ABORTION POLICY

REPRODUCTIVE HEALTH CONTEXT

United Kingdom of Great Britain and Nortern Ire!and
Gro"nd# on $i% a&ortion i# 'ermitted:
To save the life of the woman Yes
To preserve physical health Yes
To preserve mental health Yes
Rape or incest No
Foetal impairment Yes
Economic or social reasons Yes
Available on request No
Additiona! re("irement#)
Abortion is legal in England !ales and "cotland when two registered medical practitioners #only one
in an emergency$ certify that the required medical grounds as set forth in the Abortion Act of %&'( have
been met) The termination of pregnancy must be carried out #e*cept in an emergency$ in a National +ealth
"ervice hospital or in a nursing home private hospital or other approved place) Abortion is legal during the
first ,- wee.s of gestation) The consent of the spouse is not a prerequisite of the medical termination of
pregnancy) The Abortion Act of %&'( does not apply in Northern /reland)
0overnment view on fertility level: "atisfactory
0overnment intervention concerning fertility level: No intervention
0overnment policy on contraceptive use: 1irect support provided
2ercentage of currently married women using
modern contraception #aged %'3-& %&&4$: 5,
6
Total fertility rate #%&&73,888$: %)(
Age3specific fertility rate #per %888 women aged %73%& %&&73,888$: ,&
0overnment has e*pressed particular concern about:
9orbidity and mortality resulting from induced abortion No
:omplications of childbearing and childbirth No
9aternal mortality ratio #per %88888 live births %&&8$:
National &
1eveloped countries ,(
Female life e*pectancy at birth #%&&73,888$: (&)5
6
1ata refer to 0reat ;ritain)
Source: 2opulation 2olicy 1ata ;an. maintained by the 2opulation 1ivision of the 1epartment of Economic and "ocial Affairs of the <nited
Nations "ecretariat) For additional sources see list of references)
%77
United Kingdom of Great Britain and Nortern Ire!and
BACKGROUND
<ntil %&'( abortion in the <nited =ingdom was governed by a combination of statute and court
decision as interpreted by >urists #common law$) ;efore the nineteenth century there were no statutes
relating to abortion and it was not considered a crime to .ill a child in the womb so long as it had not
reached the stage of ?quic.ening@ the point in pregnancy when the movement of the foetus was felt) After
that point during pregnancy the performance of an abortion was considered an offence although there were
very few prosecutions)
The first abortion statute was enacted in %584) /t provided for the death penalty for a person
performing an abortion after quic.ening and a sentence of up to fourteen yearsA deportation or lashing with
a whip for a person performing an abortion before quic.ening) Although the law was amended in %54( it
was not until %5'% with the enactment of the Bffences against the 2erson Act that statutory abortion law
achieved the form that it was to .eep for over %88 years) <nder the Bffences against the 2erson Act any
person who with intent to procure the miscarriage of a woman unlawfully administered any no*ious thing
or used any means was sub>ect to imprisonment for fourteen years) A pregnant woman who undertoo. the
same act or consented to its performance was sub>ect to the same penalty)
Although there were no stated e*ceptions in the Act to the prohibition against the performance of
abortions the use of the word ?unlawfully@ by the Act implied that some abortions were not unlawful and
indeed it was the general opinion that the performance of abortion would not be unlawful to save the life of
a pregnant woman)
/n the twentieth century this situation was clarified somewhat by two developments) The first was the
enactment of the /nfant Cife #2reservation$ Act of %&,& which introduced the offence of ?child destruction@
the .illing of a child capable of being born alive #gestation age of ,5 wee.s or more$ unless the act that
caused the death of the child was done in good faith for the sole purpose of preserving the life of the
mother) Although the Act dealt only with abortions performed after the ,5th wee. of pregnancy it strongly
implied that abortions performed earlier in pregnancy to save the life of the pregnant woman were also
lawful)
The second development was the %&45 >udicial decision of Rex v. Bourne which dealt with the issue of
whether an abortion performed for health reasons was lawful) /n the Bourne decision a physician was
acquitted of the offence of performing an abortion in the case of a woman who had been raped) The court
ruled that the abortion was lawful because it had been performed to prevent the woman from becoming ?a
physical and mental wrec.@ thus setting a precedent for future abortion cases performed on the grounds of
preserving the pregnant womanAs physical and mental health)
Neither the Bffences Against the 2ersons Act of %5'% nor the /nfant Cife #2reservation$ Act of %&,&
applied in "cotland) Abortion was defined as a criminal offence by "cottish common law but prosecutions
typically were not brought in cases where the operation had been performed for ?reputable medical
reasons@ a term that was never officially or >udicially defined) /n Northern /reland the law was the same
as in England and !ales until %&'5)
Source: 2opulation 2olicy 1ata ;an. maintained by the 2opulation 1ivision of the 1epartment of Economic and "ocial Affairs of the <nited
Nations "ecretariat) For additional sources see list of references)
%7'
United Kingdom of Great Britain and Nortern Ire!and
Abortion in England "cotland and !ales is currently regulated by the Abortion Act of %&'( as
amended by the +uman FertiliDation and Embryology Act of %&&8 which permits abortion to be performed
on broad grounds as certified by two physicians) The two physicians must be of the opinion formed in
good faith: #a$ that the pregnancy has not e*ceeded ,- wee.s and continuance of the pregnancy would
involve a ris. greater than if the pregnancy were terminated of in>ury to the physical or mental health of
the pregnant woman or any e*isting children of her familyE #b$ or that the termination is necessary to
prevent grave permanent in>ury to the physical or mental health of the womanE #c$ or that the continuance
of the pregnancy would involve ris. to the life of the woman greater than if the pregnancy were terminatedE
#d$ or that there is a substantial ris. that if the child were born it would suffer from such physical or
mental abnormalities as to be seriously handicapped) /n assessing the ris. to the health of the woman and
her e*isting children physicians may ta.e into account the womanAs ?actual or reasonably foreseeable
environment@) Bwing to this provision and a broad interpretation about what constitutes a threat to health
abortions are available virtually on request in the <nited =ingdom)
!ithin the National +ealth "ervice the provision of abortion services as with other medical services
is controlled by the individual health3care authorities) Approval to perform abortions in private medical
facilities is vested in the "ecretary of "tate for +ealth) :urrently there is no statutory duty on the part of
the +ealth Authorities to provide a particular level of abortion service) Traditionally the provision of
abortion services as part of the gynaecological services has been a matter for local determination by the
+ealth Authorities according to local circumstances)
E*cept in cases of emergency a legal abortion must be obtained in National +ealth "ervice hospitals
or in approved institutions operating as private abortion clinics) The abortion is available free of charge
through the National +ealth "ervice or it may be paid for privately) The abortion must be performed by a
registered medical practitionerE however a nurse may also induce the abortion if delegated by a physician
as part of a team) The consent of the spouse is not a prerequisite of the termination of pregnancyE a
husband has no right to prevent his wife from having a legal abortion)
According to figures from the Bffice for National "tatistics a total of %5(-8, legal abortions were
performed in England and !ales in %&&5 an increase of -)4 per cent from %&&() The overall abortion rate
for women resident in England and !ales #e*cluding Fabortion tourismA$ increased -)5 per cent to %4)&
abortions per %888 women aged %-3-&) Eighty3nine per cent of abortions were carried out at less than %4
wee.s and another %8 per cent by %& wee.s) The most significant increase was among women %'3%& years
old: their abortion rate rose 5)4 per cent to ,')7 abortions per %888 women)
/n %&&( the conception rate for girls under %' was 5)& per %888 the highest rate of teenage
pregnancy in !estern Europe) +alf of the under3%' conceptions and over one third of the %'3%& conceptions
ended in abortion) There were also increases in virtually all the categories of se*ually transmitted
infections)
/n %&&4 the modern contraceptive rate for 0reat ;ritain was estimated to be 5, per cent) This figure
includes a high rate #,, per cent$ of male steriliDation) 9ore recently the National +ealth "ervice reported
that in %&&5 an estimated 78 per cent of women aged %'3-& in England used a non3surgical method of
contraception while an additional %, per cent had been steriliDed) Bf those women using non3surgical
contraception -, per cent chose the pill #down from (8 per cent in %&(7$ while 4( per cent used condoms
#up
Source: 2opulation 2olicy 1ata ;an. maintained by the 2opulation 1ivision of the 1epartment of Economic and "ocial Affairs of the <nited
Nations "ecretariat) For additional sources see list of references)
%7(
United Kingdom of Great Britain and Nortern Ire!and
from ' per cent in %&(7$) The number of women attending national health clinics has remained roughly
constant although the demographic profile of attendants has changed) <nder3%' attendants increased from
negligible numbers in %&(7 to ( per cent in %&&53%&&&) Attendants aged %'3%& rose from %7 per cent in
%&(7 to ,, per cent in %&&53%&&&) These increases have been offset by a decline in attendance among
women ,834- from ,% per cent in %&(7 to %, per cent in %&&53%&&&)
The Abortion Act of %&'( does not apply in Northern /reland) There the provisions of the Bffences
Against the 2ersons Act of %5'% are still in effect as interpreted by court decision) <ntil %&&4 however
there were no Northern /reland court decisions specifically applying the Rev v. Bourne decision to Northern
/reland although it was usually presumed that it would be applicable) /n late %&&4 and early %&&- two
cases resolved by Northern /reland courts confirmed this presumption) Bne involved a fourteen3year3old
girl who had become pregnant and threatened to commit suicide if she could not obtain an abortionE the
other involved a severely mentally handicapped ,43year3old woman who had been se*ually assaulted and
became very distressed over the resulting pregnancy) /n both cases the courts ruled that an abortion could
legally be performed in Northern /reland on serious mental health grounds one of them specifically stating
the holding of Bourne)
/n practice the decision to terminate a pregnancy in Northern /reland is usually made following
consultation with two physicians and with the informed consent of the pregnant woman) Although
abortions are performed each year in Northern /reland within the legal guidelines the fear of possible
accusation of acting illegally and the fact that abortion is an emotionally charged issue in Northern /reland
prevents medical staff from revealing precise data on abortions) The 1epartment of +ealth and "ocial
"ervices does not supply official statistics) /n Northern /reland a woman faced with an unwanted
pregnancy that does not fulfil the stated requirements can choose #a$ to carry the pregnancy to termE #b$ to
see. an illegal abortion and ris. endangering her health and lifeE or #c$ to travel to England where abortion
is legal) 9any women choose the third option)
/n addition to "cotland and Northern /reland there are three anomalous island >urisdictions that
although under the control of the <nited =ingdom are technically not part of the <nited =ingdom but are
considered dependencies of the ;ritish crown: the ;ailiwic. of Gersey and the ;ailiwic. of 0uernsey which
are situated off the coast of Normandy and together ma.e up the :hannel /slands and the /sle of 9an
#Tynwald$ which lies between /reland and 0reat ;ritain) Each has maintained a great deal of autonomy
from the central 0overnment and has its own system of law distinct from that of the <nited =ingdom) /n
all three abortion has traditionally been largely prohibited)
/n recent years legislators in all three >urisdictions have ta.en steps to legaliDe abortion under certain
circumstances despite great opposition among certain segments of the islandsA population) /n %&&7 the
/sle of 9an enacted the Termination of 2regnancy #9edical 1efences$ Act) <nder the Act there are three
grounds for the performance of legal abortions: #a$ when two physicians are of the good faith opinion that it
is necessary to preserve the life of the pregnant womanE e*amples include the situation in which the
continuance of the pregnancy involves a substantial ris. #other than such ris. as is normally associated
with pregnancy and childbirth$ to the life of the pregnant woman greater than if the pregnancy is terminated
and the situation in which termination of the pregnancy is necessary to prevent grave permanent in>ury to
the physical or mental
Source: 2opulation 2olicy 1ata ;an. maintained by the 2opulation 1ivision of the 1epartment of Economic and "ocial Affairs of the <nited
Nations "ecretariat) For additional sources see list of references)
%75
United Kingdom of Great Britain and Nortern Ire!and
health of the woman #throughout pregnancy$E #b$ when two physicians are of the good faith opinion that the
child if carried to full term would be unli.ely to survive #throughout pregnancy$ or would suffer from
serious handicap #up to ,- wee.s$E and #c$ when two physicians are of the good faith opinion as
substantiated that the pregnancy has resulted from rape incest or alleged assault #up to %, wee.s$) /n
addition an emergency abortion can be performed at any time with the approval of only one physician)
Gersey and 0uernsey enacted similar legislation in %&&' and %&&( respectively) Although neither law
contains special provisions for the performance of abortions in the case of pregnancies resulting from rape
or incest both laws are significantly less restrictive than the law of the /sle of 9an in terms of health
indications) /n 0uernsey an abortion can be performed during the first twelve wee.s of pregnancy when
the pregnancy involves a ris. of in>ury to the physical or mental health of the pregnant woman or any
e*isting children of her family greater than if the pregnancy were terminated) GerseyAs law allows abortions
during the same period if the womanAs condition causes her ?distress@ if she then receives information from
a medical practitioner other than the one performing the abortion #on medical ris.s connected with abortionE
on entitlements for mothers families and childrenE on counselling that is availableE on places where
abortions can be performedE and on opportunities for adoption$ and if she waits seven days until the
abortion is performed)
"ince abortion was legaliDed in 0reat ;ritain many women from other countries have travelled to
England for a safe legal abortion) 1escribed in the abortion statistics as ?non3residents@ these women
come from Northern /reland as well as from other European countries including France 0ermany
/reland /taly and "pain) Bthers have travelled from as far away as "outh Africa and the <nited "tates of
America) The number of women travelling to England to obtain an abortion has declined as abortion has
been legaliDed and laws have been reformed in other countries #7888 non3resident women had a legal
abortion in England in %&'& the first full year that abortion was legal in 0reat ;ritainE the number pea.ed
in %&(4 at 74'88 non3resident abortions$)
/n Guly %&&% the <nited =ingdom became the second country France being the first to approve the
use of R<3-5' the abortion pill) The distribution of the pill is sub>ect to strict controls confining its use to
National +ealth "ervice gynaecological units)
The 0overnment of the <nited =ingdom considers the rates of fertility and population growth to be
satisfactory) The 0overnment has no e*plicit policy of intervention with respect to fertility rates since it
believes that decisions concerning fertility and childbearing should be left to the individual) The
0overnment provides individuals with information and the necessary means for family planning and funds
health programmes to improve the prevention diagnosis and treatment of illness) The 0overnment has also
ta.en steps to reduce the increasing abortion rate due to unwanted fertility among young unmarried women
and to encourage greater male responsibility with regard to contraception) Family planning services
including steriliDation are widely available free of charge through the National +ealth "ervice)
Source: 2opulation 2olicy 1ata ;an. maintained by the 2opulation 1ivision of the 1epartment of Economic and "ocial Affairs of the <nited
Nations "ecretariat) For additional sources see list of references)
%7&