Dr Anne Doherty, Consultant Psychiatrist
Like all doctors, I want to care for women in a genuinely compassionate way. In my work as a psychiatrist, I have met many women who have had terminations of pregnancy, some in very difficult and painful circumstances. Some describe it as part of a difficult time in their past, for others it has been the source of pain and suffering. I have not met any woman for whom it was an easy or desirable choice. All doctors, regardless of our personal views on abortion, treat women (including pregnant women) in distress or with mental health problems with all possible care, and regardless of the outcome of the referendum, will continue to do so.
In this referendum, we are being asked to vote on repealing the Eighth Amendment, removing all recognition of the human rights of the unborn, facilitating legislation providing for termination. Much of the campaigning from the ‘Yes’ side has focussed on cases of women whose lives may be at risk (already provided for under the PLPAct 2013), women with pregnancies following rape, and sick unborn babies with life limiting conditions. These situations account for around 3% of UK abortions. My sympathies are with the women in these cases. From my clinical experience, I understand the pain that such difficulties bring, and that these are complex and nuanced circumstances. Due to my sympathies and clinical commitment to these women, I have concerns about meeting their suffering with procedures and courses of action which are not proven to benefit women’s mental health.
If the Eighth Amendment is repealed, the government are proposing legislation to allow unrestricted abortion up to 12 weeks, and up to 24 weeks or viability if the mother’s health is at risk, which may be due to physical or mental illness. In the UK, 97% of abortions are carried out on mental health grounds. As a psychiatrist, someone who treats serious mental illness, and has done so in the UK, it is not easy to believe that more than 180,000 women in England and Wales are seriously mentally ill (96% of 190,416: 2016 figures). Abortion on ‘mental health’ grounds is a retrograde step, using mental health problems as a reason for abortion rather than an indication for treatment. The mental health of women deserves real respect and real interventions, but not at the expense of the life of the unborn. There is no justification for describing it as a mental healthcare initiative.
There is no evidence that abortion is a treatment for any mental disorder, so it is unclear why the government would wish to legislate for this to become legitimate grounds up to six months. The proposed legislation suggests that a pregnant woman seeking a termination should receive an abortion if requested, but does not require that she actually receive any assessment or treatment of the related mental health problem. A reasonable person would have to conclude that ‘mental health grounds’ are merely a euphemism for social or non-medical grounds: ending the lives of health babies of health women. Let’s not disguise abortion as a mental health treatment.
Women with mental health problems deserve proper support and evidence-based treatments. They deserve mental health services that are appropriate and responsive to their needs and their human rights and their childrens’ human rights. Those in favour of repeal are rightly concerned for women’s health, and this concern needs to be addressed with effective treatments which are proven to work.
As a doctor, I cannot ethically accept or recommend an intervention which does not have any established benefit. It is hard to regard the government’s proposal as anything other than a pretext to allow abortion up to viability. It would be a retrograde step for us to remove all constitutional rights from unborn human beings who are vulnerable and have no protection other than the Eighth Amendment.
As a doctor, as a psychiatrist, and as a woman, I am voting no.