Sarah Catt: when we've stopped pointing the finger let's ask ourselves how much we care

Sarah Catt faces an eight year jail sentence after taking abortion medication purchased over the internet to end her pregnancy at 39 weeks. I don’t know if she had any idea that she was putting her life and her liberty at risk when she did this. There is speculation as to both her motivation and her mental state, but the only fact of the matter is that for some reason the idea of giving birth to a living baby, which she almost certainly would have done within just a couple of weeks, was intolerable to her.

Speculation about whether she is a monster or just desperately ill and unhappy will, no doubt, be rife. Arguments will rage to and fro about whether she should have received such a long sentence. Others will ask whether the current time limit for abortion is right, whether there should be time limits at all or whether our focus should be on doing everything we can to make abortion as accessible as possible, as early as possible. Some people will say that this case demonstrates an argument for taking abortion out of the sphere of criminal law altogether, others that this proves we need legal limits on abortion provision because we simply cannot trust women not to go running around choosing late term abortions.

For me this case is so unusual that I’m not sure if it can helpfully inform debates about abortion law. They say that hard cases make bad law and this is probably a case in point.

If we can draw any lessons from this it might be about the support that we can provide to those women who consistently struggle to control their fertility, to choose and use an appropriate contraceptive method, and to manage relationships. There are many reasons why women who feel negative or at least ambivalent towards pregnancy still get pregnant repeatedly including complex personal circumstances. Easy as it is to blame individual women for making bad decisions (we rarely blame their partners) we also have to ask ourselves whether sometimes repeat unintended pregnancies do highlight a shortfall in services. Did Sarah ever seek or was she ever offered any support to think about her fertility, to clarify her own feelings about pregnancy and parenthood and to make informed choices about future relationships and contraceptive use?

Did she have the emotional and practical support she needed after she placed a child for adoption? Or did that process contribute to her belief that it was better to go through the potential pain and danger of labouring alone to have a stillbirth, than to give birth safely and retain the option of placing the baby for adoption? When she was turned down for abortion after 24 weeks did anyone offer her the opportunity to think about ‘what next?’ Did anyone offer to help her talk to her husband and think through the possible consequences (good and bad) of having this conversation in terms of her safety, their relationship and the future of their family?

When a healthy woman with a healthy pregnancy seeks abortion after the legal time limit, it is likely that her circumstances and her feelings about the pregnancy are pretty desperate. For good or ill, a woman in this situation cannot have an abortion after 23 weeks and 6 days. What do we offer these women to address the circumstances they find themselves in, in which continuing the pregnancy is intolerable? Are they made aware of the dangers both medical and legal of trying to induce an abortion themselves? Is there anything we can offer to make the next 16 weeks of pregnancy tolerable, safe and manageable for them...let alone the next 20 years of parenthood?

I don’t know what kind of support is available to the handful of desperate women who are turned away from abortion because they’re just too late. Later abortion is a divisive issue, but whatever anyone feels about it, we must all feel some duty of care towards women who want one, but can’t have one.

ARC regrets DH loss of appeal over abortion statistics

Last week the Department of Health lost it's legal right to limit publication of specific data on later abortion that it believes could jeopardise the confidentiality of women and the privacy of doctors. The Department had changed the way in which they published figures for rare later abortions following the Joanna Jepson case, in order to prevent the media or anti-abortion activists identifying individual doctors who had agreed to perform late term abortions for pregnant women following a diagnosis of fetal anomaly.

While the rest of the world has an interesting theoretical debate about the merits or otherwise of transparency, some of those working on the front line are concerned about the impact of this ruling on real women and their doctors. Antenatal Results and Choices (ARC) is the only national charity which provides non-directive support and information to expectant and bereaved parents throughout and after the antenatal screening and testing process.

This statement from ARC Director, may give us all pause for thought.

We regret that the Department of Health has lost its appeal to limit the detail of annual post 24 week abortion data, which they feel is necessary in order to protect the confidentiality of those involved.

ARC is the only UK charity providing non-directive information and support to parents through antenatal testing. We offer specialised support to parents after the prenatal diagnosis of a life-threatening or severely disabling condition in their baby. We speak daily to women and their partners dealing with the shock and grief of the diagnosis and agonising over whether to continue or end a wanted pregnancy.

On our helpline we hear from desperate women and partners who have been given a late diagnosis and face the trauma of having a termination of pregnancy after twenty-four weeks. These situations are rare, but extremely distressing. Women are ending their pregnancy at a stage when they have often prepared practically and emotionally for the birth of their baby. They enter this decision knowing it is life-changing and need to feel entirely confident that their privacy and confidentiality is protected. In our experience clinicians take their legal responsibility very seriously in what are challenging circumstances for them too. They need to be able to provide sensitive care to parents without fear of retribution on a personal level from anti-abortionists.

All involved in late terminations deserve our compassion, trust and support rather than the misguided suspicion that they are engaged in some nefarious ‘pursuit of perfection’.

Jane Fisher

Director

Ante-Natal Results and Choices (ARC)