Leading Article: Women should have this choice

WHY was the abortion pill, RU486, used by only 3,000 women of the 176,000 who had abortions in Britain last year? One explanation may be disregarded straight away: these figures do not represent a preference by women for surgical procedures over medical ones. In other countries the take-up of the pill is at least a quarter of those offered the choice between a medicine and an operation to end their pregnancies.

Other explanations are more worrying. The first factor appears to be inertia and short-sighted accounting on the part of NHS hospitals. An abortion produced by the pill is about 30 per cent cheaper for them than one done surgically. This represents a saving well worth making. But it is bought at the cost of a reorganisation of procedures so that abortion becomes an outpatient service rather than an in-patient one. This requires an initial investment of time and money that few hospitals seem willing to make.

Of course, the argument is not that women should be pressured into taking the cheapest form of abortion available. The real arguments in favour of the pill, rather than the operation, are that it is safer and may be less traumatic. It is non-invasive, and does not require anaesthetic. When the advantages are coupled with the financial benefits to the health service, the case for offering the pill more widely becomes unquestionable.

Some women may find that it is harder for them psychologically to know that they have done the deed themselves, rather than have a doctor act on their bodies while they are unconscious. But all women should be given the choice of methods and this is simply not happening. The choice is being made for them by default, for the wrong reasons and by the wrong people.

The second great obstacle to the spread of RU486 is directly related to its ease of use and safety. Any woman in this country who uses the pill must have had the same certification from two doctors as she would need if she were to undergo a surgical abortion; and it is only given to women with confirmed pregnancies. But it could be used much more widely. It makes clear the difference between early, simple abortions and late, agonising ones. This is what makes it truly frightening to the opponents of all abortion, who have campaigned, so far successfully, to keep it out of the United States.

For anyone who believes, as this newspaper does, that the foetus acquires humanity gradually and that abortion is not murder, the pill is good news. So is anything that increases the proportion of early over late abortions. The NHS is bad at providing surgical abortions early. Over 70 per cent of the abortions carried out before nine weeks in this country are carried out by the private sector. That is the period during which the abortion pill may be prescribed. But private clinics require special permission from the Department of Health to offer it as an alternative to the usual surgical procedures. Some of them claim, absurdly, that it is too expensive.

So, more widespread use of the pill within the NHS would not only give women more choice as to the means of abortion, but also diminish the number of later, more traumatic, operations. At present anti-abortion pressure and producer convenience prevent women from being offered a choice that the health service should provide.