Joan Smith: Men have a responsibility for abortions, too

Women – I mean, what are we like? Having abortions for totally trivial reasons, like not wanting to be pregnant! You'd think by now we'd have got it into our heads that abortions are only for women who really deserve them, which basically means anyone who has been raped (though not according to the Vatican) or can show that they're really, really upset.

Of course, if they are really upset about the prospect of an abortion, they shouldn't be having one anyway, which reduces the number of deserving cases even further. If they're not, let's force them to have a "cooling off" period in which anti-abortion campaigners can flourish lurid pictures of aborted foetuses and tell them abortion gives you breast cancer.

One way or another, that should bring the figures closer to what "pro-life" campaigners and their shock troops – the men in red dresses – really want, which is an end to legal abortion in this country. They know they won't get it; public support for the 1967 Abortion Act has been strong and consistent, and no politician of any persuasion believes there is a realistic chance of overturning it at present.

I often think, in fact, that the sensationalist tactics adopted by anti-abortionists are evidence of the bind they find themselves in: for several years now, they've focused on a small number of late abortions (about 1.5 per cent of the total) which take place at 20 weeks or above, using it as wedge in the long-term project of eventually dismantling the Abortion Act altogether.

What they don't acknowledge is that what's likely to work in terms of reducing the number of late terminations is making early abortion easier and quicker to obtain; four decades after it was legalised by David Steel's Private Member's bill, women are still in the ridiculous position of having to plead with two doctors for consent, while GPs who object are under no obligation to refer patients to colleagues who believe in a woman's right to choose.

Earlier this year, the Royal College of Obstetricians and Gynaecologists warned that there is a growing shortage of doctors who are prepared to carry out abortions; on top of that, there are reports of pharmacists refusing to sell the morning-after pill on religious grounds. Anti-abortionists approve of this puritanism but, awkwardly for them, conscientious objection by doctors and pharmacists doesn't prevent abortion; it just means women end up having terminations later in pregnancy than they'd like.

Indeed, by placing obstacles before women who find themselves unwillingly pregnant, anti-abortion GPs and campaigners must bear some responsibility for the late terminations they find so distasteful.

Most women, on discovering that they're pregnant when they don't want to be, try to get a termination as quickly as possible; the vast majority (just under 90 per cent) of the 193,737 abortions which took place last year were carried out in the first 13 weeks. The BMA is on record as wanting abortion to be made more easily available in the first trimester by requiring women to get consent from one doctor instead of two; this is a humane and sensible proposal, as is any project to improve the quality of sex education in this country.

Nineteen-year-olds have the highest abortion rate (35 per 1,000), which suggests that teenage girls urgently need advice on contraception and on how to refuse sex if they feel unsure or unready. This is getting more difficult to achieve, I fear, as more and more state schools are placed in the hands of religious sects which oppose abortion and sex outside marriage on ideological grounds

There is another factor here. I've studied the abortion statistics quite carefully, and while they don't say how many pregnancies were the result of immaculate conceptions, I'm pretty sure the answer is nil. Just under 200,000 women didn't get pregnant on their own, and the untold story about abortion is the way in which women are expected to shoulder the blame for every single mistake or contraceptive failure.

In that sense, the discourse around abortion is weirdly gendered, as male doctors and clerics sound off about women and ignore the substantial input (so to speak) of their own sex. Where are all the anti-abortion GPs confronting their male patients and telling them to use contraception or check that their partners are protected? The cardinals?

It isn't often enough remarked that misogynist and anti-sex attitudes are at the heart of opposition to abortion. Getting pregnant and having to go through with it to birth are seen as the consequence women have to put up with in return for "irresponsible" sexual behaviour. The latter is an elastic category, embracing women who have sex outside marriage, women who don't use contraception every time they have sex and women whose contraceptive method has failed. They're all bad girls, and the puritan view is still (as it was down the centuries) that they should knuckle down and accept involuntary motherhood as their lot.

What's breathtaking about these attitudes – widely prevalent among young doctors, I'm sorry to say – is that they effectively situate pregnancy as a punishment for sexual "incontinence". Gay men will know what I'm talking about, for something similar happened to them when Aids was characterised as God's punishment for their sexual orientation. According to this logic, a single act of thoughtlessness – or just a split condom – is sufficient justification to turn a woman's life upside down and remove something men take for granted, which is autonomy over their own body.

No one should be forced into becoming a mother against her will, and the idea that a baby is likely to thrive in the care of a woman who does not want a child simply beggars belief.

It's almost 20 years since I first pointed out that no one has an abortion for fun. Except in the case of terminations on medical grounds, women ask for abortions because they don't want to be pregnant, and that is the only ground they need; making spurious distinctions between "good" and "bad" reasons is as unjustified as making moral judgements about rape victims.

It's only when we get away from this blame culture that it becomes possible to have a sensible discussion about abortion, and the starting point must be how to reduce the number of unwanted pregnancies. Boys need sex education as much as girls, not to avoid sex altogether – the impractical solution on offer from churches – but to teach them to take responsibility for the welfare of their partners. There will still be unwanted pregnancies, but the Government should follow the advice of the BMA and make it easier to get a termination in the first trimester.

There – that wasn't too bad, was it? When you stop treating half the population as frivolous, irresponsible creatures, reducing the number of abortions becomes a real possibility.