SCOTTISH hospitals have carried out abortions on severely abnormal foetuses as late as 34 weeks, an investigation by Scotland on Sunday has revealed.
One hospital conducted an abortion just six weeks short of the baby’s due date after the mother refused an earlier offer to terminate 17 weeks into the pregnancy.
Although abortions are permitted beyond the 24-week limit if the baby is abnormal,
this newspaper’s investigation has revealed for the first time just how late some of the procedures are being carried out.
Pro-life groups have reacted to the disclosures - obtained under the Freedom of Information Act - with horror.
The decision whether to conduct a late abortion is left to doctors’ clinical judgment but the Royal College of Gynaecologists and Obstetricians refuses to discuss what checks and balances are in place.
The issue of abortion has risen up the political agenda after Conservative leader Michael Howard called for the limit to be reduced to 20 weeks.
Official figures already published show that, in Scotland, there have been 25 abortions on foetuses over 25 weeks gestation since 1998.
Scotland on Sunday asked all the nation’s health boards to provide details of the stage at which they carried out the procedures. Tayside Health Board said Ninewells Hospital, Dundee, had carried out three late abortions over the period, at 34, 30 and 25 weeks. All three women had been offered much earlier terminations but had refused.
In the first case, the pregnant woman had been offered a termination at 17 weeks after the foetus was diagnosed with anencephaly, a brain defect that usually causes death within a few days of birth, but had decided to continue with the pregnancy. She changed her mind at 34 weeks and underwent an abortion six weeks before she was due to give birth.
Another foetus with anencephaly and spina bifida was aborted at 30 weeks. In that case, too, the mother had been offered a termination earlier but at that point had refused.
A foetus was aborted at 25 weeks because it had amniotic band syndrome, which causes deformities in the body parts. The mother had been offered a termination at 19 weeks but chose to go ahead with the pregnancy. Under the Human Rights Act the foetus is not legally a person and its interests cannot override those of the pregnant woman.
Guidance issued to doctors by the British Medical Association states that women have the right to an abortion if the child is seriously handicapped but it does not define that handicap and leaves that up to doctors’ clinical judgment.
A spokesman for the Catholic Church in Scotland said: "To hear that an abortion has been carried out at 34 weeks is frankly appalling, and most people will react to this with horror. This sheds new light in the debate on abortion time limits and makes the point very clearly that we need to review the law, which we feel should be a general election issue.
"There is also debate about what constitutes a serious disability. The big problem is that no one can make the prediction that a baby will die. We constantly hear stories about babies surviving with neonatal care."
Ian Murray, of the Society for the Protection of the Unborn Child said: "We are hearing more and more stories of babies surviving at 24 weeks. To think that abortions are being carried out up to six weeks before birth will surprise and horrify people, no matter the disability."
But Jane Fisher, of the support group, Antenatal Results and Choices, defended the practice. She said: "We are talking about very small numbers, and each case is quite harrowing. In some cases the condition will have been diagnosed by chance and in other cases a woman may have initially decided to continue with the pregnancy while the baby’s condition is monitored and decided to have a termination when there has been a marked deterioration.
"What is important to us is that parents get all the information they need to make their decision and we support whatever choice they make."
Ninewells Hospitals and the Scottish Executive have refused to comment on the matter.
Other health boards have generally been reluctant to cooperate. NHS Fife says it has carried out three later terminations since 1999 but refused to give details, claiming patient confidentiality would be breached. NHS Ayrshire and Arran and NHS Borders do not carry out late abortions. The remaining authorities have so far failed to provide any details. The Royal College of Obstetricians and Gynaecologists, whose members carry out the procedure, refused to answer requests to explain whether there were any checks or controls put in place to monitor the practice of late abortions.
Instead, it said in a statement: "Patients must receive sympathetic and supportive counselling before and particularly after the procedure. For all terminations at gestational age of more than 21 weeks and six days, the method chosen should ensure that the foetus is born dead. This should be undertaken by an appropriately trained practitioner.
"It is essential to have an agreed multidisciplinary management plan prior to late termination, taking account of issues such as conscientious objection. The multidisciplinary team should include, where appropriate, obstetricians, neonatologists, midwives and nursing staff."
The procedure for terminating a pregnancy which is well advanced is far more complicated than early abortions which can be administered surgically or by taking a pill.
Later on in pregnancy, guided by ultrasound, doctors inject the foetus in the heart with potassium chloride which ensures a quick death and labour is quickly brought on. Women can choose to be sedated for the procedure.
'How could I not give my baby this chance?'TRACY Rendall discovered her son Beau had spina bifida following routine tests during her pregnancy. She was offered a termination and advised that most women in her position decided to end their pregnancies. But Rendall, from Edinburgh, felt that her baby had a good chance of a happy healthy life, and decided to go ahead with the pregnancy. Now, Rendall, 37, says she is certain she did the right thing, and that Beau, who is 18 months old, is having a "wonderful" life with his sister Meg, three, and two-year-old brother Fin.
"I had two perfectly healthy children before I became pregnant with Beau. After some routine blood tests, I had a call from the hospital asking me to go in that day for a detailed scan.
"I went for the scan on my own, I saw the baby wriggling around on the screen and he looked perfectly normal, but the doctor said she was very sorry, he had spina bifida. The spine was not formed completely and there was a malformation in the head.
"It was a huge shock. I didn’t know anything about spina bifida. The doctors explained that his case was not too bad, although they couldn’t make any promises.
"They told me I would have to decide whether to go ahead with the pregnancy. They didn’t push me either way. They did say that most women choose terminations, but that didn’t mean a termination was necessary.
"My husband Stuart hadn’t seen him kicking on the scan, and he did not have the physical attachment I had. For him it was more about how much pain and anguish the baby might go through.
"But as soon as they said they thought the baby had a chance of a good quality of life, there was no debate for me. How could I possibly not have him? How could I not give him this chance?"
Beau had two major operations following his birth: to close the hole in his back; and to fit him with a shunt to drain off excess spinal fluid.
Now he has some problems - he is unlikely to be able to walk and has some learning difficulties - but Rendall is delighted with his progress.
She said: "He is a very, very happy baby with a normal life expectancy. I was absolutely right to have him. He’s going to have a wonderful life."
HOW LAW STANDSUNDER the Abortion Act 1967, women can have a termination only if two doctors agree it is justified on certain grounds.
Before 24 weeks, the doctors must agree that to continue with the pregnancy would involve risk of injury to the physical or mental health of the woman or her existing children.
Beyond 24 weeks to term, an abortion can be carried out to prevent "grave" permanent injury to the physical or mental health of the pregnant woman or risk to her life, or if there is a "substantial risk" that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.
Parliament agreed in 1990 that the legal limit for most abortions should be reduced from 28 weeks to 24 weeks’ gestation.
The limit remains therefore a matter for parliament to decide. It is accepted parliamentary practice that proposals for changes in the law on abortion come from backbench members and that decisions are made on a free vote.
Last year, the British Pregnancy Advisory Service admitted directing women to a clinic in Spain that is prepared to abort healthy pregnancies beyond 24 weeks.
Abortion at such a late stage is also illegal in Spain but investigators said the Clinic Ginemedex in Barcelona was prepared to circumvent the rules by recording them as cases of "gynaecological emergency".
However, research into 1,200 babies born alive under 26 weeks reveals that only 811 lived to be admitted to neonatal intensive care units, and only 300 lived long enough to go home.
Of those 300, 40% had moderate to severe problems with cognitive development at six years old.
A significant number suffered from cerebral palsy, blindness, deafness and arrested development.
