Earlier this week, the BBC reported that women in Wales are having to travel to England to receive abortions, finding that “most health boards refer women needing surgical abortions after 18 weeks for treatment in England”. Moreover, figures released by British Pregnancy Advisory Service (BPAS) last year found that 65 women travelled from Scotland to England to access abortion care, an increase of 55% compared to 2021. And, despite abortion being decriminalised in Northern Ireland since 2019, the latest reporting shows that over 160 women travelled from the country to England and Wales to receive abortion care.

Reading these statistics raises the question: why are women having to travel to England for abortions, particularly when the Abortion Act applies to England, Scotland and Wales? The answer seems to be dependent on whether a surgical abortion (rather than a medical abortion) is needed, and also seems to be confined to whether a pregnancy is over 18 weeks. 

As a result, some women in Wales and Scotland are having to travel to England for care. In Wales, this is predominantly down to a skills gap. “The main issue that is forcing women to travel long distances for abortion care is a lack of trained abortion surgeons,” Dr Yvonne Neubauer, associate clinical director at MSI Reproductive Choices UK (MSI), tells Stylist. “In 2021, the Royal College of Obstetricians and Gynaecologists estimated that there were only 16 abortion surgeons trained in later pregnancy procedures throughout the entire country. None of these surgeons were based in Wales, Scotland or Northern Ireland and over half of them were over 55 years old and nearing retirement, creating a ticking time bomb within abortion care.”

Neubauer also points to how funds for abortion care are allocated across the UK. “The other most significant issue is the way that abortion is commissioned,” she says. “MSI has a state-of-the-art clinic in Bristol close to the Welsh border. Yet, because we are not commissioned to provide care in Wales, women who are unable to access surgical abortion care in Wales are having to pass straight by our clinic and travel hundreds of miles to be treated further afield. It is incomprehensible and cruel when they are just trying to secure essential healthcare.”

Scotland has a similar issue with a skills gap, and women who need surgical or later-term abortions are also affected by a ‘postcode lottery’ depending on what local health board they seek their care through. “In Scotland, no health board area provides care for women over 20 weeks gestation,” explains Lucy Grieve, policy and engagement manager at BPAS. “This means that anyone requiring care between 20 weeks and up to the gestational limit of 24 weeks has to travel to a BPAS clinic for treatment. We know how traumatic it can be for women who have to travel hundreds of miles, often far away from their support systems, for a procedure in a city they aren’t familiar with.”

However, it’s not just women in Wales and Scotland who are having to travel for specific types of care. “Provision of abortion care in the UK is patchy, insufficient and a postcode lottery,” explains Sonia Adesara, an NHS doctor and campaigner for Doctors for Choice UK. “Even within England, women are having to travel unacceptable distances to get the care they need, causing significant and unnecessary distress. We would not accept this with any other form of healthcare.”

Clearly, there are huge inconsistencies in the type of care that women can access depending on where they live. “As large parts of Wales and Scotland are rural, and abortion is provided by the NHS in both of these countries, having specialised local abortion services close to everyone requiring an abortion has not been the priority of successive governments and there has been little will to change the status quo,” says Grieve. 

Neubauer adds that surgical abortion training needs to be prioritised across the UK. “For the past few years, MSI has been providing surgical abortion training to doctors who work in the NHS to expand access and reduce the distance that women are having to travel,” she says. “So far, 10 doctors have been trained, but more must be done to end the postcode lottery of abortion care.”

Although abortion care has seen vast improvements in the past few years thanks to successful campaigning for telemedicine ‘at-home abortion pills’ to continue post-panedmic (for pregnancies up to a certain date), the above figures paint a stark figure of how far there still is to go to make abortion care equal across the UK. Couple this with the fact that we’re still waiting for MPs to decide on a date for a vote on decriminalising abortion in England and Wales, and the situation looks bleak. That’s why doctors, abortion providers and campaigners are calling on the government to commit to improving abortion care for women across the UK, no matter where they live. “We are working towards the de-stigmatisation and normalisation of abortion for those accessing and those providing abortion care,” says Adesara. “We are campaigning for the full decriminalisation of abortion across the UK and are calling on politicians to prioritise abortion care and women’s health.”

Images: Getty