The claims

“Most counselling is offered by the big abortion providers themselves, like the British Pregnancy Advisory Service or the Marie Stopes clinics, which are paid millions by the NHS to carry out terminations – and so profit from the process.”

“…I am proposing an amendment to the Health Bill currently going through Parliament, which would require women to be offered independent counselling. This won’t be offered by any religion-affiliated groups, but by the British Association for Counselling and Psychotherapy…”
Nadine Dorries MP, 31 August 2011

The background

The ever-emotive subject of abortion is set to stay in the headlines in the coming weeks as MPs prepare for a free vote on an amendment to the already controversial Health and Social Care Bill.

The Conservative MP Nadine Dorries has proposed altering the legislation to stop charities who carry out abortions also providing counselling for women considering a termination.

She says there’s a conflict of interest which means the advice the organisations give to pregnant women cannot really be impartial. Her campaign is being supported by the Labour backbencher Frank Field.

The temperature of the debate is already high, with Ms Dorries vowing to defy “pro-abortion zealots” and the head of the Royal College of Practitioners, Dr Clare Gerada, warning that the move “will simply reverse the advances of the past 25 years”.

The analysis

In an article published in the Daily Mail on Wednesday, the Tory MP writes that the British Pregnancy Advisory Service (BPAS) and Marie Stopes “are paid millions by the NHS to carry out terminations – and so profit from the process”.

BPAS and Marie Stopes also offer “most counselling” to women, Ms Dorries writes, after pointing out that “doctors of pregnancy advisory services have no duty to offer professional, impartial help to women considering an abortion”.

Is there a conflict of interest?

Both organisations make no secret of the fact that they do perform thousands of abortions every year, and are indeed paid to do so by the NHS.

But they take issue with the use of the word “profit”. In fact, both are not-for-profit registered charities.

BPAS say: “Any small surplus that we make is ploughed back into providing services.”

Whether the existence of a large amount of revenue, as opposed to profit, is still evidence of a vested financial interest is of course a broader question.

Both charities vehemently deny that they push women into having abortions.

BPAS Chief Executive Ann Furedi said: “Our staff are healthcare professionals – doctors and nurses committed to treating the women in their care – and it is an insult to imply that they would push women into treatment they did not want.”

Maries Stopes said: “There are no targets or incentives for counsellors to promote abortion as an option above any other.  On average, 20-25 per cent of women that speak to one of our counsellors choose to continue with their pregnancy. 

“If we felt that a woman was not completely sure of her decision we would suggest that she speak with a counsellor.”

They also say that there is no evidence for Ms Dorries’ assertion that “the abortion system and process is abusing women” and have challenged her to provide evidence that the current system arrangements are not working.

What is Ms Dorries proposing?

The amendment to the Bill currently going through Parliament proposes that it will be the responsibility of GP consortia to commission “independent information, advice and counselling services for women requesting termination of pregnancy to the extent that the consortium considers they will choose to use them”.

The next part of the amendment clarifies that “information, advice and counselling is independent where it is provided by either — (i)a private body that does not itself provide for the termination of pregnancies; or (ii) a statutory body.”

So despite Ms Dorries’ claim in the Daily Mail that counselling “won’t be offered by any religion-affiliated groups, but by the British Association for Counselling and Psychotherapy”, there is nothing in her amendment to guarantee that.

Instead, the legal position would be that only Marie Stopes and BPAS would be prevented from offering counselling, and there would be no statutory reason why, say, a fundamentalist Christian group could not bid for a contract with an NHS consortium.

There is also nothing in the proposed amendment to back up her assertion that the British Association for Counselling and Psychotherapy (BACP) watchdog will be providing counsellors – or even that a “private body” would have to be a member of the organisation.

A BACP spokesman said: “Ms Dorries says that BACP will be supplying the counselling if her amendment becomes law. But BACP is not a therapy supply company but a members’ organisation offering self-regulation in an otherwise unregulated world. 

“I can only guess that she means those doing the counselling will be BACP Members.  But BPAS already employs BACP members!”

BPAS clarified that, while it’s not compulsory, many of the counsellors it uses are members of the association and have signed up to its code of ethics, a regulatory mechanism and a complaints procedure.

Marie Stopes said: “The counsellors that we work with are all members of BACP and receive regular supervision and training from them.”

So if the amendment became law it would appear that, rather than BACP taking a leading role in the provision of therapy, the chances of an abortion counsellor being a member of the professional body would be smaller than it is now.

The psychological effects of abortion?

In her Mail piece, Ms Dorries also refers to a study published in the British Journal of Psychiatry, which “revealed that women who have an abortion are three times more likely to develop a drug or alcohol addiction and 30 per cent more likely to have mental disorders compared with other women”.

The paper in question looked at the mental health of 117 women in New Zealand who had had abortions. The researchers concluded: “The evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders.”

They went on to say: “The results do not support strong pro-life positions that claim that abortion has large and devastating effects on the mental health of women. Neither do the results support any strong pro-choice positions that imply that abortion is without any mental health effects.
“In general, the results lead to a middle-of-the-road position that, for some women, abortion is likely to be a stressful and traumatic life event which places those exposed to it at a modestly increased risk of a range of common mental health problems.”

Also in 2008, a review of existing studies by the American Psychological Association found that “the prevalence of mental health problems observed among women in the United States who had a single, legal, first-trimester abortion for nontherapeutic reasons was consistent with normative rates of comparable mental health problems in the general population of women in the United States”.

In the same year, the Royal College of Psychiatrists issued a statement saying: “The current research evidence base is inconclusive—some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion.”

The college is expected to publish a final report on the existing medical literature in the autumn.

The verdict

While FactCheck doesn’t propose to weigh in to the wider debate on the rights and wrongs of abortion, we are going to take Nadine Dorries to task on some of the points she makes in her article.

Her claim that the leading abortion providers “profit” from their work is misleading.

More importantly, the promise that religious groups won’t be involved in abortion counselling doesn’t square with the detail of what the MP is actually proposing.

And it’s not helpful to quote selectively from one study in an effort to show that the existing scientific literature backs the claim that “the abortion system and process is abusing women”.

By Patrick Worrall