Abortion in the United Kingdom

The law on abortion started to be codified in legislation and dealt with in the courts of the state under sections 1 and 2 of Lord Ellenborough's Act (1803). The offences created by this statute were replaced by section 13 of the Offences Against the Person Act 1828. Under section 1 of the 1803 Act and the first offence created by section 13 of the 1828 Act, the crime of abortion was subject, in cases where the woman was proved to have been quick with child, to the death penalty or penal transportation for life. Under section 2 of the 1803 Act and the second offence created by section 13 of the 1828 Act (all other cases), the penalty was transportation for 14 years.

Section 13 of the 1828 Act was replaced by section 6 of the Offences Against the Person Act 1837. This section made no distinction between women who were quick with child and those who were not; it also eliminated the death penalty as a possible punishment.

Transportation was abolished by the Penal Servitude Act 1857, which replaced it with penal servitude. Section 6 of the 1837 Act was replaced by section 58 of the Offences against the Person Act 1861 which continues to be the main legislation for prosecuting personal injury in the courts of England and Wales, and was adopted elsewhere in the British Empire. In addition, section 59 of that Act created a new preparatory offence of procuring drugs or instruments with intent to procure abortion.

From 1870, there was a steady decline in fertility, linked not to a rise in the use of artificial contraception but to more traditional methods such as withdrawal and abstinence.[17] This was linked to changes in the perception of the relative costs of childrearing. Abortifacents were discreetly advertised for women with unwanted pregnancies who sought abortions and there was a considerable body of folklore about methods of inducing miscarriages. Amongst working-class women, violent purgatives were popular, including pennyroyal, aloes and turpentine. Other methods to induce miscarriage were very hot baths and gin, extreme exertion, a controlled fall down a flight of stairs, or veterinary medicines. So-called 'backstreet' abortionists were relatively common, although their efforts could be fatal. Estimates of the number of illegal abortions varied widely; by one estimate, 100,000 women made efforts to procure an abortion in 1914, usually by drugs.

The criminality of abortion in England and Wales was reaffirmed in 1929, when the Infant Life (Preservation) Act was passed. The Act criminalised the deliberate destruction of a child "capable of being born alive". This was to close a lacuna in the law, identified by Lord Darling, which allowed for infants to be killed during birth, which would mean that the perpetrator could neither be prosecuted for abortion or murder.[18] The Act included the presumption that all children in utero over 28 weeks of gestation were capable of being born alive. Where the life of child in utero was ended before this gestation, evidence was presented and considered to determine whether or not they were capable of being born alive. In 1987, the Court of Appeal refused to grant an injunction to stop an abortion, ruling that a foetus between 18 and 21 weeks was not capable of being born alive.[19][20] In May 2007, a woman from Levenshulme, Manchester, who had an illegal late-term abortion at 7+1⁄2 months in early 2006 was convicted of child destruction under the Infant Life (Preservation) Act 1929.[21]

The Abortion Law Reform Association, a pro-choice lobbying group, was formed in 1936.

In 1938, the decision in R v. Bourne[22] allowed for further considerations to be taken into account. This case related to an abortion performed on a girl who had been raped, and extended the defence to abortion to include "mental and physical wreck" (Lord Justice McNaghtan). The gynaecologist concerned, Aleck Bourne, later became a founder member of the anti-abortion group, the Society for the Protection of Unborn Children (SPUC)[23] in 1966.

In 1939, the Inter-Departmental Committee on Abortion, established by the Home Office and Ministry of Health, recommended a change to abortion laws but the intervention of World War II meant that all plans were shelved. Post-war, after decades of stasis, certain high-profile tragedies, including disability in unborn children caused by the thalidomide drug, and social changes brought the issue of abortion back into the political arena.

Westminster’s responsibility for criminal justice and health policy, including around abortion, on the island of Ireland was transferred to the Northern Ireland Parliament (on its formation in 1921) and the Parliament of the Irish Free State (formed in December 1922). Both legislatures took an essentially conservative position, viewing abortion as an offence against the person, or an offence of child destruction, in line with existing legislation in England and Wales.

The Abortion Act 1967 sought to clarify the law in Britain. Introduced by David Steel and subject to heated debate, it allowed for legal abortion on a number of grounds, with the added protection of free provision through the National Health Service. The Act was passed on 27 October 1967 and came into effect on 27 April 1968.[24]

Before the Human Fertilisation and Embryology Act 1990 amended the Act, the Infant Life (Preservation) Act 1929 acted as a buffer to the Abortion Act 1967. This meant that abortions could not be carried out if the child was "capable of being born alive". There was therefore no statutory limit put into the Abortion Act 1967, the limit being that which the courts decided as the time at which a child could be born alive. The C v S case in 1987 confirmed that, at that time, between 19 and 22 weeks a foetus was not capable of being born alive.[19] The 1967 Act required that the procedure must be certified by two doctors before being performed.

During each Parliament, several private member's bills are generally introduced to seek to amend the law in relation to abortion.[25] In the years following a supportive report in favour of the 1967 Act by the Lane Committee in 1974, Members of Parliament introduced four bills which have resulted in substantive debate in the House of Commons (votes are indicated in brackets with ayes followed by noes):

• Abortion (Amendment) Bill 1975 - referred to a select committee (260-125);[26]

• Abortion (Amendment) Bill 1976 - referred to select committee (313-172);[27]

• Abortion (Amendment) Bill 1979 - approved at second stage (242-98) but not enacted;[28]

• Abortion (Amendment) Bill 1988 - approved at second stage (296-251) but not enacted;[29]

In addition, in 1990, members voted on several proposed amendments to clause 34 of the Human Fertilisation and Embryology Bill relating to the termination of pregnancy.[30]) The Human Fertilisation and Embryology Act 1990, as enacted, lowered the term limit from 28 to 24 weeks for abortion in cases of 'mental or physical injury' on the ground that medical technology had advanced sufficiently (since 1967) to justify the change but removed restrictions for late abortions in cases of risk to life, grave physical and mental injury to the woman, and the disability in the unborn child (by separating the legal effect of the Infant Life (Preservation) Act 1929 from the Abortion Act 1967).

When a further Human Fertilisation and Embryology Bill (now enacted) was considered by Parliament in 2008, several votes were held on the term limit in Britain, as follows:

• reduction from 24 weeks to 12 weeks (71 ayes, 393 noes);[31]

• reduction from 24 weeks to 16 weeks (84 ayes, 386 noes);[32]

• reduction from 24 weeks to 20 weeks (190 ayes, 331 noes);[33] and

• reduction from 24 weeks to 22 weeks (233 ayes, 304 noes).[34]

Pro-choice groups strongly opposed any attempts to restrict abortion in the 2008 parliamentary debates and votes.[35][36][37] A number of pro-choice amendments were proposed by the Labour MPs Diane Abbott, Katy Clark and John McDonnell, including NC30 Amendment of the Abortion Act 1967: Application to Northern Ireland.[38][39][40] However, it was reported that the Labour government at the time asked MPs not to table these amendments (at least until third reading) and then used parliamentary mechanisms in order to prevent a vote; the government was, at the time, seeking to devolve policing and justice powers to the Northern Ireland Assembly (which had previously voted to oppose the extension of the 1967 Act).[41]

In 2017, the Reproductive Health (Access to Terminations) Bill was introduced by Labour Diana Johnson MP with the aim of repealing criminal law on abortion in England and Wales.[42] However, with the call for a general election, the bill fell and no further action was taken.[43]

Minor amendments to the Abortion Act 1967 have been introduced through government legislation, the most recent being the allowance of abortion consultations through telemedicine in the Health and Care Act 2022.[44]

Health, social care and criminal justice policy was devolved to the Northern Ireland Parliament at the time of the Abortion Act 1967's passage at Westminster and the Parliament did not introduce abortion legislation before its suspension in 1972. Statute law was maintained unchanged under Conservative and Labour direct rule administrations and the first Northern Ireland Assembly in 1973-1974 although the law was interpreted through case law in local courts (during the 1990s) to also allow for the grounds of "a risk of real and serious adverse effect on ... [the] physical or mental health [of the woman] is either long term or permanent". From 1983 onwards, the Constitution of Ireland, covering the Republic with a territorial claim on Northern Ireland until 1998, acknowledged "the right to life of the unborn and, with due regard to the equal right to life of the mother" and "guaranteed in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right."[45]

The new Northern Ireland Assembly, formed in 1998 following the Good Friday Agreement, voted in June 2000 to oppose the extension of the Abortion Act 1967 to Northern Ireland; the motion was proposed by the Democratic Unionist Party (DUP) and supported by the Social Democratic and Labour Party (SDLP) which was, at the time, opposed to abortion but also emphasised an understanding of the social, economic and personal circumstances that gave rise to women choosing the option of an abortion.[46] While health policy had been devolved again to Northern Ireland in December 1999, on the formation of the first Northern Ireland Executive, criminal law (including in relation to abortion) continued to be reserved to Parliament at Westminster until the devolution of policing and justice powers in May 2010.[47]

Political debate around abortion issues was renewed following the opening of a private abortion clinic in Belfast in 2012, the Protection of Life During Pregnancy Act 2013 in the Republic, and the widespread discussion of a case of fatal foetal abnormality; several debates took place in the Northern Ireland Assembly and its members, in line with party policy and/or personal conscience, decided not to proceed with changes in the law.[48][49][50] An amendment by DUP MLA Jim Wells to "restrict lawful abortions to NHS premises, except in cases of urgency when access to NHS premises is not possible and where no fee is paid" was unsuccessful.[51][52] Later, as Health Minister, Jim Wells opposed abortion in cases of rape as the unborn child would be "punished for what has happened by having their life terminated" although he acknowledged that this would be "a tragic and difficult situation".[53]

Justice Minister David Ford (a member of the Alliance Party) issued a public consultation on amending the criminal law on abortion, which opened in October 2014 and closed in January 2015.[54] However, Ford also wrote that "it is not a debate on the wider issues of abortion law – issues often labelled as 'pro-choice' and 'pro-life'".[54] The Sinn Féin deputy First Minister, Martin McGuinness, had initially stated his party's opposition to abortion and noted that the party had "resisted any attempt to bring the British 1967 Abortion Act to the North."[48] At its 2015 annual conference, Sinn Féin adopted a policy of allowing abortion under certain circumstances such as fatal foetal abnormality; this was superseded by a newer and more liberal policy adopted at its 2018 conference.[55]

In February 2016, during debates on the Justice (No.2) Bill, the Assembly considered and debated an amendment to allow for abortion in cases of pregnancies caused by sexual crime (which was rejected by 64 notes to 32 ayes), and an amendment to allow for abortion in cases of fatal foetal abnormality (which was rejected by 59 noes to 40 ayes) . Sinn Féin and the Green Party voted in favour of both proposals whereas the DUP and the SDLP supported the existing law and members of the Ulster Unionist Party (UUP) and Alliance Party voted on conscience.[56] The Abortion (Fatal Foetal Abnormality) Bill was introduced by David Ford, as a backbench MLA, in December 2016 but fell on the suspension of the Assembly in January 2017.[57]

In the 2017 UK general election, the Labour Party manifesto under the leadership of Jeremy Corbyn MP stated: "Labour will continue to ensure a woman’s right to choose a safe, legal abortion – and we will work with the Assembly to extend that right to women in Northern Ireland."[58] The election resulted in a confidence and supply agreement between the Conservative Party and the (DUP). The Conservative Government, in June 2017, made a commitment to provide free abortion services in England for women from Northern Ireland due to pressure from Conservative MPs.[59] The Labour Party commitment was, in effect, delivered through private member's amendments enacted in the Northern Ireland Executive (Formation) Act 2019, which repealed the Offences against the Person Act 1861 (sections 58 and 59) in October 2019. The political context was also changed by legal challenges, the repeal of the Eighth Amendment in the Republic in 2018 (supported by Sinn Féin), and the SDLP's decision to consider abortion as a matter of conscience.

Shortly after the introduction of the Abortion (Northern Ireland) Regulations 2020, the newly restored Northern Ireland Assembly voted – with 46 members in favour and 40 against – to reject "the imposition of abortion legislation that extends to all non-fatal disabilities, including Down's syndrome."[60] Following this vote, the Severe Fetal Impairment Abortion (Amendment) Bill – to remove the grounds for abortion for non-fatal disabilities – was introduced by DUP MLA Paul Givan in February 2021. It reached its consideration stage in December 2021 but MLAs decided – by 45 votes to 43 – against the main proposal in the Bill at that stage.[61]

The Offences against the Person Act 1861, in England and Wales, prohibits administering drugs or using instruments to procure an abortion and procuring drugs or other items to cause an abortion[62] although subsequent law has provided for a range of grounds which allow abortion to be widely available.

The Infant Life (Preservation) Act 1929 amended the law in England and Wales to create the offence of child destruction – in cases where any person "who, with intent to destroy the life of a child capable of being born alive, by any wilful act causes a child to die before it has an existence independent of its mother". For the purposes of this Act, a child whose mother has been pregnant for 28 weeks is deemed "capable of being born alive". The 1929 Act also provides a defence where it is proved that causing the death of the child was "done in good faith for the purpose only of preserving the life of the mother."[63]

The Abortion Act 1967 originally permitted abortion "by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith" on the following grounds:

• a risk to the life of the pregnant woman, or of injury to the physical or mental health of the pregnant woman or any existing children of her family; or

• a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be "seriously handicapped".[64]

The Act came into operation in 1968, and originally applied a term limit of 28 weeks, in line with the Infant Life Preservation Act. It was subsequently amended by the Human Fertilisation and Embryology Act 1990, to allow for the following grounds:

• Ground A – risk to the life of the pregnant woman;

• Ground B – to prevent grave permanent injury to the physical or mental health of the pregnant woman;

• Ground C – risk of injury to the physical or mental health of the pregnant woman (up to 24 weeks in the pregnancy);

• Ground D – risk of injury to the physical or mental health of any existing children of the family of the pregnant woman (up to 24 weeks in the pregnancy);

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

• Ground F – to save the life of the pregnant woman; or

• Ground G – to prevent grave permanent injury to the physical or mental health of the pregnant woman in an emergency.[65]

The amendment therefore allowed for a reduction in the term limit to 24 weeks for Ground C and Ground D with the law changing to reflect advances in technology to enable premature children to be born alive earlier in a pregnancy. However, no term limit was applied to other grounds and abortion was permitted throughout the pregnancy in these cases. The changes took effect in April 1991.[66]

Abortion law was not devolved to the National Assembly for Wales under Government of Wales Act 1998[67] and was specifically reserved to the UK Parliament via the Government of Wales Act 2006.[68]

Abortion became an offence in Scotland with the passing of the Abortion Act 1967 and refers to "any rule of law relating to the procurement of abortion".[4] Prior to 1967, there was no offence of abortion in Scotland; however, if harm occurred consequent to an abortion, various offences could have applied with abortion forming part of the description of the elements forming the offence on the petition or indictment presented to a court.

The Scotland Act 1998, which established the Scottish Parliament, reserved abortion law to the UK Parliament[69] but it was subsequently devolved through the Scotland Act 2016.[70] The Abortion Act 1967 remains in place.

Section 58 of the Offences against the Person Act 1861 reads as follows and prohibits administering drugs or using instruments to cause a miscarriage:

Every woman, being with child, who, with intent to procure her own miscarriage, shall unlawfully administer to herself any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, and whosoever, with intent to procure the miscarriage of any woman whether she be or be not with child, shall unlawfully administer to her or cause to be taken by her any poison or other noxious thing, or unlawfully use any instrument or other means whatsoever with the like intent, shall be guilty of felony, and being convicted thereof shall be liable ... to be kept in penal servitude for life ...[62]

Section 59 of that Act reads as follows and prohibits the procurement of drugs or other items to cause a miscarriage:

Whosoever shall unlawfully supply or procure any poison or other noxious thing, or any instrument or thing whatsoever, knowing that the same is intended to be unlawfully used or employed with intent to procure the miscarriage of any woman, whether she be or be not with child, shall be guilty of a misdemeanor, and being convicted thereof shall be liable ... to be kept in penal servitude ...[62]

The following terms in the 1861 Act may be interpreted as follows:

• Unlawfully – for the purposes of sections 58 and 59 of the Offences against the Person Act 1861, and any rule of law relating to the procurement of abortion, anything done with intent to procure a woman's miscarriage (or in the case of a woman carrying more than one foetus, her miscarriage of any foetus) is unlawfully done unless authorised by section 1 of the Abortion Act 1967 and, in the case of a woman carrying more than one foetus, anything done with intent to procure her miscarriage of any foetus is authorised by the said section 1 if the ground for termination of the pregnancy specified in subsection (1)(d) of the said section 1 applies in relation to any foetus and the thing is done for the purpose of procuring the miscarriage of that foetus, or any of the other ground for termination of the pregnancy specified in the said section 1 applies;[71]
• Felony and misdemeanour – see the Criminal Law Act 1967;
• Mode of trial – the offences under section 58 and 59 are indictable-only offences;
• Sentence – an offence under section 58 is punishable with imprisonment for life or for any shorter term[72] and an offence under section 59 is punishable with imprisonment for a term not exceeding five years.[73]

A death of a person in being which is caused by an unlawful attempt to procure an abortion, is at least manslaughter.[74][75]

The following terms in the 1967 Act may be interpreted as follows:

• The law relating to abortion – in England and Wales, this means sections 58 and 59 of the Offences against the Person Act 1861 and any rule of law relating to the procurement of abortion.[76] and in Scotland, this means any rule of law relating to the procurement of abortion;[76]
• Terminated by a registered medical practitioner – see Royal College of Nursing of the UK v DHSS [1981] AC 800, [1981] 2 WLR 279, [1981] 1 All ER 545, [1981] Crim LR 322, HL;
• Place where termination must be carried out – see sections 1(3) to (4);
• The opinion of two registered medical practitioners – see section 1(4);
• Good faith – see R v Smith (John Anthony James), 58 Cr App R 106, CA;
• Determining the risk of injury in ss. (a) & (b) – see section 1(2);
• Risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman – In R v British Broadcasting Corporation, ex parte ProLife Alliance, Lord Justice Laws said: "There is some evidence that many doctors maintain that the continuance of a pregnancy is always more dangerous to the physical welfare of a woman than having an abortion, a state of affairs which is said to allow a situation of de facto abortion on demand to prevail."[77]

Before significant changes in 2019, there were two main laws on abortion in Northern Ireland:

• the Offences Against the Person Act 1861 (sections 58 and 59) prohibited attempts to cause a miscarriage;[62]
• the Criminal Justice Act (Northern Ireland) 1945 (sections 25 and 26)[78] provided an exception for acting "in good faith for the purpose only of preserving the life of the mother" and also created the offence of child destruction i.e. to cause a child to die "before it has an existence independent of its mother".

Between 1993 and 1999, a series of court cases had interpreted the law as also allowing for abortion in cases where, for the pregnant woman, "there is a risk of real and serious adverse effect on her physical or mental health, which is either long term or permanent".[79][80][81]

In Northern Ireland Health and Social Services Board v A and Others [1994] NIJB 1, Lord Justice MacDermott said that he was "satisfied that the statutory phrase, 'for the purpose only of preserving the life of the mother' does not relate only to some life-threatening situation. Life in this context means that physical or mental health or well-being of the mother and the doctor's act is lawful where the continuance of the pregnancy would adversely affect the mental or physical health of the mother. The adverse effect must however be a real and serious one and there will always be a question of fact and degree whether the perceived effect of non-termination is sufficiently grave to warrant terminating the unborn child."

In Western Health and Social Services Board v CMB and the Official Solicitor (1995, unreported), Mr Justice Pringle stated that "the adverse effect must be permanent or long-term and cannot be short term ... in most cases the adverse effect would need to be a probable risk of non-termination but a possible risk might be sufficient if the imminent death of the mother was a risk in question".[82]

In Family Planning Association of Northern Ireland v Minister for Health, Social Services and Public Safety (October 2004), Lord Justice Nicholson stated that "it is unlawful to procure a miscarriage where the foetus is abnormal but viable, unless there is a risk that the mother may die or is likely to suffer long-term harm, which is serious, to her physical or mental health".[83] In the same case, Lord Justice Sheil stated that "termination of a pregnancy based solely on abnormality of the foetus is unlawful and cannot lawfully be carried out in this jurisdiction".[84]

In November 2015, Lord Justice Horner made a declaration of incompatibility under the Human Rights Act 1998 to the effect that Northern Ireland's law on abortion (specifically its lack of provision in cases of fatal foetal abnormality or where the pregnancy is the result of rape or incest) could not be interpreted in a manner consistent with Article 8 of the European Convention on Human Rights i.e. a right to respect for his private and family life, his home and his correspondence; the convention also protects a right to life in Article 2.[85] In June 2017, the declaration of incompatibility was quashed by the Court of Appeal on the grounds that "a broad margin of appreciation must be accorded to the state" and "a fair balance has been struck by the law as it presently stands until the legislature decides otherwise".[86][87] In June 2018, the Supreme Court of the United Kingdom held that the law of Northern Ireland was incompatible with the right to respect for private and family life, insofar as the law prohibited abortion in cases of rape, incest and fatal foetal abnormality. However, the court did not restore the declaration of incompatibility as it also held that the claimant did not have standing to bring the proceedings and accordingly the court had no jurisdiction to make a declaration of incompatibility reflect its view on the compatibility issues.[88][89] The judgments of the Supreme Court acknowledged that the court lacked jurisdiction to issue a declaration of incompatibility but included a non-binding opinion that an incompatibility existed, and that a future case in which the applicant had the necessary standing would be likely to succeed. It also urged the authorities "responsible for ensuring the compatibility of Northern Ireland law with the Convention rights" to "recognise and take account of these conclusions ... by considering whether and how to amend the law".[90][91]

During this time, abortion and child destruction offences were only occasionally recorded in Northern Ireland – a possible effect of the deterrent provided in law. Between 1998 and 2018, the Royal Ulster Constabulary and the Police Service of Northern Ireland recorded 17 cases of "procuring illegal abortion" and three cases of "intentional destruction of a viable unborn child". In several years within that timeframe, no offences of this type were recorded.[92]

The law on abortion in Northern Ireland was changed by Parliament during a suspension of the Northern Ireland Executive, which took place between 2017 and 2020. Recommendations to liberalise abortion law in Northern Ireland were published in February 2018 by the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) in the report of its Inquiry concerning the United Kingdom (under Article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women).[93]

The Northern Ireland (Executive Formation etc) Act 2019, enacted on 24 July 2019, extended the deadline for the restoration of the Executive to 21 October 2019. Under a private member's amendment introduced by Stella Creasy MP, if an Executive were not restored by that date, the Act would:

• require the Secretary of State for Northern Ireland to implement recommendations regarding abortion made in the CEDAW report;

• repeal sections 58 and 59 of the Offences Against the Person Act 1861 under the law of Northern Ireland; and

• require the Secretary of State, by regulation, to make further changes in the law for complying with the recommendations with those regulations coming into force on 31 March 2020.[94]

On 21 October 2019, as a result of the Executive not being restored, sections 58 and 59 of the 1861 Act were repealed.[95] Legal protection for the life of a child who was "capable of being born alive" continued under the Criminal Justice Act (Northern Ireland) 1945.

The Executive was restored in January 2020 but legislation on abortion continued to be implemented through Westminster. The Abortion (Northern Ireland) Regulations 2020 were laid before Parliament on 25 March 2020 and took effect on 31 March 2020.[96][97] The Regulations allowed for abortion in Northern Ireland in the following circumstances:

• where the pregnancy has not exceeded its twelfth week;

• a risk of injury to the physical or mental health of the pregnant woman (up to a term limit of 24 weeks);

• a risk to life or risk of grave permanent injury to physical or mental health of the pregnant woman;

• a severe fetal impairment – "a substantial risk that if the child were born, it would suffer from such physical or mental impairment as to be seriously disabled" (with no term limit); or

• a fatal fetal abnormality – "a substantial risk that the death of the fetus is likely before, during or shortly after birth" (with no term limit).[98]

A person who intentionally terminates or procures the termination of a pregnancy other than in accordance with the Regulations commits an offence; this does not apply to a pregnant woman or where the act which caused the termination was done in good faith for the purpose only of saving the woman's life or preventing grave permanent injury. The 1945 Act remains in law, including the offence of child destruction, although this no longer applies to a pregnant woman, or a registered medical professional acting in accordance with the Regulations.[98]

The Regulations were replaced by the Abortion (Northern Ireland) (No. 2) Regulations 2020, which were materially the same with minor corrections and came into force on 14 May 2020.[6] As of May 2022, just over two years after legalisation, abortion clinics and treatments available in Northern Ireland were limited and women seeking to have abortions continued to travel to Great Britain (mainly England).[99]

The Catechism of the Catholic Church states that human life "must be respected and protected absolutely from the moment of conception" and that from the first moment of existence, "a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life." The Church has affirmed "the moral evil of every procured abortion" since the first century and describes direct abortion "willed either as an end or a means" as gravely contrary to the moral law.[110] Pope John Paul II reaffirmed the Catechism in his papal encyclical Evangelium vitae in 1995, which taught on "bringing about a transformation of culture" in relation to abortion and the value of human life, including extensive care and support for pregnant women, their children and their families.[111]

The Church of England combines strong opposition to abortion with a recognition that there can be "strictly limited" conditions under which it may be morally preferable to any available alternative. This is based on its view that the foetus is a human life with the potential to develop relationships, think, pray, choose and love. The Church has suggested that the case for further reductions of the time limit for abortions should be "sympathetically considered on the basis of advances in neo-natal care" and has stated that every possible support, especially by church members, needs to be given to those who are pregnant in difficult circumstances.[112]

The Church of Ireland – a province of the Anglican Communion alongside the Church of England – affirms that "every human being is created with intrinsic dignity in the image of God with the right to life." It has opposed the "extreme abortion legislation" imposed on Northern Ireland, asked that legislation is developed that safeguards the well-being of both the mother and unborn child, and encouraged its members to provide more support to mothers during pregnancy, particularly during times of crisis.[113] In relation to potential grounds for abortion, the Church recognises that there are "exceptional circumstances of strict and undeniable medical necessity where an abortion should be an option (or more rarely a necessity)."[114]

The General Assembly of the (Presbyterian) Church of Scotland regards the foetus as "from the beginning, an independent human being" and therefore it can be threatened "only in the case of threat to maternal life, and that after the exhaustion of all alternatives".[115]

The Presbyterian Church in Ireland, the largest Protestant denomination in Northern Ireland, is strongly anti-abortion, and maintains that abortion should only be permitted in exceptional circumstances (e.g. where there is a real and substantial risk to the life of the mother) subject to the most stringent safeguards. The Church has affirmed the sanctity of human life, that human life begins at conception, and that complex medical and social issues such as abortion need to be handled with sensitivity and compassion.[116]

The Conference of the Methodist Church of Great Britain stated in 1976 that the human foetus had "an inviolable right to life" and that abortion should never be seen as an alternative to contraception. The Church also recognised that foetus is "totally dependent" on his or her mother for at least the first twenty weeks of its life and said that the mother has "a total right to decide whether or not to continue the pregnancy." The Church has supported counselling opportunities for mothers so that they fully understand the decision, and the alternatives to abortion.[117]

Its sister church, the Methodist Church in Ireland, is opposed to what it describes as "abortion on demand" and urges support and resources for those who have a crisis pregnancy. The Church recognises that there are complex situations "in which early termination of pregnancy should be available" and considers that these include "when a mother's life is at risk, when a pregnancy is the result of a sexual crime, or in cases of fatal foetal abnormality."[118]

The smaller Protestant churches are generally conservative on the issue of abortion.[119][120]

Congregations and members of major non-Christian religions in the UK likewise provide pastoral support for women, families and children whose circumstances are affected by crisis pregnancies and abortion, in a range of ways. Views on the morality and potential grounds for abortion vary within Islam, Hinduism and Buddhism, and Judaism.

It is lawful in Jersey to have an abortion in the first 12 weeks of pregnancy if the woman is in "distress" and requests it;[122][123] in the first 24 weeks in case of foetal abnormalities; and at any time to save the woman's life or prevent serious permanent injury to her health. The criteria were established in the Termination of Pregnancy (Jersey) Law 1997.[124]

It is lawful in Guernsey to have an abortion in the first 24 weeks of pregnancy, and at any time in cases of significant foetal abnormality or to save the woman's life or prevent serious injury to her health.[125][126]

Guernsey's laws were updated in 2020 and 2021, to increase the previous 12-week limit on a woman's right to get an abortion on request to the current 24-week limit; to remove the previous 24-week limit in cases of significant foetal abnormality; to remove the previous requirement that all abortions take place at Princess Elizabeth Hospital; to allow nurses and midwives to perform abortions, and allow women to have them at home if they so choose; and to decriminalise the act of a woman attempting to or succeeding in ending her own pregnancy outside of a medical setting.[125][126]

The Guernsey law of 1997 does not apply to Alderney and Sark,[127] which are also part of the Bailiwick of Guernsey but continue to apply an earlier law, in French, identical to the Offences against the Person Act 1861 of England and Wales, which does not explicitly mention any legal ground for abortion.[128] However, the judicial decision Rex v. Bourne in England and Wales clarified that the law always implicitly allowed abortion at least to save the woman's life, and the decision extended it also to preserve her health.[129] It is unclear whether Alderney and Sark apply only the original legal principle or also the extension by the judicial decision.

Since 24 May 2019,[130] it is lawful in the Isle of Man to have an abortion during the first 14 weeks of pregnancy at will, then until the 24th week, so long as criteria specified by the act are met, and then onwards if there is a serious risk of grave injury or death. Abortion is governed by the Abortion Reform Act 2019.[131]

Abortions in the United Kingdom over time

Statistics for legal abortions are published annually by the Department of Health and Social Care, for England and Wales, NHS Scotland, and the Department of Health in Northern Ireland. Where there is only a small number of abortions for a particular ground, the number is not published by statisticians to avoid the risk of disclosing the identity of the persons involved.

Legal abortions were carried out on the following grounds in England and Wales in 2020:

Nearly all (99.9%) of abortions carried out under Ground C alone were reported as being performed because of a risk to the woman's mental health and were classified as F99 (mental disorder, not otherwise specified) under the ICD-10 classification system.[3]

Legal abortions were carried out on the following grounds in Scotland in the same year:

In Northern Ireland, the total number of terminations in 2017–2018 was 12, followed by 8 in 2018–2019, and 22 in 2019–2020.[135][136] As indicated above, for most of that time, abortions were permitted there if the act was to save the life of the mother, or if there was a risk of permanent and serious damage to the mental or physical health of the mother.

In 2020, a total of 371 women travelling from Northern Ireland received abortions in England and Wales:

• 367 – due to risk of injury to physical or mental health of the pregnant woman; and
• 4 – due to physical or mental abnormality in the unborn child.[137]

In the same year, 194 women travelling from the Republic of Ireland received abortions in England and Wales:

• 131 – due to risk of injury to physical or mental health of the pregnant woman; and
• 63 – due to physical or mental abnormality in the unborn child.[138]

The number of pregnant women from the island of Ireland travelling for an abortion was previously much more significant although this decreased following changes in legislation in both Northern Ireland and the Republic, and travel restrictions during the COVID-19 pandemic. Scottish statistics for abortion record the place of residence of the pregnant woman within Scotland (i.e. an NHS board or a local government area); these figures includes temporary addresses for students and a small number of women travelling to Scotland from elsewhere.[139]

A significant majority of abortions in Great Britain take place at less than 10 weeks of gestation. The numbers and percentages in England and Wales, Scotland, and Great Britain overall, were as follows in 2020. Information on gestation and abortion is not available in Northern Ireland for the same year.

Percentage of conceptions which led to an abortion in English administrative districts in 2020

  Less than 22%

  22 to 24%

  24 to 26%

  26 to 30%

  More than 30%

Percentage of conceptions leading to Abortion in Wales

In 2020, the region with the largest number of abortions was London followed by South East England, the West Midlands and North West England. Statistics on abortion recorded at a regional level or national level (for England, Wales and Scotland individually) relate to residents. Abortions for non-residents are also recorded for England and Wales (collectively) although these were lower than usual (at 943 abortions) in that year due to travel restrictions during the COVID-19 pandemic. Information for Northern Ireland is recorded by financial year rather than calendar year, with 22 abortions recorded in 2019–2020.

In the decade between 2009–2010 and 2019–2020 inclusive, Home Office statistics in England and Wales recorded:

• 61 cases of procuring abortion (under the Offences against the Person Act);
• 80 cases of intentional destruction of viable unborn child (child destruction, under the Infant Life Preservation Act).[140]

Guidance from the Crown Prosecution Service, in England and Wales, lists procuring an abortion (unlawfully) as a child abuse offence[141] and notes that some unlawful abortions may be carried out as honour-based crimes, which are committed to punish women for "alleged or perceived breaches of the family and/or community's code of behaviour."[142]

Percentage of conceptions leading to abortion in the UK

Percentage of conceptions leading to abortion in different age groups in England and Wales

Percentage of conceptions leading to an abortion overtime in England and Wales

Percentage of abortions in Great Britain by gestational age, 2004

Percentage of abortions in Great Britain by gestational age, 2019

Post 1967 there was a rapid increase in the annual number of legal abortions, and a decline in sepsis and death due to illegal abortions.[143] In 1978 121,754 abortions were performed on women resident in the UK, and 28,015 on non-resident women.[144] The rate of increase fell from the early 1970s and actually dipped from 1991 to 1995 before rising again. The age group with the highest number of abortions per 1000 is amongst those aged 20–24. 2006 statistics for England and Wales revealed that 48% of abortions occurred to women over the age of 25, 29% were aged 20–24; 21% aged under 20 and 2% under 16.[145]

In 2004, there were 185,415 abortions in England and Wales. 87% of abortions were performed at 12 weeks or less and 1.6% (or 2,914 abortions) occurred after 20 weeks. Abortion is free to residents;[143] 82% of abortions were carried out by the public tax-funded National Health Service.[147]

The overwhelming majority of abortions (95% in 2004 for England and Wales) were certified under the statutory ground of risk of injury to the mental or physical health of the pregnant woman.[147]

By 2009, the number of abortions had risen to 189,100. Of this number, 2,085 are as a result of doctors deciding that there is a substantial risk that if the child were born it would have such physical or mental abnormalities as to be seriously disabled.[148]

In a written answer to Jim Allister, the Northern Ireland health minister Edwin Poots disclosed that 394 abortions were carried out in Northern hospitals for the period 2005/06 to 2009/10 with the footnote that reasons for abortions were not gathered centrally.[149]

190,800 abortions were notified as taking place in England and Wales in 2013. 0.2% fewer than in 2012; 185,331 were to residents of England and Wales. The age-standardised rate was 15.9 abortions per 1,000 resident women aged 15–44 years; this rate increased from 11.0 in 1973, peaked at 17.9 in 2007, and fell to 15.9 in 2013.[150] For comparison, the EU average is only 4.4aabortions per 1,000 women in child-bearing age.[151]

Since approval of abortion in the UK in 1967 to 2014, 8,745,508 abortions have been performed.

In 2018, the total abortions in England and Wales was 205,295. In this year, the abortion rate was highest for those of the age of 21, and 81% were for those who were single.[152]

Opinion polling occasionally considers public attitudes to the availability of abortion in Britain, which are often compared with respondents' voting habits for the main UK political parties. According to a 2004 The Times/Populus survey, feelings on abortion were:[153]

• 75% - abortion should be legal
  • 38% - "always" legal
  • 36% - "mostly" legal
• 23% - abortion should be illegal
  • 20% - "mostly" illegal
  • 4% - "always" illegal

A further YouGov/Daily Telegraph survey in August 2005 indicated: gestational age[154]

• 2% - supported abortion being available throughout pregnancy
• 25% - supported maintaining the term limit of 24 weeks
• 30% - would back a measure to reduce the limit to 20 weeks
• 19% - would support a limit of 12 weeks
• 9% - would support a limit of fewer than 12 weeks
• 6% - responded that abortion should never be allowed

A 2011 poll by MORI[155] surveyed women's attitudes to abortion.

Asked if a woman wants an abortion, she should not have to continue with her pregnancy:

• 53% agreed
  • 15% agreed very strongly
  • 12% agreed strongly
  • 27% agreed
• 22% neither agreed nor disagreed
• 17% disagreed
  • 8% disagreed
  • 3% disagreed strongly
  • 5% disagreed very strongly
• 5% did not know
• 3% preferred not to answer

Asked if too many women do not think hard enough before having an abortion:

• 37% agreed
  • 8% agreed very strongly
  • 8% agreed strongly
  • 21% agreed
• 26% Neither agreed nor disagreed
• 28% Disagreed
  • 16% Disagreed
  • 7% Disagreed strongly
  • 5% Disagreed very strongly
• 6% Did not know
• 3% Preferred not to answer

Asked if it should be made more difficult for women to obtain abortions

• 23% Agreed
  • 7% agreed very strongly
  • 4% agreed strongly
  • 12% agreed
• 23% neither agreed nor disagreed
• 46% disagreed
  • 25% disagreed
  • 9% disagreed strongly
  • 12% disagreed very strongly
• 6% did not know
• 2% preferred not to answer

An Amnesty International poll in 2014 indicated that a majority of people in Northern Ireland appeared to agree with changes in abortion law in three particular situations i.e. where a pregnancy has occurred due to rape, or incest, or where a fatal foetal abnormality (or life-limiting condition) has been diagnosed in the unborn child.[156] [157]