The article below in the Spring of 1984 was commenting on the so called "statistical argument" for abortion which alleges that statistics show that abortion is always safer for the mother than continuing a pregnancy. An abortion promoting charity still alleges on its website as a "fact" that abortion is "safer than pregnancy and childbirth". Professor Glanville Williams QC was banging the same drum in the 1980s (and for many years before that) and ALDU decided to respond and expose the nonsensical arguments that Professor Williams was propounding. Professor Glanville Williams, who died in 1997, was an extremely well known and eminent lawyer in his day. He wrote many influential books, in particular books intended to teach people about the law. This gave him the opportunity to expound his personal beliefs which was important to him for he was a prominent and active member of the Eugenics Society, President of the Abortion Law Reform Association and one of the principal authors of the Abortion Act. The views which he expressed in his legal textbooks, on this subject, were not therefore disinterested. He wanted abortion to be freely available and almost any old argument would do to reach that end.
As is mentioned in the article below, he was obliged to amend the text of an earlier edition of his book because of the comments made by ALDU's Chairman and Secretary in an article which they had written for the Law Society's Gazette but still he insisted in peddling his social theories, dressed up as legal scholarship. As the article below points out, the logical conclusion of the Professor's arguments would be that, if abortion were always safer than pregnancy and childbirth and since the NHS has a duty to improve maternal health, then the NHS would have a duty to carry out abortions on all pregnant women.
1984 Spring
Newsletter No. 22
News and Comment
The Statistical Argument
Professor Glanville Williams Q.C., in the recently published second edition of his "Textbook of Criminal Law" (Stevens 1983), argues (at page 299) that statistics show that in certain circumstances a doctor may lawfully terminate a pregnancy, even if he finds no specific grounds for termination.
This is the famous "statistical argument", which is often invoked by those who wish to claim that abortion on demand is legal. The argument is based on some statistics produced in Eastern Europe many years ago, which indicated that, taking into account the rate of maternal mortality in that country at that time, abortions in the first three months of pregnancy were always safer than allowing the pregnancy to continue. From this many pro-abortionists in this country leapt to the often-quoted conclusion that these figures meant that abortion on demand was legal because "the balance of risk always favours termination". Although this argument has never yet been tested in the courts, it has often been heard in debates, and may have influenced the authorities against prosecuting doctors who perform abortions on demand. It is therefore worth considering it carefully, so that when the opportunity arises we may expose it for the specious thing that it is.
Objections to the "Statistical Argument"
Professor Williams, as one might expect from a man in his position, is much more cautious than the average pro-abortionist in his claims as to
how far this theory is applicable. Indeed in the second edition of his "Text-book" he is even more cautious than he was in the first edition, and in a footnote he makes a point of referring to an article by the present Chairman and Treasurer of this Association which exposed some of the flaws in this argument (77 Law Society's Gazette 938).
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| Prof Glanville Williams QC |
He emphasizes that the argument can only be used for first trimester abortions. Nobody has ever argued that second trimester abortions are invariably safer than allowing the pregnancy to continue, though the relative danger of second trimester abortions to the mother is often glossed over in pro-abortion arguments. Secondly, Professor Williams admits that the argument can only apply if the doctor believes that the other risks apart from maternal death can be disregarded.
There is now, however, an enormous amount of evidence to show that even early abortions have many very unpleasant consequences, such as haemorrhage, subsequent sterility and psychological damage, which no conscientious doctor would disregard when considering whether to recommend termination. Furthermore, there are no statistics which would justify a doctor in ignoring these sequelae. Not even the medical practitioners of Eastern Europe have been able to show that, after taking all this evidence into account, early termination is always safer than allowing the pregnancy to continue.
Thirdly, Professor Williams concedes that in some cases abortion may be contra-indicated by the condition of the patient. This last is a major concession, because he thereby accepts the contention of the article by Bowles and Bell referred to above that each of the two doctors has to form a view about the balance of risk to the patient by whom he has been consulted. In other words each is bound to take the health and circumstances of that particular patient into account. There are undoubtedly doctors who, when giving the second of the two opinions required by the Abortion Act, sign forms saying that the balance of risk favours termination without even seeing the patient; they then try to justify this by claiming that the "statistical argument" shows that all early abortions are legal. Such opinions cannot be said to have been formed in good faith, and any subsequent abortion would therefore invariably be unlawful, (see s.5(2) of the Abortion Act 1967).
These three objections to the statistical argument are so substantial that even if there were no other fallacies in it a doctor would be ill-advised to rely on it. But the argument can be shown to be deficient on several additional grounds.
Statistics for maternal deaths
There is a fourth problem for the doctor who wishes to claim that he came to the conclusion in good faith that the balance of risk favoured termination on the basis of statistics. He can only do so if the statistics do in fact prove this. In any year when the proportion of maternal deaths fell below the proportion of deaths from first trimester abortion, the argument would turn against him. This, incidentally, shows the argument's inherent absurdity: any doctor who seeks to rely on it must know the latest statistics before he can recommend an abortion. Old statistics from Eastern Europe would hardly be convincing in a modern English court.
Happily, in this country the rate of maternal death in childbirth has been falling rapidly, and today it is only a quarter of what it was 30 years ago. Indeed, overall there is very little difference between the statistics for death from abortion and those for maternal deaths from other causes. Certainly the difference is not large enough to justify a doctor relying on this alone to recommend an important operation. In 1980 deaths from complications of pregnancy were about 13 per 100,000 births, and deaths from abortion were also about 13 per 100,000 abortions. This figure includes maternal deaths in second trimester abortions, but the trend towards safer motherhood is clear, and the safer motherhood becomes the earlier the pregnancy has to be terminated if one is going to attempt to use statistics to justify it. Sir Henry Yellowlees, Chief Medical Officer at the D.H.S.S., has expressed the view (The Times 19/2/83) that in 59% of cases maternal death is in part due to an avoidable factor. If maternal life was saved in these 59% of cases this would reduce the number of maternal deaths caused by complications of pregnancy to about 51 per million pregnancies. Whilst each of these is a tragedy, it is hard to see how such a remote contingency could be used to justify recommending a potentially risky operation. We may confidently hope that, as the number of maternal deaths continues to fall, in the not-too-distant future deaths in which the fact that the patient was pregnant was a major contributing factor will be almost unknown.
Normal pregnancies do not cause death
This, however, brings us on to a fifth objection to the statistical argument. This is that the vast majority of abortions, perhaps 95%, are carried out on women in normal health. Government statistics have shown for many years that the number of maternal deaths from normal pregnancies is nil. Maternal death only occurs where serious complications arise. If, for example, a woman had high blood pressure a doctor might have grounds for believing that continuation of the pregnancy could cause a threat to her life. If, however, medical examination produces no reason for a doctor to believe that the pregnancy is likely to be dangerous, it is difficult to see how he can invoke statistics derived exclusively from women whose pregnancies had serious complications. On the other hand, most maternal deaths caused by abortion are caused to women in normal health. This is simply because the vast majority of abortions are performed, without any medical justification, on women in normal health. Thus it is quite clear that, if a doctor finds his patient to be in normal health, even a first trimester abortion must invariably be contra-indicated on the basis of maternal mortality statistics.
It follows from this that except in those cases (now virtually non-existent) where an abortion is genuinely necessary to save the mother's life, abortion cannot be justified as a way of reducing maternal deaths. The fact is that legalised abortion undoubtedly increases the total number of maternal deaths. Were no abortions at all performed, except where necessary to save life, fewer women would die. Deaths from abortion must not, therefore, be set against maternal deaths, but added to them. This shows the falsity of the argument that legalising abortion reduces maternal mortality.
A poor excuse for abortion
Of course it is always argued by abortionists that legalised abortion reduces maternal death, because they say that without legalised abortion women would go to "back-street" abortionists whose medical procedures are dangerous. This argument shows what a low opinion of women the pro-abortionists have. Any normal woman would very much prefer not to have her baby killed, and it is only because a girl or woman sees abortion as the only solution to her problems, or because of the pressures to which she is so often subjected by doctors and boy-friends, and sometimes by parents, that she takes this desperate way out. The obvious solution is to help women with their problems. This might require a considerable expenditure of time, money and effort on the part of the community, but it is very much preferable to a medically unnecessary operation which sometimes kills the mothers and always kills their babies.
Honourable doctors care for both patients
It is also worth noting that even in cases where examination of the patient reveals complications, or where complications may occur at a later stage of the pregnancy, no honourable doctor would immediately terminate the pregnancy. So far as was consistent with the necessity to preserve the mother's life and health, he would allow the pregnancy to continue to the stage where the child could be delivered with the maximum chance of survival. Indeed few doctors would do otherwise in cases where the child was eagerly wanted. The statistical argument has no merit in itself as a guide to proper medical practice. It is merely an excuse for doctors who want to help a woman to get rid of an unwanted baby, and a highly tendentious and unconvincing excuse at that.
Second trimester abortions are dangerous
Another aspect of the matter is also worth noting because it shows how little importance is attached by doctors to the "statistical argument" as a guide to clinical practice. As has been pointed out, overall the rate of maternal deaths from abortion is roughly comparable to the rate of maternal deaths from all other causes. If, therefore, it is contended that, statistically, first trimester abortions are always safer, it must follow logically that second trimester abortions are statistically less safe than allowing the pregnancy to continue. If doctors really attached importance to the statistics of maternal mortality, they would refuse to do any second trimester abortions, except in those circumstances (if any) where it was necessary to save the mother's life. But in practice we find that second trimester abortions are as common as first trimester abortions. And doctors who admit that they refer for abortion any woman who requests it never suggest that they only do this in the first three months of pregnancy. It is, therefore, clear that in practice doctors ignore the statistical argument when recommending abortions; and it is submitted that this is not unreasonable because the figures for maternal death are now so low as to be statistically irrelevant. There was a time when abortion and even childbirth were so dangerous that doctors had to take into account the risk of maternal death in every case. But those days are long past in this country, and were it not for the fact that this argument is still resorted to as a debating point, it could safely be relegated to the status of an academic argument of merely historical interest.
The absurd implications of abortionist arguments
The absurdity of the argument becomes even more clear when one considers its implications. Let us take, for example, the fact that the National Health Service has a statutory duty to improve maternal health. If termination of pregnancy in the first three months were always safer than allowing the pregnancy to continue, then the National Health Service would have a duty to terminate all pregnancies in the first three months. The fulfilment of such a "duty" would not only solve the problems relating to maternity, but all other human problems as well, and very quickly too. But apparently the National Health Service does not take this view. What it appears to say is that the 55,000 or so mothers who every year request abortions on the National Health Service are precisely those mothers whose pregnancies have medical risks so great as to impose on the National Health Service a duty to carry out an abortion. This requires the D.H.S.S. to believe in 55,000 extraordinary coincidences every year, a mental feat which the Secretary of State and the Minister for Health appear to have no difficulty in performing.
The effect of age on abortion deaths
Another way of looking at the matter is to consider the age of the patients. Statistics for maternal mortality show that nearly all women who die during pregnancy are either under 20 or over 30. In other words, the risk of a pregnancy of a woman aged between 20 and 30 resulting in death is extremely small. On the other hand, the great majority of women who have abortions are aged between 20 and 30, the very age at which the risk involved in continuing with the pregnancy is extremely slight. It is therefore apparent that in the very age group where the greatest number of abortions are performed there is the least justification for performing those abortions on the grounds of maternal mortality.
Statistics are irrelevant
Statistics may be of help to doctors in situations when they show that death is almost certain to result if an operation is not provided, but in a situation such as abortion, where in more than 90% of cases the operation is medically wholly unnecessary, it is absurd to suggest that doctors should use them as a guide. If it is the statistics that make the abortion legal, then a doctor would have to know first how many deaths were caused by abortion in the year in question, and secondly how many deaths by childbirth, and then compare the two figures, before he could form a view as to whether the act he was proposing to perform was legal or illegal. This might make a good plot for a Gilbert and Sullivan Opera, but as a guide to either law or medicine it can only be described as ridiculous.
The need for good faith
Finally, the legality of an abortion in this country is dependent upon what opinions two doctors have formed in genuine good faith. No reasonable doctor after examining a pregnant patient in normal health is going to form the opinion in good faith that, if he does not terminate her pregnancy, she will die. There is no way therefore, in which the risk of maternal mortality can make an abortion legal, and this is why abortions which are performed on demand or on request are never stated on the notification form to be done on the ground of risk to maternal life, but on one of the other grounds set out in section 1 of the Abortion Act 1967. Doctors are presumably well aware that in the normal case of a termination done on demand they would not be able to argue that they genuinely believed the mother's life was in danger, and therefore the argument mentioned by Professor Williams would not be of any assistance to them.
So far as abortion on other grounds is concerned, there are no statistics available either way, and it is noticeable that both the Government and doctors have been very careful to avoid collecting statistics or evidence. There is apparently no evidence at all that women who have had their babies aborted have better mental health than those who have not, and indeed ordinary observation would suggest that the very opposite is true.
