Abortion: Forty years of the woman's right to choose

The days of brutal back-street terminations are long gone, but debate still rages over the legal time limit

Helena has just murdered her unborn child. Or simply prevented a baby from happening, by ending her pregnancy before life began. It depends on your personal point of view. Either way, it was Helena's decision. "I had to do this," says the 26-year-old as she prepares to leave the clinic. "I cannot have a baby. It is not possible."

So she caught the Tube this morning, walked down a quiet street in the West End of London and pressed the buzzer of a terraced house, an unremarkable place except for the historic blue plaque on the wall outside. This is Marie Stopes House, former home of the great pioneer of contraception and sexual freedom.

"They gave me a pill that stops the blood supply to the ... I don't know, whatever you want to call it," says Helena. Tomorrow she will return for more pills that will cause the tiny seven-week-old foetus to be expelled from her body. "They say the miscarriage might begin within the hour."

This is what termination is like for some women now, 40 years after an Act of Parliament made it legal and ended the brutal practice of backstreet abortions. Last year, there were just over 200,000 safe and legal procedures in Britain. The official rate has more than doubled since 1967 – now 18 women of childbearing age out of every 1,000 choose to end an unwanted pregnancy – but nobody knows how many dangerous, secret procedures were performed back then.

The anniversary is next Saturday. It comes as MPs are investigating whether the limit for abortions should be reduced from 24 weeks, because of medical and scientific advances. The pro-choice movement says no, but does want the law changed to allow easier access to abortion. The group Abortion Rights is screening Mike Leigh's film Vera Drake in London to remind people what it was like in the bad old days. Deadly, for some women then; far better to take a pill in a quiet, clean clinic with nurses in white tunics who smile a lot.

"They asked me to pay first," says Helena. The father is a performer with no regular income. They have not been together long and this was not supposed to happen: a condom burst, then – worse – the morning-after pill did not work. Somehow he came up with the money: £70 for a consultation and £395 for the tablets that make up a medical abortion. Helena's will is strong, yet as she talks her chin begins to wobble. Her eyes are watering. "You have mixed emotions," she says, as if talking about somebody else. "Your head is telling you that you just can't entertain the idea of being pregnant. Your heart is telling you it's an amazing thing to happen, the most important thing anyone can do in their life ..."

Her head won, then. Just. Was it close? "Uh-huh," she says quietly, and nods.

A miscarriage is unpleasant even when it's by choice. But there are other far more dramatic kinds of abortions for women who leave it later than Helena. Some of them are happening down in the basement of the centre as she speaks. If you are squeamish, prepare yourself: we're going down there in a moment.

Last Wednesday a Dispatches programme on Channel 4 showed shocking images of the remains of foetuses pulled or sucked from the womb in bits: long, slick trails of blood and jelly-like tissue containing a tiny foot here, or a hand with five translucent fingers there. "We are quieter than usual today," says the clinic manager, who says women have cancelled after seeing the film. "They will probably ring us again, though, in a couple of days."

The images were given to Channel 4 by the anti-abortion (or pro-life) movement, which is using the anniversary to campaign for a reduction in the legal time limit. Campaigners say there is growing evidence that the foetus can feel pain by 24 weeks or earlier, and that advances in medical science mean more babies born very prematurely are surviving.

Increasing numbers of doctors and nurses are refusing to take part in abortions towards the upper end of the legal limit, deciding for themselves where to draw the line. The Royal College of Obstetricians and Gynaecologists has warned of a looming shortage of people willing to carry out the procedures. A survey last week showed that two-thirds of GPs want the limit reduced. But more than half would also like to make abortion easier for women by removing the requirement for women to obtain permission from two doctors first.

The pro-choice lobby – including the charity Marie Stopes International, which runs the clinic where Helena has come – says there is no hard scientific proof about pain, and disputes the evidence for survival rates. Liz Davies, head of Marie Stopes in the UK, says the two-doctor rule should go but the legal limit should stay. "The needs of the woman are paramount. Not the needs of the foetus."

That's not what they think outside the clinics, where protesters regularly stand with placards and kneel to pray. Hundreds will gather outside the QE2 Centre in London on Wednesday when MSI hosts the Global Safe Abortion conference.

Meanwhile, the cross-party group of MPs on the Commons science and technology committee has been hearing from both sides. Their inquiry was partly provoked by the astonishingly detailed "4D" scan pictures of young foetuses made by Professor Stuart Campbell, who says they appear to suck their thumbs and make faces in reaction to movement.

"I found them shocking," says Helena. "If I had been 13 or 14 weeks gone, after seeing them, I don't know what I would have done."

The radio is playing from unseen speakers, partly to distract anxious women and partly to mask the conversation at the front desk. Nobody seems to notice the song that is playing, with brutal irony. The chorus says, "Baby, can I hold you tonight?"

No. Not tonight. Not here. There are no babies in the language of this clinic, only neutral words like foetal tissue. "We do everything we can to demedicalise this place," says Deanna, the centre manager. "These women are not sick; they have come here for a procedure. We don't want it to look or feel or smell like a hospital."

Perversely, it is more like a fertility clinic. The same scents of air freshener, antiseptic, latex and something darker and the same body language in the waiting room: a woman flicking through OK!, clearly distracted by worry; her partner trying to be the big man, staring into space, saying nothing. There are fewer couples here. And on the whole, the women are younger.

"After the fees room you go for a scan," says Helena. What did she see? "It was a shape that was just beginning to elongate, on its way to becoming like a kidney bean." Her parents do not know what she is doing. "They are Victorian about these things. They would say I am being irresponsible."

This centre will terminate only up to 12 weeks. After that, you have to go to one of the bigger centres. They see 500 people a month here, of whom the majority – 62 per cent – have a termination with conscious sedation. That means they are awake, although drowsy and relaxed, as they lie with their feet apart and knees up on a gynaecological couch and a doctor extracts the foetus from the womb, using a suction pump.

That happens down in the basement where partners – those few that come – are never allowed. It is too small, too crowded and too private. In the recovery room are a dozen navy-blue recliner chairs arranged with their backs to the walls, as in a beauty spa, but nobody has cucumbers over their lids. One of the women has bloodshot eyes that look like they have cried today, but she quickly turns away. Another returns my look with confidence. She is smiling, as she lies back with her feet up on the end of the chair, knees up and a heated strip of material across her stomach. The leaflets say it will hurt; there's no point pretending otherwise.

The gynaecologist on duty today is a softly spoken man whose accent suggests he comes from a French-speaking part of West Africa. He doesn't want to be named. "This is a five-minute procedure," he says. A nurse explains what is happening as the cervix is dilated. "It is like having a smear test," says the gynaecologist, but that's not quite true, is it? He works with what looks like a giant syringe (with no sharp end), pulling it back to suck the foetal tissue from the womb.

"In some cases there may be some retained products," he says, meaning something left behind which can cause infection, "but that is very rare."

His colleague Dr John Spencer, senior clinical director for Marie Stopes, was quoted by Dispatches describing what it was like to abort a foetus that was much older and larger, when it could not be removed like this or even all in one piece. "The foetal parts are soft enough to break apart as they are being removed," he said. Using an ultrasound as guidance he was seen using forceps to pull out the body parts bit by bit, describing those which were too big. "Those parts are the skull and then the spine and pelvis and in fact they are crushed."

Liz Davies says Dispatches showed pro-life propaganda, namely a whole foetus being wrapped in plastic. She thinks it was a stillbirth, not an abortion. But what about her own doctor's words? Were they exaggeration?

"These are the bald facts of abortion," she admits flatly. "We make no attempt to hide from them. The foetus is not removed whole in late abortion. We give a general anaesthetic. Death of the foetus is instantaneous at the commencement of the procedure. The purpose of abortion is to bring about the demise of a foetus for the betterment of a woman's life."

Marie Stopes International runs 38 clinics in Britain and the profits from them go to fund its work in developing countries. The charity was started in honour of Stopes, voted Woman of the Century in a poll in 1999. Its research shows women have "compelling" reasons for leaving it late, says Ms Davies. Some may not know they're pregnant, if they're used to menstrual cramps or weight gain. Some take a long time to act. "If the limit were lowered it would rush them into an abortion that was not actually right for them."

When the procedure is over, what happens to the foetus? That is not something they like to talk about. "We don't want the pro-lifers getting hold of this stuff," says Liz Davies. But she also insists they have having nothing to hide, so describes how the "foetal tissue" is put into a large plastic tub, along with all the other "products" of the rest of a day's work at the clinic. The tub is sealed and securely stored by the clinic until it is taken away by a specialist clinical waste firm to be incinerated.

As patients feel able, they stand and dress and go to the recovery room. Within a day or so they will start to bleed heavily for a while, far more than a period, and may experience contractions. Before they leave, Marie Stopes offers counselling and painkillers.

Helena does not need them. She has acted quickly and avoided the suction pump and the recovery room. This time. "I might as well tell you," she says, "since this is anonymous. This is not my first time." She had an abortion four years ago and it was later, a messier business. "The second time is harder, though," she says. "You are older and more aware of the missing piece in your life. Children can be that.

"I do want children, one day, and I dread the idea that by doing this I might somehow bring something dreadful on myself and it won't be possible. There are times when I feel, 'Wow this is a lovely feeling.' But I know that it can't last."

Helena rises and pulls on her coat. "Look, if I could I would have it, absolutely. I can't though. Financially, I would not feel in a position to do that."

Cramps have made it impossible to ignore what has been happening to her. "I do feel I have a relationship with ... I don't know what to call it. Definitely." That surprises her, she admits as she leaves, going back to a sofa, a hot chocolate and a favourite film. "I'm not sure what to think. It's not a person though because it has not formed enough and not taken on an identity," she says tentatively. "It's still special, though. It's still something. It's not nothing, is it?"

The Banksy image in Folkestone before it was vandalised
Life and Style

Sales of the tablet are set to fall again, say analysts

football West Brom vs Man Utd match report: Blind grabs point, but away form a problem for Van Gaal
Arts and Entertainment
Gotham is coming to UK shores this autumn
tvGotham, episode 2, review
Have you tried new the Independent Digital Edition apps?
ebooksAn unforgettable anthology of contemporary reportage
Arts and Entertainment
Bloom Time: Mira Sorvino
tvMira Sorvino on leaving movie roles for 'The Intruders'
First woman: Valentina Tereshkova
peopleNASA guinea pig Kate Greene thinks it might fly
Brian Harvey turned up at Downing Street today demanding to speak to the Prime Minister

Met Police confirm there was a 'minor disturbance' and that no-one was arrested

Arts and Entertainment
George Lucas poses with a group of Star Wars-inspired Disney characters at Disney's Hollywood Studios in 2010

George Lucas criticises the major Hollywood film studios

Chris Grayling, Justice Secretary: 'There are pressures which we are facing but there is not a crisis'

Does Chris Grayling realise what a vague concept he is dealing with?

Life and Style
A street vendor in Mexico City sells Dorilocos, which are topped with carrot, jimaca, cucumber, peanuts, pork rinds, spices and hot sauce
food + drink

Trend which requires crisps, a fork and a strong stomach is sweeping Mexico's streets

Life and Style
The charity Sands reports that 11 babies are stillborn everyday in the UK
lifeEleven babies are stillborn every day in the UK, yet no one speaks about this silent tragedy
Blackpool is expected to become one of the first places to introduce the Government’s controversial new Public Space Protection Orders (PSPOs)

Parties threaten resort's image as a family destination

Life and Style
Northern soul mecca the Wigan Casino
fashionGone are the punks, casuals, new romantics, ravers, skaters, crusties. Now all kids look the same
Life and Style

I Am Bread could actually be a challenging and nuanced title

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Year 5 Teacher

£80 - £140 per day: Randstad Education Leeds: Year 5 Teacher KS2 teaching job...

Software Developer

£35000 - £45000 Per Annum Pensions Scheme After 6 Months: Clearwater People So...

Systems Analyst / Business Analyst - Central London

£35000 - £37000 per annum + Benefits: Ashdown Group: Systems Analyst / Busines...

Senior Change Engineer (Network, Cisco, Juniper) £30k

£30000 - £35000 per annum + Benefits: Ampersand Consulting LLP: Senior Change ...

Day In a Page

Two super-sized ships have cruised into British waters, but how big can these behemoths get?

Super-sized ships: How big can they get?

Two of the largest vessels in the world cruised into UK waters last week
British doctors on brink of 'cure' for paralysis with spinal cord treatment

British doctors on brink of cure for paralysis

Sufferers can now be offered the possibility of cure thanks to a revolutionary implant of regenerative cells
Ranked seventh in world’s best tourist cities - not London, or Edinburgh, but Salisbury

Salisbury ranked seventh in world’s best tourist cities

The city is home to one of the four surviving copies of the Magna Carta, along with the world’s oldest mechanical clock
Let's talk about loss

We need to talk about loss

Secrecy and silence surround stillbirth
Will there be an all-female mission to Mars?

Will there be an all-female mission to Mars?

Women may be better suited to space travel than men are
Oscar Pistorius sentencing: The athlete's wealth and notoriety have provoked a long overdue debate on South African prisons

'They poured water on, then electrified me...'

If Oscar Pistorius is sent to jail, his experience will not be that of other inmates
James Wharton: The former Guard now fighting discrimination against gay soldiers

The former Guard now fighting discrimination against gay soldiers

Life after the Army has brought new battles for the LGBT activist James Wharton
Ebola in the US: Panic over the virus threatens to infect President Obama's midterms

Panic over Ebola threatens to infect the midterms

Just one person has died, yet November's elections may be affected by what Republicans call 'Obama's Katrina', says Rupert Cornwell
Premier League coaches join the RSC to swap the tricks of their trades

Darling, you were fabulous! But offside...

Premier League coaches are joining the RSC to learn acting skills, and in turn they will teach its actors to play football. Nick Clark finds out why
How to dress with authority: Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear

How to dress with authority

Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear
New book on Joy Division's Ian Curtis sheds new light on the life of the late singer

New book on Ian Curtis sheds fresh light on the life of the late singer

'Joy Division were making art... Ian was for real' says author Jon Savage
Sean Harris: A rare interview with British acting's secret weapon

Sean Harris: A rare interview with British acting's secret weapon

The Bafta-winner talks Hollywood, being branded a psycho, and how Barbra Streisand is his true inspiration
Tim Minchin, interview: The musician, comedian and world's favourite ginger is on scorching form

Tim Minchin interview

For a no-holds-barred comedian who is scathing about woolly thinking and oppressive religiosity, he is surprisingly gentle in person
Boris Johnson's boozing won't win the puritan vote

Boris's boozing won't win the puritan vote

Many of us Brits still disapprove of conspicuous consumption – it's the way we were raised, says DJ Taylor
Ash frontman Tim Wheeler reveals how he came to terms with his father's dementia

Tim Wheeler: Alzheimer's, memories and my dad

Wheeler's dad suffered from Alzheimer's for three years. When he died, there was only one way the Ash frontman knew how to respond: with a heartfelt solo album