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November 2020  |  Dr Calum Miller

Surely you can't be opposed to abortion in the case of incest?'


Are you going to force a woman who's been raped to have a child against her will?'


Calum Miller, a medical doctor and a fellow at the Oxford Centre for Christian Apologetics, tackles the hard questions for us.

Transcript | Rape, incest and backstreet abortion:

Handling the hard questions

There are five particular areas that I want to look at and these are some of the hard cases, some of the hard questions.  There are more than just these hard questions, but these are some of the top ones.  And they're supposedly hard cases of abortion - where abortion seems to be right.  How can pro-lifers even be opposed to abortion in these cases?


So, starting with the most simple, which is the case of [1] unwanted children.  What if the woman really doesn't want a child?  Won’t it be better for the child if they don't have to go through a painful life?  Secondly, [2] life limiting diagnoses, also known as fatal foetal anomalies or sometimes called fatal foetal abnormalities in the old times.  In the abortion law itself they talk about ‘serious handicaps’.  You can see how the language changes quite a lot, but I'll be talking about babies who are not expected to live very long at all.  [3]  Life saving abortions.  Isn't abortion sometimes okay to save the life of the mother?  What about the question of [4] rape or sexual assault?  Surely a woman who has not even consented to being pregnant in any sense - it's not her fault - how can you still say that she's forced to continue a pregnancy?  And finally the case of [5] backstreet abortions.  Isn't it the case that if we ban abortion, women will just die from illegal abortions without actually changing anything else?  All it will do is kill women.


So these are some of the challenges.  But I do want to begin by firstly levelling the playing field, by saying that if we do have to talk about the hard cases as pro-lifers, it’s only fair that we also are aware of, and draw attention in our conversations, to the hard cases of pro-choicers, like partial birth abortion, where the baby is halfway delivered, and then killed, as is still we think legal in the UK.  It doesn't happen much, or we don't know if it happens at all, but it probably is legal in the UK.  Late term abortions: There are 1000s of these in the UK each year.  Dilation and evacuation abortions are the minority of abortions, which are colloquially called ‘dismemberment abortions’.  These are a minority of abortions, but they're still common.  There are still 9000 or so in the UK every year.  Sex selective abortions: These are responsible for about 100 million missing women according to the UN in the world today.  The UN doesn't say that this is because of abortion.  It says this is due to preference and sex selection.  The reality is, in most cases it is due to abortion, and now there are 100 million missing women from the world today because of it.  Abortion for disability: We'll say more about that in a while.  Colonialist abortion: What I mean by this is that in many parts of the world, pretty much everyone is pro-life.  So if you look at surveys, recent polling from much of the Global South, particularly Sub-Saharan Africa or the Islamic world, the Pacific Islands, pretty much everyone thinks that abortion is wrong and they don’t want it in their country.  So in Ghana for example, they asked, “Is abortion acceptable or unacceptable?”  98% said it was unacceptable.  That is the kind of culture in many parts of the world.  And yet the British government and many other governments pour millions and millions of pounds into funding, changing the laws in countries that really don't want their laws to be changed, that really appreciate the value of unborn life.  Forced and coerced abortions: We've seen recently in the UK that the state basically ordered a woman to have an abortion after the doctors recommended it, and it was only stopped at the last minute by a last-minute legal challenge, but the initial court said that she should have it against her will.  We know many other cases where people are pressured by other sources - doctors or spouses or family or abusers in some cases.  These are difficult cases.  There are babies left to die after abortions, which is why they now in the guidelines recommend that a baby has to be deliberately killed, called feticide, before the baby is evacuated from the womb in late-term pregnancies.  And of course, plenty of scandals with abortion providers like BPAS and Marie Stopes International and so on.  So there's a whole litany of hard cases either side.  And I think the only communication tip I’ll give, is: set the rules of the discussion first.  So either agree with the person you're speaking to, from the outset, that you're only going to talk about the 99% of abortions, (the average case, the one that doesn't involve sexual assault, the one that doesn't involve life-limiting condition) and say, “Let's talk about the overwhelming majority - the 1000s and 1000s and 1000s of abortions that happen, setting aside the more difficult cases.”  Or where you're the person you're discussing with does want to talk about the hard cases, at least level the playing field a bit by saying, “Okay, we realise that there are actually hard cases on both sides, so we need to speak about these.”


1.  Unwanted Children

So let's get into those hard cases. The first one which I said is in some sense the most simple, even though it's a hard case, is the case of unwanted children.  Well, the most basic response here is to say, “Who says they have bad lives?”  So, the classic scenario is, someone says, “Well, this person is unwanted.  How can you justify bringing a child into the world?  They’ll have such a horrible life, and they really would prefer that they never had existed.”  Well, realistically, there's simply no evidence to support the idea that children born into difficult circumstances, on the whole, resent their lives or regret being born.  On the contrary, most children seem to be very glad that they're alive, even when they were born in very difficult circumstances.  And that is why of course we don't make the same argument for unwanted born children. We don't say if someone has already been born into poverty and into a difficult family situation, it's better for them not to have lived at all, and so end up taking their lives.  We would never use that sort of reasoning for a born child, so human equality suggests that we should not use it for a pre-born child.  But actually there's this other argument that comes up, which accuses pro-lifers of being hypocrites saying, “Well, who is going to look after these children then, if the mother can’t?  I don’t see Christians or pro-lifers stepping up to look after all these unwanted children.  Where are they?  They just care about the baby being born and then completely neglecting it.”  Again, there's really very little evidence for any of this. The most interesting evidence I think is, if you look at adoption studies and adoption statements, and the information on it, it's actually pretty much impossible or very, very difficult to adopt a newborn baby in the UK, because there are so few of them.  There is a long list of people waiting to adopt a newborn baby in the UK, and they're simply not able.  So it's not the case that there are many newborns who have no one to look after them.  In The Independent they reported it this way; they said, “Demand for babies is so high that this adoption agency doesn't list its name in the yellow pages.  Their fear is being swamped with calls.  They just can’t handle it.  There aren't any more babies available,” said the spokeswoman.  And in The Spectator a few years ago it talks a little bit about the waiting times to adopt other sorts of children in different circumstances, and it says, “up to nine years typically to wait to adopt a newborn.”  So it simply isn't the case that there are all these newborns waiting to be adopted, and that Christians and pro-lifers are not stepping up to do this.  Nor is it true that the pro-life movement doesn't support women in difficult situations, pre-birth or after birth. In fact, the opposite is true, that there's an immense amount offered by pro-lifers, much of which you've already seen today.  We have better data from the US, but in the US in 2017 for example, pro-life pregnancy centres of which there are nearly 3000 served almost 2,000,000 people in a year, saving about $160,000,000 at least.  There were 400,000 free hours offered by sonographers, there were 70,000 volunteers including nearly 8000 medical professionals. And all of this is pretty much done voluntarily through funding, through giving of people's own time, people's own expertise.  Whereas if by contrast you look at abortion providers themselves, and the support that they give to women, ostensibly enabling those women to make a choice, if you look at those abortion providers they get millions and millions of pounds and dollars in funding from governments, from extremely rich billionaires around the world.  So for example, Marie Stopes International got £70,000,000 from governments in the UN in 2018.  If you ask them what do they do for women who want to keep the baby, and how they support women who have already had a baby, there's very little answer.  And if you compare the funding between the pro-life and the abortion providers, and if you compare what they actually do for women after birth, I think it's clear which one really supports women, both before and after birth.


So moving on to some of the more difficult categories. This is an overview of the statistics about when abortions happen, in which circumstances abortions happen, and why.  So in the UK there are about 200,000 abortions a year. This equates to about one in three women in their lifetime in the UK.  98% of these before 24 weeks are for physical or mental health reasons.  And if you look at the statistics, it says that of those about 99.8% are for mental health reasons.  So really 98% of abortions in the UK are officially done for mental health reasons, and this is always specified by ‘mental disorder not otherwise specified’, so it's not a recognised mental health concern.  It's simply someone has said that their mental health will be affected and it's been licenced therefore.  And this can include sex selective abortion in UK.  The remaining 2%: most of those, about 3000-4000 are for what the 67 act called ‘serious handicap’, which we now call disability or differently-abled people or certain medical conditions. 3000 of these are after 20 weeks in abortions. In total are about 100 to save the life of women. And that's really an upper estimate, and possibly quite a number of these are not strictly necessary to save the life of a woman.


2.  Disability


So let's look at the cases first, in terms of disability.  Abortion, as I said for disability, is legal up til birth, possibly even during birth.  There was a bid to outlaw it, I think, back in the 90s in the UK and it didn't go through.  And no one denies that it was legal.  So as far as we understand this is legal, to abort for disability during birth.  There are over 3000 in the UK and rapidly increasing each year.  This ends up essentially having the consequence that 80 to 90% of children diagnosed with Downs Syndrome in the womb will be aborted, and that equates to about 700-800 in the UK every year.  And actually many other conditions are grounds for abortion up to birth, including things which are surgically correctable, such as cleft palette, including twins.  For example, you can choose one of the twins to have their life ended, and so on.  And the disability doesn't actually need to be proven.  So, there are probably also some children, with no disability or no condition at all, who are aborted under these grounds, up to birth as I said.  This kind of discrimination in the law which allows abortion up to birth for children with disabilities but only up to 24 weeks for other children, has been condemned pretty widely by everyone, including some very pro-abortion authorities, so the Disability Rights Commission I think was set up in the Blair government, and it’s talking about this section of the Abortion Act.  This section is offensive to many people.  It reinforces negative stereotypes of disability, and there is substantial support for the view that to permit terminations at any point during the pregnancy, on the grounds of risk of disability, while time limits apply to other grounds set out in the Abortion Act, is incompatible with valuing disability and non-disability equally.  Likewise, the UN, which is an extremely pro-abortion organisation that tries to push it on the rest of the world which doesn't want abortion, says that at least in one of their communities, one of their subgroups, on the rights of people with disabilities, they say the committee is concerned about perceptions in society that stigmatise persons with disabilities as living a life of less value, and about the termination of pregnancy at any stage on the basis of fetal impairment. The Committee recommends that the state party amends its abortion law accordingly. It says that this law is ultimately discriminatory. And this helps to bear in mind when we're talking about and thinking about abortion in that hard case of disability, or particularly life-limiting disability, that actually it is pretty widely agreed even by various pro-choice authorities, that this sort of distinction in the law is actually very clearly discriminatory and is incompatible with human inequality.


So I've just included some statistics here about the numbers of children who are aborted for different reasons, different medical conditions found.  Some of these are very severe complex conditions, anencephaly, where the child is born without most of their brain or with their brain extraordinarily changed in a way that usually doesn't allow them to live for a very long time, is an extremely difficult condition to manage, and it does have a very bad prognosis.  Most of these children do not live very long.  On the other hand, there are many children aborted, as I say, for cleft lip and cleft palate.  You can see in the government statistics, about nine children were aborted for those reasons in 2017.  Other reasons: Down’s Syndrome, about 700.  You can see multiple gestation at some point, which is essentially twinning, and other reasons.  So there's a huge variety of reasons given for abortion for disability. And there are statistics which I could send round on the method of abortion for those abortions.


3  Life-limiting Diagnoses


Now of course there's a hard question about life limiting diagnoses.  So we could all agree that people who have a genetic condition, perhaps, but who have a reasonably ordinary lifespan to be expected, most of us would say actually we think those people are really valuable and they should be allowed to live.  At least everyone in this room I imagine would say that.  Many people find it much more difficult to explain and understand these ideas when we're talking about babies who really do not have a long time to live at all, who are either expected to pass away in the womb or shortly after exiting the womb.  But one of the first things I think he should say here is that often suggestions that abortion should be allowed in these circumstances are based on profound prejudice about the value and the quality of life of disabled people.  So, there have actually been studies on this, perhaps stating the obvious, but Scott Co and a number of his fellow researchers show that 99% of people with Down’s Syndrome are happy with their lives, and they’re glad that they were born. Now, as I say, probably to everyone here this is blindingly obvious. But actually, the way that abortion is talked about leads people to think that people with disabilities really do not enjoy their lives, and would rather not have been born at all.  Perhaps more surprisingly there's a condition called ‘locked in syndrome’, with which some of you may be familiar, in which usually due to a stroke, there are people who are unable to move really at all, except their eyes and blink.  This is a profoundly disabling condition, and is one when I have imagined or tried to imagine having it, I cannot even imagine tolerating a life like that.  It’s extraordinarily difficult to understand living in that condition and actually being glad that you're alive.  I certainly find it difficult to sympathise with that.  And yet when we actually asked people with that condition, there was a study which showed that they rated their quality of life on average, as about a 7, which is the same as an average student.  So really, we make deep, deep and huge assumptions about the quality of life that people with disabilities have, and of course about the value of life that people with disabilities have, and the value of that life is obviously always infinite.


What is also interesting is if we look at the mental health evidence of the mothers in these circumstances.  So often these kinds of cases are framed in the media as extraordinarily distressing cases, and of course they are.  Any women who has had a diagnosis of their child in this way where they're told that their child is unlikely to survive for very long at all, any woman going through that is going to find it extraordinarily difficult, and rightly so.  It's an extremely difficult situation to go through.  But what we're usually told in the media is that the obvious thing to do in that case is essentially to cut things short, to not force her to go through extra torment, and simply to end the pregnancy in a way that doesn't prolong that suffering that she is experiencing.  But again, if we look at the evidence on this which is never told to women in this harrowing situation, the evidence points to quite a different story.  Yes, in all of these cases, it is tragic and it's extraordinarily difficult for the parents.  But out of those two extraordinarily difficult alternatives of ending the pregnancy or continuing the pregnancy, it seems that women who continue the pregnancy seem to have much better psychological outcomes.  So a study from last year by Wool et al. found that 97.5% of parents in this situation who continued the pregnancy, had no regrets whatsoever, and Wool describes those feelings that they described about the opportunity to love, hold and meet their child, even for a very short time.  And there are other studies which show similar things.  And this is true for parents, whether they're religious or not.  Other studies have shown the importance in cases like this of parents spending time with their child, either alive for a short time, or even with their child who has passed away.  They’ve shown the importance of parents spending time with that child for getting long-term psychological outcomes.  In terms of other mental health considerations, these are typically wanted pregnancies in the first place, and it was a reluctant, painful decision to end them, which is a risk factor for having psychological poor outcomes after a termination.  In 2017 a paper in a top midwifery journal described women's experiences of delivery after abortion in these cases, and described these experiences as overwhelmingly negative.  And they also documented the importance of spending time with the baby afterwards.  And they quote a number of women saying things like, “No one can understand the torture of having an abortion [in that case].  It was one of the worst things in my life.  There was no hope.  I thought I would die.”  Likewise, NICE, just this year published an evidence review of abortion cases and the impact on the mother, and they said very similar things, that it's almost an entirely overwhelmingly negative response to abortion that women have.  Most of the women were not able to work or do anything.  “I had a hard time to focus the first three months after termination. Everything felt quite meaningless.”  Most women find grief intensifying for the first 3 to 6 weeks and lasting until the due date and so on.  And there’s lots of talk of torture, and it being the worst experience that anyone could possibly go through.  Now if we look by contrast at women who have the baby in those conditions, yes, it’s obviously an immensely difficult thing to go through for the woman and for the man, and for anyone else in the family.  But if we compare the two options, both of which are extremely bad options which no one would want to go through, it seems that the better psychological outcomes are there for people who continue the pregnancy, and have some time to spend with their child and who really cherish that time.  And there's actually a direct study by Cope et al. showing a direct comparison between these two groups of people, showing that those who continue the pregnancy have better psychological outcomes.


4.  Life-saving Abortions

So then to move onto life-saving abortions. As I say these are very rare in the UK.  So in emergency situations there's only about one abortion a year to save the life of a woman in emergency circumstances.  If you include non-emergency circumstances, it goes up a fair bit, but still to about almost 100.  In most of these cases the baby will die if the mother dies, and so the options really are to save one person or not to save any one at all.  And for that reason most pro-lifers say that abortion is permitted in these circumstances, because you are saving one life, as opposed to not saving either life.  But when you have an abortion in those circumstances, there is no intent to end the life of the child.  Rather the ending of the life of the child is an inevitable consequence and it’s a foreseen consequence, but it's not an intended consequence.  And so many people will say that this strictly does not count as an abortion, thinking that abortion is only intentional ending of life.  And of course, most countries in the world allow abortions in these circumstances.  Certainly Ireland did, and despite the hype around Ireland’s law, Northern Ireland, until the recent change also allowed abortion circumstances.  And again some data that we got from the Department of Health on which kind of life-threatening conditions were involved in these cases - you'll see that some of them are for mental health - only five in 2017.  It's unclear exactly how serious this threat to someone's mental health was, but you can see that there is some room for malleable interpretation of the life-saving abortion clause.


5.  Rape

Penultimately we'll come to the most difficult question to speak about, particularly as a man. The question of sexual assault and what about abortion in the case of rape.  The whole point of communicating on these hard cases is that we have patience and that we have time to speak about them with people in a pastoral context.  So please don't take this as a model for your pastoral engagement on this.  Firstly, I think we need to say something just about the incidence.  How common are these?  Different studies suggest different things but I've never seen a study showing more than about 2% of abortions being for the case of rape.  In a 2005 study they suggested 1%, but even in that study, sexual assault or rape was the main reason for the abortion in less than 0.5% of the cases.  They didn't say exactly what percent of cases, but it was essentially four or fewer women out of nearly 1000 women, so extraordinarily rare that this is the main reason for having an abortion.  The more recent data from Florida last year suggests that it’s much less than that, 0.1% to 0.2% of abortion, so an extremely rare case.  But I would always counsel, whenever I speak about this, initially start by saying that these are an extraordinarily rare minority of cases, but not leaving it at that.  I would always say these cases still matter because these women matter and these children matter. So certainly I would not recommend in any way using the rarity of them to undermine the importance of them because it can make people feel unrecognised.  But a way to approach this that I usually start with is, ultimately the fundamental question, “Will abortion help heal a woman who has been through sexual trauma?”  Now there are only two options here, and neither of those options eliminates the trauma, neither of them gets rid of the trauma, neither of them wipes away the suffering in an easy way, or a simplistic way.  There is no easy or simple way to deal with this kind of trauma, but of those two options, one of them really at best patches over the trauma and pretends it never happened, and often fails in that pretension, whereas the other – I’ll give some evidence to show – can lead to deep healing and victory in surprising ways.  And there are two ways to answer this question ultimately of whether abortion will help heal.  Those are by listening to women, and by looking at the evidence of what women say on a larger scale.  So when we listen to women, what do they say about these situations?  Firstly, they say it is deeply personal, and actually that we need to listen to women, rather than just making assumptions on their behalf.  We need to give these women a voice, and yet these women are usually silenced.  So in the Ireland campaign against abortion some survivors of rape were invited to give a pro-life talk all over Ireland, and many people just cancelled their talks and refused to host them, even after initially agreeing, because they were pro-life.  So these women's voices are actually often silenced, which is one of the worst things that I think we can do.  It goes without saying that many victims of sexual assault don't want to be exploited for the pro-choice cause and certainly not for abortion on demand.  Women actually say that possibly even the majority of times they keep the baby in these cases.  We would never expect this because most medical counsel in these cases, most family counsel and counsel from friends, is to obviously have an abortion in these cases.  But actually repeated studies seem to show that most women continue the pregnancy in such cases, even despite this pressure to abort.  And actually studies seem to suggest that abortion is often regretted in these cases, whereas having the baby in these cases, is almost never regretted.  There's a book by David Reardon, called ‘Victims and Victors’ which is essentially a group of testimonies of 200 women who were the victims of rape, and who became pregnant, some of whom had abortions, some of whom gave their child up for adoption, some of whom raised the child themselves.  Not a single one who continued the pregnancy regretted doing so.  But actually I think most women who had abortions in their circumstances regretted it, and this is something that we don't hear.  But that book does a great job of actually listening to those women.  One of these women is Helene Evans, who says, “Abortion does not help or solve a problem.  It only compounds and adds trauma to the already grieving victim.  It only takes away the one thing, her child, that can bring joy.”  So let's think a little bit about the psychology of these cases.  Well, one of the most important things for trauma victims in general is for them to make sense and derive meaning from their traumatic experience, so that they have some story in which to place their experience, to make some sense of why it happened.  Now abortion, it seems, can never do this.  Abortion can never make sense of what is going on.  It can never provide meaning for a woman who has lost her sense of hope and meaning because of the trauma that she’s been through. But actually what these women who have been through this have said themselves, is that having a child can be a profoundly healing and victorious way to find meaning in that deeply painful experience.  We know this is extremely important for people’s psychological wellbeing.  There’s a psychologist who I don’t think is religious at all – I’ve never seen him write about the pro-life debate - he says actually the main results from the study he looked at, was that for both adults and students, the more redemptive the life story, the more pain was overcome in someone's life through healing and victory, the better a person's overall psychological wellbeing.  They had better psychological wellbeing in people who had never really experienced much pain.  And of course as Christians we know this in the most profound way of all, because we know that victory through suffering actually came in the deepest way and that it is profound, because that is exactly what Jesus accomplished with us and for us.


One final thing I'll say is mental health evidence in general shows pretty unanimously there is no evidence that abortion helps a woman's mental health.  But actually there's significant evidence that abortion is bad for women's mental health.  So  the most recent major review conducted by a pro-choice psychologist David Ferguson, in 2013, in the top psychiatry journal showed that even when you controlled for all the other factors like prior mental health, or whether the pregnancy was wanted, or socioeconomic status, even when you kept all of these constant, women who had abortions had more anxiety, more drug abuse, more alcohol abuse, and more suicidal thoughts and behaviours than women who continue the pregnancy in those circumstances.  And this is borne out by other studies which show higher suicide rates, much higher suicide rates after abortion than after continuing pregnancy and much higher mortality rates.  And so actually, to sum all of that up, when people invoke the case of sexual assault to talk about abortion, they're often making huge assumptions on behalf of these women and saying things that these women do not say.  So, again, to sum up the case of sexual assault, the question is not, “Will the victim suffer?” because we know that whatever happens, a victim of such a horrendous crime will suffer.. The question is ultimately, “Will abortion help them heal?  And what is the unborn?”  Those are the two ultimate questions. And, as I suggested, there are two options there, both of which involve an enormous amount of hurt, sacrifice, and difficulty.  But one of which seems to try and wipe away the crime and adds to the trauma, and one of which can be a very profound way of healing.  So you can sum up by saying that abortion only adds a second trauma to the victim and a second victim to the crime.


6.  Backstreet Abortion

Finally, I wanted to talk about the case of backstreet abortions and I've got four main points.  So firstly, when it comes to backstreets abortions, the question of the morality of abortion is still central.  Some people try and use backstreet abortion as a way of saying it doesn't matter what you think about the morality of abortion.  I actually might think abortion is wrong, I am pro-life and I oppose abortion, but I think that all banning it will do is lead to dangerous backstreet abortions, which don't stop abortions, but which lead to women dying.  So they try to say that actually the morality of abortion is irrelevant.  Well, actually my first point is that the morality of abortion, the ethics of it, is absolutely central.  Firstly because the law plays a powerful expressive role.  It expresses what we believe about humans and about human dignity, even if no-one obeys it.  A good example is the transatlantic slave trade.  Many people initially who were opposed to the abolition of the slave trade said that it didn’t matter whether slavery or the slave trade was wrong.  It will still happen, so we need to make sure it happens in the safest way possible.  That's completely wrong.  We know that whether people do it illegally or not, we need to say in the law that the people who are being trafficked in the slave trade are equal human beings worthy of dignity and respect, and that goes, no matter what the consequences of that law will be.  Wilberforce says essentially the same thing.  He's responding to the backstreet slave trade argument.  And what people said at that time was that abolishing the slave trade led to revolutions in the Caribbean that killed many people.  In one case they say the slave trade went on illegally, so 60,000 slaves were being shipped across the Atlantic each year, many of them illegally shipped, even once abolition had been put into law.  Illegal traders often used ships which had not being designed for holding slaves at all, cramming them into the hulls of converted warships, and other vessels, which gave the victims even less space than in the days when the British trade was legal and regulated. We can see the parallel very clearly here. In both cases, yes, there will be some illegal activity that goes on, even if it is made illegal, and perhaps you could make the argument that a legal, regulated system is ultimately better, but I think in hindsight we know that that perspective does not work.  Actually, banning the slave trade did lead to its abolition eventually, at least in that form at the time, and lead to much better prospects for everyone involved.


The other reason the morality is central and why you can't use this backstreet abortion argument is that we know that pro-life laws do work, but we know that when we put in pro-life laws, whether banning abortion or putting limits on it, or putting financial restrictions on it, or putting informed consent laws in, all of these reduce the numbers of abortions.  And just as an example of that, the British Medical Journal just a few years ago estimated that just before the 1967 Act there were 10,000 abortions in the UK every year.  And, of course, with much more widespread contraception and legal abortion, that figure has multiplied by 20 over the last 50 years.  Secondly, what about the question of mortality from illegal abortions?  What about women who will die as a result of illegal abortions?  Well essentially one of the short answers to this is that most of these figures were completely invented by admission of pro-choicers.  There were very few deaths from illegal abortions in the developed world, even 50 years ago and now there will be almost none or probably even none.  Bernard Nathanson was one of the foremost pro-choice doctors in the movement in America in the 1970s and he says, “How many deaths were we talking about when abortion was illegal?  In our organisation we usually emphasised the drama of the individual case, but we spoke about 5,000-10,000 a year.  I confess that I knew the figures were totally false. But in the ‘morality’ of our revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics?”  Likewise, Mary Calderone, who was the medical director of Planned Parenthood, which is the main abortion provider in the US, said, “When abortion was still illegal in the US abortion illegally is no longer a dangerous procedure.  It is carried out in sanitary conditions, and there are not many deaths from it at all.  Abortion, at the end, whether therapeutic or illegal, is in the main no longer dangerous because it's been done well by physicians.”  Just to give some statistics on that - in 1973 when abortion was legalised in the UK there were only 19 deaths recorded from illegal abortion and 50 years later we would expect there to be far fewer and I would hope none at all.  By contrast, if we look at mortality from legal abortions, I think we can expect significantly more.  Even now with legal abortion, some women die directly from legal abortions from complications such as bleeding. But actually, abortion seems according to the studies to contribute to one of the biggest killers of women of childbearing age, which is suicide.  I already gave some evidence on this and I'm not going to go through it in detail, but studies suggests that potentially between 1% and 5% of all suicides among women can be attributed to abortion.  And actually if you look at the statistics, and work out how many women would be affected therefore, you could make the argument that at least 15 women die from suicide as a result of abortion in the UK every year.  And that along probably exceeds the likely mortality rate from illegal abortion if abortion were to be made illegal.


So finally, in responding to this, we have to think about the human cost.  No option is without cost in human lives.  Someone who asks the question about backstreet abortions is trying to come up with a eutopia where they say, “Look, these women are dying if abortions are made illegal.  How can you allow that to happen?”  Now of course these are tragic cases and we don't want that to happen. But the point is that neither option is completely without cost in human lives.  So yes, it is true that some women may die in illegal abortions in the UK, if it were to be made illegal.  I think the number would be very few, probably less than five.  That is obviously a tragedy, but we have to weigh that against the other tragedy of legal abortion, and the human cost of legal abortion is exponentially higher.  Plausibly you would have even more women dying because of the suicide rates associated with abortion, you would have a culture and a law that says at its root, not all humans are equal.  And of course, the ultimate thing which all of this comes down to, whichever hard case you're talking about, the human cost from allowing abortion, even if you consider the hard cases, is at least 200,000 dead unborn children in the UK every year. That is something that I don’t think can be outweighed very easily if at all, and that is something that's the pro-choicer has to reckon with when they're thinking about these cases.

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