.