Sexual Health Team
Department of Health
6th Floor Skipton House
80 London Rd
27th September 2000
Dear Ms Ellis,
Thank you for your letter of 4th August inviting our views on changes to the Abortion Notification Form HSA4. The time available does not allow us to consult as widely as we would wish on this important topic but we would like to make the following comments which we hope may assist The Joint Ethico-Medical Committee considers these matters on behalf of The Guild of Catholic Doctors, representing Catholic members of the profession, and The Catholic Union of Great Britain - the standing Catholic parliamentary lobby.
We are sure that the spirit of the Abortion Act is not being complied with. The Royal College of Gynaecology and Obstetrics has recently stated that 98% of abortions are for social reasons. Nevertheless it is medical reasons which are offered in order to comply with the law. The usual diagnoses are "depression" or "neurotic illness".
We believe the medical diagnoses given are false. If not then unwanted pregnancy would be one of the most serious causes of mental ill health and having a huge impact on the NHS. If this is so then where are the statistics showing this to be found?
The use of such spurious reasons do not detract from the fact that long term psychological consequences to abortion do arise beyond the immediate post abortion period taking the form of post traumatic stress disorder and a variety of psychological sequelae loosely termed "post abortion syndrome" We would be glad to provide more information on these and other complications, including the risks of future miscarriage and possible breast cancer.
In order to reduce the risks of some of these complications a proper psychological assessment should be carried out by practitioners with particular regard to mental health before an abortion is carried out. Evidence that such an assessment has taken place should be included in HSA4 and notification that the possible complications have been discussed given.
The parity of women and number of previous abortions do seem to be facts which the Department of Health should collect in order to monitor its policy of reducing the number of abortions particularly in younger women. We also think that the number of late abortions, after 24 weeks, are of legitimate public and parliamentary concern.
Legal informed consent depends upon information about possible complications being given. There is now a growing number of women in the United States and Australia who have received damages as a result of the harm that abortion has done them that they had not been warned about. No doubt such actions will come to this country if the present lack of candour continues and there are implications for the NHS as well as for private practitioners.
The review of the notification form provides an opportunity to correct some of these defects. Your welcome review is a chance to address a number of important matters and we hope that the consultation will be ongoing.
Dr Anthony Cole JP FRCP