Health: Second opinion

IN 1990 one million teenagers in America became pregnant, and 521,626 gave birth - far higher numbers, taking account of population, than in most Western countries. In fact the number of teenage pregnancies has declined in recent years, yet the birth rate has steadily increased. The reason is that fewer teenage girls are having their pregnancies terminated.

Abortion is becoming more difficult for American women, especially teenagers, because of terrorism by anti-abortion campaigners. Clinics are shutting because they are being bombed, picketed, blockaded, and burnt. According to the Lancet, up to the end of September 1993 there had been 1,417 acts of violence against

family planning and abortion clinics and their staff - including

36 bombings, 289 bomb threats,

149 death threats and two kidnappings. In March of this year David Gunn was murdered in Florida by an anti-abortion activist; other doctors have been shot. In some clinics the staff have taken to wearing bullet-proof vests.

Termination of pregnancy has become a dangerous no-go area for young doctors, and one-third of gynaecology training programmes no longer teach abortion techniques. In the US, funding has been withdrawn. Meanwhile, though global population growth has slowed, it is still frighteningly rapid: the increase is running at 100 million more people every year, and the current population of 5.6 billion is likely to have doubled by 2050.

The tragic feature of the worldwide freeze on population control strategies is its timing. A scientific conference in New Delhi in October concluded that social, economic and environmental problems could not be solved without a stable world population. It set a goal of achieving zero population growth 'within the lifetime of our children'.

The technological means are now available to achieve that aim. New, cheap, safe and reversible contraceptives have been developed; sterilisation procedures have been simplified; and, whatever people may think about the ethics, medical termination of early pregnancy has been shown to be safe and reliable - yet it is available in only a few countries. What is missing is a determination by Western countries to provide the finance and the technical skills to make these methods available to the millions who would welcome them. Freedom from unwanted pregnancy is as basic a human need as freedom from hunger, disease, poverty and war.