ABORTIONS AND ADOPTION

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ABORTIONS AND ADOPTION: 6.

Mr Christopher de Souza asked the Minister for Health in view of some foetuses being viable before 24 weeks

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and given that the Abortion Act of 1974 was introduced when curbing population growth was a social priority, whether he will consider amending the legislation to lower the 24-week limit for unrestricted abortions since Singapore now needs to increase her population.

7.

Mr Siew Kum Hong asked the Minister for Health whether his Ministry will (i) affirm the fundamental right of women to choose, subject to objective considerations of medical safety, whether to have abortions, which has been accepted in Singapore for the past four decades without question; (ii) confirm whether there is reason to change the current prevailing objective medical evaluation of independent foetal viability; and (iii) focus on influencing societal attitudes towards abortion and counselling persons seeking abortions, instead of the 24-week-limit for unrestricted abortions and women's legal right to choose.

8.

Mr Christopher de Souza:

Mr Christopher de Souza asked the Minister for Health what would be Singapore's annual total fertility rate from 2000 to 2007 if (i) no abortions were carried out during those years; and (ii) abortions were only permitted on an unrestricted basis for foetuses up to 12 weeks of age.

Mr Christopher de Souza asked the Minister for Health whether he will consider the promotion of adoption as a serious alternative to abortion to increase our total fertility rate.

Mr Khaw Boon Wan: Sir, may I have your permission to take Question Nos. 6, 7, 8 and 9 together?

Mr Speaker: Yes.

Mr Khaw Boon Wan: The Termination of Pregnancy Act was enacted in 1974, to provide for the safe termination of

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unwanted pregnancies by trained persons in appropriately equipped facilities. It is to safeguard the health and well-being of the woman who has, for various reasons, decided to terminate her pregnancy. This is intended to ensure that all children born in Singapore are wanted children, who will be properly cared for, and will have opportunities to develop to their full potential.

The Act was not introduced to curb population growth. Neither will its restriction or cancellation help to grow the population. It is simplistic to assume that one fewer abortion equals one more baby. Hong Kong and Poland do not allow abortion for social reasons or on demand, but their birth rates are among the lowest in the world, not better than that of Singapore. Among the many countries which legalise abortion on demand, there is a wide range of birth rates. So, clearly, there are other factors at play which determine the birth rate of a population.

As for the time limit for unrestricted abortion, it is determined on objective medical grounds, based on the doctors' assessment of the survivability of the foetus outside the womb.

The Act requires all women contemplating abortion to be counselled. The counsellors will advise the women of the full implications and the risks of an abortion, and of the alternatives available, including adoption.

The issue of abortion is an emotive and divisive one. It has been debated at length and decided in Singapore. The decision respects the different views that some community and religious groups hold on abortion. It is not useful to talk about abortion in absolute terms as there are practical human, medical and social issues involved. It would not be wise to reopen the debate and introduce into Singapore the divisive battles going on in the West, especially in the US.

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We will continue with the other efforts in public education, such as sex education to school children and the public, as well as in providing assistance to married couples to have more children.

Mr Christopher de Souza (Holland-Bukit Timah): I thank the Minister for his response and I agree that in 1974, the Termination of Pregnancy Act was not introduced as a curbing population mechanism. It was, nonetheless, introduced as being consistent with the Government's policy then of population control.

I have four supplementary questions. First, given that the Government's position, as I take it, is that viability is at 24 weeks, will the Minister review this limit if future research shows that viability is before 24 weeks? Second, in light of the Minister's reply, will the Minister consider setting up a soft and caring regulatory framework to put couples, struggling with fertility or couples seeking to adopt, in touch with pregnant ladies considering abortion? The purpose would be to see if the pregnant ladies are willing to give their babies to the couple for adoption, thereby, creating a win-win situation. Thirdly, given that the Ministry of Health is thinking out of the box in regulating organ trading, would the Minister consider this adoption proposal?

Unlike organ trading, no payment for profit would be involved in this proposal. Fourthly, Sir, would the Minister consider this proposal, given that this particular proposal envisions that the lady considering abortion would still be able to terminate her pregnancy if she decides not to give the baby up for adoption, making this proposal beneficial to the ladies as well as the couples.

Mr Khaw Boon Wan: Sir, although there are four supplementary questions, there are really two because the last three are related to adoption and I will address them.

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First on the 24-week time limit. The Member is quite correct. As stated in my reply, this is purely based on science, and we are advised by the medical experts on the viability of the foetus outside the womb. While preparing for this Question, I decided to ask the experts again for the latest assessment on this particular issue and they gave me a statement, which I would like to read it here, and I quote:

"We are quite confident that babies born after 24 completed weeks of gestation should have a very good chance of surviving intact and the most optimal care should be offered to them. Between 22 to 24 weeks gestation, survival rates dip sharply, even in the presence of the latest technologies, and the disability rates will also climb sharply, especially disabilities in the moderate and severe range. Therefore, it is recommended that the legal limit of abortion should be kept at 24 weeks at this moment. The dividing line can always be redrawn when future survival and disability statistics on children born in the threshold of viability warrant a review."

So, this is the position that I take. Let us base our decision purely on science so that we take the emotion out of this particular subject.

As for adoption, the current arrangement is like this: the law mandates pre-abortion counselling. These involve trained counsellors who will talk to the pregnant mothers of the various options available to them besides the risk of abortion procedures. And one alternative is adoption – to consider keeping the pregnancy to term and then pass the baby to the couple who are interested in adopting him. Over the years, a small percentage of the mothers would agree to continue with the pregnancy and to consider adoption. In such cases, the SOP will require us to get the pregnant mother in touch with MCYS (or NGOs because some parents would prefer to deal with

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NGOs), and arrangement is then made to match-make the couple who are interested in adopting with the pregnant mother who may then decide to continue the pregnancy to term. This is the current arrangement and we will continue with it. In fact, our experience is that the mothers who decide to keep the pregnancy often decide to keep the babies as well. So, not 100% of such babies will end up being adopted.

Mr Speaker: Yes, Mr de Souza, last question from you.

Mr Christopher de Souza: I would just like to thank the Minister for answering very objectively and his answers were very helpful.

Mr Speaker: Your question?

Mr Christopher de Souza:

I just want to thank him, Sir.