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18 October 2006

Tory MP pursues abortion restrictions

Tory MP Nadine Dorries has resigned from a Parliamentary select committee to work on reducing the time-limit on abortion.

Mrs Dorries, MP for Mid Bedfordshire, has stood down from the prestigious select committee on education and skills to commit time to her own ten minute rule bill on abortion, reported Bedfordshire on Sunday on 15 October (1).

‘In the case of abortion, I fully endorse a woman’s right to choose. However, that right should be upheld by humanity and responsibility,’ said Mrs Dorries. ‘It is unacceptable, in this day and age, that the legal age at which a fetus can be aborted is 24 weeks – six months. Medical advancement in the area of neo-natal care has moved on dramatically and life is often supported outside of the womb as early as 20 weeks. This parliamentary term I will be devoting a considerable amount of time to pursue in my name the case to reduce the length of time at which abortions are available.’

In fact, it is hard to find any examples of ‘life … supported outside of the womb as early as 20 weeks’. Data from the EPICure study of UK and Irish premature birth outcomes (2), published in 2000 and 2003, show that of 104 babies born at 21 weeks, none survived to discharge from hospital, and that of 138 babies born at 22 weeks, only two (one per cent) survived to discharge.

As Dr Rodney Rivers, Reader in Paediatrics at the Imperial College Faculty of Medicine and co-authors, pointed out in the Pro-Choice Forum briefing Late Abortion: A Review of the Evidence: 

‘The Royal College of Obstetricians and Gynaecologists (RCOG) advises that it is professionally acceptable not to attempt to support life in fetuses expelled before 22 weeks gestation. They emphasise that “it is extremely important to distinguish between physiological movements and signs of life, as well as being aware that observed movements may be of a reflex nature and not necessarily signs of life and viability”’.

As Rivers and co-authors argue: ‘Threshold viability needs to be understood as the earliest starting point for possible medical intervention for women with wanted pregnancies who are in premature labour. Not all immature infants will be treated and the outcomes for infants born at 22-24 weeks gestation are very poor’ (3).

The poor outcomes for infants born at very early gestations were confirmed by the most recent EPICure study, published in 2005. This study found high rates of disability amongst these children: the rates of severe, moderate, and mild disability were 22 percent, 24 percent, and 34 percent, respectively. The authors concluded ‘[a]mong extremely preterm children, cognitive and neurologic impairment is common at school age.’ (4)

(1) MP switches focus to abortion review, Bedfordshire on Sunday, 15 October 2006.

(2) Neurologic and Developmental Disability after Extremely Preterm Birth. Nicholas S. Wood, M.B., Ch.B., Neil Marlow, D.M., Kate Costeloe, M.B., B.Chir., Alan T. Gibson, Ph.D., Andrew R. Wilkinson, M.B., Ch.B., for The EPICure Study Group. New England Journal of Medicine, Volume 343:378-384 Number 6 August 10, 2000

(3) Late Abortion: A Review of the Evidence, Pro-Choice Forum, November 2004

(4) Neurologic and Developmental Disability at Six Years of Age after Extremely Preterm Birth. Neil Marlow, D.M., Dieter Wolke, Ph.D., Melanie A. Bracewell, M.D., Muthanna Samara, M.Sc., for the EPICure Study Group. New England Journal of Medicine, Volume 352:9-19 Number 1 January 6, 2005