My Lords, Amendment 183 was tabled in the name of my noble friend Lady Sugg and, like many others, I want to honour her for her commitment to vulnerable women and international development. There are a number of reasons why I cannot support this amendment, but, first, it is important to be clear what it is and is not actually about. In many of the emails that have been flying around from supporters on both sides of the argument, and the various stories in the media, it would appear that Amendment 183 is about abortion and easier access to it. However, although the subject matter is one of abortion, in practice this amendment is significantly more about the health and protection of women.
First, let us take a look at why this is not an abortion amendment. Perhaps, in this instance, I may be able to address some of the recent comments from the noble Baroness, Lady Barker. In the UK, in practice if not in law, we have abortion on demand up to 24 weeks. In 2020, there were 209,000 abortions for women resident in England and Wales—the highest number since the Abortion Act was introduced. This stands in a context where, in the same year, there were 613,000 live births. So, there was roughly one abortion per three live births. We also have access to the morning-after pill without question, and in 2018-19, there were 91,000 procured from sexual and reproductive health services—and that does not include pharmacies. Also, in today’s world, pregnancy tests are as sensitive as Covid tests, so women know from a much earlier stage in their pregnancy whether they are pregnant—not like in my day. It is quite clear that over time, women have been able to take control of their body and their reproductive choices.
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If this is not an amendment about abortion, what is it about? With all due respect to the noble Baroness, Lady Sugg, public policy is littered with the results of the unintended consequences of policy decisions. In the name of wanting to serve women, this amendment removes protections for women and leaves them vulnerable and isolated at a time when support, both medical and emotional, is needed. For those of us who participated in the Domestic Abuse Bill or have taken a stand against violence against women and girls, this should cause concern. So, let us take a look at why and how it removes protection for women.
This amendment, as is obvious, provides for a telemedicine service, and the consultation takes place by phone. Hence, an ultrasound is not available. These pills, though, are deemed safe only if they are taken up to nine weeks and six days into a pregnancy. But, without accurate date keeping, and without an ultrasound to confirm the development of the baby, it is impossible to check this on the phone. Taking pills in a more developed pregnancy can be high risk, and this amendment completely abolishes the necessary checks, balances and safeguards that were previously in place to protect the health of the women involved. My noble friend Lord Duncan said it has worked and worked well, but there were over 50 cases officially reported to the Department of Health and Social Care of women who were provided pills by post beyond the 10-week gestation period, including one where, as we have heard, the unborn child was at 28 weeks’ gestation, well beyond the legal limit. There is simply no way of knowing across a phone call the actual gestation period of the baby.
It is difficult to quantify the number of complications that have arisen from these pills, such as incomplete abortion and continued bleeding, because of insufficient data collection on patients receiving the pills. This is where my noble friend Lord Bethell’s comments are appropriate and need to be heard tonight—that significantly more work needs to be done around this issue. FoI requests have revealed the aftermath from the pills by post process to include sepsis, haemorrhaging, embolisms, renal failure and trauma to pelvic organs, among other medical complications.
Secondly, the amendment leaves women to bleed on their own and opens them up to increased health risks. It is extraordinary to me that many of the arguments used against back-street abortion that drove the introduction of the Abortion Act 1967 seem to be being ignored by this amendment. It puts women back to bleeding on their own, in their rooms at home, passing the early stages of the baby into the loo, and all without medical care—the very thing the Abortion Act 1967 was passed to stop.
Finally, this amendment leaves women open to coercion, as we have heard this evening, by actors within the home who do not want a child. We need to be acutely aware that self-administration of abortifacient medication in this way removes the opportunity to check whether abuse or coercion are involved in the decision. This poses a threat to vulnerable women and girls who are at risk from an abusive partner, or from child sex abuse.
Noble Lords this evening have quoted from the Savanta ComRes poll that 77% of women believe that doctors should be legally required to verify in person—