According to a number of newspaper articles last week, abortion rates are unaffected by legislation. In other words, countries with more restrictive abortion laws have pretty much the same rates as those with very few restrictions. The news headlines read:
‘Countries with restricted access to abortion, including the UK, do not have lower termination rates than those which are more liberal, a new study has suggested. Experts examined data for 27 EU countries and found no overall difference between termination rates for those allowing women abortions on request compared with those with certain conditions.’
The co-author of the study in the BJOG, an International Journal of Obstetrics & Gynaecology, Mika Gissler, said: ‘There are large variations across the EU and it is interesting to see that restricting women’s access to termination doesn’t mean the rates of termination are lower.’
The study found that countries which allowed termination on request had an abortion rate of 11 per 1,000 women, with a country variation from 6 to 25 per 1,000 women. Those that restricted access had a very similar rate (12.3 per 1,000 women, with a country variation from 9 to 14 per 1,000 women).
Unsurprisingly, the pro-abortion organisation, the Family Planning Association (FPA), was very supportive of the conclusions, saying: ‘There’s a myth that if you make services less restrictive you’ll be encouraging women to have abortions.
This research shows it clearly isn’t true. Women have abortions because they have an unplanned or unwanted pregnancy and not because the service is easier to access.’
The conclusion drawn by the BJOG authors and repeated in the media goes along the following lines:
‘This study highlights the importance of sexual education and provision of access to reliable and affordable contraception. This is vital in order to achieve low rates of termination of pregnancy.’
Whilst the acknowledged high rates of teenage pregnancy in the Northern European countries: ‘…can be reduced by improved access to youth-friendly reproductive and sexual health services [read: abortion], better sexual education in schools, and free or heavily subsidised contraceptives.’
Despite these headlines, it does not take long to deconstruct the main conclusions, as long as you can get hold of the original article, not the authors own press release. The hard data presented is interesting and it is helpful to observe the varying rates of abortion between European countries – a useful resource for anyone who wants to compare national abortion rates.
The problems come with the classifications and conclusions. Whilst abortions in Great Britain (not including Northern Ireland) come under The Abortion Act 1967 and Section 37 of the Human Fertilisation and Embryology Act 1990, and are subject to certain conditions (abortions can only be performed under grounds C & D before 24 weeks, but can be performed at any stage of foetal development for grounds A, B and E), it is quite a stretch of the imagination to claim that the UK really restricts abortion in practice, up to 24 weeks. It is tacitly understood that almost any woman who wants to have an abortion here can have one, up to 24 weeks, with very little difficulty. Most women assume that it is their right to choose to have one, if they want. Thus over 98% of abortions are performed under the general grounds C and D.
So to classify the UK as having ‘restrictive’ rights to abortion, and then to use the UK as a benchmark to compare with more ‘liberal’ countries (again, according to their classification), is disingenuous and highly misleading. Of course the rates are the same as other more ‘liberal’ countries, because in practice the UK is little different.
Moreover, in order to be able to claim that restrictive legislation makes little difference to rates, it does help to exclude from the comparison the three countries that have the most restrictive legislation! Perhaps if the authors had not excluded Ireland, Malta and Poland (which all have no or very restrictive access to termination of pregnancy and extremely low abortion rates) from their conclusions they would have come up with rather different findings.
Hidden away in the text of the article is this short, but rather revealing, paragraph on Poland which has some of the most restrictive legislation in Europe:
‘Poland had a low rate of termination of pregnancy (15/1000) compared with other Central and Eastern European countries in the 1980s, and the rate of reported legal terminations decreased to below 0.1/1000 after adopting a restrictive legislation in 1993’. (my emphasis).
So the authors do know that legislation does make a difference, it’s just this does not fit the conclusion and press release, because the message that the authors want to send is that no country should bother with having restrictive abortion laws, as it will make no difference. (Try telling that to Ireland, Malta and Poland!)
There is more that can be said about these research findings. The rate of abortions in each country is not dependent solely upon legislation and the grounds on which women are permitted to have abortion by law. Requirements such as waiting periods, information provision, informed consent and the availability of independent pre-abortion counselling all have an effect on reducing abortion rates. Variation in rates between countries is also a function of culture and history.
A CMF paper has some interesting analyses of the influence of informed consent legislation on abortion rates in EU countries. It shows that the group of countries that provide counselling and/or a cooling-off period had an average abortion rate of 11.9 per 1,000 women of childbearing age, compared to 18.1 per 1,000 women in the group with neither requirement. In other words, informed consent has a strong, and positive, influence on reducing abortion rates.
To conclude with the BJOG study’s own conclusion. As noted above, the authors claim that the ay to reduce abortion rates is therefore not through legislation but by: ‘…improved access to youth-friendly reproductive and sexual health services, better sexual education in schools, and free or heavily subsidised contraceptives.’
However this is not what the research was about, the research was about abortion rates and national legislation. The authors did not research reproductive and health services, or variations in sex education, across EU countries. This conclusion is simply their own subjective and ideological viewpoint, not enforced by the article. What is unfortunate – and immensely frustrating but not surprising – about this is that because it was in the BJOG press release, it was simply quoted verbatim by all media outlets, none of whom appeared to have had a look at the original article or questioned the analysis and recommendations.
What a shame the researchers and media have all ignored research elsewhere that shows that morning-after pills don’t actually cut teen pregnancy rates and instead increase the incidence of sexually transmitted infections. If they did, they might be in less of a rush to promote heavily subsidised contraceptives and perhaps take this new ideological analysis about ineffectual legislation with a heavy dose of the scepticism it deserves.