Abortion, decriminalisation, and the right to choose

The jailing for 28 months of Carla Foster, a 44-year old woman with three children, one with special needs, for terminating a pregnancy during Covid lockdown has shone a spotlight on abortion laws in England and Wales.

We have a Tory government quick to foment ‘culture wars’ over migration, and to a lesser extent trans rights, in order to deflect from the multiple crises they face, and which they are totally incapable of solving. However, we have so far not seen the attacks on abortion rights that have taken place in the US and in other countries where right-populist governments have been in power. This is because of a general understanding that there is overwhelming support for the right to abortion, and that any attack could provoke a backlash, adding to the crumbling of their electoral base.

When last year the Tories proposed scrapping telemedicine and ‘pills by post’, which were introduced during the Covid pandemic, opposition was so strong that they had to back off and make the scheme permanent. It allows women much better access to safe medical abortion in the early stages of pregnancy – up to ten weeks, when 89% of abortions take place. This has been especially important to those who have difficulties travelling, finding childcare, taking time off work, or who are in a coercive relationship.

However, this shocking case has underlined that 56 years after the 1967 Abortion Act was passed there is still not a legal right to abortion in Britain. The Act stipulates that anyone seeking an abortion must have the authorisation of two doctors to be able to proceed, and it merely sets out exemptions from prosecution. The 1861 Offence Against the Person Act, under which Carla Foster was jailed, was not repealed when the 1967 Act was passed. It is an archaic piece of legislation providing for a maximum sentence of life imprisonment for anyone administering poison with intent to procure a miscarriage.

And Carla’s is not an isolated case. Several women, including a 15-year old, have been investigated for ‘unexplained’ stillbirths. Last year eleven people were reported to police in England and Wales, accused of illegally procuring an abortion, up from seven in 2020 and two in 2018. As the law stands, anyone experiencing a miscarriage at or beyond 24 weeks could potentially come under investigation.

Campaigns have been initiated to decriminalise abortion, and Labour MP Stella Creasy has called for access to abortion to be enshrined in law as a human right. These demands will undoubtedly garner support. But abortion is much more than a legal issue. It has to be seen against the wider backdrop of access to reproductive rights more broadly, the crisis in the NHS, and the economic crisis.

214,869 abortions were carried out in England and Wales in 2021, the highest since 1967. Figures have been rising since 2016. According to Dr Jonathan Lord, an NHS consultant gynaecologist, this increase has been driven by “the economic downturn, the cost of living crisis and the ability to access good quality contraception”. Clare Murphy, chief executive of the British Pregnancy Advisory Service, said: “Faced with economic uncertainty and job insecurity, women and their partners have been making sometimes tough decisions around continuing or ending a pregnancy”.

While medical abortions now comprise 87% of terminations, there will still be a need for surgical abortions in some instances. But services are at crisis point. The NHS finances around 99% of abortions but 77% are performed by private providers. Just one in five hospital trusts offer specialist surgical abortion services. Women report having to wait weeks for an appointment or having to travel hundreds of miles to secure one.

Chronic staff shortages and the closure of sexual health services are exacerbating the situation. Government spending on sexual health clinics fell 18% from 2015 to 2022. Twenty-six percent of councils have cut spending on clinics. Some women are having to wait as long as ten weeks to have a coil fitted because of a lack of trained GPs.

This recent jailing could be the trigger for a campaign by anti-abortionists to further attempt to reverse or restrict access to the abortion pill, which should be strongly resisted by a movement involving the trade unions, women’s organisations, and socialists. But it’s clear that a real danger to accessible abortion, contraception and other reproductive health care is the chronic underfunding and creeping privatisation of the NHS.

Stella Creasy will most likely be an MP in a Starmer-led Labour government after the next election. Jeremy Corbyn’s 2019 election manifesto pledged to “uphold women’s reproductive rights and decriminalise abortions”. Keir Starmer supported that pledge, but now he has added it to the long list of ditched Corbyn policies.

Even if, under pressure, a Labour government were to introduce legal change – which, let’s face it, would not actually cost anything financially – resources would still need to be made available to fully fund abortion and other services within the NHS in order for that right to be exercised. The legal right to abortion was introduced in Northern Ireland in 2020, and yet a year later 161 women still travelled to Britain because the facilities to access abortions had not been put in place.

But Starmer and shadow chancellor Rachel Reeves have made it clear that fiscal restraint will rule under a future Labour government – with no more money available for the NHS and other public services, including free universal childcare. Shadow health minister, Wes Streeting, says the answer for the NHS is ‘reform’ – what The Economist magazine called the ‘Reform Fairy’, now replacing the ‘Magic Money Tree’. This would in reality mean even further reliance on the NHS-funded, private sector-provided model for which the crisis-ridden abortion services were the original template!

The fight to defend and extend abortion rights is a political fight that cannot be limited to legal changes. It’s a fight for the reversal of all cuts and privatisation of reproductive services, and for abortion and other services to be publicly funded and provided as part of a fully-funded NHS. It’s a fight for policies that will allow people to have a real choice about when and whether to have children, such as a minimum wage of £15 an hour, decent benefits, universal, free, flexible, good-quality childcare, and massive investment in building genuinely affordable public housing. And to maximise the fight for all of those things we need a collective political voice in the form of a new mass workers’ party, based on the trade unions, in which the discussion of a socialist alternative to a capitalist system in crisis would be central.

Christine Thomas