Who carries the greatest responsibility for the deaths of unborn children in this country? I accuse the leader of the Catholic Church in England and Wales, His Eminence Cardinal Cormac Murphy-O’Connor. I charge that he is partly to blame for our abnormally high abortion rate.
Let me begin with a point of agreement. "Whatever our religious creed or political conviction," Murphy-O’Connor writes, the level of abortion in the UK "can only be a source of distress and profound anguish for us all."(1) Quite so. But why has it climbed so high? Is it because of the rising tide of liberalism? The absence of abstinence? Strange as it may seem, the evidence suggests the opposite.
Last week the cardinal sacked the board of a hospital in north London(2). It had permitted a GP’s surgery to move onto the site and the doctors there, horror of horrors, were helping women with family planning. Though it is partly funded by the NHS, St John and St Elizabeth’s is a Catholic hospital, which forbids doctors from prescribing contraceptives or referring women for abortions. The cardinal says he wants the hospital to provide medical help that is "truly in the interests of human persons"(3).
Murphy-O’Connor has denounced contraception and abortion many times before. That’s what he is there for: the primary purpose of most religions is to control women. But while we may disagree with his position, we seldom question either its consistency or its results. It’s time we started. The most effective means of preventing the deaths of unborn children is to promote contraception.
In the history of most countries which acquire access to modern medical technology, there is a period during which the rates of contraception and abortion rise simultaneously. Christian fundamentalists suggest that the two trends are related, and attribute them to what the Pope calls "a secularist and relativist mentality"(4). In fact it’s a sign of demographic transition. As societies become more prosperous and women acquire better opportunities, they seek smaller families. During the early years of transition, contraceptives are often hard to obtain and poorly understood, so women will also use abortion to limit the number of children they have. But, as a study published in the journal International Family Planning Perspectives shows, once the birthrate has stabilised, the use of contraceptives continues to increase and the rate of abortion falls. In this case one trend causes the other: "rising contraceptive use results in reduced abortion incidence"(5). The rate of abortion falls once 80% of the population is using effective contraception(6).
A study published in the Lancet shows that between 1995 and 2003 the global rate of induced abortions fell from 35 per 1000 women each year to 29(7). This period coincides with the rise of the "globalized secular culture" the Pope laments(8). When you look at the broken-down figures, it becomes clear that (except in the countries of the former Soviet Union) the incidence of abortion is highest in conservative and religious societies. In the largely secular nations of western Europe, the average rate is 12 abortions per 1000 women. In the more religious southern European countries, the average rate is 18. In the United States, where church attendance is still higher, there are 23 abortions for every 1000 women(9), the highest level in the rich world. In Central and South America, where the Catholic Church holds greatest sway, the rates are 25 and 33 respectively. In the very conservative societies of East Africa, it’s 39(10). One abnormal outlier is the UK: our rate is 6 points higher than those of our western European neighbours(11).
I am not suggesting a sole causal relationship here: the figures also reflect the regions’ changing demographies. But it’s clear that religious conviction does little to reduce the abortion rate and plenty to increase it. The highest rates of all – 44 per 1000 – occur in the former Soviet Union. Under communism, contraceptives were almost impossible to obtain. But, thanks to better access to contraception, this is also where the fastest decline is taking place: in 1995 the rate was twice as high. There has been a small rise in the level of abortion in western Europe, attributed by the Guttmacher Institute in the US to "immigration of people with low levels of contraceptive awareness."(12) The explanation, in other words, is consistent: more contraception means less abortion.
There is also a clear relationship between sex education and falling rates of unintended pregnancy. A report by the United Nations agency Unicef notes that in the Netherlands, which has the world’s lowest abortion rate, a sharp reduction in unwanted teenage pregnancies was caused by "the combination of a relatively inclusive society with more open attitudes towards sex and sex education, including contraception."(13) In the US and UK, by contrast, which have the highest teenage pregnancy rates in the developed world, "contraceptive advice and services may be formally available, but in a ‘closed’ atmosphere of embarrassment and secrecy."(14)
A paper published by the British Medical Journal assessed four programmes seeking to persuade teenagers in the UK to abstain from sex. It found that they "were associated with an increase in number of pregnancies among partners of young male participants"(15). This shouldn’t be surprising. Teenagers will have sex whatever the grown-ups say, and those who are the least familiar with contraceptives are the most likely to become pregnant. The more effectively religious leaders and conservative newspapers anathemise contraception, sex education and pre-marital sex, the higher the abortion rate will go. The cardinal helps to sustain our appalling level of unwanted pregnancies.
But while his church causes plenty of suffering in the rich nations, this doesn’t compare to the misery inflicted on the poor. Chillingly, as the Lancet paper shows, there is no relationship between the legality and the incidence of abortion. Women who have no access to contraceptives will try to terminate unwanted pregnancies whatever the consequences might be. A report by the World Health Organisation shows that almost half the world’s abortions are unauthorised and unsafe(16). In eastern Africa and Latin America, where religious conservatives ensure that terminations remain illegal, they account for almost all abortions. Methods include drinking turpentine or bleach, shoving sticks or coat hangers into the uterus(17) and pummelling the abdomen, which often causes the uterus to burst, killing the patient(18). The WHO estimates that between 65 000 and 70 000 women die as a result of illegal abortions every year, while five million suffer severe complications. These effects, the organisation says, "are the visible consequences of restrictive legal codes."(19) I hope David Cameron, who has just announced that he wants to place restrictions on legal terminations in the UK(20), knows what the alternatives look like.
When the Pope tells bishops in Kenya, the global epicentre of this crisis, that they should defend traditional family values "at all costs" against agencies offering safe abortions(21), or when he travels to Brazil to denounce the government’s contraceptive programme(22), he condemns women to death. When George Bush blocks US aid for family planning charities that promote safe abortions, he ensures, paradoxically, that contraceptives are replaced with backstreet foeticide(23). These people spread misery, disease and death. And they call themselves pro-life.
Bring on the Apocalypse: Six Arguments for Global Justice, by George Monbiot, is available for £10.99 from Guardian Books
1. Cardinals Cormac Murphy-O’Connor and Keith O’Brien, 22nd October 2007. Open Letter on the occasion of the 40th Anniversary of the 1967 Abortion Act from the Presidents of the Catholic Bishops’ Conferences of Scotland and England and Wales. http://www.timesonline.co.uk/multimedia/archive/00222/Open_Letter_Abortio_222943a.pdf
2. Riazat Butt, 22nd February 2008. Archbishop orders Catholic hospital board to resign in ethics dispute. The Guardian.
4. Catholic News Agency, 19th November 2007. Defend marriage and family life at all costs, Benedict XVI tells Africans. http://www.catholicnewsagency.com/new.php?n=11014
5. Cicely Marston and John Cleland, March 2003. Relationships Between Contraception and Abortion: A Review of the Evidence. International Family Planning Perspectives, Volume 29, Number 1. http://www.guttmacher.org/pubs/journals/2900603.html
7. Gilda Sedgh et al, 13th October 2007. Induced abortion: estimated rates and trends worldwide. The Lancet vol 370, pp 1338-45.
8. Catholic News Agency, ibid.
9. The Guttmacher Institute, May 1999. Abortion in Context: United States and Worldwide. http://www.guttmacher.org/pubs/ib_0599.html
10. Gilda Sedgh et al, ibid.
11. Office of National Statistics and Department of Health, June 2007. Statistical Bulletin: Abortion Statistics, England and Wales: 2006. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697
12. Hannah Brown, 17 November 2007. Abortion round the world. British Medical Journal. doi:10.1136/bmj.39393.491968.94
13. UNICEF, July 2001. A league table of teenage births in rich nations. Innocenti Report Card No.3. UNICEF Innocenti Research Centre, Florence. http://www.unicef-irc.org/publications/pdf/repcard3e.pdf
15. Alba DiCenso et al, 15th June 2002. Interventions To Reduce Unintended Pregnancies Among Adolescents: Systematic Review Of Randomised Controlled Trials. British Medical Journal 324:1426.
16. World Health Organisation, 2007. Unsafe abortion. Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003. Fifth edition. http://www.who.int/reproductive-health/publications/unsafeabortion_2003/ua_estimates03.pdf
17. Andy Coghlan, 21st October 2007. Family planning lowers abortion rates. New Scientist.
18. World Health Organisation, ibid.
19. World Health Organisation, ibid.
20. James Chapman, 25th February 2008. Cameron: Cut the abortion limit to 21 weeks. Daily Mail.
21. Catholic News Agency, ibid.
22. Tegan Fleming, 21st June 2007. Contraception spree: Brazilian government lowers birth control costs for the poor. Pharmacy News.
23. See http://www.globalgagrule.org/
Published in the Guardian 26th February 2008