An abortion pill will be made more widely available under proposals aimed at cutting waiting lists. But, as Nick Morrison reports, the move has prompted claims that it could lead to a huge increase in the number of terminations.

IT will open the floodgates to thousands more abortions, lead to a huge increase in teenage pregnancy and encourage promiscuity, particularly among the young. Or, at least, that is what anti-abortion campaigners claim will be the result of moves to increase access to an abortion pill.

The pill, RU486, has been around for more than ten years but availability has varied between different parts of the country. Now the Government is aiming to make it more widespread as an alternative to a surgical termination, reducing waiting lists which can see women wait up to six weeks for an abortion.

The move comes at a time when the Government is committed to reducing the number of conceptions among under 18s by half over the next eight years, a target which could have a particular resonance in the North-East, with some of the highest teenage pregnancy levels in the UK.

But while anti-abortion groups claim this strategy will be undermined by making RU486 more widely available, making abortion more of a form of contraception, this is dismissed by Ian Jones, chief executive of the British Pregnancy Advisory Service.

"The anti-abortion groups are all jumping up and down saying this will increase the number of abortions, but they don't like abortion, full-stop," he says. "You can almost take a sideways stance and say that once a woman has become pregnant and decides she wants an abortion, and qualifies under the law, all you have to look at is how that service can be provided in the safest, most accessible and most effective way.

"There are large variations and inequalities in the level of NHS support for abortion, and these proposals are about being able to provide this service from rather more centres than is currently the case. In those areas where we have waiting lists and it is difficult for women to access abortion, this might be a way to enable that to happen rather more easily.

"We totally support this and don't give any credence to the view that it will increase promiscuity or pressurise women into having abortions. To get pregnant you have to have sexual activity - are the anti-abortion people really saying that what influences men and women to have sex is the availability of the abortion pill?"

THE RU486 pill is usually taken in a hospital or clinic, where the woman is kept for an hour to monitor possible side effects. It works by altering the level of hormones in the woman's body, forcing the foetus to detach from the lining of the womb. Another pill is taken 48 hours later, forcing the foetus to be expelled, which can take up to eight hours.

Women who are up to nine weeks pregnant can use the pill, and will still have to obtain the approval of two doctors before they can go ahead, the same as for a surgical abortion.

Anti-abortion groups make no bones about their contention that abortion is wrong whatever the method, but say widespread use of medical termination represents a cavalier approach to what is essentially a life-and-death issue.

"Our primary concern in this whole issue to the right to life of a child - whether it is more or less traumatic, the effect on the child is always to kill it," says Josephine Quintavalle, of the Pro-Life Alliance. "Having said that, we would dispute this rather gung-ho approach of taking a pill and all will be well."

She says medical abortions provide a 48-hour period when the woman may change her mind about having a termination, but the procedure cannot be reversed without risking abnormalities in the baby. And, as well as the known side-effects of pain, nausea and, in some cases, haemorrhaging, the long-term consequences both for the women involved and for any children they may go on to have are unknown.

And she says the trauma of a medical abortion may be more serious than a description of the procedure suggests.

"If you have a surgical abortion you can, if you wish, go into denial - you don't see anything and you are encouraged not to face up to reality, but we think women deserve to know the truth," she says. "With a medical abortion, there is no way that the women can pretend that it is not happening to her, because she is actually going to see it.

"Women who have described to me what it is like weren't all that enamoured of the process, where you have to see what comes out of your womb. The baby is not coming out in pieces, it is coming out whole, and a foetus at seven or eight weeks is going to have qualities that are distinctly human."

But, despite the reality of a medical abortion, she says making it more widely available is likely to see more pregnancies end in termination.

"I think there will be an increase among people who can't afford private abortions, and I can't see any reason why it won't lead to an overall increase. It will just become easy to do, and anything that becomes easier just gets done."

But making RU486 more readily available is not about making abortion likely, but about helping women who have already decided on a termination, according to Dr Deborah Beere, assistant medical director for the Middlesbrough Primary Care Trust.

'There are people who say it is making it easier, but I don't think that deciding to have a termination of pregnancy is ever easy, either emotionally or physically," she says.

Women who want to have an abortion will still have to have the signatures of two doctors, who agree it is appropriate under the terms of the Abortion Act, meaning there is no reason why the number of terminations will rise, she says. And there are advantages to some women in having a medical, rather than a surgical, abortion.

"From the physical point of view, the woman is not having to have an anaesthetic and then a surgical procedure in order to end their pregnancy, therefore it is medically safer, and usually it is less physically difficult to take the tablets, rather than have to go through the surgical procedure," she says.

But there are still some women who may prefer, or who may be advised, to undergo surgical terminations.

"A surgical procedure under anaesthetic takes place when the women doesn't know anything about it, and she might feel it would be better for her, rather than having to take the tablets," she says. "But terminating a pregnancy is never easy."