Dorries: The Abortion Debate Fisk

I’ll keep the preamble to a minimum – what follows is a foll-on fisk of Nadine Dorries’ speech in the Westminster Hall debate on induced abortion, so let’s get on with the show. David Crausby is in the Chair, I’ve skipped the ritual sucking up to the Chair that marks the beginning of most parliamentary debates and I’ll also be skipping any interventions that add nothing of substance to the debate:

Nadine Dorries (Mid Bedfordshire) (Con):

The last time I introduced a debate on the 20-week limit was during the parliamentary stages of the Human Fertilisation and Embryology Act 2008, but my amendment was defeated. At that time, it had been 18 years since the upper limit had been debated and voted on.

Abortion law is made in Parliament, and there should be no taboo on discussing it in Parliament. Abortion law should be debated and reformed here, yet each and every time I have raised an abortion issue in the House, one MP after another has risen to comment that this is not really the place to discuss abortion and that the Bill I seek to amend should not be hijacked by discussing abortion. There are many MPs, and I think I may include the hon. Member for Hackney North and Stoke Newington (Ms Abbott), who would quite like the Abortion Act 1967 to be put into a dark cupboard and left there, never again to be brought out and discussed. If we are not to discuss abortion in this House, I am not sure who is supposed to make up the laws as they go along.

MPs are, of course, perfectly entitled to complain about other MPs efforts to shoehorn the personal hobby-horses into what is, otherwise, largely unrelated piece of legislation. Parliamentary time is limited and debates on fractious issues, such as abortion, can serve as a distraction from what others see as much more important issues, issues that deserve the fullest possible scrutiny.

It goes without saying that no one in parliament is making things up as they go along, apart from Nadine Dorries, the provision of abortion services and the legal terms under which it is made available are fully covered by primary and secondary legislation and by a licensing regime administered by the Department of Health. Parliament is not obliged, in any sense, to debate or amend any of these things just because a back bench MP has a bug up her ass about abortion; that’s what Private Members’ and 10-minute rule Bills are for and MPs are, of course, free to blow those out of the water too if they consider the proposals in them to be lacking in merit.

No one is trying to stifle parliamentary debate here other than in the sense that I suspect many MPs would like Nadine Dorries to shut up and stop making an embarrassing spectacle of herself as her attention-seeking antics and the abject dishonesty of her arguments reflect badly on both her party and on MPs generally.

Put simply, if Nadine Dorries were to become a professional wrestler or boxer, she’d enter the ring to the sound of Madness’s ‘Embarrassment’ echoing around the arena.

As it stands, the 1967 Act is a joke. Everyone knows that in this country abortion is obtained on demand by whoever wants it, whenever they want it. I am pro-choice, and I believe that, up until 12 weeks, that should be the case. I am delighted that more than 90% of abortions in this country take place before 12 weeks. But Parliament’s reluctance and nervousness about reforming abortion law, or even discussing it, creates an atmosphere of disrespect for Parliament among abortion providers.

Dorries is right, in a sense. The 1967 Act is no woefully out of date and out of step with actually happens out in the real world where women make real choices about whether or not to terminate an unwanted pregnancy. Where she is wrong, of course, is in her suggestion that the correct response to this situation would be for Parliament to seek to unilaterally impose its will on these women – not that it has the will to do that, anyway – rather than reform the current law to bring in into line with current practice. If there is disrespect for Parliament it is only because compromises were made in order get the 1967 Act through Parliament that are now widely considered to have outlived their usefulness, provisions such as the ‘two doctor rule’ that could be dispensed with entirely were it not for the trenchant opposition of an unrepresentative rump MP who would much prefer to drag the country back in time to the position that existed before the 1967 Act became law.

As for her claim to be ‘pro-choice’ and fully supportive of abortion ‘on demand’ up to 12 weeks gestation, I would like to introduce the following screenshot into evidence as Exhibit A.

Still, we should look on the bright side here. Dorries did manage to get three paragraphs into her speech without resorting to outright bullshit, which is an improvement on her usual modus operandi.

Due to the fact that the 1967 Act is so little discussed and its format is so archaic, over the past year we have seen a number of abortion providers flout the law. One of the reasons for that is that Parliament itself shows no respect for the law. In the past year, abortion clinics have been exposed using the law creatively to offer abortion illegally and criminally based on the gender of the pregnancy. In fact, the Care Quality Commission and the General Medical Council are now investigating, I believe, 14 cases of malpractice, and arrests have been made at other clinics. The Calthorpe clinic in Birmingham has been closed down and handed over to another provider.

Those cases point to an erosion of respect for the law by abortion providers. The culture of fear in Parliament, which is held by many MPs, on discussing abortion law has contributed, or may have contributed, to the situation. That has to stop.

That would be 14 cases of misconduct out of around 180,000-190,000 abortions performed annually in England and Wales, which is hardly evidence of widespread disrespect for either the law or Parliament.

Mr Nigel Dodds (Belfast North) (DUP):

I admire the hon. Lady’s courage and perseverance in bringing these issues to the House.

A Marie Stopes clinic has recently opened in Northern Ireland, a province where the law is very strict on abortion and where there is no support for the extension of the 1967 Act. Does the hon. Lady share my concern that the opening of the clinic may be an attempt to stretch the law, or even to get behind it?

Nadine Dorries:

I am afraid that I have to disappoint the right hon. Gentleman—I discussed this with one of his colleagues yesterday—because I believe the law on abortion should be equal in all parts of the Union. Abortion law needs to be reformed in the UK, and there needs to be parity across the board. If any abortion provider is to come to Northern Ireland, Marie Stopes is probably the best bet. Marie Stopes is one of the most professional and non-advocacy-driven abortion providers. It has no political ideology and is concerned only for the health of the woman, and it operates in a professional manner. So I think that, if Northern Ireland is to have an abortion provider, Marie Stopes are the people to have. The law here needs to be reformed, and there needs to be parity on both sides of the water.

My, hasn’t she changed her tune?

Marie Stopes International is now ‘professional’ and ‘non-advocacy-driven’ when, only a short while ago is was part of an evil ‘abortion industry’ that propelled women into having abortions purely to inflate their income hence the need to strip MSI of any involvement in the provision of pre-abortion counselling services – although admittedly she did reserve most of ire and outright fabrications for the British Pregnancy Advisory Service.

Has she finally seen the light?

Probably not – if you’ve followed her antics over the last five years, as I have, then you’ll know perfectly well that she has a long and inglorious of saying anything if she thinks it will rook the public into thinking that she’s being reasonable and adopting a ‘moderate’ position on abortion when, in reality, she’s doing nothing more than pursuing a classic wedge strategy in a calculated effort to chip away at the current law in the hope of building momentum for a future push for even more restrictions.

Time, I think for Exhibit B, Dorries’ response, on Twitter, to a direct question from Cath Elliott about her position on the current upper limit…

And Exhibit C, the Public Whip’s record of votes cast in the House of Commons on 20 May 2008 on an amendment that would, had it passed, have cut the current upper limit to just 12 weeks. This, of course, shows that Nadine Dorries voted in favour of this amendment and is should that what she was voting for was not a 12 week ‘on demand’ limit with a higher secondary limit carried out on medical or other grounds, which is what you’ll find across much of Europe, but a 12 week limit on all abortions except those carried out where the mother’s life is put at serious risk by the pregnancy or where there is a significant risk of serious foetal disability.

This year alone, three abortion clinics have been closed down. This is my last point: we must bring abortion law before the House because it needs to be reformed.

And why have these clinics closed, exactly?

One of them would, I presume, be the Calthorpe Clinic, which appears to have lost its contract in the wake of the Telegraph’s sex-selective abortion sting. As for the other two, without knowing why they closed it’s impossible to say whether or not the reasons for their closure have any relevance to Dorries’s already desperately weak argument for ‘reform’.

Following today’s debate, I have already applied to the Backbench Business Committee for a longer, dividable debate to be held next May. I am using today’s debate to give notice of that future debate. I want to give pro-choice and pro-life supporters ample time to prepare, to gather their research and to set their stall ready for a debate next May.

Ah yes, that would be time to introduce Exhibit D, Nadine Dorries’s somewhat unique take on epistemology and the nature of science.

At the foot of this report there are links to others and there are plenty more where they came from. But it’s all about science. Which is about the definition of fact. Which facts are indisputable and which are not. There are as many ‘facts’ as you wish to choose from on both sides of the argument.

I have chosen the ‘fact’ I wish to believe. It’s up to those who don’t believe a foetus in the womb can feel pain to test their facts and prove that it can’t and that is the issue, it cannot be proven. Science is about testing until the facts are indisputable and absolute. There is enough evidence to suggest a baby could feel pain, pretty compelling actually, for me to be of the opinion that if there is any element of doubt, shouldn’t the decision whether or not to abort at 20 weeks be a value based decision? If the scientific evidence either way cannot be proven 100% we have to ask what kind of society are we?

The obvious retort to this ‘argument’, if it can be called that, is the aphorism that everyone is entitled to their own opinion but not to their own facts. I’ll get tot he evidence relating to foetal ‘pain’ in due course but for now it’s worth reflecting on the fact that it’s nigh on impossible to have a rational debate with someone who judge the validity of scientific evidence solely on the basis of whether or not it coincides with her own, pre-existing, beliefs and prejudices.

Mark Field (Cities of London and Westminster) (Con):

I join other Members in praising my hon. Friend for bringing forward this issue.

Is not one of the problems that—my hon. Friend alluded to this when she talked about pro-life and pro-choice Members of Parliament—this whole debate has become so unbelievably polarised? Many of us Members of Parliament see both sides of the argument and feel that our voice is often squeezed from the debate. It is particularly important that the voices of the vast number of legislators who, as she rightly says, should have a say on this matter are allowed to be heard, rather than the entire debate being polarised in the way that she describes.

Nadine Dorries:

My hon. Friend is absolutely right. It is the almost ghettoisation of pro-life and pro-choice that has over the years prevented rational and reasonable discussion of abortion.

This is classic wedge strategy stuff, framing the debate in order to create the false impression that you’re taking a moderate, compromise, position in a debate that’s polarised between two extremes when, in reality, the position you’re taking up is itself an extreme one.

To be absolutely clear on this point, the extreme positions in this debate are those which either propose a total or near total prohibition on abortion (in opinion polls this view has the support of about 10% of the UK’s adult population) or which see the right to terminate a pregnancy as being one that women should be permitted to exercise, without restriction, at any time prior to the actual birth of the child, and polling suggest that only around 4-5% of the UK population would support this view. The 12 week limit amendment that Dorries’ voted for in 2008 would, had it been accepted by Parliament, have left the UK with one of most restrictive abortion laws in Europe after Poland and the Irish Republic, both of which prohibit abortion in all but the most extreme circumstances.

I am attacked by both pro-life and pro-choice, because I support abortion up to a certain point but I want independent counselling to be provided to women who seek abortion and I would like the upper limit to be reduced. So I fall foul of both camps. It is important that MPs such as my hon. Friend come forward—he has views that encompass both sides of the argument—as they can be more rational in their presentation.

The only attacks on Dorries’s position to come from the so-called ‘pro-life’ side of the debate have come from Roman Catholic commentators and the Society for the Protection of the Unborn Child, both of which take the uncompromising view that abortion should be prohibited in any circumstances. She has not, however, been attacked by what, I suppose, could be considered to the be the ‘mainstream’ anti-abortion lobby, which include organisations such as Life, Christian Concern, the Christian Medical Fellowship. CARE (Christian Action Research and Education) amongst others, organisation which came together in around 2005 to form the now defunct ‘Alive and Kicking’ campaign and which, crucially, agreed to adopt a wedge strategy-based approach of seeking incremental changes to the current law in an effort to sway public opinion and build momentum toward the real objective, total prohibition.

Some may be inclined to view that as an argument that borders on a conspiracy theory, which means its time to introduce exhibit E, a Powerpoint presentation compiled by Dr Peter Saunders of the Christian Medical Fellowship in 2007 that sets out, amongst other things, the Alive and Kicking campaign’s main [wedge] strategy. If you download then one thing I’d suggest you pay particular attention to are the slide that show Saunders marshalling arguments against abortion in on grounds of rape, foetal disability and even serious risk to a woman’s life. This particular presentation was given to members of the Lawyer’s Christian Fellowship, which, at the time, employed Andrea Minichiello Williams, one of the founders of Christian Concern, as its national policy officer. Christian Concern actually started out, under the name Christian Concern For Our Nation, as sub-project of the LCF before being floated off as independent organisation, with Minichiello Williams as CEO, in 2008 in order it prevent its political activities compromising the LCF’s charitable status.

As for the connection to Nadine Dorries, this was covered by a Channel 4 Dispatches documentary on the rise of the Christian right in the UK the relevant sections of which you can view below as Exhibit F.

[youtube]http://www.youtube.com/watch?v=E8l7eJv8pB0[/youtube]

I have applied to the Backbench Business Committee for a debate on a votable motion next May. Of course, a Back-Bench vote does not amend legislation. If the result of the vote endorses a reduction to 20 weeks, however, it will inform the Government that perhaps it is time to bring the 1967 Act back to the House on Government time.

After the forthcoming debate allocated by the Backbench Business Committee, if there is a positive vote, if the debate is strongly attended and if Parliament expresses a strong feeling, that will send a strong message to the Government to bring the 1967 Act back to the House.

We can only hope that the Backbench Business Committee has more pressing matters in mind for next May.

In 1990, the 1967 Act was amended to reduce the upper limit from 28 weeks to 24 weeks. I hope there will be a fuller debate in May, but in the meantime, following today’s debate, I will write to the Royal College of Obstetricians and Gynaecologists guideline committee, enclosing a copy of the Hansard of our speeches today, and ask it to look again. 1990 was a long time ago. As my hon. Friend the Member for Tiverton and Honiton (Neil Parish) said, things have progressed and science has moved on.

If the RCOG guidelines committee advised, based on the evidence available at the time, that the upper limit should be 24 weeks—

As Kate Green will point out, in a moment, RCOG’s most recent guidelines were published in 2010 after it conducted a through review at the behest of the Commons Science and Technology Committee of Dorries was briefly a member back in 2007- I say briefly because she inveigled her way on to the Committee only after it announced its intention to review the scientific evidence relating abortion, attended a couple of meeting and then published a ‘minority report’, which was I strongly suspect was actually drafted by Minichiello Williams and others associated with the Alive and Kicking campaign, which tried to contradict the committee’s findings. After that, Dorries lost interest in the committee and no showed any further meetings.

Kate Green (Stretford and Urmston) (Lab):

Will the hon. Lady give way?

Nadine Dorries:

I will give way only once more, as lots of people want to speak.

Kate Green:

The hon. Lady implies—perhaps I misinterpret her—that the RCOG has not considered the guidelines since 1990. In fact, its most recent report was published in 2010, and it still says that foetal viability is very low up to 24 weeks. In fact, at 20 weeks it is 0%.

Nadine Dorries:

I will address that point in a moment. I will not give way any more, as I know that lots of people want to speak.

Dorries will, indeed, address the issue of foetal viability at and around the current 24 week limit, but what she doesn’t bother to address, at all, is her attempt to misrepresent the position vis-a-vis RCOG’s most recent review of its guidelines.

I want to make it clear that my proposal to reduce the upper limit does not include babies with foetal abnormalities or, sadly, disabilities. That is a discussion to be held, as I have said, between parents and doctors. Abortion is available up until birth for foetal abnormalities. My proposal applies to abortions for social reasons.

A study by the Centre for Sexual Health Research at the university of Southampton and the School of Social Policy, Sociology and Social Research at the university of Kent found that 41% of women who have second-trimester abortions do so because they were not sure about having an abortion and took a while to make up their mind to ask for one. I believe that one positive effect of reducing the limit to 20 weeks might be to focus the mind slightly sooner than 23 weeks. Because abortion is available until 24 weeks, there is a laxity, as people have a prolonged period to make up their mind. The research says that women took a long time to make up their mind. Maybe reducing the upper limit will help.

This is just a thoroughly unpleasant, contemptible and hypocritical line of argument.

Remember Dorries was, only very recently, arguing for supposedly independent pre-abortion counselling in order to prevent women being propelled in making a hasty decision about whether or not to terminate a pregnancy and now she’s suggesting that it might be beneficial to change the law to force those women who struggle most with that decision to hurry up and make their minds up.

It’s also a view that runs contrary to the clinical evidence on induced abortion and mental health which, although it shows, overall, no difference in the risks associated with terminating an unwanted pregnancy when compared to the risk of carrying an unwanted pregnancy to term, also shows that a small sub-group of women who have abortions in circumstances in which they are deeply ambivalent or uncertain about their decision do exhibit a much higher risk of experiencing significant levels of distress after having an abortion and of developing subsequent mental health problems as a result.

It is clear to me that we cannot allow the present situation in our hospitals to continue. In one room in a hospital, there might be a premature poorly baby born at 22 or 23 weeks at whom the NHS will throw everything it has to help it survive. In another room in the same hospital, a healthy baby will be aborted at 24 weeks. Dr Max Pemberton recently wrote in The Daily Telegraph that

“many doctors are uncomfortable with the current cut-off point. It is not something we openly discuss, because we know it is a highly emotive area. But privately, many doctors will express discomfort that the current legislation is inherently illogical and inconsistent. Any doctor who has found themselves in the neonatal intensive care unit of a hospital will be acutely aware of it. In the same hospital where doctors are trying to save a premature baby born at, say, 23 weeks, a woman down the corridor is legally allowed to undergo a late-stage abortion on a foetus of the same gestation. So on the one hand we throw considerable money and resources to try to save a baby’s life, while on the other we sanction its destruction.”

I have consistently made that argument for the past seven years. The medical profession cannot make two arguments. Doctors cannot say that a poorly baby’s life is worth trying to save from 20 or 21 weeks onwards while stating at the same time that there is no chance of life up to 24 weeks, so it is okay to abort up until that point. There is an inconsistency in retaining 24 weeks. Should there be a case to say that doctors should not try to save the life of a poorly baby born before 24 weeks’ gestation? Can hon. Members imagine the uproar if we said, “Okay, the RCOG has said that viability is 24 weeks, so we really shouldn’t be saving premature babies before 24 weeks”? We should say, “No, the point of viability is 24 weeks, so we should stop. Wipe out the neonatal units, wipe out the premature units. Viability is not consistent before 24 weeks.”

Doctors cannot have it both ways. They cannot say in the NHS, “We try to save babies from 20 weeks because they are viable,” and then say, “We abort at 24 weeks because they are not.” The two arguments cannot stand. That is an anomaly, and it must end.

Foetal viability is not a consistent argument from start to finish, nor it one that Dorries appears to understand in anything but the most superficial terms, not least because disregards, entirely the question of parental choice.

It is not doctors, alone, who decide whether or not to pull out all the stops and make every effort possible to save the life of a extremely premature neonate. Ultimately, the decision on how far to go in seeking to resuscitate and treat an extremely pre-term infant rests with the child’s parent(s). Some may decide to instruct medical staff to throw the kitchen sink at trying to save the life of their newborn child, and some may look at the poor odds of survival and the high risk of serious disability and choose, instead, to sign an ‘do not resuscitate order’ and doctors are ethically bound to act in accordance with the parent’s (or parents’) instructions. To do otherwise, and particularly to ignore a DNR order is to risk disciplinary action for a serious breach of ethics and, if the neonate does survive but has a serious disability, a malpractice lawsuit and a claim for compensation against their employer that could run to millions of pounds to cover the cost of long-term care for the child.

The proposition that we should treat the argument from viability as simple simple binary question with a fixed cut-off point is nothing more than the product of asinine stupidity, which accounts for the fact that Dorries is about to get her arse handed to her on plate by Dr Sarah Wollaston.

Dr Sarah Wollaston (Totnes) (Con):

Will the hon. Lady give way?

Nadine Dorries:

No. I have said that I will not give way any more. I must crack on, because lots of people want to speak.

Some people ask whether medical science in the area has moved on. Is there a difference between the science in 2008, when we had the vote, and the science today? The answer is that viability can never be proven. Until healthy women agree to allow healthy babies to be aborted at 20 weeks and we then try to save them, we can never actually know what viability is.

Dr Wollaston:

Will the hon. Lady give way on that point?

Nadine Dorries:

I will give way, but this is the last time.

Dr Wollaston:

I thank the hon. Lady for giving way. On that point, we are not trying to save babies at 20 weeks. No babies survive at 20 weeks’ gestation. If she refers back to the British Medical Journal paper considering two periods of survival, the increase in survival of pre-term babies after the 2000 period was due entirely to babies born at 24 and 25 weeks. The absolute limit of survival is about 22 weeks; that is when we try to save them. Will she please stop suggesting that the NHS is capable of saving babies at 20 weeks? It is simply not true.

Nadine Dorries:

Maybe the NHS should stop trying to save babies from 20 weeks. My neighbour 10 years ago was a 22-week survivor. Although she had slight problems, they did not prevent her from going to school and living a full and wonderful life. Babies do survive from 22 weeks, which is my argument for viability. If the RCOG wants to say that viability is at 24 weeks, it must look at the living babies born at 22 weeks and say, “That’s wrong.”

Well, this is a new one even for me.

In the five years I’ve been following and writing about Dorries’s antics this the first occasion on which, to the best of my knowledge, she’s pulled out this particular ‘anecdote’ about her former neighbour who was supposedly a 22-week survivor. I say ‘supposedly’ here because Dorries has something of the chequered history when it comes to using personal anecdotes.

Last time she took a run at the upper limit her stock anecdote was an ‘I saw an botched late-term abortion back when I was nurse’ story the details of which changed with every retelling, leading many – including myself – to suspect that she was flat out bullshitting, not least because the botched abortion story has long been a staple of anti-abortion campaign literature – the earliest example I manage to trace dated back to 1975 – and yet this story is always related second-hand and without any kind of supporting evidence or identifiable eye-witness. In essence this is a classic ‘my mate down the pub heard from his sister’s boyfriend’s cousin that…’ tales, so after thirty years of unverified, unevidenced claims, the chances of an actual eyewitness turning up was pretty remote, let alone one that a;so just happened to a Member of Parliament who was trying to introduce legislation to restrict access to abortion.

Suffice to say that past experience and the fact that Dorries appear to have suddenly found herself a new personal anecdote that she has never previous mentioned or even alluded to in the five years of her wibbling on abortion does leave one with significant questions about the veracity of the story, not least because she is ordinarily incapable of engaging in anything other than an argument by anecdote without some else having given her a preprepared script to work with in advance.

Oh, I should also note that Dorries’s “can’t prove viability” argument is of much the same character as the argument on foetal pain that she put forward when asserting that she chooses the fact she wishes to believe and is, therefore, another example of her unique line of epistemological thinking.

The only measure of viability that we have is the premature poorly baby—the baby who arrives early for a reason. Doctors must fight to deal with two complicated situations: whatever made the baby arrive prematurely, and the fact that it has arrived prematurely, which involves lung function and other things. I am afraid that a healthy aborted baby and a premature poorly baby cannot be compared, particularly not at 23 weeks.

I have been asked in numerous interviews, and only this week by Victoria Derbyshire during the filming of a “Panorama” programme, “How do you know that aborted babies are healthy babies?” For the record, between 96 and 97 out of every 100 babies are born healthy. The viability argument needs to be discussed in the context of what we do in our neonatal and premature baby units, and what we do in terms of abortion. The two must be compared.

Oh noes, not the ‘poorly baby’ argument again.

The causes of premature birth are, sadly, still poorly understood to the extent that in 50% of cases no exact cause is ever determined.  In some cause an problem is found with the foetus, which could be a developmental problem or the result of foetal infection. In many cases it isn’t and the foetus is found to have been perfectly health up until the point at which the mother unfortunately went into labour. The birth, itself, can be traumatic, which is why around 20% of neonates born at 23 weeks gestation dies during labour, but many of those that survive the birth are ‘poorly’ and die before ever being admitted to a neonatal ICU for the simple reason that they’re body is simply too immature to enable the neonate to survive outside the womb and, of particular importance in this is the development and maturation of the lungs. If the neonate’s lung cannot supply its body with the oxygen its need to survive and continue its develop, it dies and were it not for the invasive medical treatment provided by neonatal ICU’s the mortality rate for neonates born at 22 and 23 weeks gestation would be 100% and not between 90% (23 weeks) and 99% (22 weeks).

Dorries’s ‘poorly baby’ argument is complete and utterly and, somewhat curiously, also not an argument that one commonly finds in anti-abortion literature which rather suggest that it may be largely the product of her own ignorance and faulty reasoning.

I want to discuss sentience, because it is an argument for life. We know that a baby can feel pain in the womb before 20 weeks. If a woman’s stomach is poked post-20 weeks or earlier, it can wake up the baby. Thanks to Professor Stuart Campbell’s amazing and pioneering work with 3D imaging, we can see how a baby in the womb responds to stimuli, and thanks to the work of Professor Sunny Anand, we know exactly how a foetus responds, due to how it reacts to anaesthetic during in-utero operations.

Stuart Campbell’s 3D ultrasound images may be visually compelling but they no more tell us anything about foetal sentience than the fact that a human foetus is covered from head to foot with a fine layer layer of fur (the lanugo)  right up until around 33 weeks gestation tell us that the mother will eventually give birth to Donkey Kong Jr.

I’ve tackled the foetal pain/sentience argument on several occasions of which this article best covers the evidence base while, at the same time, explaining why things like Campbell’s 3D images and Martin Ward Platt’s personal observations from his work as a neonatologist fail to provide reliable evidence of foetal sentience before 24-26 weeks gestation. Dorries’ continued insistence on throwing Campbell’s images into the debate is, of course, entirely consistent with her behaviour during the infamous ‘hand of hope’ incident, which serves as a classic example of a picture painting a thousand words – all of the wrong.

While a research fellow at Oxford, Dr Anand became aware that many premature and early gestation babies died during in-utero operations due to shock induced by pain during the procedure. General thinking at the time, in the 1980s, was that no baby could experience pain before birth—that until birth, a baby was not sentient. In his pioneering work, Dr Anand developed anaesthesia to be delivered to foetuses. Thanks to that work, introduced at the John Radcliffe hospital, anaesthetising babies during in-utero operations is now standard procedure, and babies now live.

Dr Anand went on to continue his work and research in America. When I sat on the Science and Technology Committee, we considered abortion, and one of the members of that Committee—Evan Harris, the former Member for Oxford West and Abingdon, who lost his seat at the last election—described Professor Anand as a little doctor from Little Rock. Dr Anand did much of his further research in America, first at the university of Arkansas and now as the St Jude chair for critical care medicine and professor of paediatrics, anaesthesiology and neurobiology at the university of Tennessee health centre in Memphis.

Again, I’ve dealt with Anand’s work in detail in this article so I won’t repeat the arguments here, not least because its an extremely complex issue. However what is clear is that Anand’s work has not delivered evidence that foetuses are capable of ‘feeling’ or ‘experiencing’ pain because the neurological connections and structure necessary for ‘feeling’ and ‘experiencing’ do not begin to develop until around 26 weeks gestation.

Anand’s response when pressed on the issue of the absence of relevant neurological connections is perhaps indicative of the wholly speculative nature of his position on foetal pain – he accepts that these connections are not present before 26 weeks gestation but then goes to suggest that its possible that foetuses might experience pain by some some other route/mechanism, even though, last time I checked, he had no idea what this other route/mechanism might be let alone any evidence for its existence.

None of this has, of course, preventing Anand from working as a paid ‘expert witness’ in lawsuits in the United States testing the constitutionality of legislation which aims to circumvent the US Supreme Court’s ruling in Roe vs Wade by justify restrictions on access to abortion using foetal pain as a supporting argument, which, of course, demonstrates clearly that Dorries’ entire argument here is one that has been imported wholesale from the United States’ Christian right-dominated anti-abortion lobby.

My only point in relation to Evan Harris’s comments about Professor Anand is that Dr Anand is a gentle, polite academic who is well renowned and respected and has a successful career. To describe such a man as a little man from Little Rock, and to have binned and not considered the evidence on abortion that he presented to the Science and Technology Committee, was a travesty. I complained about it to the Clerks at the time, and I will continue to complain about it, as it tainted the report. If a foetus can feel pain stimuli, it is a sentient being. Anyone who feels, is. They exist. If one feels, one is a human being.

Again, the claim that Evan Harris referred to Dr Anand as ‘a little man from Little Rock’ is a another brand new anecdote and necessarily needs to be taken with a large pinch of salt unless Evan is willing to confirm that he did indeed refer to Anand in those terms.

However when it comes to the claim the evidence that Anand ‘presented’ to the SciTEch committee was ‘binned’ and ‘not considered’ this is demonstrably a complete and utter falsehood as is shown by the SciTech report itself:

49. We received written submissions on this matter from Dr Stuart Derbyshire. Professor Maria Fitzgerald, who appeared as an oral witness, is a recognised expert in neuro-developmental biology and has been successful in a number of grant applications to the MRC in this area.[52] Although we did not receive evidence from Professor Sunny Anand, nor did any of those originally submitting evidence refer to his work or publications, we did consider a review article co-authored by him which was published recently,[53] together with submission from Dr Stuart Derbyshire which offers commentary upon it and refers to Dr Anand’s earlier work in this area.[54] We note that the main thrust of his important previous work has been to show neonates have better outcomes when provided with anaesthesia and analgesia during surgery and other stressful procedures and that noxious stimuli during gestation can have a detrimental impact on the long-term development of an infant; we have been unable to see the direct relevance of this work to the question of abortion.

Anand’s evidence wasn’t binned because he didn’t submit any evidence to the committee in the first place and yet the committee still made an effort to consider his work in the review and it’s therefore unsurprising that even the most polite and respectful blogger I can think of – Richard Bartholomew – has come to refer to Dorries’ evident disregard for the truth as being ‘perhaps sociopathic’.

I move to the feminist argument. As the mother of three young adult daughters, I am a strong believer in a woman’s right to choose. Never, ever would I want to see a return to the bad old days of backstreet abortionists, or restricted access to early abortion. Do I champion this issue from the perspective of religion? No, I do not. I do not come to this from a religious perspective. I champion this from the perspective of compassion, humanity and civility. I believe in the right to choose, but, provocatively, I would like to throw this in: what about the female baby, post-20 weeks? I often hear the argument, “It is a woman’s right to choose.” What about healthy female babies who are aborted at 24 weeks?

I’ll pass on Dorries’s ‘what about the female babies’ argument save for echoing Patrick Strudwick’s comments on Twitter in which he correctly suggest that anyone who cannot comprehend the difference between and adult (woman) and a foetus has pretty much forfeited any right to be taken seriously in this debate.

Here one might wish to contrast Dorries’ assertion that she doesn’t ‘champion this issue from the perspective of religion’ with an interview she gave to the Salvation Army’s ‘War Cry’ newspaper back in 2007.

My faith tells me who I am. It tells me why I am here. It tells me who is with me while I am pursuing my goals. I sometimes think if I didn’t have my faith, who would I be? How would I live my life?

My faith constantly gives me my reference point. It keeps me grounded. I am not an MP for any reason other than because God wants me to be. There is nothing I did that got me here; it is what God did. There is nothing amazing or special about me, I am just a conduit for God to use.

Or the fact that her original 20 weeks campaign website was set up and run by staff from the Christian Institute and then, of course, there’s the video I posted earlier of Dorries working closely with Andrea Minichiello Williams and the fact that she gets all her arguments on abortion from anti-abortion organisations that are run by the Christian right and has been, and continues to pursue, the same strategy of seeking incremental changes in abortion law that’s laid out in Perter Saunders’ Powerpoint presentation.

But no, she not coming at this debate from a religious perspective… oh no.

Time for a reality check. Religious arguments for legislative restrictions on abortion don’t fly, either in the US, where the legality of abortion was established by the Supreme Court in Roe vs Wade placing religious arguments beyond the pale of the First Amendment’s establishment clause, or in the UK where religious arguments are most closely associated, in the eyes of the public, with public figures and campaign organisations who with to turn back to the clock on abortion to the position that existed before the 1967 Act, a view the commands the support of only around 9-10% of the general public while being widely mistrusted by a majority of adults.

That is why Dorries makes such a performance of claiming that she’s not operating from a religious perspective although, in truth, it doesn’t really matter whether Dorries’s antics are motivated by her religious beliefs or by the pick’n’mix counter of fallacies, misrepresentations and fabrications she advances as ‘arguments’ for a change in abortion law; the agenda she’s been pursing for the last five year is demonstrably linked to, and derived from, the contents of Peter Saunders’ presentation and the wedge strategy that its sets on behalf of the-then Alive and Kicking campaign, and agenda that is unequivocally religious in its origins, motives and in it’s core principles.

I champion this issue because I believe passionately in the reduction of the upper limit. When I visit pregnancy crisis centres, I hear women who are undergoing counselling. Some actually say, “I would have preferred an option other than ending my baby’s life.” Well, there are other options. That is one of the reasons why I tabled the counselling amendment—there are always other options.

And without realising what she said, she said it all. The term ‘crisis pregnancy centres’ is primarily, if not exclusively, associated with services operated by anti-abortion organisations, a sector where the quality and accuracy of information and adherence to ethical standards is, to say the least, rather variable. This is brings into play yet another exhibit – although I forgotten what letter we’re on – this being Dorries risible attempt to present a Taunton-based organisation called ‘Forsaken’ as being ‘neither pro life or pro-choice’ and which point I’ll call Richard Bartholomew as an expert witness:

Having seen the book, there is no way that it can be described as ”neither pro-life nor pro-choice” – it is blatantly anti-abortion, with two very obvious aims: (a) to make women contemplating abortion feel that they shouldn’t do it; and (b) to persuade women who have had abortions to convert to Christianity. The stories abound with sentences such as “As I prayed, I felt a weight lifted from me”… “I had a new calling in my life – God”… “My son is in the arms of God”… “God has forgiven me, that’s his promise to us all”… “Tears of joy rolled down my cheeks as I realised that they forgave me and so did Jesus”. Interspersed are poems, including one in which a fetus remarks on how the womb is “so wonderfully designed by my Creator”. There’s also a lengthy New Testament quote, from 1 Timothy 1:12-17:

I thank Christ Jesus our Lord, who has given me strength, that he considered me trustworthy, appointing me to his service. Even though I was once a blasphemer and a persecutor and a violent (wo) man, I was shown mercy because I acted in ignorance and unbelief. The grace of our Lord was poured out on me abundantly, along with the faith and love that are in Christ Jesus. Here is a trustworthy saying that deserves full acceptance: Christ Jesus came into the world to save sinners—of whom I am the worst. But for that very reason I was shown mercy so that in me, the worst of sinners, Christ Jesus might display his immense patience as an example for those who would believe in him and receive eternal life. Now to the King eternal, immortal, invisible, the only God, be honor and glory for ever and ever. Amen.

Not the least bit religious then, eh?

I would like to talk about the truth about abortion. It is not just articulate, clever women who abort; vulnerable women are coerced. They are the women who are seen by pregnancy crisis centres. Not every woman who has a late-term abortion for social reasons actually wants one. I was staggered to hear what one MP who came up to me the other day said. Her actual words were, “Every woman who wants an abortion knows exactly what she is doing.” Well, in her rather slick, well-educated Oxbridge world and her leafy shires I am sure they do, but what about the young Asian girl who was recently marched into a clinic in floods of tears by two family members? No one knew her age, but she was marched in by two family members for an abortion. Is that a one-off story? No. Speaking to abortion providers, that happens on a regular basis.

What about the young women who have waited to have their abortion because they did not want to have it, and who then found themselves being coerced by partners or others? One woman at a pregnancy crisis centre that I went to aborted at 24 weeks because she had been told by her partner and other family members that it would be beaten out of her if she did not. Not every women makes the decision because she went to university and marched up and down streets in Oxford and chanted about women’s rights. Lots of women are actually incredibly vulnerable. It seems to me as though many of the women who make the feminist “women’s right to choose” argument have no regard whatever for those women. In pushing one particular mantra and ideology, no consideration is taken of those women at all.

And now we’re back to ‘proof by anecdote’. Yes, some women are more vulnerable than others and yes, some woman do face pressure, if not outright coercion, from partners and family members but research from the United States shows that vast majority of women base their decisions primarily on issues such their financial situation, the impact that a pregnancy would have on their education or employment situation/prospects, the stability or otherwise of their relationship and the support their partner is willing offer (or not, as the case may be) in addition to just not feeling ready to have a baby or, for older women, having already reached the decision that they didn’t want any more children.

Although 14% of women indicated that their husband or partner wanting them to have an abortion was a factor in their decision, with 6% citing the wishes of their parents (Table 2) when women were asked to identify the most important factor that influenced their decision (Table 3) the numbers citing the wishes of their husband,/partner or parents in extremely low – less than 0.5% in both cases – which suggest that instances of women being pressured, threatened and coerced into having an abortion are, similarly, uncommon.

THe low incidence of these issues doesn’t that they can be safely ignored – and they aren’t. Last year’s NCCMH/RCPsych review of the evidence on the relationship between induce abortion and mental health includes a clear recommendation that women who exhibit clear sings of ambivalence or uncertainty when seeking an abortion should be offered a counselling referral, a recommendation that RCOG has pre-emptively incorporated into its own guidelines well in advance of the publication of the review. Where women complain of coercion and threats, or there is other evidence to suggest that this may be happening, they can be, and are, offered appropriate information and a referral to an appropriate source of support in either the domestic violence or child protection sector, depending on the exact circumstances in which these issues come to light.

There are, of course, limits to how far abortion service providers can go in seeking protect women who are genuinely vulnerable as the women, themselves, are free to refuse any and all offers of additional support, but contrary to the impression that Dorries is seeking to create here, those support structures and system do exist and they are used wherever possible, hence Dorries inability to produce any concrete evidence in support of her efforts to change the current system of pre-abortion counselling and information provision save for the usual clutch of largely unverified and dubiously sourced anecdotes.

The plural of anecdote is, yet again, absolutely not evidence.

It is assumed, and I am told, that it is a woman’s right to choose, and that by wanting to limit from 24 weeks and by wanting to introduce counselling, what I am trying to do is limit a woman’s right to choose. Well, let me inform everybody that a woman’s right to choose is limited because the upper limit is at 24 weeks. To say that a woman’s right to choose is being limited is nonsense—it is already limited. It is limited because at 24 weeks it is felt that a baby is viable. I argue this: a baby’s life is viable before 24 weeks, so it is time to reduce the limit, because this is 2012, not 1990. I hope we live in a society that is civilised and compassionate, and which cares for vulnerable women who do not want to have abortions and are forced to do so. I hope that we would give as much consideration to those women as we do to the Oxbridge-educated, articulate women who change their job and want to have an abortion.

Yes we already know that the current law limits women’s right to choose to end of the 23rd week of gestation. The argument here isn’t that Dorries isn’t seeking to impose limits on a currently unfettered right but that she is trying to place more stringent limits on access to abortion than can reasonably be justified by the best available scientific and clinical evidence and, indeed, by any moral arguments that are reasonably informed by that evidence.

Some of the women who end up at pregnancy crisis centres do so because they are scarred and need counselling, which is not available to them, because they aborted at a very late stage. Those women are more likely to suffer mental health consequences than those who abort at an early stage. If we do not go for the viability argument; if we do not look at sentience and all the other arguments I have made; if we just decide to disregard the fact that in one hospital, there might be two babies, one being aborted at 23 weeks and another having her life saved at 20; if we choose to ignore all that, let us just decide that we should be a little more considerate to the women who find themselves forced into a situation in which they have a late-term abortion.

Unfortunately, for Dorries, there is no credible evidence to support a trauma-based linkage between induced abortion and mental health or for increased risk of mental health problems associated with late-term abortions and the evidence that does exist comes primarily from discredited sources such as David C Reardon, who likens women who choose to have abortion to the Jewish Kapos who worked as barracks supervisors in the Nazi death camps of WWII – and Priscilla Coleman who, only very recently, was busted for what many, myself included, would consider to be research misconduct.

I hope that the Backbench Business Committee grants the next debate on this issue next May. I hope that there will be a vote. I hope that, by then, enough information will have been put before hon. Members for them to decide that what they want to do is what the public want to do. I finish on this note: I am overwhelmed by the amount of support that I have received from members of the public in wanting to reduce the limit. The more this is debated, as it should be, the more public opinion will become informed, and the more MPs will realise that what they need to do in this place is carry out the will of their constituents, not follow their own political ideology.

That brings us to the end of Dorries’ set piece speech but not quite to the end of this article as one cannot leave this debate behind without reflecting on the appearance, towards the end of the debate, of the recently appointed Health Minister Anna Soubry, who quickly dropped this bombshell on a wholly unsuspecting Nadine Dorries.

Anna Soubry: Forgive me, but I want to make progress, because the clock is against me. I will give way when I have made some points. In the short time available, it is important that I make some of the main points in my speech.

It is right that abortion is a matter of conscience. It is important to respect the views of all individuals and accept that we have different views, whichever side of the political fence we sit on. My hon. Friend the Member for Southend West (Mr Amess) reminded us that certain Cabinet members have expressed their own views on the upper limit for legal abortions. They all made it clear that those are their own personally expressed views. I want to make it quite clear that, notwithstanding the fact that some Cabinet members may want a reduction in the upper limit, the Government have no plans to bring about a change to the time at which an abortion can be carried out. I want to stress that point again, so I repeat: we have no plans to review the Abortion Act 1967.

We are by no means complacent. When I was fortunate enough to be made a Minister, I made it clear that in the time I am in office I want a reduction in the number of abortions. We all want that, but there is a debate about how we best achieve it. I take the view that we best achieve it through better contraception and by empowering our young men and women to make the choices that they want to make, if they have a sexual relationship.

I want to say something on counselling that may interest my hon. Friend the Member for Mid Bedfordshire in particular. As the new Minister with responsibility for this matter, I have carefully considered how we move forward on abortion counselling. I believe that the best way forward is about contraception, how we reduce the repeat abortion rate, how we empower young men and women and how we improve abortion counselling services for women generally. A committee was formed as a result of the measures that my hon. Friend tried to introduce. There is also a cross-party inquiry into unwanted pregnancy, led by my hon. Friend the Member for Hastings and Rye (Amber Rudd). I commend that.

They will do important work and hear important evidence, but the simple reality is that we therefore no longer plan to undertake a separate consultation on abortion counselling. I am sorry if that disappoints members of the committee.

For the purposes of transparency, I will today place in the Library a short document on abortion counselling, representing the great work done by my predecessor, my hon. Friend the Member for Guildford (Anne Milton). I pay tribute to the work she did when she was Minister for Public Health, and to the cross-party committee, which looked at counselling arrangements for women requesting an abortion. I am extremely grateful for the work it did, and I thank its members for their efforts. I am sorry if there is disappointment, but we do not intend to change the law, so a separate consultation would be an otiose exercise.

Nadine Dorries: It is not a case of changing the law, but changing the Government’s commitment. The Government made an absolute commitment to consult. In fact, the British Medical Association moved a motion in agreement. Why have the Government changed their mind about the consultation on non-compulsory independent counselling?

Anna Soubry: The committee has done some good work. I do not think that it would be right to take the matter any further. I am sorry if that disappoints people, but that is my view. I can see no purpose in a consultation, because we do not intend to change either the law or the guidelines.

As the committee identified, counselling services throughout the NHS are patchy. That is not acceptable. It also decided that it is of primary importance that there are no delays when a woman seeks a termination of her pregnancy. That is why it is important that if a woman is going to have a termination, she does it as quickly as possible. The group was in unanimous agreement on that, which I welcome. There is other work to be done on counselling, but I take the view that that is not the primary issue that we should address, which is why I made the decision I did.

Et Tu Soubry – and don’t expect a Christmas card from Mid-Narnia this year.

Dorries hasn’t so much been knifed in back here as beaten about the head with a baseball bat in plain sight and told, in uncertain terms, to drop the subject of abortion entirely. Perhaps the only bright spot in all this for Dorries is that Soubry chose to deliver the government’s unequivocal message in the course of Westminster Hall debate, sparing Dorries the even greater public humiliation of a statement in the main chamber of the House but otherwise Soubry has laid the smackdown on Dorries in such a comprehensive manner that its now unlikely that she’ll get the main chamber debate she’s asked for unless Tory members on the committee are in particularly seditious mood when her request comes up for consideration.

Whether or not Dorries gets the message on this occasion is,as yet, unclear. Past experience suggest that she won’t and that the humiliation visited on her yesterday, by Soubry, will eventually be recycled into another conspiratorial tale involving George Osborne and his wife, leaving Dorries to continue to bang on abortion in a state that remains seethingly oblivious to the fact that the only thing she’s got to bring to a bazooka fight is a spud gun.

Revenge may very well be a dish best served cold, but then so is ice-cream, which is all that Dorries has in her freezer.

30 thoughts on “Dorries: The Abortion Debate Fisk

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