I wrote a looooong post earlier today and it seems to have been eaten by the ether, so I'll try to do less of a monologue this time!
I worked for BPAS for many years, back in the day when ALL clients received counselling from highly trained counsellors who prided themselves on operating independently. It was a matter of professional pride to them that they helped a number of women choose not to have abortion, and to tackle the issues in their lives that were leading them in that direction. These counsellors were a fantastic bunch of women, for sure.
BUT it was undeniable that most of our clients didn't actually need the counselling, or want it. They knew what they wanted, and they were so focused on getting it and moving beyond it that they found counselling a distraction at best. Counselling did delay the process and it also had to be paid for by all clients (in those days there wasn't much NHS funding, and no external funders - all costs had to be covered by the women themselves). The vast majority of our clients were young women who had had to scrabble around desperately to get the money together for their abortion. A good number had had to travel from Ireland in conditions of great secrecy, paying for transport and hotels as well as clinic fees.
When first Marie Stopes and then BPAS decided to make counselling optional I was rather taken aback, but actually couldn't argue it. Undoubtedly a small number of women would lose out because they would lack confidence/insight to ask for counselling, and also lacked sufficient support from family and friends. But they were a very small minority, and it was untenable to force the majority to undergo (and pay for) counselling just to ensure we caught everyone. At some stage you have to treat women as adults, after all.
Three other things I wanted to say.
One is the impact of delays. We already make women get permission from TWO doctors before obtaining abortion - this costs and also creates delays. When I had an NHS abortion, age 16, I had to wait SIX WEEKS to see the second doctor, creating considerable extra anxiety and trauma.
I also had a pretty horrible experience at the hands of those doctors. When I worked at BPAS I was genuinely impressed at how much nicer and more caring the staff there were. People often don't realise how low-status, almost taboo, it is for a doctor or nurse to choose to work in abortion services. Most who do so are deeply committed to women's reproductive freedom, and I hate hearing them discussed as though they're just after the money.
I'm not saying every BPAS (or Stopes) abortion is a good experience. I didn't hear that radio programme, but I have heard many, many women who describe the experience as being on a conveyor belt. The lack of congruence between the emotional experience and the clinical experience is vast, and distressing to lots of women. There's no easy answer to this. Abortion IS a very quick and straightforward procedure in the vast majority of cases; it is more clinically sound and cost-effective to provide it in dedicated slots - so you get a couple of dozen women queueing up for the procedure, and that does feel sausage factoryish. If we want NHS money to be used to make the experience a bit more humane we could of course do that - but do we?
Sorry, it's ended up being another long post after all. Just one last point to finish on: Life and Care and whatnot are already providing independent pre- and post-abortion counselling. They have done for at least 30 years. It's very widely marketed, at least in London where they often advertise on tube escalators and free magazines. So why don't more women use them? Surely if women were crying out for these services, they would be using them already?