Dr. Patricia Lohr:

Widespread and free availability of contraception is one of the most important contributors to reducing the risk of unintended pregnancy. As I have said, most women who present for abortions in the UK had not intended to become pregnant. Widespread availability of free contraception in family planning clinics has been important in the UK, as has been the concerted effort to reduce teenage pregnancies by ensuring that young people have available to them the full range of contraceptive methods, including national guidance which supports the use of long-acting methods of contraception in young people, which many doctors and nurses may have been reticent to provide in the past, as well as the education of young and older people about their bodies, the risks of becoming pregnant, when a woman can and cannot get pregnant and how one might prevent pregnancy. Last but not least, the availability of emergency contraception in order that women can prevent a pregnancy if they have had an episode of unintended, unprotected intercourse has also been hugely important. All of these initiatives have been undertaken to try to reduce the risk of unintended pregnancy.

As discussed, no contraceptive method is perfect and in typical use, the failure rates are relatively high, even with what most people might consider to be some of the more effective methods such as the injectable or oral contraceptive pill. There is a finite degree to which one can prevent the need for abortion through access to contraception or sex and relationship education. As we know, and as already referenced today, a small number of abortions are for pregnancies which are very much wanted but because the woman has a medical condition it is unsafe for her to continue to the pregnancy or, as described, there is a foetal anomaly which is an indication for a termination.

Deputy O'Connell asked how ground E was defined. As with all of the grounds for abortion in the UK, it is up to a doctor to determine whether the woman's presentation meets the ground of the Act. There is language in the Act, and in particular ground E, that describes foetal anomaly, to which a doctor may refer but we do not, for example, have a list of foetal anomalies which meet those criteria. I agree with the Deputy that doctors look to the whole picture, particularly in cases where the pregnancy is less than 24 weeks. It may be the case that some terminations may be performed later, for example, in cases of chromosomal abnormality, but the woman would also qualify for an abortion under ground C, that is, risk to mental or physical health.