Interview with Professor Wendy Savage – a response to the Mail on Sunday

This weekend, the Mail on Sunday published an interview with Professor Wendy Savage, Press Officer for Doctors for a Woman’s Choice on Abortion and member of Voice for Choice.

The Mail on Sunday chose to focus only on Professor Savage’s comments on ‘sex-selective’ abortion rather than report the majority of the discussion, in order to further their own agenda.

We stand by Professor Savage’s comments that there is no evidence for ‘sex-selective’ abortion taking place in the UK. Like Professor Savage, we believe that information during pregnancy should not be withheld from prospective parents and hold concerns about proposed bans on ‘sex selective’ abortions (as outlined in this letter).

Voice for Choice stands against the sexist devaluation of women in society while recognising that gender equality cannot be achieved by placing additional restrictions on abortion services. Instead, we believe in protecting women from coercion by making sure that consent procedures are robust and in safeguarding for vulnerable women in cases where it’s needed.

For Professor Savage’s verbatim comments to the Mail on Sunday please see below. These comments were transcribed and arranged under the subheadings below by the Mail on Sunday journalist Stephen Adams and emailed to Professor Savage. We have made a few corrections to the spelling of names and places.

Verbatim comments from Professor Wendy Savage (16th March 2017)

On why abortion needs to be decriminalised.

The current law does not give women the right to choose what happens to their own bodies. It requires them to get the consent of two doctors, which is understandable in the context of 1967, but 50 years on, things have moved on.

The woman needs have the facts, which need to be discussed with her. You need to find out that she’s not under any pressure [to abort] that she is making her own decision and she is not being pushed into it by somebody else. But women are adult human beings – they can make their own minds up. And it’s the woman who tends to look after the child, for the rest of her life.

On what you would like to happen legally

I would like us to do what the Canadians did, which was to remove abortion from criminal statutes. You can control it [abortion] by regulation, like other medical operations and procedures are already done.

On the motion ‘to set up a working party’ [etc] at last year’s BMA ARM

I did it on behalf of the Islington division of the BMA, where I am the chair. It was the third time we had put in a motion like that, in three years.

It was the members who were trying to get it on to the agenda, and the members who voted for it. It certainly wasn’t the BMA hierarchy

On concerns that you, with a very clear agenda to decriminalise abortion, should also be on the BMA’s MEC and potentially having a strong influence on the Discussion Paper

The discussion paper was drawn up by the staff of the Medical Ethics Committee, and then it is circulated to us all and then we discuss it at a meeting and people can suggest amendments and these are agreed, or not agreed.

My position [on abortion] is quite well known; and we have other members on the committee who are [of other opinions].

[We have] ethicists and religious people. It’s not a committee which you can actually sway one way or the other….It’s not like I’d have a casting vote or anything. It’s very much a consensus amongst the members, and people’s views vary quite widely.

On accusations the BMA is on a ‘crusade’ to decriminalise abortion

It’s not a crusade, it’s coming from the grassroots. The fact that it took us three years before we managed to get it on the agenda, and we only got it on the agenda because we got it as a chosen motion – certainly doesn’t suggest that the BMA is having a crusade.

The BMA is a reasonably democratic organisation. And the way policy is made, you bring motions to the ARM. The chair is scrupulous in taking ‘for’ and ‘against’ viewpoints, and then we vote on it. There are people in the BMA who are violently opposed to abortion, just as there are people like myself who feel that women should have a choice.

On whether doctors are in favour of decriminalising abortion or not

It’s not something that’s been discussed with doctors very much

We [you and Colin Francome at Middlesex University] did a survey of gynaecologists in 2015 and asked them if they thought abortion should be decriminalised. And there was a slim majority that said yes. About a quarter didn’t know and there were a few who didn’t realise that it was a criminal offence.

On the Daily Telegraph’s 2012 ‘sting’ and claims of sex-selective abortion in the UK

I think that to entrap the doctors by posing as a [pregnant] woman and giving a false story, is not a good way to go.

The thing is, the question of women requesting abortions on the grounds of foetal sex, is a complete red herring. It just isn’t something that happens in practice.

In my experience, women asking for abortion on the grounds of foetal sex, are extremely rare.

….

I only ever had one woman ask for an abortion, on the grounds of foetal sex, and that was a woman who didn’t want a boy.

I don’t think it’s an issue. Women don’t come asking for it.

We did ask the question [if UK gynaecologists had been asked to perform sex-selective abortions] when Colin and I did this survey in 2015, and we asked gynaecologists whether they had had requests for sex selection. And 96% of them said ‘Never’. That was to a random sample of practising gynaecologists.

It isn’t a problem, people requesting terminations on the grounds of foetal sex. In this country it’s not a problem.

On whether it is still your view that “We are also opposed to gender discrimination, but sex selective abortion is not gender discrimination. Gender discrimination applies only to living people.”  [Contents of the Voice for Choice letter in Open Democracy you signed in 2012]

Yes

[You continued] I just don’t think it’s a problem in practice in this country. It is a problem in India but the steps they have taken to try to deal with that haven’t dealt with it. And the way to get rid of gender discrimination is to improve education and the lot of women in society.

On the fact that both WHO and the UN regard sex-selective abortion (notable of female foetuses) as a major issue worldwide.

It is a problem in other parts of the world, because it’s affecting the sex ratio. But it’s not a problem here and the Department of Health has checked our statistics and they have not found that there’s a sex imbalance.

Women are doing it [requesting sex-selective abortion in other countries] because they are being forced into it by sexist assumptions.

On whether women should as a matter of principle be able to have a termination solely on the grounds of the sex of the foetus, putting aside the question of whether or not it happens in the UK.

I do think that it is a woman’s right to decide whether or not to carry on with a pregnancy. It’s her body. She is the one taking the risks. The foetus of course is a potential human life at that stage, it is not an actual human life…. My feeling is that the rights of the foetus increase as the pregnancy continues. So the nearer it is to viability, the more its rights are.

On whether the guidance brought in by the Department of Health on May 2014 on sex-selective abortion [‘Abortion on the ground of gender alone is illegal.’] was in your view legally sound and the right thing to do.

The law is clear. The law doesn’t say ‘You can have abortion on the grounds of X or Y’ – rape or whatever. It says, ‘You can have an abortion if, two doctors in good faith, believe that etc etc.’ [i.e it would jeopardise the physical or mental health of the woman to continue with the pregnancy]. It doesn’t mention the grounds. The fact the Chief Medical Officer sent out something that said otherwise, I disagreed with that…The way the law is framed is not about grounds, in that way. What you have got to talk about is the effect upon the woman. Is it a risk to her physical or mental health, if the pregnancy continues?

I think it [the DH guidance] was a response to a political thing. I don’t think it was correct, legally…. If a woman does not want to have a foetus who is one sex or the other, forcing her to do that is not going to be good for the eventual child, and it’s not going to be good for her mental health…. I think that is you are looking out for the woman’s health, yes [she should be allowed to terminate on grounds of foetus gender]. [But] I just don’t think it’s an issue [in the UK]. In practice, it isn’t an issue.

Because of this sort of anxiety [about sex-selective abortions] some places won’t tell the woman the sex of foetus, which I think is outrageous. It’s her body and her foetus, so she should have that information. I think it’s up to the doctor to talk to the woman and if the doctor thinks the woman is being put under pressure to have a termination that she doesn’t want, then it’s not her requesting it and he or she won’t do it.

On the prevalence of late abortion in the UK and whether decriminalising abortion would change that

Women don’t request terminations late on in pregnancy, unless they are mentally ill or whatever.

..

On the whole women don’t present for abortions after 24 weeks unless a foetal abnormality has been detected. It’s quite rare for women to do that [request late abortion] and I don’t think that changing the law [to decriminalise abortion] would make any difference to that.

The only study that has been done in this country [on late abortion] is one that I did in Tower Hamlets in 1983. [This identified 10 or 11 late abortions across the whole of Tower Hamlets’ population.]… In my career as an obstetrician and gynaecologist, I have only had a couple of cases over 24 weeks, over 35 years.  I’ve had about one every 10 years…. So it’s not something that women tend to do.

This is another of these myths propagated by the anti-abortion lobby, like women wanting sex selection.

Fortunately, women don’t come asking for abortions at 22 or 23 weeks. Because it’s hard for the doctor, weighing up the rights of the foetus versus the rights of the mother. It’s not an easy thing, doing a late termination. It’s difficult.

Doctors do not do this [late termination] willingly. They do it because they feel it is the best solution for the woman, to a problem that everybody wishes has never happened, but it has happened.

Scotland has a different legal situation from us. Before the 67 act there were not lots of very late terminations in Scotland, and it would have been possible for women to do if they had wanted to do it. But they don’t want to do it, basically. The woman herself, when she starts feeling the baby move, doesn’t. It’s only if she’s really, really troubled that she will do something [request / attempt late abortion].

On whether the moral rights of the foetus to life can and should ever override the rights of the woman to choose, e.g. post 24 weeks

I feel that it’s not something that in practice you have to make your mind up about. Because women don’t request terminations late on in pregnancy, unless they are mentally ill or whatever. When you think about the fact that 50% of fertilised eggs are lost before the woman would have missed her period – so you’ve lost half those potential human beings. And you’ve got another 10% or so lost in the next 13 weeks. So if you are losing over half of them before 13 weeks, it’s quite hard to say ‘When does this become an entity with moral rights?’ So I don’t really like to ascribe moral rights to a foetus, I wait until it’s a baby.

I think you have got to concentrate on the woman, that’s what my position is. She is the one who is here, and she has got a whole network of relationships, and she is the one usually who ends up looking after the baby when it’s born.

On whether women should be able to legally obtain abortion pills directly, without seeing a health professional, for example via the internet

Women can obtain pills from the internet and do it themselves, and are doing that.

I think it’s always helpful for a woman to discuss whether she should continue with a pregnancy with a professional, who doesn’t have to be a doctor, it could be a nurse.

I don’t think it should be mandatory [that they must see a doctor / nurse before getting abortion pills]; I think it is advisable but I don’t think it should be mandatory. Because I think the majority of women are adults who can make their own decisions.

On why you became involved in the provision of abortion in the first place

I became aware of the strength of feeling that women had, when my own housemaid [became pregnant and] I told to go home and tell her parents. She didn’t tell her parents, went to a native doctor, came back to Enugu, started vomiting blood and was dead within half an hour. She was 17 years old. It was shocking.

..

We were taught abortion was wrong and I hadn’t questioned that. But when I saw these young women coming in having taken this native medicine and just dying of organ failure, it really did affect me.

On the effect of the Abortion Act 1967

Abortion had been the leading cause of maternal mortality [pregnant to 6 weeks post-birth] from the mid 50s until after the Act was brought in. Then it declined. In the last decade we have only had one death….I would argue that the 67 Act was one of the most important public health measures of the last century. So the battle about maternal mortality has been won. But this is about the human rights aspect. Women are autonomous beings; they should have control over their own lives.

On whether you think the BMA will adopt a policy of supporting decriminalising abortion, and whether you think the law will change.

I think it’s a long term thing….If the ARM agreed to support the BMA having a policy to support decriminalisation of abortion I would be very pleased, but I don’t expect that [the law change] to happen overnight.

[If the BMA was to agree such a policy] Parliament does take notice of the people who deal with a particular issue, I think it would be very positive, but I’m not holding my breath.

On the ‘pro-life’ lobby

Quite a lot of high profile abortionists like Ronald Reagan for example, weren’t at all anti-war. So it’s a misnomer to say that they are pro-life. Often they are against using contraception, they are against assisted conception, and you could say that assisted conception is a pro-life issue.