Wednesday, March 26, 2008

EXCLUSIVE: Margaret Somerville on late-term abortion

In a discussion surrounding this post on late-term abortion, Joyce Arthur expressed her skepticism about whether abortionists in Canada perform elective, non-urgent late-term abortions.

Tanya cited a TVO interview with Margaret Somerville in which she said that late-term elective abortions do happen. (I also questioned that assertion in another post, citing the Abortion Rights Coalition website.)

In response, Joyce Arthur responded:

Oh yeah, I remember that. Many months ago in a column, Somerville spun an anecdotal yarn about a couple women who had allegedly approached doctors about doing a very late-term abortion on an apparent casual whim. Just a few months later, Somerville had somehow morphed her tall tale into how the women HAD gotten late-term abortions on a whim. What utter and total BS!!

I challenge you to find me a single such case anywhere in Canada at any time, where a woman managed to get a "casual" abortion in the 3rd trimester. Because the crucial piece that's missing from Somerville's claim, is that even if a few women do request such abortions on very rare occasions (that's essentially an urban myth, though), no doctor would do them! Doctors need a supportive team and entire infrastructure behind them to do late-term abortions, and that would be lacking except under the most compelling circumstances.

Although there's no abortion law in Canada, doctors do adhere to the CMA recommendation of no abortions on request after 20 weeks. Even then, so-called "elective" abortions after 16 weeks are rare and generally done because of desperate circumstances in the woman's life.

I thought I would email Margaret Somerville and ask for her response to this comment. She was kind enough to respond. I have edited out one piece of information to prevent identifying a woman undergoing abortion. It's a trivial point. I will post the relevant parts:

Dear Suzanne,

It was not an "anecdotal yarn"; it was one of several late term abortion cases on which I have been consulted by people - some of them healthcare professionals - involved in the decision making about abortion, who were extremely distressed about the situation they were facing.

The case in question involved a married couple - man and woman - who had conceived naturally, the woman was 34 weeks pregnant and the scan showed the baby had a cleft palate. They requested an abortion, because they did not want to have a "defective baby".

In another case, a 29 year old graduate student from [OMITTED] was 32 weeks pregnant and wanted an abortion for social reasons. I was consulted on the case and later followed up to see what happened. The answer I received was that "You don't want to know", said in such a way it was clear an abortion had been undertaken.

I've also been consulted on late term selective reduction of multiple pregnancy in which one or more fetuses are killed in utero with a lethal injection of potassium chloride into their heart and the dead fetus(es) delivered at term with the living one(s). In two cases I know of involving twins, one twin was killed. In fact, I wrote in the New England Journal of Medicine on an early case in which this was done because the woman did not want to have twins and said she would abort both babies unless one was killed.

There is an abortion clinic on Saint Catherine Street in Montreal that, as I understand the situation, does all the very late term (over 22 weeks gestation) abortions in Quebec. It's been reported that the Quebec Government has sent at least one obstetrician to the US to be trained to do these abortions - if they were not happening, why have a clinic and why train someone to do them? And I also understand that late abortions up to 22 weeks (i.e. past the CMA's cut-off for viability of 20 weeks) are usually done at a University of Sherbrooke hospital in Sherbrooke.

I do not have information on other provinces, but I'd be surprised if the situation I describe above is unique to Quebec. There's a truism in ethics, but no less important for that, that good facts are essential to good ethics. We all need to know these facts. The reason we do not, is that some years ago, instructions were given to Statistics Canada not to request from hospitals and clinics reporting, as required, on the number of abortions, the gestational age at which abortion occurred. My understanding is that this was a politically motivated instruction.

I just want to add that she wrote:

PS If you want to post this you may as a response to you after being notified of Joyce Arthur's comments. I don't want to get into an exchange as I'm too busy. I'm off to New York in an hour to give a speech "Would you want to be an embryo in 2008?" at the UN.

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