HC Deb 04 December 1996 vol 286 cc1041-4 3.30 pm
Mrs. Elizabeth Peacock (Batley and Spen)

I beg to move, That leave be given to bring in a Bill to prohibit partial-birth abortions. Partial-birth abortion is defined in the Bill as an abortion in which the person performing the abortion partially vaginally delivers a living foetus before killing the foetus and completing the delivery. The procedure, which originated in the United States, is usually used after the 20th week of pregnancy, and often much later. The practitioner, guided by ultrasound, pulls the living unborn child through the mother's vagina, except for the child's head, which is deliberately kept just within the uterus. The practitioner then puts surgical scissors or another medical instrument into the back of the skull, inserts a catheter and sucks out the brains.

In 1992, Dr. Martin Haskell of Dayton, Ohio, wrote an eight-page paper explaining step by step how to perform the procedure. Haskell himself has performed more than 1,000 such procedures, for which he coined the term "D and X". It is also known as brain-suction abortion. A diagram illustrating the procedure has been circulated widely to hon. Members. It was confirmed as accurate by a spokesman for the American National Abortion Federation in evidence to the House of Representatives judiciary sub-committee in June 1995.

The Bill would amend the Abortion Act 1967 to prohibit the partial-birth abortion procedure. Under the Bill, any person performing a partial-birth abortion would be guilty of an offence punishable on summary conviction to imprisonment for a term not exceeding six months, or a fine not exceeding level 5 on the standard scale, or both. No proceedings would be brought without the consent of the Attorney-General. It would not be an offence for a medical practitioner to perform a partial-birth abortion if he or she reasonably believed that the procedure was immediately necessary to save the life of the mother, and that no other procedure would achieve that.

It is not known to what extent the technique may be practised in the United Kingdom. Provided that the terms of the 1967 Act are complied with, there is nothing to stop a practitioner from using it. Replies to parliamentary questions show that abortion notification forms do not specify whether abortions are carried out by that method.

The Secretary of State for Health has stated that the Royal College of Obstetricians and Gynaecologists has asked all its members and fellows to ensure that they record details of any abortions involving intra-uterine decompression of the head of the foetus on HSA4—the form that notifies the chief medical officer of all abortions. However, there is no legal requirement for practitioners to notify the use of the technique.

In the partial-birth abortion method, a woman visits the abortion clinic on three successive days. On the first two days, her cervix is mechanically dilated with material called laminaria. The baby is removed on the third day. American Medical News reported on 5 July 1993 that two leading practitioners of the method, Dr. Haskell and Dr. McMahon, had stated in interviews: the majority of foetuses aborted this way are alive until the end of the procedure. Dr. Martin Haskell, the principal exponent of the technique in the United States—he has performed it more than 1,000 times—said in a tape-recorded interview with the American Medical News: In my… case, probably 20 [per cent. of abortions by this method] are for genetic reasons. And the other 80 per cent. are purely elective. Elective abortion is another name for abortion on demand. Dr. Haskell's statement refutes the claim by some advocates of abortion that the procedure is used only where the woman's life is in danger or in cases of extreme foetal abnormality. The RCOG has claimed that the procedure would be used in Britain only in extreme cases of disability. Nevertheless, under the Abortion Act 1967, there is nothing to prevent a practitioner from using the technique in abortions certified under any grounds.

In the previous parliamentary Session, an early-day motion calling for a ban on partial-birth abortion was tabled. Several hon. Members signed an amendment objecting to such a ban, in which they cited the objections of the RCOG and the British Medical Association, and argued that it was not the role of Parliament to regulate the details of clinical procedures. No one suggests that the opinions of those bodies should be excluded from the debate, but there is particular cause for concern about the RCOG's opposition to a ban of the procedure in view of its guidelines on termination of pregnancy for foetal abnormality, which stipulate that, to avoid the possibility of prosecution, a legal abortion must not be allowed to result in a live birth". That means that steps must be taken to ensure that the unborn child is dead before being expelled from the mother. The practice of partial-birth abortion would conform with those guidelines.

In a paper opposing a similar Bill, which was sent to members of the other place at the time of the Bill's introduction by my right hon. and noble Friend Lord Braine, the RCOG stated: partial-birth abortion could be considered more respectful to the foetus than established methods of abortion… in which the foetus is removed from the uterus in fragments. As the editor of The Sunday Telegraph aptly commented, "respectful" is not the first word that springs to mind at the description of the sucking out of a baby's brain.

The fact that an unborn child has a disabling condition is no reason for killing the child, and in such an appalling manner. Furthermore, disability in the child does not mean that the procedure is indicated for the benefit of the mother. Even in cases of hydrocephalus, a condition which enlarges the head of the foetus, there are alternative methods of clinical management. If necessary, a caesarean section can be performed.

Former abortionist Dr. Bernard Nathanson wrote in 1983 that the "destructive operation" in which a baby's head was crushed to allow vaginal delivery became obsolete towards the end of world war two as a result of medical advances that greatly improved the safety of caesarean sections. In the light of Dr. Nathanson's observation, it is ironic that, despite continuing advances in modern obstetric care, partial-birth abortion is defended as though medicine had not progressed since the 1940s.

Furthermore, there is evidence that the procedure could endanger the mother. Dr. Pamela Smith, head of the obstetrics teaching programme at Mount Sinai hospital in Chicago, told the US Senate Judiciary Committee that the partial-birth abortion procedure is an adaptation of a procedure occasionally used to deliver a baby in a breech position, but that that procedure carries risks for the mother and its use is recommended only to deliver the second baby in the birth of twins.

The Bill allows a medical practitioner to perform a partial-birth abortion if he or she reasonably believes that it is immediately necessary to save the life of the mother and that no other procedure will achieve that. Evidence that before the 10th week of human development foetal structures relating to pain are present and functional supports Dr. Giles' and others' opinion. Even many of those among us who do not agree with the principle of the right to life of the unborn child accept that avoidable suffering should not be inflicted on the foetus. Under current practices, there are more restrictions on how the remains of aborted babies may be disposed of than on how they may be killed.

It is perplexing that several hon. Members who called on the Government to ensure more humane treatment of veal calves signed the amendment opposing a ban on partial-birth abortion. Surely Parliament has no less interest in protecting the young of our own kind from cruel and unusual punishment than in protecting the welfare of animals. I hope that the House will give me leave to introduce the Bill.

3.40 pm
Mrs. Ann Clwyd (Cynon Valley)

Partial-birth abortion, more correctly described by doctors as intact dilatation and evacuation, is a procedure used on rare occasions by some doctors in the United States of America when they believe it to be in the best interests of the woman. It is not currently used in the United Kingdom. Members may have already noted from the Official Report that on several occasions Conservative Members have asked how many times partial-birth abortions have taken place. On each of those occasions, Ministers have repeatedly confirmed that they are not aware of that procedure being used in the United Kingdom. A Bill therefore to prohibit its use is clearly unnecessary and a misuse of the valuable time of the House.

The descriptions of the procedure, as it is supposedly carried out in the United States, are both inaccurate and misleading. Descriptions such as the one we have just heard contain horrific accounts of the foetus being partially delivered while alive. It is my understanding that, on the rare occasions when intact dilatation and evacuation is carried out in the United States, the foetal heart is humanely stopped before the procedure. President Clinton himself has recently vetoed attempts to ban the procedure, referring to it as a potentially life-saving, certainly health-saving, measure for a small but extremely vulnerable group of women and families.

Emotive, grisly descriptions of abortion procedures are often used by those who oppose abortion to shock and repulse people. The anti-choice movement considers it an important tactic because it believes that those who are pro-choice attempt to deny what is involved when a pregnancy is ended. That is not the case. Those of us who support legal abortion do so because we believe that it is necessary for the well-being of the woman.

It seems that the Bill proposed by the hon. Member for Batley and Spen (Mrs. Peacock) is an attempt to reintroduce the topic of abortion to the House. She may expect that the emphasis on the details of that technique—her version—will attract support for further legislation to limit the availability of legal abortion. The present abortion law was accepted as necessary by a majority of both Houses in 1990. Nothing has changed since to justify any amendment.

Abortion at any stage of pregnancy is performed only after careful consideration and within the grounds permitted by law. Late abortions are often of wanted pregnancies, terminated because a severe foetal abnormality has been detected. Those women are especially vulnerable and it is important that when decisions are taken by doctors about the management of their care, they are free to act in the best interests of their patients.

When, earlier this year in another place, Lord Braine introduced a private Member's Bill to prohibit partial-birth abortion, it was opposed by the British Medical Association and the Royal College of Obstetricians and Gynaecologists. Those organisations support the view, which has also been expressed by Ministers in response to questions on the matter, that methods of abortion are a matter of clinical judgment.

As the procedure referred to as intact dilatation and evacuation is not used in this country, the Bill that the hon. Lady seeks leave to introduce would not affect abortion practice directly. It would, however, undermine the principle that a clinician should have freedom to choose the method of abortion most appropriate to a specific clinical situation.

That could interfere with doctors' ability to act in the interests of their patients. A gynaecologist or obstetrician could be convicted of a criminal offence, even when his or her peers considered the actions taken to be the safest and most appropriate management of an abortion. The clinical decisions taken by doctors could be influenced by their fear of prosecution. That would be an unacceptable outcome, and I ask the House to oppose the motion.

Question put, pursuant to Standing Order No. 19 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business), and agreed to. Bill ordered to be brought in by Mrs. Elizabeth Peacock, Sir Andrew Bowden, Mrs. Ann Winterton, Mr. Thomas McAvoy, Mr. A. J. Beith, Ms Liz Lynne, Mr. Toby Jessel, Mr. Keith Vaz, Mr. David Atkinson, Mr. Joe Benton, Sir Michael Grylls, and Rev. Martin Smyth.