Insights into the UK’s abortion practices

abortionsCC: Amacchio at Unsplash

Abortion is a topic that’s rarely away from the headlines. Recently, it’s been gaining fresh traction both in the United States and the United Kingdom. While Alabama has been enforcing stricter laws, one politician in the UK has chosen to use it as a bid to gain support for becoming our next Prime Minister.

The majority of the UK benefits from liberal access to abortions. An exception is Northern Ireland. Despite this liberal access, our abortion rates are quite low. For those who don’t live here, learning more about how the UK’s abortion practices may be enlightening.

Abortion in the UK became legal in 1967

Abortion in the UK became legal in 1967. Interestingly, it wasn’t technically illegal until 1861.

In the highly religious medieval period, English law stated that abortions were acceptable until ‘quickening’ began. As this was an era where women would drink herbal tinctures with the aim of aborting, this may not mean much. However, it is fascinating that a religious government would deem abortion acceptable until the point where movements were felt. This could be anywhere between 20 and 24 weeks.

In 1861, The Offences Against the Person Act include abortion as a practice that could result in life imprisonment. Fast-forward to 1923 and a fifth of all maternal deaths are due to the abortions women would seek anyway. Campaigns to legalize the practice started in the 1930s, but WWII took precedence in government. In the 1950s, the campaigns gained traction again, eventually leading to the 1967 act.

Since then, the cut off point for abortions has been reduced from 28 weeks to 24 weeks. As Scotland and Northern Ireland have their own devolved governments, they don’t follow the same rules as England and Wales. In Scotland, the laws are almost exactly the same as England and Wales. In Northern Ireland, abortions are illegal unless the mother’s life is deemed to be absolutely at risk.

Northern Ireland’s approach to abortion has resulted in harrowing deaths. In one case, doctors felt that the law meant they would need to try and treat septicaemia before defaulting to aborting a non-viable fetus attached to a detaching placenta. They chose to wait because a fetal heartbeat was still present. The patient, Savita Halappanavar, died after a prolonged battle with septicemia.

Abortions are available for free via the NHS

The National Health Service (NHS) provides the most abortions in the UK. To access them, the patient visits their General Practitioner (GP) and informs them of their intentions. Two doctors must agree that having an abortion is the preferable option. The woman must be at greater risk if she continues with the pregnancy, which means most terminations are carried out on the mental distress that continuing with pregnancy may cause.

GPs who are religious can refuse to refer a woman for a termination. However, they must recommend that the patient sees another GP for such services. They’re allowed to refuse referral if it’s at odds with their religion, but they cannot prevent access or discourage access entirely.

If someone under the age of 18 wishes to have an abortion, they can do so without parental consent. Similarly, so can someone under the age of 16 (the age of sexual consent in the UK). This is protected by a legal framework called Gillick Competency. According to Gillick Competency, if a child is mature enough to understand the ramifications of a medical decision, they can make that decision for themselves. At the same time, referring GPs need to consider the child’s overall wellbeing. As such, if a child presents to them who is pregnant and quite underage, they’re likely to make a referral to social services to keep the child safe.

Having a termination privately is also an option. One major charity that provides them is Marie Stopes. Many terminations carried out at Marie Stopes are also free, as it’s a not-for-profit charity. Overall, 98% of abortions were carried out by the NHS.

Unlike in the United States, visiting a dedicated clinic is rare. This means the process is fairly anonymous, and it’s difficult to tell why someone is entering the clinical area where terminations take place.

A few key statistics

In 2017, 192,000 abortions were carried out on English and Welsh residents. Just under 5,000 were carried out on non-residents; primarily women from Northern Ireland and the Republic of Ireland.  Around 90% of terminations are carried out at under 13 weeks, and 80% at under 10 weeks.

Since 2007, the number of medical abortions has doubled since the NHS has tried to step away from surgical methods.

All these statistics represent a slight increase compared to previous years. It doesn’t appear to be a consequence that this has happened at the same time that access to contraceptives has decreased.

Overall, abortion remains uncontroversial in the UK. Even if a politician did push to reduce the time limit, it’s unlikely any such law would make it through parliament.

About the Author

Laura McKeever
Laura has been a freelance medical writer for eight years. With a BSc in Medical Sciences and an MSc in Physician Assistant Studies, she complements her passion for medical news with real-life experiences. Laura’s most significant experience included writing for international pharmaceutical brands, including GSK.