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Abortion: The Case for Independent Counselling

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Next week the House of Commons will debate new proposals that mean that every woman considering a termination should receive an offer of independent counselling provided by someone with no vested financial interest in the outcome of her decision. Under these moves counselling will be non-compulsory and will not be an obstacle to women who have already made up their mind.

For those women who have made up their mind and who don't want to take up the offer of counselling, they will be able to proceed in exactly the same way that they are today.

But for the first time ever, an offer of independent counselling will be made to all women requesting a termination. After these proposals are adopted, no woman will ever say again, that she felt rail-roaded through the process, or that she was on a conveyor belt and that no-one ever stopped to ask me what I want, because every woman will be offered access to this very basic level of independent support.

So why are these measures needed?

Every year thousands of UK women will have an abortion, for some that experience makes no major impact and life carries on as normal. For others, it can have a significant and lasting effect that requires follow-up post abortion counselling, treatment and in some cases therapy.

Organisations like the British Association of Counselling and Psychotherapy have been working in this space for years. As it is their Counsellors who are most likely to see women after an abortion, it is little surprise that they too have recognised that there are big deficiencies in the availability of pre-abortion counselling. The article, a Woman's Right to Choose Counselling, published on BACP's site makes many important points, two are extracted below:

'Few patients 'mourn' their appendix when it is removed. Many women who choose abortion still 'mourn' the lost possibilities of the life that will not be. Several years ago the privately funded Post Abortion Counselling Service was established in London to cope with these very problems. However, that leaves the rest of the nation and those who cannot pay.'

For these women independent counselling will offer a space in which they have the option of fully thinking through their situation.

At the most basic level our abortion system should contain checks and balances to enable women to fully explore their situation in a space that is designated solely for them. Experience tells us that this space doesn't exist and the system as it has evolved over the years doesn't stand up to scrutiny.

The amendments will introduce equity into the system. Women who pay for abortions privately, can afford to pay for independent counselling wherever they choose, but a woman who is referred to an NHS outsourced organisation for an abortion, is restricted to accessing counselling through that organisation alone. A captured market for the abortion provider.

Abortion providers are conflicted

The experience of women who suffer trauma after an abortion is one example of evidence that demonstrates problems with the current system. The other type of evidence can be found from scrutinising how private providers operate and where their emphasis lies.

Abortion providers such as bpas and Marie Stopes operate in a very business like way. I'm sure they feel like they do a good job, but when you examine their operating ethos, their obsession like emphasis on promoting the abortion choice, it's very easy to see that they are in a very conflicted position. This doesn't do anyone any good, least of all women who are forced to access their services.

In our report The Case for Independent Counselling we explore these conflicts further.

The report demonstrates that abortion providers are motivated to increase their revenues and grow their market share. Like any business, they employ business development managers; bpas state that they see a 13% growth in the number of abortions that they preform as a 'significant achievement'. If it's a success to increase abortions, the converse is equally true; it cannot under any circumstances be a success if the abortion numbers go down. Is an organisation with this clear level of motivation the right body to be providing counselling? Not only this, but women who are referred to bpas or MSI are prevented from accessing any other form of NHS funding counselling.

Counselling, information and advice should be delivered in a completely neutral environment. A kind of woman centred bubble, that allows the woman facing the situation to explore fully her own feelings and emotions. That is what the amendments to the Health and Social Care Bill will deliver.

It's purely an optional facility, but it is one that is very much needed and which will deliver a better outcome for women. Some commentators have said that the provision of independent counselling actually bolsters choice for women as it's about ensuring that every woman who undergoes an abortion, has the right to fully explore whether that choice is right for her, without being influenced by those with a financial vested interest in the outcome of her decision. These very basic changes are long overdue.