Maxine Frith: Medical advances compel us to rethink abortion

When premature babies can and do survive at 22 weeks, I have to reassess my once-implacable view

It is telling that Michael Howard should choose the glossy pages of Cosmopolitan magazine to reveal that he believes the legal abortion limit should be reduced from 24 to 20 weeks. For more than 30 years, Cosmo has been a byword for sexually confident young women who have grown up with the assumption that they have an unquestionable right to make choices about their reproductive health - including the option of a termination.

Yet in this febrile time of pre-election vote-chasing, when politicians tend to pander to the prejudices of which- ever periodical they are being interviewed by, Mr Howard said he wanted the law changed to stop "abortion on demand."

A few years ago this may have seemed like a political gaffe guaranteed to alienate the "high-heeled vote", as Cosmo is styling its 18- to 34-year-old readership. I am 32 - almost as old as Cosmopolitan - and until recently, Mr Howard's comments would have raised a howl of indignant outrage from me Reducing the abortion limit, I believed, would restrict women's freedom over their own bodies and have the worst impact on the most vulnerable: young girls who wait until the last moment to admit they are pregnant, and expectant mothers who, just a few weeks before giving birth, discover that their unborn child has severe abnormalities.

But, this week, the Conservative leader's remarks struck an uncomfortable chord. At a time when premature babies can and do survive at 22 weeks' gestation and sometimes below that, and new images show foetuses of 18 weeks "walking" in the womb, I am having to reassess my once-implacable view that abortion should be available as late as possible.

My doubts surfaced six months ago, when Sir David Steel, the architect of the 1967 Abortion Act, voiced his own concerns about the 24-week limit. The law, he said, needed to reflect modern medical science and the "viability" of foetuses towards the end of gestation. It is viability that is one of the most persuasive arguments in the debate on the abortion limit. Survival rates vary, but in top neonatal units, 50 per cent of babies born at 23 weeks are surviving.

I have always believed that abortion is not about "killing a human being" but about denying the potential for life of a small mass of cells. But that line becomes more blurred if one considers the idea that, at 24 weeks, the foetus you are terminating could gasp for life and breathe unaided.

It has become even harder in the last year, with the publication of a book of astonishingly clear ultrasound pictures of babies in the womb. Foetuses of 14 to 18 weeks are shown sucking their thumbs and making seemingly purposeful movements. Some hospitals are now debating whether they should routinely try to resuscitate and save premature babies born at below 23 weeks. Survival rates for premature babies have soared in the last two decades - modern medicine means that immature lungs can be treated and brain damage averted.

If the survival age of premature babies is constantly lowered, will I have to reassess constantly my view on the abortion limit? Sir David Steel backs a reduction to 22 weeks, except in exceptional medical emergencies, alongside reforms that would make it easier for women to have access to early abortions.

This seems to me the best answer to the abortion question. An overwhelming majority of terminations are performed at under 13 weeks, with just 0.6 per cent taking place between 22 and 24 weeks into pregnancy.

While some cases involve very late diagnoses of severe handicaps and abnormalities, many last-minute terminations are carried out on young teenage girls who have desperately tried to ignore the changes in their bodies, too terrified to tell their parents and often living in areas where sex education and abortion services are still lacking.

Abortion, especially abortion at six months, is harrowing and painful. A few years ago, I accompanied a friend to a south London abortion clinic. I still haven't forgotten seeing the dark, terrified eyes of three girls, all around 15, who were very obviously pregnant, with no one to support them as they waited in the flimsy gowns and paper knickers for their turn on the operating table.

Far from preventing young girls from accessing abortions, a reduction in the legal limit may encourage teenagers to come forward earlier. Women, especially young ones, do not need the "right" to terminations at 24 weeks - what they need and have a right to is proper sex education and safe and easy access to early abortion.

The abortion debate cannot be anything other than personal and emotive, which is one reason why all three political parties offer MPs a free vote whenever the issue comes up. And in contrast, thankfully, to the United States, the subject still rates low down in the priorities of both the public and politicians.

I still passionately believe in a woman's right to have a termination, but now I have to ask myself, at what cost?