Abortion

Abortion is the surgical or medical termination of a pregnancy. It comprises of the removal of a developing embryo or foetus from the uterus, usually before it can survive outside the womb. 

There are 3 main ways to get an abortion on the NHS:

• Self-referral: Contacting an abortion provider directly such as The British Pregnancy Advisory Service (BPAS). A pregnant woman can also go on the NHS sexual health website to see their eligibility and services in their area.
• Contacting a GP: Speaking to a GP and asking for a referral to an abortion service. They are able to object to the pregnancy, but can refer the patient to another doctor.
• Contacting a sexual health clinic: Asking for a referral to an abortion service. Some sexual health clinics are called family planning or genitourinary medicine clinics, and they can also refer somebody to an abortion service.

If a woman is less than 10 weeks pregnant they may be able to have a medical abortion at home after an initial appointment with the hospital or clinic. Waiting times do not usually exceed 2 weeks from when an abortion provider is first contacted by the pregnant woman or the doctor.

There are a number of abortion procedures, depending on the stage of pregnancy, and other factors such as the woman’s health:

• Medical abortion: This involves taking medications, to induce a miscarriage. This is typically carried out during the first trimester of pregnancy (0-13 weeks) and is considered to be a safe and effective method. 
• Vacuum aspiration: A procedure which involves the use of a suction device to remove the embryo or foetus from the uterus. This is considered minimally invasive and effective, during the first trimester of a pregnancy.
• Dilation and Curettage (D&C ): D&C involves dilating the cervix and scraping or suctioning out the contents of the uterus. This takes place for abortions in the first trimester of pregnancy but may be necessary for a pregnancy that has already ended, but the body has not expelled the foetal tissue.
• Dilation and Evacuation (D&E): D&E is similar to D&C, but is a procedure typically done during the second trimester of pregnancy (13-24 weeks) and involves dilating the cervix and using surgical instruments to remove the foetus and placenta from the uterus. 

In the UK, women can have an abortion up to 24 weeks of pregnancy, although the procedure is usually carried out much earlier. The decision to have an abortion must be made by the woman herself, with the support of her healthcare provider.

If the pregnancy is more than 24 weeks along, an abortion can still be carried out if continuing the pregnancy would pose a risk to the woman’s life or if there is a risk of serious physical or mental health problems for either the woman or the child. It is important to note that this is extremely rare, and takes place in very limited circumstances.

Abortion is legal in Great Britain through the Abortion Act of 1967. According to National Statistics, 214,869 abortions were reported in England and Wales in 2021, the highest since records began.  This represents an age-standardised abortion rate of 18.6 per 1,000 resident women aged 15 to 44.

For more information on abortion legislation around the world, go to the legislation page.

Abortions can only be carried out under the care of an NHS hospital or a licensed clinic. If the hospital or clinic is private then there will be a fee for the abortion.

In the UK, any woman who is pregnant and meets the legal requirements for an abortion can access abortion services. This includes:

• Women of any age: There is no minimum age requirement for women seeking an abortion in the UK. However, healthcare providers will assess whether the woman is capable of making an informed decision about her care.
• Women who are UK residents: Women who are ordinarily resident in the UK can access abortion services on the National Health Service (NHS) free of charge. Non-residents may also be able to access abortion services, but they may have to pay for treatment.
• Women who are within the legal gestational limit: As mentioned earlier, women can have an abortion in the UK up to 24 weeks of pregnancy, although the procedure is usually carried out much earlier.
• Women who have made an informed decision: Women who are seeking an abortion must have made an informed decision, with the support of their healthcare provider. They will be provided with information on the procedure, as well as the risks and benefits, to help them make an informed decision.
• Women who have given their consent: Women must give their consent before an abortion can be carried out. Healthcare providers will explain the procedure and obtain the woman’s consent before proceeding.

There may be additional legal or medical requirements in certain cases, such as if the woman has a serious medical condition or if there are concerns about her mental capacity.

No matter the age, girls and women seeking an abortion have a right to confidentiality. Therefore there is no requirement for anyone, other than the pregnant woman, to have knowledge of the abortion.

Women may choose to terminate their pregnancy for many reasons.

• Personal circumstances: A woman feeling that she is not emotionally, logistically, or financially ready for a child, can be a reason. They may feel that having a child would interfere with their career, education or other life aspirations and goals.
• Health concerns: A woman may also choose to have an abortion due to health concerns, as having the baby could pose a risk to their mental or physical health. This could include situations where proceeding with the pregnancy would not be viable to the mother or child.
• Relationship issues: Feeling that the father of their child is not in a supportive, stable, or healthy relationship with them, may cause a woman to feel she cannot take on the responsibility of parenting.
• Rape and incest: A woman may choose to have an abortion if she does not want to carry a child conceived through sexual assault.
• Expanding family: It is not just non-mothers that have abortions, a woman who already has children may undergo an abortion, as she feels she cannot manage a larger family. 

Reasons for having abortions are complex and personal, and unique to every woman. A small percentage of abortions are needed for the protection of the mother’s physical health, or because of foetal abnormalities. Most women seek abortions because of emotional or mental wellbeing concerns, and social or financial circumstances. A pregnancy would not be permitted by a doctor, if the reason was because of unhappiness around the baby’s gender, or a booked holiday.

The practice of abortion has been around for millenniums, with evidence of early attempts at inducing abortion found in ancient texts from various cultures. The methods used for inducing abortion have varied over time but have often been unsafe and of a high risk. 

In ancient Greece, women used herbal remedies to induce abortions. In ancient Rome, abortions were performed by midwives or by women themselves using various methods, including consuming poisonous plants, and taking violent physical actions such as jumping from heights or inflicting pressure on their stomachs. In some cases, crude surgical procedures were utilised with the intended purpose of terminating pregnancy.

During the Middle Ages, the Catholic Church began to take a strong stance against abortion, considering it a sin and a crime. The church’s opposition to abortion became widespread in Western Europe and continued into the modern era. 

In the 19th century, with the development of medical knowledge and technology, safer methods of abortion became available. However, abortion was often illegal, and risky to the women’s health and life. In the mid 20th century, several countries, including the United States of America, began to liberalise their laws on abortion, leading to greater access to safe and legal termination procedures.

In 2021, the British Pregnancy Advisory Service (BPAS) found that 71% of Brits agree that “if a woman does not want to continue a pregnancy, she should be able to have an abortion”.

SavantaComRes, a member of the British Polling Council, created an opinion poll in May 2017, and found that:

• 60% of the general population and 70% of women believe that the current 24 week gestational limit for abortion should be reduced.
• 93% of women agree that a woman considering abortion should have a legal right to independent counselling from a source that has no financial interest in her decision.
• 79% of the general population and 84% of women agree women who want to continue with their pregnancies, but are under financial pressure to have an abortion, should be given more support.
• 65% of the general population and 70% of parents agree parental or guardian consent should be required for girls aged 15 or under to undergo an abortion.
• 56% of the general population agree that doctors with a conscientious objection to abortion should not have to participate in abortion procedures against their will.