England's Abortion Laws: What's The Current Stance?

Abortion laws in England have changed over the years, with the current legislation permitting abortions in the first 24 weeks of pregnancy. The Abortion Act of 1967, amended by the Human Fertilisation and Embryology Act of 1990, outlines the legal grounds for abortion, which include risk to the pregnant woman's life and physical or mental health, as well as the potential for fetal abnormalities. This Act decriminalised abortion and allowed for legal abortions to be carried out by registered medical practitioners, authorised by two doctors acting in good faith. While England's abortion laws have been a topic of debate and proposals for change have been made, the current framework ensures access to safe and legal abortions within specific parameters.

Abortion laws in England and Wales

Firstly, it is important to note that abortions can only be carried out under the care of an NHS hospital or a licensed clinic and are typically available free of charge on the NHS. However, private abortions are also available at a cost that varies depending on the stage of pregnancy and the method used.

Abortions in England and Wales are usually carried out before 24 weeks of pregnancy. After 24 weeks, abortions are permitted only in very limited circumstances, such as if the mother's life is at risk or the child would be born with severe disabilities. Most abortion services will perform an ultrasound scan to determine the gestational age, which is calculated from the first day of the last menstrual period.

Abortions can be approved by two doctors if they agree that continuing the pregnancy poses a greater risk to the physical or mental health of the pregnant woman than termination. The doctors must act in "good faith", meaning they cannot be dishonest or negligent in forming their opinion. The law also allows doctors to take into account the woman's social and financial circumstances when making their decision.

It is worth noting that abortions are not permitted solely based on the fetus's sex, although this may be a factor in some cases. Additionally, doctors have the right to conscientious objection and are not required to perform abortions unless it is necessary to save the woman's life or prevent grave, permanent injury.

The process of obtaining an abortion involves either self-referral to an abortion provider or a referral from a GP or sexual health clinic. Waiting times are typically within two weeks from the initial contact. The abortion can be carried out through medical or surgical methods, depending on the stage of pregnancy and the woman's preference. Medical abortions involve taking two pills to induce abortion, while surgical abortions involve a procedure to remove the pregnancy.

While abortion is a safe procedure, there are small risks of complications such as infection, incomplete abortion, or damage to the womb. Abortion does not affect future fertility, and contraception should be used to prevent unwanted pregnancies.

In summary, abortion laws in England and Wales allow abortions to be carried out under specific conditions, with the approval of two doctors, and within the gestational limits. The process involves referrals, ultrasounds, and either medical or surgical procedures. Abortions are accessible and can be obtained through the NHS or private clinics, ensuring women's rights and health are prioritised.

Abortion after 24 weeks

Abortion is a procedure to end a pregnancy, also known as a termination of pregnancy. In England, abortions can be carried out under the care of an NHS hospital or a licensed clinic and are usually available free of charge on the NHS.

Abortions are generally carried out before 24 weeks of pregnancy. However, they can be carried out after 24 weeks in very limited circumstances, such as if the mother's life is at risk or the child would be born with a severe disability.

The decision to have an abortion is yours alone, and you can discuss your options with a trained pregnancy counsellor. You can self-refer by contacting an abortion provider directly, or speak to a GP and ask for a referral to an abortion service.

There are two methods of abortion: a medical abortion, where you take two medicines to induce an abortion, and a surgical abortion, where a procedure is performed to remove the pregnancy.

Abortions are safer when carried out earlier in the pregnancy, and you should seek advice early on to have more time to make a decision.

Abortions after 24 weeks are only carried out in very limited circumstances. The Abortion Act 1967, as amended by the Human Fertilisation and Embryology Act 1990, allows abortions after 24 weeks in the following circumstances:

• Risk to the life of the pregnant woman
• Prevent grave permanent injury to the physical or mental health of the pregnant woman
• Risk of injury to the physical or mental health of the pregnant woman or any existing children of her family
• Substantial risk that, if the child were born, they would "suffer from such physical or mental abnormalities as to be seriously handicapped"

The decision to authorise an abortion after 24 weeks rests with two doctors, who must act in good faith and agree that at least one of the above grounds is met. This means that they must not be dishonest or negligent in forming their opinion. The doctors can take into account the pregnant woman's actual or reasonably foreseeable environment when making their decision.

Abortions after 24 weeks are rare, with around 3,000 out of 200,000 abortions in Britain conducted after 20 weeks.

Abortion in Northern Ireland

The Abortion (Northern Ireland) (No.2) Regulations 2020, introduced by the UK government in March 2020, allow access to abortions up to 12 weeks gestation without conditionality. This must be certified by one medical professional. Abortions beyond 12 weeks are lawful in specific instances, including severe foetal impairment and fatal foetal abnormalities.

The procurement of an abortion remains a criminal offence in Northern Ireland under the Offences Against the Person Act 1861. However, the Abortion (Northern Ireland) Regulations 2020 allow abortions to be carried out in certain circumstances.

The type of abortion service available in Northern Ireland depends on how many weeks pregnant the woman is. Early abortion services are available for pregnancies less than 12 weeks, and medical abortions are available for pregnancies up to 24 weeks. Surgical abortions are available for up to 20 weeks, and work is ongoing to set up a service for pregnancies beyond this stage.

The decision to have an abortion is the woman's alone, and she is not obliged to tell her partner, friends, or family. If she is under 16, her parents do not usually need to be informed, although the doctor or nurse may encourage her to tell a parent or another trusted adult. Non-directive pregnancy choices counselling is available for women who need support when considering their options.

To access abortion care in Northern Ireland, women must contact the British Pregnancy Advisory Service (BPAS), which is the only access point to abortion in the region. BPAS offers advice, counselling, and access to abortion services.

Abortion law changes

Background

Abortion laws in England have undergone significant changes over the years, with the most notable being the introduction of the Abortion Act in 1967. This legislation made abortion legal under specific circumstances and up to 28 weeks of pregnancy. However, in 1990, the Human Fertilisation and Embryology Act amended the Abortion Act, reducing the time limit to 24 weeks.

Current Abortion Laws in England

In England, abortions can be carried out legally up to 23 weeks and 6 days of pregnancy, as per the Abortion Act 1967. Two doctors must authorise the procedure, acting in good faith and agreeing that at least one of the following criteria is met:

• Continuing the pregnancy poses a greater risk to the physical or mental health of the pregnant woman or her existing children than termination.
• Termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
• Continuing the pregnancy poses a risk to the life of the pregnant woman, greater than if it were terminated.
• There is a substantial risk that the child, if born, would suffer from physical or mental abnormalities, resulting in serious handicap.

Recent Developments

While abortion laws have been largely stable in England since the 1990 amendment, there have been some recent developments:

• Decriminalisation Efforts: There have been proposals to decriminalise abortion in England, removing it from criminal law. This would mean that those who undergo or perform abortions outside the parameters of the Abortion Act would no longer face police investigation or prosecution.
• Telemedical Abortion: During the COVID-19 pandemic, the government approved the home administration of early abortion pills, with remote consultations and telemedical support. This change was later made permanent, allowing women to take both pills at home up to 10 weeks into the pregnancy.
• Northern Ireland: Abortion laws in Northern Ireland have historically differed from the rest of the UK, but recent changes have brought them closer to those in England. In 2019, abortion was decriminalised in Northern Ireland, and a new legal framework took effect in 2020, allowing unconditional abortions up to 12 weeks and aligning with English law after this period.

While England's abortion laws have been largely stable for the past few decades, recent developments indicate a shift towards greater accessibility and flexibility for women seeking abortions. Efforts to decriminalise abortion and the introduction of telemedical abortion options reflect a modernising approach to abortion care, prioritising women's health and wellbeing.

Abortion safety and side effects

Abortion is a safe procedure in England, and it is carried out either medically or surgically. The procedure is safer and less painful when performed as early as possible in the pregnancy.

Medical Abortion

The medical abortion procedure involves taking two medicines, mifepristone and misoprostol, usually 24 to 48 hours apart, to induce an abortion. Mifepristone ends the pregnancy by blocking the hormone progesterone, which is necessary for the pregnancy to continue. Misoprostol then causes the womb to contract, resulting in cramping, bleeding, and loss of the pregnancy, similar to a miscarriage.

The expected side effects of a medical abortion include lower abdominal pain/cramping, vaginal bleeding, nausea, vomiting, diarrhoea, headache, dizziness, and fever/chills. Pain can be severe in some cases, requiring the use of strong painkillers like codeine.

There are also some risks associated with a medical abortion. These include:

• Needing another procedure to remove parts of the pregnancy that remain in the womb.
• Serious complications such as heavy bleeding, damage to the womb, or sepsis.
• Undiagnosed ectopic pregnancy.
• Infection of the womb or fallopian tubes.
• Blood clot in the lung or leg (VTE).
• Psychological problems.
• Surgical abortion or uterine aspiration.
• Blood transfusion.
• Laparoscopy or laparotomy – an operation to look inside the abdomen.
• Hysterectomy – surgical removal of the womb.
• Intravenous antibiotics.
• Salpingectomy (removal of fallopian tube) or salpingostomy (opening the fallopian tube).

Surgical Abortion

The risks of a surgical abortion depend on the stage of pregnancy. Before 14 weeks of pregnancy, the main risks are needing another procedure to remove parts of the pregnancy that remain in the womb, serious complications such as heavy bleeding, damage to the womb, or sepsis. After 14 weeks, the risks include needing another procedure, very heavy bleeding, infection, and injury to the womb or entrance to the womb (cervix).

General Side Effects and Risks

Abortion does not increase the risk of breast cancer or mental health issues. It also does not affect a person's chances of becoming pregnant and having normal pregnancies in the future. However, many women are able to get pregnant immediately after an abortion, so conception should be used if another pregnancy is not desired.

There is a small risk to fertility and future pregnancies if an untreated womb infection develops and spreads to the fallopian tubes and ovaries, known as pelvic inflammatory disease (PID). PID can increase the risk of infertility or ectopic pregnancy.

Abortion Laws in England

Abortion in England is permitted under the Abortion Act 1967, which states that an abortion is legal if performed by a registered medical practitioner (a doctor) and authorised by two doctors acting in good faith on specific grounds. These grounds include risk to the life of the pregnant woman, preventing grave permanent injury to her physical or mental health, and substantial risk of the child being born with physical or mental abnormalities.

While abortion is generally a safe procedure, it is important to be aware of the potential side effects and risks associated with both medical and surgical abortions.

Frequently asked questions