Dozens of British women forced to continue pregnancies that risk their health
Dozens of women in the UK were denied abortion care before their pregnancies reached 24 weeks in 2016 and 2017, even though their pregnancy threatened their health, a new report has revealed.
Women with medical conditions including epilepsy, heart problems, cancer and blood disorders all struggled to obtain abortion care.
On 46 occasions in 2016 and 2017, or roughly twice a month, the British Pregnancy Advisory Service (BPAS) was unable to secure suitable NHS hospital treatment for women by the strict legal cut-off point for abortion of 24 weeks.
BPAS runs a dedicated specialist placements service to find hospital appointments for these women.
However, as they obviously don’t see all women in need of abortion, the organisation believes it is reasonable to assume that at least once a week a woman with medical conditions is unable to access the care she needs.
The briefing, published by BPAS, based on 2,900 women with medical complexities who went to BPAS for abortion care during 2016 and 17, highlights the fact that women are being forced to continue pregnancies they do not want due to lack of appropriate services.
Many others were forced to endure stressful, long waits for care while having to cope with a pregnancy that could exacerbate their condition.
These women cannot be seen in stand-alone clinics such as those run by BPAS, but must instead be cared for in hospital settings where they can have swift access to medical care if their condition deteriorates.
Women affected include very young women and women in complex situations, including those experiencing domestic abuse, who present towards the end of the second trimester.
This can be due to late detection of pregnancy, sometimes because they are using contraception that has altered bleeding patterns so pregnancy is not suspected, or because they believed pregnancy was unlikely as a result of their conditions affecting their fertility.
In other cases, their circumstances, including their health, may have deteriorated, making an originally wanted pregnancy no longer viable.
Some examples of women with complex health issues for whom BPAS was unable to secure an appointment for in 2016/17 included a teenage who had recently left foster care.
She was alone and felt unprepared to become a parent, and also had a thyroid condition which put her at risk of a potentially fatal thyroid storm.
This woman contacted services at 22 weeks for an abortion, but there was no appointment available.
Another client had a heart condition and was attempting to get a non-molestation order against an ex-partner due to domestic violence. She already had a child with a serious illness, and presented at 22 weeks requiring an abortion, but there was no appointment available.
A further woman had pulmonary fibrosis and a range of medical problems. She had planned a pregnancy but after getting pregnant her health deteriorated, and she decided to end the pregnancy as she needed to be able to care for her existing child.
She presented to BPAS at 22 weeks, but there was no appointment available.
As the three hospitals able to provide abortions up to the legal limit of 24 weeks in these circumstances are all in London, the distance women have to travel can also prove impossible, especially as for many it means too long spent away from home.
For example, one woman, who had recently had a heart attack, was unable to travel far for treatment as she had to care for her existing children and a disabled partner. There was no suitable appointment available for her.
Other woman are being forced to wait far too long before an abortion appointment can be found.
In one case, a mother with cancer, who could not start treatment until the abortion was performed, waited 45 days for an appointment.
In another case, a mother with epilepsy and learning difficulties who presented at the end of the first trimester had to wait nearly seven weeks for treatment.
Work is currently underway to commission a specialist pathway for women who cannot be cared for in stand-alone clinics.
The Royal College of Obstetricians and Gynaecologists (RCOG) has also established an Abortion Taskforce to improve women’s access to high quality abortion care.
However, BPAS’s stance is that ultimately abortion has to be removed entirely from criminal law, and the unique threat of prosecution of healthcare workers involved in abortion care must be lifted, enabling abortion to be regulated in the same way as other comparable healthcare procedures.
The criminal law acts as a deterrent to doctors training in this area, and has inhibited the development of integrated women’s reproductive healthcare services, meaning many young medics are not exposed to abortion care, nor offered any opportunity to train.
The 1967 Abortion Act did not decriminalise abortion, but rather only made it legal up to 24 weeks when two doctors authorise the procedure on specific grounds.
There is no gestational limit for abortions if there is evidence of a fatal foetal abnormality or a significant risk to the life of the pregnant person if the pregnancy is continued.
Any abortion performed outside of the Act carries the threat of life in prison and in recent years those opposed to abortion have even called for the sanctioning of doctors for failing to fill in legal paperwork, that is unique to abortion, correctly.
Understandably, this has had a chilling effect on practice.
Ann Furedi, chief executive of BPAS, said: “Those opposed to abortion sometimes claim there are ‘too many’ abortions, or casually declare that the time limit needs to be reduced.
“The fact is that in 21st century Britain there are women who are not getting the abortions they need, despite fully meeting the grounds of the 1967 Abortion Act.”
She added that these are women for whom the continuation of the pregnancy threatens their health, or who have other children to care for, or who are often in complex social circumstances at the same time as struggling to deal with a health condition and an unwanted pregnancy.
She continued: “There is no one single solution to problems with service provision, but one thing is certain.
“While abortion remains in the criminal law, separated and stigmatised, we will struggle to provide women with the reproductive healthcare services they need and deserve.
“Abortion is part and parcel of women’s healthcare. It should be regulated and delivered as such.”
In March 2017 MP Diana Johnson presented a bill seeking to decriminalise abortion up to 24 weeks of pregnancy, which was supported by MPs across the political spectrum and passed its first stage by 172 votes to 142.
However, due to the general election, the bill was not able to progress any further.