January 10, 2005

THE BRUTAL TRUTH ABOUT VERA DRAKE ; A New Film Portrays a 1950s Abortionist As Kindly and Altruistic. Those Who Saw the Suffering Such Women Caused Beg to Differ

AYOUNG pregnant woman lies huddled on a bed in a dank flat in North London, petrified at the prospect of what is about to happen. This is 1950s Britain and, like everyone else, she has heard all the horror stories about back-street abortions.

She expects the abortionist to be a tough, contemptuous woman who will treat her in the most brutal fashion in return for her two guineas.

Instead, she gets Vera Drake - a frail-looking, middle-aged lady who wouldn't dream of taking her money but just wants to do a good turn.

Nor does Vera produce knitting needles, crochet hooks, a pickle spoon or any of the other assorted apparatus that was the staple of some of the illegal abortionists operating during that time. Instead, Vera uses a rubber syringe to fill the girl's womb with soapy water. Afterwards, she gives her a kindly look, tells her to wait a couple of days and everything will be all right.

Vera, played by actress Imelda Staunton, carries out several such abortions in Mike Leigh's acclaimed new film before one girl on whom she operates is rushed to hospital in agony. The girl survives - just.

This is, though, a disastrous exception in Vera's 20-year philanthropic mission to 'help' young women who have 'got themselves into trouble'.

Vera Drake, which opens in Britain tonight, has already earned its director, Mike Leigh, acclaim around the world, while its star, Staunton, has been nominated for a Golden Globe award. She is also tipped for an Oscar.

Much has been made by Leigh of the painstaking research done before filming to ensure accuracy. Yet according to Jennifer Worth, who was a midwife in the Fifties and Sixties, before abortion was legalised in 1967, Vera Drake is a fanciful character who does not come close to portraying accurately the grim brutality and danger of what really happened in those days of back-street abortion.

What's more, Jennifer Worth says, this portrayal is downright dangerous.

'Women who were abortionists were tough to the point of brutality, and I never once heard of anyone doing it for philanthropic reasons,' she says.

'Basically, they were in it for the money. If a woman died after an illegal termination, the abortionist would be charged with manslaughter. It was a very risky business, and no one would risk that "just to help out".

'It was also a very dangerous procedure, which could lead to infection and, in some cases, even death. When I was a ward sister in the East End in the 1950s, you would have between four and eight women in at any one time with severe complications caused by abortion.

'I think it's rather implausible to suggest that Vera had such a high success rate.

'I'm also concerned that a young woman today, who has got herself pregnant and is afraid of going to a doctor, might decide, literally, to try to abort her baby at home because it looks relatively straightforward.' While the film is presented as a morally neutral but highly accurate portrayal, the truth is very different.

If abortionists were to be portrayed accurately, the audience might come away with a totally different opinion.

'Social conditions were very different then,' says Jennifer, 69. 'People had too many children and inadequate housing. You'd get a family with six children living in a two-room tenement flat.

'There were women who simply could not cope with or afford another child.

A lot of men would refuse to wear condoms, so there were all these unwanted pregnancies.

'Then there were the single girls, working-class and middle- class, who'd got themselves in trouble.

There was a terrible stigma attached to illegitimacy then.

'A lot of women who fell pregnant were put into mental asylums by their families - and remained there for the rest of their lives. There were also a lot of suicides by so- called "fallen women". The desperation that drove these women can not be underestimated.' Pregnant women would often, says Mrs Worth, take various concoctions, such as quinine or a lead-based liquid, in the vain hope that it would bring about a miscarriage. Others took scalding hot baths and consumed vast quantities of gin.

Only when all this failed would they seek out the back-street abortionist - as portrayed by homely Vera Drake.

It was a gruesome procedure and would have been carried out in a perfunctory fashion. None of Mrs Drake's comforting words about putting the kettle on for a nice cup of tea.

'The abortion would be performed on the kitchen table in the woman's flat,' says Mrs Worth, a mother-of-two and a grandmother, who now lives in Hemel Hempstead, Hertfordshire, and is married to a retired schoolmaster-turned-painter.

'It was done without anaesthetic by someone who wasn't medically trained. It was so excruciatingly painful that the girl would have to be physically held down - usually by her mother or an aunt.

'It was a very difficult operation to perform. The whole of nature is directed towards the propagation of the species, and when a woman becomes pregnant the body does everything it can to protect the foetus.

The cervix will clamp tight for the protection of the foetus.

'Most abortionists somehow managed to get hold of obsolete surgical instruments, but some would use knitting needles or crochet hooks. A pickle spoon might be used, or a curette, which had a long handle and a slightly bulbous tip, like a small spoon.There would be blood everywhere.

'Once the foetus was removed, it would be wrapped up in newspaper and put in the fire. But often bits would be left behind in the womb - bits of a mangled foetus or bits of mangled placenta - which would putrefy and cause severe infection.' ' In the film, there is none of this.

There is a little discomfort during the procedure, and then nice Mrs Drake waves a cheery goodbye. She does this day in, day out, out of the goodness of her heart, risking a manslaughter charge every time.

In real life, the trauma suffered by the pregnant girl would be compounded if she then developed an infection or complication and had to be admitted to hospital.

While working as ward sister at Elizabeth Garrett Anderson Women's Hospital in London from 1960 to 1965, Mrs Worth, who left nursing in 1973 to become a professional singer (she is now a writer and music teacher), witnessed some harrowing scenes.

'These poor souls would come in with massive injuries to their reproductive tract. Some would have a torn cervix or a punctured uterus, or a punctured rectum or bladder.

Once, we had a girl with total renal failure. How she survived, I don't know.

'When a woman came to us with complications, we never asked what had happened, because if a doctor found out he would have a legal obligation to inform the police. We were not social workers or police informers: we were there to give medical assistance.' (In the film, by contrast, the doctor does inform the police.) Most of these women would have been left infertile. Many others died.

'When I had just begun my career at a hospital in Reading, one woman, a 35-year- old mother-of-five, came in with a punctured uterus,' recalls Mrs Worth. 'She developed a terrible infection and deteriorated for several weeks before she finally died.

'I will never forget her children, all aged under ten, being brought in to say goodbye to her. It was heartbreaking.' Some deaths, no doubt, would have been brought about by Vera Drake's soapand-water method. One woman who underwent an abortion this way was Lucy, who recalled her experience for Voices For Choice, a publication by Marie Stopes International and the National Abortion Campaign, now called Abortion Rights.

'They were two biddies from Stepney,' Lucy said. 'They used that awful pink soap, Lifebuoy, and hot water. It didn't work first time round, so they had to come over and do it again.

Seven hours later, the labour pains started and I went and sat on the loo.

'The worst thing was that I had no idea it was going to look like a baby.

This was extremely devastating for me. It still is. It was a tiny baby - but a baby nevertheless. Afterwards, I was losing so much blood that I had to go to hospital.' Peter Bowen-Simpkins, a gynaecologist and spokesman for the Royal College of Obstetricians and Gynaecologists, says the method - portrayed as so straightforward in Vera Drake - placed a woman at risk from infection and other complications.

'If the water was not sterilised, there would be an extreme risk of infection,' he says. 'And if water entered the bloodstream, an air embolus - bubbles in the blood - could occur and result in death.' It was the poorer women who suffered the most. Those who were well off enough to part with around 150 guineas - as opposed to the two guineas charged for an illegal operation - could have an abortion at a private clinic.

Legally, all they had to do was persuade a psychiatrist that they were mentally unstable.

Among them was Deborah Ainger, now 62. 'I had a steady boyfriend and we were responsible and used condoms, but one time the condom split and I got pregnant. I had absolutely no intention of having the baby. My boyfriend was from overseas and was preparing to go back, and I did not want to uproot my whole life.

'I was very lucky in that I had supportive parents who agreed to pay for me to go to a private clinic. But the first psychiatrist I saw said I didn't seem upset enough and refused to authorise an abortion. I had to put on a terrible act with the second, smoking like a chimney and the like. Today, I feel very strongly that abortion should be available on request.' Ms Ainger was one of the lucky ones. Thousands more suffered injuries - physical and mental - that they never fully recovered from.

The first reference to abortion in English law appeared in the 13th century, when the law followed Church teaching that abortion was acceptable until 'quickening'. This, it was believed, was when the soul entered the foetus at around 13 weeks.

The legal situation remained like this until the 19th century, when a series of laws were passed severely restricting abortion, which was at one time punishable by death. By the fictional Vera Drake's day, in 1950, a woman undergoing an illegal abortion and the abortionist would be liable to prosecution.

In today's high-tech world, we have a far greater knowledge of the development of the foetus because of extraordinary pictures of babies in the womb - such as those captured last year by Professor Stuart Campbell, former head of obstetrics at King's College Hospital and St George's Hospital, London, using a new 3D scanning process.

There were babies at 12 weeks' development 'jumping off the womb like a trampoline'; at 18 weeks, opening their eyes; at 22 weeks even appearing to smile.

Enormous advances have also been made in medical science - to the point where it is possible for an emergency Caesarean to save the life of a baby at 24 weeks of gestation.

What concerns many people today is how late into a pregnancy it is possible to have a termination. Mrs Worth, who has written a book on her experiences of midwifery, entitled Call The Midwife, says she was shocked at the 28-week limit for abortion. (It has since been reduced to 24 weeks.) 'I was profoundly shocked by that. All babies born prematurely at 28 weeks are capable of surviving, and nowadays, with all the modern equipment we have, you get babies born prematurely at 24 weeks who survive.' Mrs Worth, who was a midwife until the early 1970s, says that for all the modern debate over the law, there was ' enormous relief' among the medical profession when abortion was legalised.

Until then, there were upwards of 250,000 illegal abortions a year.

Thousands of women are believed to have died, and sometimes children were born with mental or physical impairment following a failed abortion.

'When abortion was legalised, it immediately brought an end to terrible suffering and often death,' says Mrs Worth. 'The situation had been such that some women felt they had no choice but to go to a backstreet abortionist. I think that was terribly sad.' With his film, Mike Leigh has succeeded in reminding us of that terrible time for women, which no sensible person would ever wish to return to.

Yet his homely portrayal of the abortionist is ultimately misleading. It was, in fact, a nasty, brutal business - and the Vera Drakes were at the heart of it.