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Legal Abortion Time-Limits: Arbitrary Limits Harm Women

By Dr. Lachlan de Crespigny, Department of Obstetrics and Gynaecology, University of Melbourne

The vote by the British parliament to keep the upper legal limit on abortion at 24 weeks was headline news around the world. An article in The Economist (1) considers that the British were spared America’s abortion wars partly because Britain is less religious than America, but also because abortion laws are made in Parliament, where shades of grey can be debated, not in the courts, where black or white usually prevails.

Interestingly much of the debate was about ‘viability’ – the minimum gestational age at which a newborn is said to be capable of surviving with modern intensive care facilities. This is a simple across-the-board week count. But the survival rate of newborns also depends on many other factors, including where they are born (2, 3), fetal health including the presence or absence of an abnormality (which remains lawful where the child will be ‘seriously handicapped’), plus the condition of the newborn. While around half or so of 24 week newborns in Britain may survive, many or most of the abortions at around that gestation are of problem, or unhealthy, pregnancies.

For problem pregnancies it is irrelevant that healthy fetuses are viable at this gestation; just as it is irrelevant to consider viability in another country or era. Indeed any single gestational age limit is arbitrary; and arbitrary limits harm women. They discriminate against women who happen to fall on just the wrong side of the line. They can also harm those approaching the line forcing some to have compromised testing earlier than optimal, and others to make a rushed decision on abortion.

Pregnancy termination remains lawful when ‘there is a substantial risk that if the child were born it would suffer from physical or mental abnormalities as to be seriously handicapped’. Defining a serious handicap is, however, often problematic.

The vote on a 22-week limit was defeated by only 304 to 233. Unless the debate moves beyond linking legal abortion to survival rates of premature newborns, the issue inevitably must resurface. Survival rates of premature newborns will improve. 

1 Abortion laws: Hard cases and slippery slopes. The Economist May 22nd 2008 
2 New research on baby survival rates stokes abortion limit row.
No improvement in chances of life before 24 weeks, despite medical advances

The Guardian, Friday May 9 2008
3 Some numbers in abortion debate just can’t be relied on.
Ben Goldacre. The Guardian, Saturday October 27 2007
4 The Nuffield Council on Bioethics. Critical care decisions in fetal and neonatal medicine: ethical issues. London: Nuffield Council on Bioethics, 2006. (accessed Jun 2007).

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