House of Lords vote underscores need for continued engagement by healthcare professionals
this article is adapted from the original on the Healthcare for Both Lives website at bit.ly/3PVov3W
The nighttime debate in the House of Lords on 18 March held significant weight for healthcare professionals committed to healthcare that protects and values both the pregnant woman and her pre-born child.
Peers voted against two significant amendments to the Crime and Policing Bill. Baroness Monckton’s amendment, which sought to remove the proposed decriminalisation of abortion up to birth, was defeated despite substantial support (185–148).1 Baroness Stroud’s amendment, which aimed to reinstate in-person consultations prior to at-home abortions, was also rejected (191–119).2
These decisions are still more concerning when considered together. If the Bill proceeds in its current form, abortion will be decriminalised for women in relation to their own pregnancies, while the current model of telemedical provision (‘pills by post’) continues without any requirement for in-person clinical assessment. As several peers highlighted during the debate, this combination represents a troubling convergence of reduced legal safeguards and reduced clinical oversight.
During the debate, both Baroness Monckton and Baroness Stroud referenced the recent letter signed by around 1,000 healthcare professionals.3 Your collective voice was clearly heard in the chamber. Baroness Hollins also drew attention to the concerns raised by clinicians.
The open letter set out concerns that, without in-person consultation, the accurate assessment of gestational age, underlying health risks, and the possibility of coercion becomes significantly more difficult. A system that depends on self-reported information, often provided remotely, inevitably carries a risk of error, pressure, or misrepresentation, particularly in more complex or vulnerable situations.
The letter also highlighted the evidence that the risks associated with medical abortion increase significantly with gestational age. Government data has shown markedly higher complication rates at later gestations, even within supervised clinical settings.4 The prospect of self-administered abortions at later stages of pregnancy, without direct medical assessment, therefore, raises serious patient safety concerns. Rather than removing the legal deterrent, we ought to provide accessible services to help vulnerable women find support in a time of crisis.
In the same debate, while some peers drew attention to these concerns from health professionals, others claimed that medical opinion is consistently supportive of further decriminalisation. The existence of the letter, which many of you signed, demonstrates that this is not the case. There remains a substantial body of healthcare professionals who believe that the current direction of travel raises serious ethical, clinical, and safeguarding concerns. However, until now, these clinicians have not been given a voice.
In addition to the concerns for the health of mothers, Baroness Monckton highlighted these words from the UN Convention on the Rights of the Child: ‘The child…needs special safeguards and care, including appropriate legal protection, before as well as after birth.’5
A change in law so that a woman terminating her own pregnancy, even at full term, does not commit a crime risks obscuring the presence of a second human being, the unborn child. Such a change reflects a failure to give due weight to the child’s need for care and appropriate safeguarding in both law and practice.
While the amendments were not successful, the debate made clear that these issues are far from settled. The future shape of law and practice will continue to be influenced not only by Parliament, but also by healthcare professionals who speak with clarity and conviction into this space.
The debate on 18 March underscores the clear need for a network of clinicians who wish to remain informed, connected, and engaged. Healthcare for Both Lives6 exists to support exactly this: bringing together healthcare professionals committed to the care and dignity of both lives in pregnancy, supporting one another, including support to contribute thoughtfully and responsibly to ongoing discussions in policy and practice.
At a moment when legal change and clinical provision are moving together in ways that raise significant concern, your continued engagement matters greatly.
You can find out more about Healthcare for Both Lives and how you can add your voice to its campaign for healthcare that protects and values both the pregnant mother and her pre-born child at healthcareforbothlives.org.
