Given that women in Northern Ireland and Ireland still do not have access to abortion in the vast majority of circumstances, and women in the US are currently facing the biggest threat to reproductive rights in a generation, it’s easy to look at abortion laws in England, Scotland and Wales and think that they’re pretty good. In those countries, women have had the legal right to terminate unwanted or unviable pregnancies up to 24 weeks since the passing of the Abortion Act 1967.

But despite this relatively liberal approach, abortion is still technically a criminal offence in the UK – leading many MPs and medical bodies to call for change. Now, a group of doctors has joined the call for the UK’s abortion laws to be reformed, saying that they are no longer fit for purpose.

As part of a new study, the British Pregnancy Advisory Service (BPAS) consulted 14 experienced abortion doctors working across the UK in the NHS and not-for-profit services. The organisation found that the doctors were strongly critical of the current law, and believe it forces them to provide care “in a way that departs from clinical practice with a clear negative impact on women’s experience”.

“This is an important study which shines a light on the challenges doctors working in abortion face, and the negative impact the criminal law has on their ability to provide women with optimum clinical care,” said Dr Patricia Lohr, medical director at BPAS. 

While revolutionary, the 1967 Abortion Act did not repeal key sections of a Victorian-era law – the 1861 Offences Against the People Act, which still applies in England and Wales – or equivalent common law in Scotland. These laws state that anyone who procures an abortion for themselves, or provides someone else with the tools for an abortion, should face prosecution and imprisonment.

Instead, the 1967 Abortion Act simply provided legal exemptions for those sections in England, Scotland and Wales (but not Northern Ireland, which is why abortion is still illegal in almost all circumstances there). This means that women can only get abortions if they meet certain grounds: if continuing with the pregnancy would pose a risk to their life or mental or physical health, or if the child is likely to be born with mental or physical abnormalities.

Two doctors must also legally authorise the procedure before it can take place, a process that was described by the doctors in the study as “ridiculous”, “unnecessary” and “completely outdated”.

If a medical professional provides an abortion outside of the terms laid out in the 1967 Abortion Act, they could risk criminal punishment – something that British anti-abortion campaigners have increasingly pushed for in recent years.

One doctor interviewed for the study, which was published in the journal Social Science & Medicine, said that this threat of prosecution “sends fear” into medical professionals. “It does disorganise and destabilise doctors who are functional people who wanted to do a specific task.”

Overall, the study showed that doctors felt that the current abortion law in the UK does not improve services or protect women, but actually makes it more difficult for them to provide the best care. Services are not able to adapt to medical advances, they said, and doctors are forced to adhere to a 50-year-old law rather than use their own judgement.

“The regulation is about putting [up] barriers rather than doing things that would benefit the individual in terms of quality,” said one doctor.

Another doctor said that abortion should be treated like any other medical procedure, and permitted to develop and change with advances in medicine. “I’m not saying [abortion] should be unregulated… but I’m saying it should be regulated in the same way as health generally,” they said.

Medical bodies including the British Medical Association (BMA), Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have all already come out in support of the decriminalisation of abortion.

Later this year, a cross-party group of MPs led by Labour MP Stella Creasy is set to add an amendment to the government’s forthcoming Domestic Abuse bill, which would repeal the relevant sections of the 1861 Offences Against the People Act. If approved, this amendment would decriminalise abortion across the UK, including in Northern Ireland. Labour MP Diana Johnson has also said she will bring a private members’ bill on the issue.

“Decriminalising abortion does not mean deregulating abortion,” said Dr Lohr.

“But it would mean that the service could be organised in the same way as other healthcare procedures, giving healthcare professionals the ability to provide women with the best possible care.”

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