Is self-regulation appropriate when there are reports that babies struggle to breathe after abortion at 18 weeks?

A shocking study in the August edition of the British Journal of Obstetrics and Gynaecology reveals that 31 babies were born alive following abortions on babies who were 18 weeks or older, with the babies struggling to breathe and crying in two cases. 13 babies died after an hour. One baby aborted at just over 19 weeks died after nearly five hours. There are no official national figures for the number of babies born alive following abortion, but it is inevitable that the national figure is much higher since the BJOG study only covered the North West region of England and the authors frankly admit that there is “significant underreporting”.

These revelations should have been front page news in every paper in the country in terms of the loss of life involved, the public's right to know, the proper scrutiny of medical practice and the major significance of the report for a thorough and informed debate on restricting abortion law. How many people for example are aware that late abortion involves the horrific procedure of feticide to kill the baby, which is recommended by the RCOG, or that babies can be born alive as early as 18 weeks? The Daily Mail, to its credit, reported the study on Saturday, but the seriousness of the issue – nothing less than the reporting of infanticide - demands much greater public attention and action to ensure that it is prevented from happening again.

It is an additional cause for concern that although these reports have been brought to public attention before, there has been no action to prevent these babies dying from neglect, despite the assurances of medical associations. In February 2004, The Sunday Times reported a study published orginally in the BJOG of a baby who survived three abortion attempts and was born alive at 24 weeks after his 24- year-old mother changed her mind about wanting the child after feeling it move on the way home from an abortion clinic. The attempted abortions had been carried out at the British Pregnancy Advisory Service’s Blackdown clinic in Leamington Spa, Warwickshire. Although the clinic had told her an ultrasound scan had confirmed the child was dead, she went into labour that afternoon and the boy was born alive. The journal reported that this little boy is now a healthy two year old.

A few months later, in June 2004, the Sunday Times reported cases of babies who were born alive following abortions. One baby thought to have a severe abnormality was born healthy, but was not resuscitated when it stopped breathing. Another baby was left to die in a sluice-room, even though it was born with a heart-beat and was breathing. Another baby born at 25 weeks the day before he would have been killed through the barbaric practice of feticide. The ProLife Alliance noted at the time that survival rates of premature babies between 23-26 weeks are reaching the 90% mark according to a major US retrospective study published this year.

These reports prompted a successful motion at the BMA conference proposed by a number of medical students, calling on the BMA to "work with the GMC, NHS and appropriate Royal Colleges to ensure that babies born alive as a result of termination of pregnancy procedures receive the same full neonatal care as that available to other babies".

Even before the conference, the BMA protested vigorously that the motion was unnecessary because they already had guidelines to ensure that babies born alive received medical care. This echoes the RCOG guidance on the issue which states “The management of fetuses and newborn infants at the threshold of viability should be in accordance with the British Association of Perinatal Medicine’s Framework for Practice. It is professionally acceptable not to attempt to support life in fetuses below the threshold of viability." BBC Newsonline quoted Louise Silverton, deputy general secretary of the Royal College of Midwives as saying that: "There are guidelines to prevent the live birth of babies following late abortions. However, should the baby be born alive, it must receive the necessary life support, as would any other baby born at such an early gestation."

However the survey of the 31 babies struggling to live in BJOG frankly contradicts this by saying that "although midwives are bound by their code of practice, there are many who will still ignore signs of life at this gestation....Many terminations at this gestational age are performed on gynaecology units; the women being cared for by nursing staff rather than midwives, who are not governed by the midwives rules and code of practice, although the Births and Deaths Registration Acts and Public Health Acts apply to all."

If there is any doubt that the abortion law is out of date and urgently in need of restriction, then these stories of babies struggling to breathe should remove all doubts. The current law allows babies to be aborted for any reason up to 24 weeks (6 months) or up to birth on grounds of disability. The 24 week limit was based on the baby being able to survive at that point, so even from the flawed logic of the Abortion Act, the current time limit of 24 weeks is outdated and incomprehensible when premature babies can be born and survive after 21 weeks and these babies struggled to breathe after abortions at 18 weeks.

When the reality of babies being born alive following abortion is before us, we have passed the stage of esoteric debate about when life begins. It is blindingly obvious that these babies are alive and have human rights and that they deserve as much protection as any other child under child protection guidelines and international human rights law. Only a tiny extreme fringe thinks that it is acceptable to abort babies up to and including birth. The majority of people in this country are naturally appalled by the brutal reality of late term abortion. Dr. Stammers, senior lecturer in general practice at St. George's University Hospital in London was reported in the Mail as saying that even doctors who carry out abortions sometimes break down: "I know of obstetricians who have been doing abortions for many years who have broken down saying they cannot carry on any more. Despite all attempts at emotional neutrality, the heart does not work that way when you get a baby in front of you that colleagues on another floor of the same building would be trying to keep alive. For the parents it must be extremely upsetting, as it is for the doctors."

The humane response to these babies suffering and deaths is not to discuss, as the authors of the British Journal of Obstetrics and Gynaecology report do, with horrifying calm, whether these babies could be killed earlier using feticide, or to suggest that it could be up to the parents whether they prefer feticide or neonatal death, or to suggest that "the reasons why feticide is necessary should be made clear, along with the potential benefits". It is outrageous that parents could be presented with propaganda and euphemism about feticide. It should be blindingly obvious that feticide is as wrong as neonatal death, since it is only a legal fudge to prevent the doctors being prosecuted for murder.

It is overwhelmingly clear that we cannot leave it up to midwives and nurses involved in abortions to regulate themselves. The wider arguments about abortion will take more time, but there is immediate and obvious action that must be taken. The only humane response to knowing that babies can be born alive at 18 weeks is to outlaw abortion during the second and third trimester.