Disability & Abortion: The Hardest Choice review – this intelligent documentary deserved two episodes

In the opening scenes of Disability and Abortion: The Hardest Choice (Channel 4) we are getting to know our hosts, the actors Ruth Madeley and Ruben Reuter. Reuter, who has Down’s syndrome, is loved up with his girlfriend and enjoying his own flat. Madeley, who has spina bifida, goes for cocktails with the girls and has a Bafta nomination. The purpose is clear: any viewer who believes that the lives of disabled people are not worth living should re-evaluate their prejudice. It is an important, albeit simplified, point and in many ways sums up the challenge ahead for the film-makers: boiling a highly complex ethical debate into a one-hour mainstream vehicle.

Madeley and Reuter start the documentary with an understandable but crude idea: that the UK’s abortion law, which permits termination of a pregnancy with foetal abnormalities after the standard term limit of 24 weeks, amounts to “discrimination” against disabled babies. The hosts plan to meet various people – parents, doctors, charity workers – to challenge their ideas.

The most moving of these meetings are the interviews with women who have made the “hardest choice” the title speaks of. We meet Natasha, a young woman who has endured two pregnancies with fatal abnormalities. In the first case, Natasha chose an abortion – tellingly at 24 weeks and four days. In the second, she chose to go ahead with the pregnancy. After giving birth by caesarean section at 29 weeks, her little girl died three days later. Watching Natasha at the babies’ graves, small wooden hearts marking their names, the complexity and pain of this so-called “choice” is impossible to deny.

Madeley and Reuter make engaged, compassionate hosts, and it is a testament to their intentions that they contemplate a choice that, rightly or wrongly, feels to them like a judgment on their own lives. To her credit, Madeley in particular gamely enters into – often highly difficult – discussions with experts who present her with new information and nuance. Her interview with a consultant who grants women permission for abortion based on diagnosing foetal abnormalities – “We don’t place value on life. It’s providing support for people so that they have the choice”, he implores – leaves her in tears. Left with the doctor’s words that it is “brutal” to remove a woman’s bodily autonomy, Madeley is visibly moved.

I can’t help but think, though, the film would have been fairer, and ultimately better, if there had also been a host who was fully pro-choice. The format is designed to enable the two presenters to have a “revelation”, but both holding the same views creates a sense of imbalance, particularly at the start. For the first 15 minutes or so, the “anti” side is all the viewer hears, and black-and-white claims are left to go unchallenged. When Heidi Crowter, whose ultimately unsuccessful high ocurt case against the UK’s abortion laws acts as a hook for the film, frames the law as believing disabled babies aren’t “as valuable” as non-disabled children, she is never pressed on the fact that there may be other, much more credible reasons at play for the disparity (for example, that most foetal abnormalities are only detected after 20-plus weeks), because her interviewer agrees with her. This is only compounded by the fact that there is not a single disabled person interviewed who supports the right to an abortion after 24 weeks. In contrast, every fully pro-choice voice is a non-disabled person. It is a strange omission, not least when a YouGov survey commissioned for the programme finds that 55% of people born with a disability support the time limit.

The film is on stronger ground when it highlights how healthcare workers often give couples a falsely bleak prognosis of the life their prospective disabled child could expect, and the general prejudice around disability. The scene of a happy little boy with Down’s syndrome playing in his beautiful home is contrasted effectively with his mum – an activist who challenged the law alongside Crowter – describing how she was appallingly asked three times by medics if she wanted to end her pregnancy. It would have served the issue better, however, if there had been some acknowledgment in this scene of the privilege at work: that middle-class women with family support and resources are not making the choice in the same context as women suffering domestic violence, poverty, or with four children already.

This lack of analysis of wider inequality is perhaps the weak part of the film. “Why is disability seen as a bad thing?” Reuter asks. It is an important question but it is not the only one that the hosts could be asking. As well as prejudice, it is surely practical matters such as the UK’s high rates of disability and child poverty, lack of special needs nursery provision and inaccessible housing that contribute to parents’ choices to terminate a pregnancy. Upon closer inspection, you could conclude it is the way disabled people are treated outside the womb that is the real “discrimination”. The issues raised by this emotionally intelligent film are of such importance it would have benefited from being a two-parter. Madeley and Reuter – and all the brave women affected – deserve our attention.

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