Editorial - Why are abortion advocates afraid of informed choice?
The polarising issue of abortion has come to the fore again, triggered by the Abortion Supervisory Committee’s annual report to Parliament. Despite the ASC chairwoman saying that the committee had no opinion on major reform of the abortion laws – that it was solely a matter for parliament – many commentators who want further liberalisation have taken the opportunity to lambaste the current law, labelling it a legal obstacle course, archaic, hypocritical, a charade, cumbersome, and intrusive.
The simple solution, they say, is abortion on demand – no need to ask any questions. As articulated by David Seymour MP: “The right thing to do is reform abortion law to reflect what actually happens: women exercise choice for their own reasons.” He and others argue that the current law disempowers women. As one blogger wrote: “At the heart of it all is a distrust of women, innit? … a failure to understand that women are full moral adults.”
The debate that has ensued highlights an important point: the current abortion law is being consistently undermined by the way in which it is being implemented. This is what undoubtedly leads supporters as well as some opponents of abortion to label the present regime as hypocritical.
While the debate raises many interesting questions, the one critical question not often asked is whether removing the procedures that are part of the current law will in fact lead to better choices and better outcomes for women contemplating an abortion.
Our choices are limited by the constraints of our knowledge and context. These constraints generally take two forms: (i) a lack of proper information and (ii) the presence of coercion. Informed and free consent based on full, balanced and factual information, while allowing time to adequately consider that information, is the ‘sine qua non’ for making quality choices.
Research into the potentially negative health effects of abortion is characterised by claims and counter-claims. For example, research reported by the Health Research Council of New Zealand (by Professor David Fergusson of the University of Otago’s Christchurch Health and Development Study, 2008) suggests “women who undergo an abortion face a 30 per cent increase in the risk of developing common mental health problems such as depression and anxiety.” Conversely, other overseas studies have concluded that the rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth. Academically speaking, the question of potential harm to women remains a contested one.
The strongest evidence that there are real negative health effects following an abortion arises out of the day-to-day work done by clinical psychologists and counsellors. Their consistent experience is that they encounter many women whose mental well-being has been adversely affected on a number of levels by their experience of abortion.
Further reflection on “what actually happens” to women who have had abortions highlights the reality of coercion. Many women, after the event, report feeling that they had no other option at the time but to proceed, often because of pressure from parents, partner and/or peers. At times this pressure is also experienced as coming from staff at the Termination of Pregnancy Units. For other women, the pressure they feel is generated by employment or social factors. In the words of another commentator, in such situations, the decision for an abortion is best described as a tragic response to lack of choice.
Section 14 of the Contraception, Sterilisation and Abortion Act, which details the functions of the Abortion Supervisory Committee, states that they are “to take all reasonable and practicable steps to ensure that sufficient and adequate facilities are available throughout New Zealand for counselling women who may seek advice in relation to abortion.” When women repeatedly recount they were offered five to ten minutes with a social worker before the abortion ‘if you want it’, and when there is reliable evidence that abortions are signed off by some consultants over the phone with no face-to-face interview, it is hard to argue that this provision is being properly implemented.
In which case, it becomes impossible to argue that the current New Zealand practices surrounding abortions consistently promote informed and free choice.
There is surely no greater expression of “distrust of women” than society paternalistically deciding, whether through law reform or the inadequate implementation of its current laws, to censor the information provided to women contemplating an abortion. Equally, it is surely also a failure of care to neglect to put in place mechanisms that can help women contemplating an abortion to recognise and deal positively with any feelings of ambivalence as well as the actualities of coercion.
It is in the interest of free and informed consent and empowerment that all women are offered independent counselling that addresses the coercive realities surrounding many abortions and which makes them aware of all the risks as well as all the options they have. Honest reflection on what is actually happening only reinforces the fact that abortion on demand will not achieve this.
If as a society we truly want to respect choice, then why would we be afraid of promoting free and informed consent?
Cynthia Piper has over 20 years’ experience as a trained volunteer lay counsellor working with pregnant women and teens and their families, and with Project Rachel, a post-abortion healing and support service.
Dr John Kleinsman is director of The Nathaniel Centre.