Irish Independent Sat 19th May 2007

A growing number of UK doctors no longer want to do Ireland's 'dirty work' by carrying out terminations, writes GEMMA O'DOHERTY

As the teenager at the centre of the Miss D controversy travels to Britain to end her pregnancy, the estimated 7,000 Irish women who make the same choice every year may find themselves having to travel to the Continent for terminations. The so-called Irish solution to an Irish problem may cease to exist as a sizeable number of British doctors say they are no longer willing to carry out the "dirty work" of their Irish counterparts.

Last month, the Royal College of Obstetricians and Gynaecologists warned there was a growing shortage of doctors trained to carry out abortions.

Distaste at performing terminations combined with ethical and religious beliefs and the sense that too many abortions are being performed has led to soaring numbers of "conscientious objectors" requesting exemption from the task.

A new poll by doctors' newspaper 'Pulse' found that 24% of British GPs would not sign referral forms for abortions and 19% believe it should be banned outright.

The situation has led to a crisis within the National Health Service, which pays for four out of five abortions but is gradually running out of doctors willing to perform them. A survey of 309 GPs also found that more than half wanted the 24-week limit for abortions to be reduced.

This groundswell of anti-abortion sentiment within the medical profession has been put down to a number of factors, with some doctors blaming the lack of glamour involved in the work. While obstetricians and gynaecologists receive the height of praise for their work, no-one is respected for being an abortionist. It has been dubbed "the dinner party syndrome" where doctors are increasingly embarrassed to say they work in the area.

"You get no thanks for performing abortions," says Katherine Guthrie, of the Royal College of Obstetricians and Gynaecologists. "You get spat on. Who admits to friends at a dinner party that they are an abortionist?"

But new highly developed scanning technology, which has captured the development of the foetus in images like never before, has also led to growing opposition among doctors.

The new 4D scans, pictures of which were released earlier this year, show the foetus in minute detail smiling, gurgling and blinking. It also revealed social interaction between twins and triplets including kissing and hugging. Some medics have argued that the pictures prove the foetus exhibits human feelings and emotions from a very early age and many have been deeply moved by the pictures.

Doctors say they are becoming increasingly intolerant of women seeking terminations because they forgot to take the pill or it doesn't fit into their career plan.

"I am what is called a conscientious objector," says James Gerrard, a GP based in Leeds. "Abortions are abusive to women and the doctors who perform them because we are dealing with the death of a human life. Out of the six doctors in our practice, three of us object to abortion. I made up my mind on abortion before entering the medical profession. I feel the foetus is a person and killing that foetus is wrong.

'It is sad to think of so many Irish women coming to our country for abortions. We have to start asking why is it so many feel they have no other choice and tackling those reasons. It is really deeply shocking the way it is dealt with in this country and that abortion has become the default for a crisis pregnancy."

Dr Rob Hardie, a GP based in Wiltshire, left his practice after refusing to sign a new contract which required him to condone abortion.

"With abortion, there's the ethical problem of destroying a life, and even if you have different beliefs, there's surely an ethical problem in doctors being forced to do something they do not believe in."

Roman Catholic doctors who refuse to perform abortions are being joined by other Christian colleagues and Muslims.

Abortion is legal in the UK up to 24 weeks but it can occur up to full term if the baby has a disability or the mother's life is at risk.

About 190,000 abortions take place in England and Wales every year, representing nearly a quarter of all pregnancies. More than one third of British women will have had an abortion by the time they reach the age of 45.

A controversial new British study which showed that one in 30 babies aborted for medical reasons is born alive has further increased the exodus of doctors from abortion clinics.

The study, conducted in the West Midlands region of England, looked at 3,189 abortions performed on "seriously handicapped babies" at 20 hospitals between 1995 and 2004. Some of the children born alive after attempted abortion lived as long as six hours, including those killed for having Down's syndrome or heart defects.

Most of the abortions were what is called medical, which means chemically-induced miscarriages in which the baby dies from the trauma of premature birth. The study found that this method results in high numbers of survivals, particularly in late term children.

In one of the most significant decisions since the Roe-versus-Wade case, which gave American women the right to abortion, the United States Supreme Court has just voted to uphold the ban on what have become known as partial birth abortions. Pro-life advocates condemn the operation in which the foetus is partially removed alive and then aborted.

As the number of doctors performing abortions becomes limited, women are facing increasing delays and the NHS is struggling to cope. In five years' time, it is expected that access to abortion will be severely limited.

The charity Marie Stopes, Britain's biggest provider of abortions and the agency that refers most Irish women to the UK for the procedure, says it already experiencing difficulties in recruiting doctors. They say young doctors do not remember the situation faced by women before the 1967 Abortion Act and can be judgemental. Those who remember the dangers of backstreet abortions are now facing retirement.

After 40 years of campaigning, anti-abortion organisations are set to achieve their ambition by default but the crisis in Britain could have far-reaching consequences here and put even more pressure on the next government to call a referendum on the matter.

"Nobody wants to carry out an abortion," says Dr Ian Jessiman, of the British Guild of Catholic Doctors. "More and more British doctors are no longer prepared to undertake the work others are unwilling to do. Irish doctors are relieved of that burden by Irish law but their counterparts here are not willing to be pushed around and carry out a procedure they are ethically opposed to.

"It is very regrettable that so many Irish women come to this country to terminate their pregnancies but they will find in the coming years, that option is not as easily available to them."