By Marina Politis of the British Medical Association.
Many individuals, including both medical students and doctors, do not know that under the Offenses against the Persons Act 1861, made law at a time when women could not even vote, abortion is still criminalised in the UK.
Indeed, at the time of writing, investigations still go on under this archaic act, with dozens of Women in England and Wales who have suffered miscarriages or stillbirths investigated by police in the past 10 years on suspicion of having illegal abortions and for suspected breaches of this 1861 law. Illegal and abortion are not two words that we should still see following one another in 2022.
Yet in 2022, global reproductive rights are more under threat than ever. This is exemplified by the US Supreme Court decision to overturn Roe versus Wade, which in removing the Constitutional right to abortion, will cause immeasurable, unnecessary harm. Universal access to safe, quality, legal abortion must be seen as a basic human right and the decision to overturn Roe versus Wade will extend far beyond the US through empowering the anti-abortion lobby. This decision puts reproductive rights at risk world-wide.
Criminalising abortion makes no difference to how many pregnancies are terminated; it only changes the context and safety of how this is done. Banning abortion does not mean fewer abortions, and when abortion bans are enacted, pregnancies more often result in death, as we have seen across the globe. Indeed, estimates of the impact of an abortion ban in the United States suggest that there could be a 21% increase in mortality overall and a 33% increase for Black women.
Importantly, we cannot talk about the US, without looking at what is happening here, with inadequacies in the UK’s abortion provision ranging from failures to commission abortion services in Northern Ireland, to a lack of third trimester abortion provision in Scotland, to UK hostile environment policies which charge migrant women for abortion, an essential medical procedure.
Most notably, more than 150 years after it was put into writing, the 1861 OAPA still remains in existence. Yes, abortion is still in criminal law in England, Scotland and Wales. The maximum sentence for terminating a pregnancy is life in prison.
The 1967 Abortion Act, too, is no longer fit for purpose. It passed when medical abortion was not yet possible. Permission is also needed from two doctors to obtain an abortion – something we see in no other medical procedure: abortion is the only procedure with its own legislation. Legislation and policy-makers ought to have no place in a consulting room, standing between doctor and patient, adding only barriers and stigma, rather than clinical safety or safeguarding.
Importantly, decriminalisation also does not mean a lack of regulation. Indeed, Canada decriminalised abortion thirty years ago and once restrictive regulations and legislation were revoked and largely replaced with supportive policies, abortion rates remain stable three decades later. This emphasises how abortion care can – and ought to be – safely and effectively regulated as a normal component of medical care.
In 2022, this is no longer a conversation that should be ongoing. Decriminalisation should not be a hypothetical debate, but a tangible reality, and we must advocate for this as students and healthcare professionals.
The British Medical Association recently passed the following motion, moved by Marina Politis and seconded by Emma Runswick:
“This meeting believes that the US Supreme Court decision to overturn Roe vs Wade removes the Constitutional Right to safe, legal abortion. This decision will cause immeasurable harm by allowing states to remove reproductive rights, which are deemed essential human rights by the UN. This meeting calls on the BMA to:
i) Continue to condemn the overturning of Roe vs Wade and lobby all UK Governments to condemn this decision.
ii) Lobby the GMC, all UK Governments and other stakeholders to stand in solidarity with healthcare workers providing safe abortion care, including disregarding any criminal charges or convictions for providing safe abortion, when considering UK registration applications.
iii) Work with the American Medical Association to support doctors providing medical and surgical abortions in the US.
iv) Support the provision of free and safe abortion care to all nationals seeking this in the UK, without subjecting them to the overseas patient upfront tariff, regardless of borders.
v) Call on all UK Governments to strengthen their own abortion provision and decriminalise abortion.
vi) Support the Safe Access (Abortion Services) Scotland Bill, which would introduce safe access zones around abortion clinics and healthcare settings that provide abortion services through creation of a criminal offence of contravening the zone, and lobby to have this approach adopted on a UK basis.”