A Chance to Create an Abortion Law That's Fit for Purpose - Let's Take It

There's a fresh chance to remove the anachronistic requirement that two doctors must authorise a woman's request for an abortion before it can be performed. On Thursday, a private members' bill to reduce the number of doctors required to authorise an abortion from two to one is to be introduced by Baroness Jenny Tonge in the House of Lords.
|

"If a woman needs an abortion in terms sanctioned by the Abortion Act 1967, it must surely be better for it to be an early, medical abortion than a later, surgical one. I therefore hope that the House will consider whether the requirement for two doctors to consent to an abortion being performed, and the restrictions on nurses providing medical abortions, need to be maintained."

It perhaps seems surprising now, but this was the (then) Conservative shadow health secretary Andrew Lansley in 2008 on proposals to modernise the abortion act to better meet the needs of women and those who care for them. The amendments, which had widespread support, were sadly never voted on by parliament - allegedly the result of underhand political manoeuvring to stop any attempt to extend the act to Northern Ireland which was also included on the list of modernisations.

But there's a fresh chance to remove the anachronistic requirement that two doctors must authorise a woman's request for an abortion before it can be performed. On Thursday, a private members' bill to reduce the number of doctors required to authorise an abortion from two to one is to be introduced by Baroness Jenny Tonge in the House of Lords.

In an ideal world, abortion would be taken out of the criminal law altogether and regulated like every other area of women's reproductive healthcare. As the Royal College of Obstetricians and Gynaecologists notes - "there are no other situations where either competent men or women require permission from two third parties to make a personal healthcare decision." In 2014 the decision whether to end a pregnancy should really be one that rests solely with she who bears the consequences for it, the woman herself. But this simple amendment is a good place to start. The need for a second signature brings no clinical benefit. It can prevent women who are sure of their decision from obtaining care as early as possible. Abortion is safer than continuing the pregnancy and giving birth, but the earlier it can be offered the more straightforward the procedure can be. Mr Lansley himself noted this in 2008, and nothing has changed since then.

The legal barriers to abortion exist in addition to the requirements for informed consent that govern every healthcare procedure, including abortion. It is essential that women considering abortion are provided with the advice and information they need to support their decision making, and that specialist counselling is available to all women who need it - but this is good practice that has nothing to do with the law, and will not change if the need for two signatures were removed.

We know anecdotally that ongoing threats to prosecute doctors for how they fill in abortion forms have made some healthcare professionals reluctant to continue to provide a second signature. Last year's abortion statistics showed the first drop in the proportion of abortions carried out before 10 weeks in years, which may suggest women in some parts of the country are waiting longer as staff struggle to obtain the required legal authorisation.

This is not good for women. This amendment represents an opportunity to create a law better suited to the needs of women and their doctors. Politicians should seize it.