The England and Wales total increased by just 0.2% compared with the 2010 figure, but this represents a slowly-increasing trend over the last three years, and a 7.7% increase over the last decade.  Last year’s rate was the same as that of 2010, namely, 17.5 abortions per 1,000 residents aged between 15 and 44 years old.  This too represents an increasing trend – the rate was 17.1 in 2001.

More details about abortion in your city, town and area can be obtained by downloading them at: http://transparency.dh.gov.uk/2012/05/29/abortion-statistics-2011/

There are no signs that these figures are about to improve.  It might have been expected that the widespread use of abortifacients, like morning-after pills, and long-acting reversible contraceptives (LARCs) would have dented these totals over the last few years, but not so.

Among these tragic statistics two newish trends are discernible.  First, repeat abortions are continuing to rise.  Over a third (36%) of women undergoing abortions last year had had one or more previously – ten years ago, it was 31%.  Among women in the 30-34 age group, this figure reached 46% last year.  It seems that many are using abortion as a method of contraceptive. It is hard to even imagine that 76 of these women have had seven or more abortions.

The second trend is also related to this 30-34 age group.  They are having more and more abortions, a total of 29,579 during 2011, a 5.7% increase over the previous year, and they are the fastest rising age sector.  Why is this?  No doubt there are many, complex reasons.  Certainly, increasing financial pressures and opportunities on career ladders have caused many women to delay childbirth and family life – they continue to work to pay the mortgage, while their biological clocks continue to tick.  For them, having a child in their mid-thirties is too inconvenient.  Some, sadly, believe they can catch up later in life with the help of IVF – few have calculated its failure rate, especially for older women.  This money-versus-child thing is a sad development of our times.

Is there any solace in any of these figures?  The downward trend among teenagers offers a little consolation.  A total of 34,923 teenagers (under-19s) had abortions in 2011 compared with 38,269 the year before.  Similarly, the under-16 total was 3,258 versus 3,718 for 2010.  And the abortion rates are lower for both groups – 15.0 for the under-18s and 3.4 for the under-16s, compared with 16.5 and 3.9 for 2010.  True, these are small decreases amid a field of increases, but any reduction, anywhere, is always welcome.

For completeness and for a more nuanced understanding, consider the ‘average’ abortion in England and Wales.  It occurs when a white, 22-year-old, single woman, living with a partner, goes to an independent sector abortion clinic, with her unborn child of 7 weeks gestation.  She has a surgical abortion, by means of vacuum aspiration, funded by NHS contract, under statutory ground C, the so-called ‘social clause’, that is, because of ‘risk of injury to the physical or mental health of the pregnant woman.’  Moreover, this young woman is probably in good health, in decent housing, with a regular income and carrying a healthy unborn child.  Perhaps you thought that abortion was for the poor, overworked woman, struggling with three or four children, living in squalor, with a useless, drunken husband.  How wrong you have been!

Is pro-life 'the new normal'?
Since 1995, Gallup has polled the US population about its attitude to abortion.  The 2012 poll showed that 50% of Americans identified themselves as ‘pro-life’.  The ‘pro-choice’ camp registered just 41%, the lowest figure since this annual survey began.  Gallup has called this steady shift towards a pro-life stance ‘the new normal’.

Opinion polls – with all their caveats – are beginning to look encouraging.  Unsurprisingly, the USA leads the way, while Britain lags behind and remains more solidly pro-choice, though the trend is in the right direction.  A 2011 MORI poll showed that although half (53%) of the public agreed that abortion should be legally available, this figure has fallen from 65% in 2001 and 63% in 2006.  In addition, a YouGov poll published in 2012 found that half (49%) of all women favoured a reduction in the current 24-week upper-time limit.  Are men and women on both sides of the Atlantic becoming less enamoured with the ethics and practice of abortion?  When the physical and mental health risks associated with abortion are fully understood and acknowledged, that swing rate will only increase.

From abortion to infanticide
If abortion is legal, why not infanticide?  It is a good question.  If abortions under ground E can be performed up to birth, this is, up to 40 or so weeks, then why not 40 weeks and a day?  The logic is surely unassailable.

Infanticide has a long and miserable history, but it also has its twenty-first century advocates.  The Journal of Medical Ethics published an article in March 2012 entitled, After-Birth Abortion: Why Should the Baby Live? by Alberto Giubilini and Francesca Minerva.  These authors contended that the killing of newborn infants should be permitted on the same grounds currently used to justify abortion.  After all, they insisted, ‘… both fetuses and newborns do not have the same moral status as actual persons.’  And therefore they concluded that, ‘… what we call "after-birth abortion" (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.’  None of this outlandish thinking is new, but it is still frightening.

£1m for what?
After the February revelations by The Daily Telegraph that a number of UK clinics were performing illegal gender-based abortions and generally disregarding the provisions of the Abortion Act 1967, the Health Secretary, Andrew Lansley, ordered spot checks on about 300 clinics in England during three days in March.  The inspectors from the Care Quality Commission (CQC) found that about 50 of these abortion providers were not complying with the law and regulations.

Critics castigated Mr Lansley’s action.  Some pro-abortionists said he had acted disproportionately, others said he was ‘chasing headlines’, and some said the exercise was a waste of £1m.  Few saw it as a sensible check to ensure that a rather clandestine industry was operating within the law.

The waste of money argument is interesting.  In May 2012, it was revealed that the NHS is spending around £1m EACH week providing repeat abortions, mostly via the same clinics that grumbled about being investigated.  Not many abortionists called this on-going cost, a waste of money.

Chen Guangcheng and Feng Jianmei
In April, Chen Guangcheng, the Chinese blind, political activist, escaped house arrest in China and a few weeks later fled, with his wife and children, to the USA.  The legal and political aspects of this affair are tangled.  For many years Chen had had numerous brushes with the Chinese authorities, but it was his exposure of China’s forced abortion and sterilisation strategies that, in August 2006, landed him with a four year and three months prison sentence.  The telling of Chen’s story is curious – to the pro-abortionist press, he is a human rights hero, opposing only coercive abortion.  To the pro-life press, he is a whole-hearted, anti-abortion hero.  Whatever his real position on these issues, he is certainly a brave man.

And his allegations of the horrors associated with China’s one-child policy rang true on 14 June when the story of Feng Jianmei, from Shaanxi province, was published.  She was seven months pregnant, but could not afford the huge fine for breaching the rules and having a second child.  On 2 June, officials from the local family-planning authority had forcibly taken her to the nearby hospital, blindfolded her and held her down while her unborn child was injected with poison.  Two painful days later the traumatised Mrs Feng delivered her dead baby girl.  A hideous – meaning, ‘frightful’ – picture of them was posted on the internet and it went viral within hours.  Worldwide shock and outrage followed.  On 15 June, in a most unusual step, it was announced that city representatives had apologised to Mrs Feng and that three officials had been suspended.

The story gets worse.  By the end of June, Mrs Feng’s family and husband, Deng Jiyuan, had endured several days of bullying and threatening by local officials and he had ‘disappeared’, but was later seen meeting with Zhang Kai, a lawyer in Beijing.  Meanwhile, Mrs Feng’s mental state had deteriorated – she had been detained in hospital, watched and followed, and as a consequence had become suicidal.  Furthermore, a local government and a family-planning bureau official had been fired and five more given formal warnings.

According to Chai Ling (how could I resist that name?), such forced abortions are commonplace throughout China, but banned from being reported.  She was an important student leader during the 1989 Tiananmen Square uprising, became a Christian in 2009, and in 2010 founded All Girls Allowed, a US-based organisation dedicated to revealing the injustice of China’s one-child policy and rescuing mothers and children from it.  Could this whole Feng affair be the catalyst in exposing the practice of forced late-term abortions – any abortion is illegal under Chinese law after 6 months – as well as revitalising the debate over the country's 1979 draconian policy?

Mother-versus-child
Over the years, I have collected this sort of heart-rending story, though with improved obstetric and gynaecological care, they are becoming decidedly rarer.

Four weeks after she had given birth to a healthy 6lb 3oz baby girl, Rennae, she had the life-saving operation which removed half of her left lung.  A year on, mother and baby are doing just fine.

In May 2012, the National Institute for Health and Clinical Excellence (NICE) proposed that older women in England and Wales should be given greater access to IVF on the NHS.  The NICE draft guidelines recommended that the current age limit of 39 be extended to 42 for women who have no other chance of conceiving.  In addition, other groups – same-sex couples, those facing infertility-inducing cancer treatments, couples who have been trying for a baby for two, rather than the current three years, carriers of infectious diseases, such as hepatitis B or HIV, and those who are physically unable to have sexual intercourse – should all be entitled to IVF treatment.  According to NICE, the more the merrier.

For some cash-strapped, over-burdened NHS primary care trusts this will not be welcome news.  Others say that extending IVF on the NHS is unjustified because infertility is not life-threatening.  Moreover, age and sexual orientation should not be regarded as medical conditions that warrant IVF on the NHS.  On the other hand, IVF advocates argue that the postcode lottery must be ended and that every reasonable chance of pregnancy must be taken.  But how ‘reasonable’ is this?  A woman’s fertility plunges after about 35 years of age – that is not a medical disorder, it is a fact of nature!

The current success rate of IVF, calculated as ‘live birth events’ per 100 treatment cycles, is a pretty poor 24.1% (or conversely, a 75.9% failure rate).  For women between 40 and 42 years old, the figure drops to 12.7%, or a 1 in 8 probability.  Should such women be encouraged into late and unlikely motherhood?  An older woman is allowed to have three, rather than the normal two, IVF embryos transferred, thus increasing the likelihood of a multiple pregnancy – a condition universally recognised as the greatest health risk to IVF mothers and their babies.  Is any of this good, sensible medicine?  Is there not a case for calling it an unrealistic, costly, even dangerous, enterprise?

Michael J. Fox, the actor from the Back to the Future trilogy, was diagnosed with Parkinson’s disease in 1991.  Again, he became a vocal celebrity advocate for embryonic stem-cell research.  Interviewed on US television, he has recently admitted that there have been ‘problems along the way’, and that other forms of treatment, especially newer drug regimens, are now showing more promise.

‘Komen for the Cure’ is a breast cancer foundation, which supports research, education, health services and social support in the USA and 50 other countries.  In 2011, it changed its position on funding those engaged in embryonic stem-cell research.  Its website stated, ‘Komen supports research on the isolation, derivation, production, and testing of stem cells that are capable of producing all or almost all of the cell types of the developing body and may result in improved understanding of or treatments for breast cancer, but are derived without creating a human embryo or destroying a human embryo.’  In 2012, its website was updated to include, ‘A recent review of our funded grants revealed that human embryonic stem-cell tissue has not been used in breast cancer research funded by Komen.’  And, ‘Whether embryonic stem cells will have a role or will be of value in the fight against breast cancer has not been clearly determined.  To this point, embryonic stem-cell research has not shown promise for application in breast cancer.’

There is now a decidedly more sober, less hyped, assessment of the promise of embryonic stem cells among scientists, politicians and even celebrities.  The razzmatazz has died down.  Meanwhile, it has been estimated that as many as 50,000 people worldwide have benefited from adult stem-cell treatments.

Adult stem-cell papers – a selection
What follows is a (very) small, and rather random, selection of recent refereed reports from the scientific press.  They demonstrate the diversity of applications to which adult stem cells are being used.  The wording is abstracted from the original papers – it can be a little opaque, but the positive themes are clear enough.

‘Human stem cells taken from the retina, located in the back of the eye, have been used to restore some vision in blind rats, according to researchers.’  Stem Cells Translational Medicine (2012) 1: 188-199.

‘Cardiosphere-derived cells (CDCs) [these are adult stem cells derived from the heart] reduce scarring after myocardial infarction, increase viable myocardium, and boost cardiac function in preclinical models.’  Lancet (2012) 379: 895-904.

‘New research holds the promise of freeing many organ transplant patients from a lifetime of anti-rejection drugs.  In the first study of its kind, eight kidney transplant patients received stem cells from their kidney donors manipulated to ‘trick’ their bodies into accepting the foreign organ as its own.’  Science Translational Medicine (2012) 4: 124.

‘A new approach to treatment involves the use of three-dimensional biological scaffolds made of allogeneic or xenogeneic extracellular matrix derived from non-autologous sources.  These scaffolds can act as an inductive template for functional tissue and organ reconstruction after recellularisation with autologous stem cells [these are adult stem cells derived from the patient] or differentiated cells.  Such an approach has been used successfully for the repair and reconstruction of several complex tissues such as trachea, oesophagus, and skeletal muscle in animal models and human beings.’  Lancet (2012) 379: 943-952.

‘The use of adult-tissue stem cells to treat gastrointestinal diseases holds much promise.  A method for in vitro growth of gut stem cells and their use in repairing damaged intestines in mice has been described.’  Nature (2012) 485: 181–182.

There were numerous amendments and speeches.  Some MPs wanted the guidelines enshrined in law so that only Parliament, rather than the courts, could amend them.  The evangelical Christian MP Fiona Bruce laid an amendment calling for improvements in palliative care.  Labour's Frank Field, believed the issue was really, ‘a debate that dare not enter its name on the order paper – euthanasia.’

In the end, the motion was passed without a vote.  Assisted suicide thus remains a criminal offence.  Nevertheless, such debates can create a sense of unease.  What were the real intentions of Mr Ottaway?  Was he a stool pigeon of the Dignity in Dying organisation?  Worryingly, before the debate, he had stated, ‘I am sympathetic to further developments in the law.’  Worryingly, after the debate, Dignity in Dying’s chief executive, Sarah Wotton said, ‘The passing of Richard Ottaway's motion represents a landmark in the evolution of a more compassionate approach to end-of-life decision making.’

Euthanasia – away and at home
Debates over euthanasia and assisted suicide will not fade away.  Some distort them by suggesting that only legalisation will bring a settled end to these acrimonious disputes and a happy stability for the few who wish to end their lives prematurely.  Certainly the numbers do not support this sort of optimistic argument.  In Oregon, the latest statistics show that assisted suicide cases have risen from 16 in 1998 to 71 in 2011.  This is a 450% increase.  Similarly in Switzerland, there has been a 700% increase, from 43 in 1998 to 297 in 2009.  These figures include only Swiss nationals and not the growing numbers of people from abroad who are making use of facilities like those of Dignitas.  It is a basic rule across all bioethical issues that legalisation inevitably results in a new clientele and an increase in user numbers – think abortion, for example.

We in the UK should be warned – legalisation begets escalation.  And the pressure to legalise some form of euthanasia continues in the media, the courts, the medical profession and Parliament.

The 16 June edition of the British Medical Journal was another demonstration of this sort of concerted effort by pro-euthanasiasts.  It contained about half a dozen such pieces, including editorials, articles and letters – never before has there been such an obvious, coordinated push.

On 19 to 22 June, three Judges in the High Court, Lord Justice Toulson, sitting with Mr Justice Royce and Mrs Justice Macur, heard the cases of two men with conditions resembling locked-in syndrome who are seeking to change the law.  Tony Nicklinson is seeking a declaration that, ‘it would not be unlawful on the grounds of necessity for Mr Nicklinson's GP, or another doctor, to terminate or assist the termination of Mr Nicklinson's life.’  He will also seeking a second declaration that the ‘current law of murder and/or of assisted suicide is incompatible with his right to respect for private life under Article 8 of the European Convention of Human Rights.  In other words, he is asking for a change in the law on murder.

The other man, known only as ‘Martin’, is also arguing under Article 8 and wants the Director of Public Prosecutions (DPP) to amend the policy on assisted suicide prosecutions so that professionals, namely, solicitors and doctors, could assist in his suicide.  If these cases were to be successful the vulnerable would become less protected and the legalisation of voluntary euthanasia would become a serious step nearer.  Judgement was reserved in both of these landmark cases – we await their outcome.

On 24 to 28 June, the Annual Representative Meeting of the British Medical Association (BMA) took place in Bournemouth.  On the Wednesday, there was a 95-minute session reserved for debating ethical issues and this year an unprecedented 20 motions dealt with euthanasia.  It was clear that several doctors, especially those from the pressure group Healthcare Professionals for Assisted Dying (HPAD) and linked to the Dignity in Dying organisation, were attempting to use 14 of these motions to push the BMA to move from its current opposing position to a neutral stance on the legalisation of euthanasia and/or assisted suicide.  In the event only one of the euthanasia motions was debated, namely motion 332, part of which stated, ‘That this Meeting believes that the BMA should adopt a neutral position on change in the law on assisted dying.’  A neutral position would be a betrayal of the doctor-patient relationship, it would also tell Parliament and the public that assisted suicide was acceptable.  The good news is that the motion was lost!  Incidentally, the meeting approved a motion, ‘that women considering abortion should be able to access counselling that is independent of the abortion provider.’  More good news!

At the end of June, Lord Falconer, who chaired the bogus Commission on Assisted Dying last year, announced that he intends to bring an assisted suicide Bill before Parliament next year.  In the meantime, the All-Party Parliamentary Group on Choice at the End of Life, is commencing a public consultation on the issue and will use its conclusions to tweak Lord Falconer's Bill. 

And throughout July, the BBC, that champion of assisted suicide, is showing four TV programmes on old age called When I Get Older, starring Gloria Hunniford, Lesley Joseph, Tony Robinson and John Simpson.  The content of these programmes is, as yet, unknown to viewers, but already John Simpson, the BBC's World Affairs editor, has used the opportunity to declare in the news media why he would prefer to commit suicide before he becomes 'a drooling ancient' and that, 'I have a couple of bottles of pills handy.'  He thus joins the list of celebrity advocates.

On 4 July, Dignity in Dying is holding a mass lobby of Parliament in the hope of persuading MPs to change the law, the Suicide Act 1961.  Earlier in the day, members have a business meeting at the Queen Elizabeth II Conference Centre and then later in the afternoon there is the promise of a keynote address by a ‘special guest’!!

Scotland is not exempt – earlier this year, Margo MacDonald MSP lodged the draft of her proposed Assisted Suicide (Scotland) Bill with the Scottish Parliament.  This is despite her last euthanasia-type Bill being trounced by 85 to 16 by the Scottish Parliament in December 2010.  Her new Bill covers assisted suicide only, not euthanasia.  A public consultation closed on 30 April 2012.  The next step is awaited.

Included in the total were 186,196 cases of Chlamydia (-2%), 31,154 of herpes (+5%), 20,965 of gonorrhoea (+25%), 2,915 of syphilis (+10%) and 76,071 of genital warts (+1%).  The groups most at risk are heterosexual adults, especially those aged between 15 and 24 years, and men having sex with men.  Of course, all these data depend upon people attending clinics – they are therefore underestimates of all the infections ‘out there’.  While these trends are unsuitable for polite conversation at the dinner table, they do demand some sober reflection.

Morning-after pills (MAPs)
Bioethical ructions broke out when The New York Times (NYT) announced on 5 June that the MAP, known as Plan B One-Step in the USA, almost certainly has no post-fertilisation effect.  The article was entitled, Abortion Qualms on Morning-After Pill May Be Unfounded.

MAPs have three acknowledged modes of action – even the manufacturers agree.  First, anti-ovulatory, they can prevent, or delay, ova production.  Second, anti-migratory, they can thicken cervical mucus thereby impeding the movement of gametes, keeping sperm and ova apart.  Third, anti-implantationory, they can alter the endometrium, making it hostile to the developing embryo, preventing implantation and thus causing death.

It is this latter, the post-fertilisation, mode which has always been the basis of objection to MAPs – they can cause early abortions.  Now the NYT maintained that, ‘Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say.’  Quite who these ‘leading scientists’ are remains unclear, as do their uncited ‘studies’.  Rather the article contained vague statements from vague doctors.  It degenerated into a piece of wishful thinking rather than serious science.  But then the NYT’s understanding of biological science became questionable when it stated, ‘The notion that morning-after pills prevent eggs from implanting …’  Eggs do not implant, embryos do.

This is not just some arcane bioethical argument.  The issue is big enough to feature in the upcoming US Presidential race.  Already several doctors and pharmacists have gone to court for refusing, on grounds of conscience, to prescribe and supply MAPs.  But the even bigger issue is that the President’s reorganisation of US medical care, so-called Obamacare, requires all medical insurance funded by employers to cover the supply of contraceptives and MAPs.  This has caused fury among many evangelical and Roman Catholic medical and educational institutions.

A world upside down
Christians understand why the world is abnormal (Genesis 1; Romans 1, and so on).  We know why men and women do wicked things to other men and women, and children.  But we live under obligations, such as, Micah 6:8, Matthew 7:12, and so on.  That is why we oppose human embryo destruction, euthanasia, abortion, and so on.  That is why we protect and cherish all human life – young and old, able and disabled, unborn and born, and so on.  And that is why we honour men and women who speak up and lead these just and good causes.

So it is odd, even perverse, that a country should award its highest civic honour to a man who exhibits none of these qualities.  In June, Professor Peter Singer was made a Companion of the Order of Australia.  This is the man whose repugnant views on abortion, infanticide, euthanasia, animal rights and bestiality have caused bioethical storms around the world.  He has become one of the world’s most vocal advocates for the culture of death.  He has been described as, ‘the most celebrated bioethicist and moral philosopher of our times’ and also as ‘the most dangerous man on earth today.’

As I child, I could never grasp how Australians, down under, could stand upright.  Then I learned about gravity.  Now, as an adult, I cannot grasp how their ethical insight and honours system can be so upside down – there is certainly no gravitas there.