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Doctors have called for a change in the law to speed up access to early abortion by proposing that only one doctor, rather than the two currently required, should need to approve an abortion. The call effectively means that abortions in the first 13 weeks of pregnancy should be available on an “informed consent” basis in just the same way as other medical procedures.
However, doctors at the BMA's annual representatives meeting rejected a call for appropriately trained nurses and midwives to be allowed to carry out early abortions and for the rules on where abortions can be carried out to be relaxed to allow them to take place in premises that do not have specific approval, such as general practice surgeries.
An emergency motion to ballot all BMA members on whether to adopt the policy was also rejected by the meeting.
The 1967 Abortion Act requires that women satisfy two doctors that they have a medical justification for a termination. But because terminations before 13 weeks are safer than continuing with pregnancy, few if any women will fail to meet the medical criteria to be eligible for a termination, doctors argued.
“Early abortion is now so low risk for complications that one of the criteria is always satisfied—that it is riskier for the physical health of the mother to continue the pregnancy than to have an abortion. What is the point of having a criterion that is always met and then requiring second opinion confirming that?” asked Dr Evan Harris, a Liberal Democrat MP and member of the BMA's medical ethics committee, who proposed the motion.
The call for easier access to abortion and for health professionals other than doctors to be able to do them is due partly to increased use of medical abortion, which can be done up to nine weeks of pregnancy.
It is also a response to evidence that women are experiencing delays of up to seven weeks in getting abortions because of the need to get a second doctor's signature, which can take women beyond the nine weeks when a medical abortion would have been possible, said Tony Calland, chairman of the ethics committee. “The vote shows that doctors feel the current act is outdated,” he said.
David Pring, a consultant obstetrician and gynaecologist and a member of the consultants' committee, was against nurses and midwives being trained in carrying out abortions.
“Surgical abortion, even in the first trimester, could at times be technically difficult and needs surgical expertise,” he said. “To have people from other specialties taking on termination is inappropriate on the grounds of safety; particularly midwives, because they are needed to provide obstetric support.”
Anne Weyman, chief executive of the Family Planning Association, welcomed the BMA's new policy. “There is no justification in making women seek the permission and approval of two doctors to have an abortion, so we are delighted that the BMA has voted in favour of removing this criterion,” she said. However, she was disappointed that the other proposals had not been accepted.
Julia Millington, of the ProLife Alliance, said that abortion on demand was already a reality. Less than 1% of the 89% of abortions carried out in the first 13 weeks of pregnancy in 2006 had been performed because of a serious risk to the life or health of the pregnant woman.
“The BMA vote in favour of liberalisation of the abortion law flies in the face of medical and public opinion on the issue. Liberalisation of the law is the last thing we need,” she said.
The Department of Health said it had no plans to change the current abortion law.