The UK’s outdated abortion laws are restricting doctors’ ability to provide the best care for women, according to experienced physicians. The journal Social Science & Medicine conducted interviews with both NHS and private-sector doctors, finding that those providing the care believe that the current law forces them to “depart from clinical practice with a clear negative impact on women’s experience”.
The doctors interviewed also strongly resented the legal requirement for two doctors to give their signatures in order for an abortion to go ahead. They described it as “ridiculous”, “unnecessary” and “completely outdated”, as it can create delays that “compromise the service”, particularly in rural areas.
If a doctor performs an abortion outside of these terms, they currently risk criminal punishment. One doctor described the impact of the threat of prosecution on medical care: “It sends fear… it disorganises and destabilises doctors who are functional people who wanted to do a specific task.” Over the past few years, anti-abortion campaigners and MPs have been pushing for doctors to face prosecution for incorrectly completing the legal paperwork required by the 1967 Abortion Act.
Abortion remains a criminal offence in the UK under the 1861 Offences Against the Person Act (OAPA). The law was updated 51 years ago, but only to provide legal exemptions for medical professionals and women if they meet certain requirements, rather than remove the sanctions the OAPA put in place.
According to the study, the threat of prosecution is leading some doctors to abandon abortion provision and is deterring younger doctors from training in the field. Not only does this have a significant implication for future medical services, but also for women with complex medical conditions. The British Pregnancy Advisory Service (BPAS) published a report earlier this year, which found that British women with epilepsy, heart problems and cancer often struggle to obtain abortion care, even though the continuation of the pregnancy poses a significant threat to their health.
Doctors felt that the law itself didn’t improve services or protect women, but acted as an obstacle to providing optimum care
Overall, they felt that the law itself didn’t improve services or protect women, but acted as an obstacle to providing optimum care. The study showed that doctors felt they were governed by laws half a century old and couldn’t adapt to new medical advances, or use their own clinical judgement: “The regulation is about putting up barriers rather than doing things that would benefit the individual in terms of quality.”
The restrictions also mean that clinics are often unable to provide nurse- or midwife-led care. The requirement for medical oversight in the provision of early medical abortions can result in women miscarrying on their way home from the clinic, instead of having the option to delay the process until they are in the privacy and comfort of their own home.
Recently, MPs, led by Stella Creasy, have indicated that there will be cross-party moves to decriminalise abortion up to 24 weeks of pregnancy in an amendment to the upcoming Domestic Abuse bill, which will allow reform in Northern Ireland. The proposed reforms would repeal sections 58 and 59 of the OAPA, which criminalise the procurement of “any poison or other noxious thing” or the use of “any instrument” with the intent of inducing abortion. This wouldn’t impose specific legislation on Northern Ireland, but prompt the government to create their own legislation on regulating abortion. The 1967 Abortion Act was never extended to Northern Ireland, meaning that, in order to access abortion, women living there must make arduous and costly journeys to Britain for what is simply basic healthcare.
The secretary of state for Northern Ireland, Karen Bradley, has cautioned that the debate would “disenfranchise” Northern Irish citizens. Even if the new legislation prompts a referendum in Northern Ireland, the result wouldn’t be legally binding, as Stormont has no official government to outline new laws. In addition to this, the current UK government is hesitant to upset the anti-abortion DUP, saying the issue could “topple” Theresa May.
Patricia Lohr, medical director at BPAS, commented that the study was important to highlight the challenges abortion doctors face: “Decriminalising abortion does not mean deregulating abortion, 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."