More on the Reported Explosive Growth in Victoria’s Late Term Abortions

In a press release issued on 7th October 2010 ("Anglican minister spreading misinformation about abortion law") Women’s Health Victoria and its Executive Director Ms Marilyn Beaumont have made serious allegations against me, including:

• I am spreading misinformation about Victoria’s abortion law;
• I have put this misinformation ‘into the public domain without proper fact checking’;
• I have a ‘tendency to inflate and take liberty with the facts’.

Ms Beaumont has also sent me a letter, which lays out her views in greater detail. 

It is disappointing that in launching what amounts to a public attack on my reputation, Women’s Health Victoria has itself put out information containing serious omissions and inaccuracies.  These give a misleading impression concerning both the abortion law in Victoria, and statistics for late-term abortions.

1. The Abortion Law Reform Act 2008

One of the claimed inaccuracies concerned a report, published in the Melbourne Age on 7th October 2010, that I had claimed conscientious objection by medical staff was now illegal in Victoria.  This comment was reported in the context of the employment of hospital medical staff. 

Ms Beaumont alleges that this is inaccurate, on the grounds that:

• Section 8 of the Abortion Law Reform Act allows health practitioners to object to abortion.
• However a health professional who has a conscientious objection to abortion is required to refer a woman for termination of pregnancy services.
• Any conscientious objection to making such a referral ‘does not have merit’.
• The Act’s rejection of conscientious objection in relation to referral is ethically correct, because in the context of referral, a woman’s right to make informed choices about her health must take precedence over the conscience of the health practitioner.

In response to this argument, I note first that Ms Beaumont has correctly conceded that it is illegal in the state of Victoria for a health practitioner to object, on grounds of conscience, to referring a woman for abortion services.  In this respect, conscientious objection by health practitioners is illegal in Victoria.  Ms Beaumont appears to regard this illegality as trivial – she maintains such an objection ‘does not have merit’ – however this value judgment relies upon a contentious ethical opinion about the moral value of abortion, which regards it simply as a decision made by a woman about her own body.

Second, and more importantly, the Section 8 concession to conscientious objection only applies in the case when a woman has requested a health practitioner to advise or treat her in relation to abortion.  No such concession exists in the case of hospital staff – such as operating theatre workers – who do not have a direct relationship with the woman.  In this context Section 8 is irrelevant, and conscientious objection by health practitioners receives no protection under the Abortion Reform Act 2008.

The comments attributed to me in the Melbourne Age were specifically in relation to hospital health workers.  It is therefore disappointing that Ms Beaumont has misrepresented the scope and application of the Abortion Law Reform Act.  Nothing in the WHV press release acknowledges that Section 8 of the Act does not apply to hospital health practitioners who have no direct relationship with the patient.  This was a significant omission.

2. Government Statistics for Abortion in Victoria

Ms Beaumont stated that “A significant proportion of late-term abortions, including the 52 mentioned in this article, [i.e. in The Melbourne Age, 7th October 2010] are for congenital abnormality.”  Based on this observation, she alleges that:

“The minister’s [i.e. Mark Durie’s] comments are not only inaccurate but grossly insensitive both to the health care providers and families involved in late-term abortions for congenital abnormality and the impact this can have.”

The rebuke appears to rely on an implication that late-term abortions in Victoria are primarily for congenital abnormality.  This is not true.  For example in 2005 there were 129 late-term abortions reported in Victoria for reasons of congenital abnormality, but 180 for ‘psychosocial indications’ (i.e. there was nothing wrong with the baby).  The proportion between abortions for congenital abnormalities and psychosocial indications depends upon how late in the pregnancy the abortion takes place, as the following tables show:

TABLE 1. Late-term abortions conducted in Victoria at 23+ weeks, 2001-2007. 
CA=Congenital Abnormality.  PS=Psychosocial Indications
(Source: Annual Report for 2007 of the Consultative Council on Obstetric and Paediatric Mortality and Morbidity, p.12)

TABLE 2. Late-term abortions conducted in Victoria at 20-22 weeks, 2001-2007. 
CA=Congenital Abnormality.  PS=Psychosocial Indications
(Source: Annual Report for 2007 of the Consultative Council on Obstetric and Paediatric Mortality and Morbidity, p.12)

These charts indicate that:

1. Late term abortions in Victoria were dramatically increasing even before the liberalization of abortion laws in 2008.
2. The greatest growth was in late-term abortions for psychosocial indications.  These went up by c. 400% 2001-2007.
3. ‘Late’ late-term abortions (23+ weeks) are mainly for psychosocial reasons, but ‘early’ late-term abortions (20-22 weeks) are mainly for congenital abnormality. 
4. It seems reasonable to speculate that the later a baby is aborted, the more likely it will be for psychosocial indications.
5. The most stable category of late-term abortions is congenital abnormality at 23+ weeks.  Presumably this is because testing for congenital abnormalities keeps on getting better, and the resulting abortions are happening earlier as a result.

Victoria has seen explosive growth in late-term abortions for psychosocial indications.  This trend was well underway before the Abortion Law Reform Act in 2008, and there has been an indication that it may be continuing.

A Channel 7 news report, aired on 17 April 2010, reported that late-term abortions at the Royal Women’s hospital had allegedly increased six-fold since the Abortion Law Reform Act 2008 was introduced.  This has to be considered on top of the previous 400% state wide increase in late-term abortions for psychosocial indications from 2001-2007.  While it is impossible to be sure of figures without further information, the combined multiplicative effect of two such reported increases could be an overall 2400% increase in late-term abortions for psychosocial indications within a ten year period.  Such a possibility caused me to move that the Melbourne Synod of the Anglican Diocese request a report from the Victorian State Government about the impact of its liberalization of abortion laws. (See my previous blog post).

The Abortion Law Reform Act went into force in late October 2008, so the full impact of Victoria’s liberalization of abortion laws on late-term abortion statistics will only be publicly known when the 2009 report of the Consultative Council on Obstetric and Paediatric Mortality and Morbidity is released.  This will presumably be sometime in late 2011 to early 2012. (The 2008 report has not yet been released as of October 2010, and the 2007 report was only released in April 2010).

I deplore the serious omissions and misleading information concerning the application of abortion law which were contained in the Women’s Health Victoria press release.

I repeat my call for the Victorian Government to report to the public on the impact of Abortion Law Reform, and specifically its impact on the frequency of late term abortions in Victoria.  I remain deeply concerned about the implications of what appears to be explosive recent growth in late term abortions in Victoria, including the obvious potential of such growth to impact the recruitment and morale of health practitioners in those hospitals which perform late-term abortions.