Abortion

Last updated August 2016

This factsheet covers law, policy, guidance and key statistics on abortion in the United Kingdom (England, Wales, Scotland, Northern Ireland).

Data for each country may not be strictly comparable due to the differences in methods of data collection and analysis.

Contents

The law in Great Britain (England, Wales, Scotland)

Abortions in Great Britain are carried out in accordance with the Abortion Act 1967 (1), which was amended by the Human Fertilisation and Embryology Act 1990 (2).

Before 1967, abortion was illegal under the Offences Against the Person Act 1861 in England and Wales and under common law in Scotland. The 1967 Act provided exceptions to the previous legislation, giving circumstances in which abortion could be carried out legally.

Two registered medical practitioners must agree that:

Up to 24 weeks:

  • the continuance of the pregnancy would involve risk, greater than if the pregnancy was terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family.

The woman’s actual or reasonably foreseeable future environment may be taken into account.

With no time limits:

  • the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
  • there is a risk to the life of the pregnant woman, greater than if the pregnancy were terminated
  • there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

Access for under 16s

A woman aged under 16 may have an abortion without parental knowledge or consent if both the required doctors agree that she has sufficient maturity and understanding to appreciate what is involved.

Health professionals are trained to work within the Fraser guidelines, which cover the provision of contraception, abortion and other sexual health services to under 16s (3,4).

Conscientious objection

Health professionals are not obliged to perform or participate in an abortion to which they have a conscientious objection, but they still have a duty to participate in treatment which is necessary to save the life of or to prevent grave permanent injury to a woman. Any doctor or nurse who feels unable to give information or counselling to a woman seeking an abortion, because of conscientious objection, should refer her to another doctor without delay (5,6).

The role of nurses in providing abortion services was examined by the Supreme Court, which ruled in 2014 that a nurse does not have the right to avoid supervising other nurses involved in abortion procedures (7).

Responses to the law

In 2007, the government’s Science and Technology Committee carried out a review of scientific developments since the passing of the 1967 Act. It made several recommendations, including that the latest evidence on fetal viability supported maintaining the 24-week time limit, that nurses could safely carry out some types of abortion and that the requirement for two doctors, rather than one, to approve an abortion should be removed (8).

There have been various attempts to amend the 1967 Act, including proposed amendments to the Human Fertilisation and Embryology (HFE) Bill in 2008, to reduce the legal time limit, and to the Serious Crime Bill in 2015, to specify that abortion on grounds of gender alone is illegal. Both were rejected. A number of amendments to the HFE Bill that would have modernised abortion law were also tabled but were never debated or voted on.

British Medical Association (BMA) policy opposes any change to the current time limit for abortion. In 2007 the BMA also made it policy that in the first trimester of pregnancy it should not be a requirement for a woman to meet specified medical criteria or for two doctors to approve an abortion, so that abortion in the first trimester is available on the same basis of informed consent as other treatments (9).

Policy and guidance

Governments in England (10,11) Wales (12) and Scotland (13) have published policy and guidance documents which address sexual health issues and services. These include recommendations for improving abortion services, and ensuring equitable access and minimum waiting times between the initial referral and the abortion.

Detailed guidance from the Royal College of Obstetricians and Gynaecologists (14) aims to ensure that all women considering abortion have access to a service of uniformly high quality. This guidance should be used as the basis for the development of local protocols or guidelines in the United Kingdom.

Abortion services are also included in broader recommended standards for sexual health services from the Medical Foundation for AIDS and Sexual Health (15). Although specifically intended to support the implementation of the government’s sexual health policy in England, they can be applied elsewhere.

Northern Ireland

The1967 Abortion Act was not extended to Northern Ireland. Abortion is governed by the Offences Against the Person Act 1861, as well as the Criminal Justice Act (Northern Ireland) 1945.

Abortions can be carried out legally in very restricted circumstances – when the pregnancy is a threat to the woman’s life or there is a risk of a real and serious, permanent or long-term adverse effect on her mental or physical health.

Abortion law in Northern Ireland falls within the scope of the criminal justice and policing powers, which were devolved to Northern Ireland’s Assembly in 2010.

Women from Northern Ireland are not currently entitled to an NHS abortion in Great Britain, although a current court case (2016) is seeking to challenge this.

See our Northern Ireland abortion factsheet (PDF) for further information about abortion law and policy in Northern Ireland.

Statistics England and Wales (resident women)

In 2015 (16):

  • The total number of abortions was 185,824, 0.7% more than in 2014 (184,571) and 0.3% less than in 2005.
  • The abortion rate was 16 per 1,000 women aged 15–44, 0.6% higher than in 2014 (15.9) and 6.4% lower than in 2005 (17.1).
  • The abortion rate of women under 16 was 2 per 1,000 women, down from 2.5 per 1,000 in 2014 and 3.7 per 1,000 in 2005. There were 1,853 abortions to women aged under 16 – 509 aged under 15 and 79 under 14.
  • The abortion rate for women under 18 was 9.9 per 1,000 women, down from 11.1 in 2014 and 17.8 in 2005.
  • The highest abortion rate (at 28.7 per 1,000) was among women aged 21; in 2014 it was women aged 22 (28.5 per 1,000).
  • 730 abortions were carried out among women aged 45 or over.
  • 92% of abortions were carried out at under 13 weeks gestation.
  • 80% of abortions were carried out at under 10 weeks gestation, the same as in 2014, and compared to 67% in 2014. There has been a continuing increase in the proportion of abortions that are performed under 10 weeks since 2005.
  • There were regional variations in abortions carried out under 10 weeks, from 60% in the Vale of Glamorgan to 88% in NHS Trafford.
  • 98% of abortions were funded by the NHS. Of these, 68% took place in the independent sector under NHS contract, up from 67% in 2014.
  • Medical abortion accounted for 55% of all abortions. This was higher than in 2014 (51%), and more than double the proportion in 2005 (24%).
  • Abortions beyond 24 weeks gestation accounted for less than 0.1% (230) of the total.

Grounds for abortion

In 2015:

  • The vast majority of abortions (98%) were carried out under ground C (pregnancy not exceeded 24th week and continuance of pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnancy woman).
  • 3,213 abortions (2%) were carried out under ground E – substantial risk the child would be born seriously handicapped.

Ethnicity

Of women whose ethnicity was recorded in 2015, 77% were white, 9% were Asian or Asian British and 8% were black or black British.

Statistics Scotland

In 2015 (17):

  • The total number of abortions was 12,082, compared to 11,776 in 2014, a 2.6% increase.
  • Abortion rates continued to decline in women under 20 years but increased among older women, particularly those aged 35-39.
  • The rate was 11.6 per 1,000 women aged 15-44.
  • Historically the lowest abortion rates have been in the 40+ age group but in 2015 it was among those under 16 (1.6 per 1,000 women aged 13-15). Among women aged over 40 it was 2.5 per 1,000 women aged 40-44, which has remained the same since 2012.
  • The biggest increase from 2014 was in the 35-39 age group, rising from 6.9 per 1,000 women aged 35-39 to 8.1, a 17.5% increase.
  • The abortion rate was highest for women aged 20-24, accounting for 30% of all abortions.
  • 72.5% of abortions were carried out under nine weeks’ gestation, up from 71.9% in 2014.
  • 81.1% of abortions were medical, accounting for 88.4% of abortions carried out under nine weeks. This was a much higher proportion than in England and Wales (55%).
  • The rate of abortion was highest in NHS Tayside (13.9 per 1,000) and the lowest was the Island boards, which includes NHS Orkney, Shetland and Western Isles (4.4 per 1,000).
  • There continued to be a strong link between abortion rates and deprivation. In areas of high deprivation the rate was 15.4 per 1,000 women aged 15-44, 1.8 times higher than the rate of 8.7 per 1,000 in the least deprived areas.
  • 3,787 abortions (31.3%) were to women who had previously had at least one abortion, similar to 31.7% in 2014.

Grounds for abortion

In 2015:

  • The majority of abortions (98.3%) were carried out under Ground C (pregnancy not exceeded 24th week and continuance of pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnancy woman).
  • 1.5% of abortions were carried out under Ground E (substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped).

Statistics Northern Ireland

In 2015 (18):

  • 833 women from Northern Ireland travelled to England or Wales for an abortion (this figure is given based on the addresses provided by clients and is likely to be an underestimate).
  • 36% were aged under 25 and 12% were under 20.
  • 88% of abortions were carried out under 13 weeks of gestation and 73% under 10 weeks.

See our Northern Ireland abortion factsheet (PDF) for abortion statistics from within Northern Ireland.

References

1 House of Commons, Abortion Act 1967 (London: HMSO, 1967).

2 House of Commons, Human Fertilisation and Embryology Act 1990 (London: HMSO, 1990).

3 House of Lords, Gillick respondent and West Norfolk and Wisbech Area Health Authority first appellants and Department of Health and Social Security Second Appellants (London: HOL, 1986).

4 High Court, The Queen on the application of Sue Axon v The Secretary of State for Health (The Family Planning Association: intervening) [2006] EWHC 37 (Family Law Week, 2006 Archive)

5 General Medical Council, Good Medical Practice (2013). (London: GMC, 2013).

6 Nursing and Midwifery Council, The Code: Professional standards of practice and behaviour of nurses and midwives (London: NMC, 2015).

7 Supreme Court, Greater Glasgow Health Board (Appellant) v Doogan and another (Respondents) (Scotland) (PDF) (London: The Supreme Court, 2014).

8 House of Commons Science and Technology Committee, Scientific Developments Relating to the Abortion Act 1967. Volume 1 (London: House of Commons, 2007).

9 British Medical Association, The Law and Ethics of Abortion (London: BMA, 2014).

10 Department of Health, Guidance in Relation to Requirements of the Abortion Act, 1967 (PDF) (London: DH, 2014).

11 Department of Health, A Framework for Sexual Health Improvement in England (PDF) (London: DH, 2013).

12 Welsh Assembly Government, Sexual health and wellbeing action plan for Wales, 2010-2015 (PDF) (Cardiff: WAG, 2010).

13 Scottish Executive, Respect and Responsibility, Strategy and Action Plan for Improving Sexual Health (Edinburgh: Scottish Executive, 2005).

14 Royal College of Obstetricians and Gynaecologists, The Care of Women Requesting Induced Abortion. Evidence-based clinical guidelines 7 (London: RCOG, 2011).

15 Medical Foundation for AIDS and Sexual Health, Recommended Standards for Sexual Health Services (PDF) (London: MedFASH, 2005).

16 Department of Health, Abortion Statistics, England and Wales: 2015 (London: DH, 2016).

17 ISD Scotland, Termination of Pregnancy Statistics, Year Ending December 2015 (Edinburgh: ISD, 2016).

18 Department of Health, Abortion Statistics, England and Wales: 2015 (See complete tables in Excel: tab 12a) (London: DH, 2016).