More on UK abortion law

Summary of legal grounds and time limits for abortion as laid out in the 1967 Abortion Act

Up to 24 weeks two doctors must decide that the risk to a woman’s physical or mental health or the risk to her child(ren)’s physical or mental health will be greater if she continues with the pregnancy than if she ends it.

There is no time limit on abortion where two doctors agree that a woman’s health or life is gravely threatened by continuing with the pregnancy or that the fetus is likely to be born with severe physical or mental abnormalities.

In the event that an abortion must be performed as a matter of medical emergency a second doctor’s agreement does not need to be sought.

Consent

Providing that two doctors confirm that her need for an abortion fits the legal criteria, a woman does not need the consent of her own doctor, her partner or her family to have an abortion.

Women under 16 can have an abortion, without parental consent in some circumstances.

What happens in practice

Despite legal time limits 87% of abortions take place within the first 12 weeks of pregnancy. In many parts of the country it is difficult to access abortion after 12 weeks.

Most abortions are carried out under grounds C and D of the Abortion Act i.e. two doctors agree that the risk to a woman’s mental or physical health or the health of her existing child(ren) would be at greater risk if she were to continue with the pregnancy than if she were to end it. These are very broad criteria, which demand that doctors rely on their own judgment of risk.

Some doctors believe that women are the best people to make decisions about their own pregnancy and will refer any woman who requests an abortion on the grounds that her mental health will suffer by being forced to continue with a pregnancy which is unwanted.

Some doctors claim that since abortion is statistically safer than carrying a pregnancy to term and giving birth, that abortion always represents a lesser threat to a woman’s health than pregnancy, and any woman requesting an abortion should have one on health grounds.

Other doctors interpret the law more narrowly. They want to be convinced that there is specific evidence that a woman’s health will be put at risk by the pregnancy, and will not always refer a woman for abortion.

Some doctors oppose abortion on principle and might refuse to refer a woman for an abortion in any circumstances, on the grounds that they have a ‘conscientious objection’ to abortion.

Full wording of the 1967 Abortion Act

Abortion Act 1967 as amended by the Human Fertilisation and Embryology Act (HFEA) 1990

This Act applies in England, Scotland and Wales, but not in Northern Ireland

A legally induced abortion must be:

• performed by a registered medical practitioner, performed, except in an emergency, in a National Health Service (NHS) hospital or in a place for the time being approved for the purpose of the act, and
• certified by two registered medical practitioners as justified under one or more of the following grounds:

A   the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated;

B   the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman;

C   the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman;

D   the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing child(ren) of the family of the pregnant woman;

E   there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped;

or in emergency, certified by the operating practitioner as immediately necessary:

F   to save the life of the pregnant woman; or

G   to prevent grave permanent injury to the physical or mental health of the pregnant woman.

The act provides that in relation to grounds C and D the certifying practitioner may take account of the pregnant woman’s actual or reasonably foreseeable environment. The changes made to the Abortion Act 1967 by section 37 of the Human Fertilisation and Embryology Act 1990 came into effect on 1 April 1991 and included a time limit of 24 weeks for abortions under statutory grounds C and D. Statutory grounds A, B and E, F and G are without time limit.

The Abortion Act allows for medical staff to opt out of providing abortions if they have a moral objection to the procedure. ‘…no person shall be under any duty…to participate in any treatment authorised by this Act to which he has a conscientious objection.’

Conscientious objection

Doctors’ views on abortion probably reflect the views of society more generally. Most doctors will refer women for abortion, but a minority feel that abortion is always wrong. A local audit of GPs in England concluded that at least one GP in 24% of practices will not refer a woman for abortion, on the grounds of ‘conscientious objection’.

Government guidance to doctors makes it clear that women should not be obstructed from seeing a doctor who will refer them for abortion in the event that their own doctor refuses.

 ‘(if GPs are not willing to refer women for abortion services) they must make that clear in practice information and make explicit alternative arrangements for their patients through other practices or community services.’

The National Strategy for Sexual Health and HIV July 2001