Abortion investigation: Available – if it’s a boy you wanted

But for one visitor earlier this month the nature of its business could not have been more serious. Despite its appearance, this was an abortion clinic at Pall Mall Medical and it was a matter of life or death. The woman, accompanied by a Daily Telegraph reporter posing as her stepsister, was shown into a small consultation room and introduced to an NHS consultant undertaking private work at Pall Mall Medical. “I’m Doctor Sivaraman … how can I help you?” she said. The pregnant woman, who said she was eight weeks into her term and in reality was looking forward to having a baby, was there to establish whether illegal sex-selection abortions were really available “on demand” in Britain. She claimed to have had a blood test in France that showed that she was expecting a baby girl. “That’s not really appropriate for us right now, we were hoping for a boy,” the pregnant woman said. “So we’re not looking to have this baby at the moment.” Alarm bells should have started ringing — as they did at other abortion clinics visited by The Daily Telegraph in recent weeks. But, instead, Prabha Sivaraman asked: “And how certain are they about this foetal gender?” “It is pretty certain,” came the response. The consultant then asked to see proof of the results from the French test, which the pregnant woman was unable to supply. Was this a problem? “Oh no … I don’t ask questions, if you want a termination, you want a termination.” “Yeah, yeah, that’s my reasons for it though,” the woman reiterated. The doctor continued: “That’s my job that’s all … I don’t ask questions.” After carrying out an ultrasound scan to check the foetus, Miss Sivaraman called a colleague to arrange the termination saying it was for “social reasons”. She explained to the consultant that the patient “doesn’t want to go through NHS … because you’re part of our team and she doesn’t want questions asked”. But Miss Sivaraman should have been asking questions. This type of sex-selective abortion is illegal in Britain and the behaviour of the doctors witnessed by undercover reporters will lead to renewed questions about the availability of abortions in this country, and the advice offered to women. Over the past three weeks, four pregnant women of different ethnic backgrounds, accompanied by undercover reporters, travelled around the country to appointments with staff working for clinics offering abortions. The Daily Telegraph decided to investigate the issue of sex-selection abortions after doctors, academics and pro-life campaigners all alleged that the procedure was being offered at specific organisations. The regulator of the clinics, the Care Quality Commission, has faced numerous questions over the rigour of its inspections, adding to the concerns that any malpractice was unlikely to have been uncovered through conventional channels. Terminating pregnancies because of a baby’s sex has been seen as one area vulnerable to lack of regulation. There is a suggestion that it is part of the reason why some hospitals have stopped telling prospective parents the gender of their unborn child. Baby girls are seen as most at risk of this practice. In 2007, two Oxford academics, Sylvie Dubuc and David Coleman, carried out a study into sex ratio using the annual birth registrations in England and Wales between 1969 and 2005 and found that there was “indirect quantitative evidence of prenatal sex selection against females performed by a small minority of Indian born women in England and Wales”. The study found that there was a “significant increase” in the ratio of boys to girls in Indian-born women, especially in relation to the third or later-born child. However, the prevalence of sex-­selection abortions is hard to prove – as discussions between patients and doctors within a consulting room are necessarily sacrosanct. Therefore, this newspaper decided to take the step of accompanying happily-pregnant women, posing as people seeking abortions, to a limited number of private clinics. Initially, reporters contacted specific organisations by telephone to see if they were willing to arrange terminations due to the sex of the foetus. Some, such as Marie Stopes, made clear it was policy not to arrange abortions for that reason, but others indicated they could help. When a reporter called Pall Mall Medical, where Miss Sivaraman offered to arrange the termination for the woman who was pregnant with a girl, the adviser expressed no surprise. Instead she began to reel off the various prices for the services on offer. “After nine weeks, it wouldn’t be within our centre here . . . within 14 weeks, we can organise a termination as such at our sister clinic, which would cost £500. Anything beyond 14 weeks to 18 weeks would be £640 . . . do you want me to find out if there is availability?” A similar pattern emerged at other clinics. A woman who was 17 to 18 weeks pregnant booked an appointment with Claudine Domoney, a consultant obstetrician and gynaecologist at Chelsea and Westminster Hospital, after being referred to her by a practice in Harley Street. Miss Domoney arranged for the woman to see a nurse when she arrived at the hospital early in the morning. As the nurse tried to check the size of the baby, she asked why the woman had come to the hospital. “We already have a son and we’ve been told that it’s a boy. So we were wondering if there was any way of having a termination right now”, said the pregnant woman. The nurse asked if there was a congenital reason, but the woman explained it was about having a girl. “My husband has a son only from the first marriage . . . we can’t afford to have more than two kids”, she said. The nurse then continued to scan and tried to check the sex of the baby but found it difficult. “The baby’s moving around. I think it is a boy actually but I wouldn’t want to give 100 per cent”, she said. Wit the scan completed, the woman returned to see Miss Domoney and again explained the reason for wanting a termination. “I mean it’s a boy, and that’s the reason we don’t want to have a second boy”, she said. But rather than focusing on, or discussing, the illicit reason being provided for requesting a termination — the consultant instead moved on to explain that the abortion was relatively late in the pregnancy. As the woman was now 17 to 18 weeks pregnant, the consultant explained that it was “not a straightforward operation”. “It’s not something that that many people do, because of the gestation. Most people stop at about 12 to 14 weeks . . . it’s not something that we undertake lightly generally at this sort of stage because of the risks to you.” Miss Domoney explained that she would have been able to do that procedure that day, but because she was going away she was going to ask a colleague to carry out the termination the following week. She left the room to call him. “Right, he is OK for Tuesday”, said Miss Domoney as she returned. “I’m literally going away from mid-afternoon today, which is why the timing’s really bad.” But there was no need for the would-be patient to worry. “The two of us are … very experienced in this area. He will organise for you to have a room on the private ward.” When Miss Domoney was contacted by the Telegraph, she said she was “uncomfortable” with the situation in the consultation, so had decided to refer the case to a colleague. Stephanie Byrom, the chief executive of Pall Mall Medical, insisted that terminations were not offered on the grounds of gender determination. “We categorically confirm that the service is only offered on medical grounds,” she said. “The information we have is that the service has not been sought on the grounds of gender determination. If we are provided with any information that one of our consultants has breached this then we will take immediate action. We take the provision of the law concerning terminations very seriously. We are updating our website to ensure this is absolutely clear.” From The telegraph