NHS pressures leave one woman a week unable to access abortion with no legal option other than childbirth, charity warns

Experts 'deeply saddened' by shocking number of women denied access to legal abortion care

One woman a week in Britain is unable to get access to specialist abortion care because of a lack of capacity in the NHS, leaving them with no legal option but to give birth, a report has warned.

The British Pregnancy Advisory Service (Bpas) said “service pressures” mean women with complex medical needs are having their lives put at risk waiting for abortion care.

Those with conditions like epilepsy, blood disorders or heart conditions are particularly affected as they cannot safely have the procedure in standalone clinics and need a hospital setting to manage any complications.

In many cases being forced to give birth puts both the mother, and child, at risk, the UK abortion care charity warned.

In 2016 and 2017 the charity helped 2,900 women to access specialist abortion care, but it said that on 48 occasions it was not able to get them an appointment before the 24-week legal cut-off had passed.

As the charity, the largest of its type in the UK, only sees a third of women presenting for abortion care, the report states: “This suggests that the numbers of women unable to access care will be higher and it is reasonable to assume that every week a woman with medical conditions is unable to get the abortion she needs.”

There are a number of other contributory factors that mean there can only be limited time to find them an appointment, including domestic circumstances, distance from a suitable hospital, and delays identifying the pregnancy.

One case in the report, says: “A teenager who has recently left foster care, lives alone and feels unprepared to become a parent. She has a thyroid condition (at risk of potentially fatal thyroid storm).

“She contacted Bpas at 22 weeks, but no appointment was available.”

Another woman, with a heart problem, another child with a serious illness, and in the middle of trying to get a restraining restriction against a former partner who had subjected her to domestic violence was unable to get an appointment.

The report says an increasing number of women are living with complex conditions.

This is a result of more people surviving from things like childhood congenital heart disease, as well as the growing burden of lifestyle conditions like obesity, leading to Type 2 diabetes.

However the development of specialist care services and training of staff has not kept pace.

Bpas is calling for additional funding for specialist NHS sites and hubs, so fewer women are prevented by geography alone, and a “national tariff for treatment” to fund hospital capacity.

It also wants to see termination of pregnancy in the medical curriculum and a change in legislation to decriminalise abortion care, up to the existing 24 week window.

Currently doctors risk life imprisonment if they breach the abortion act, and assessments are legally bureaucratic needing to be authorised by two doctors. Pressures which deter doctors from training in this area.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, said abortion opponents claim there are “too many abortions” or call for the reduction of the time limits.

“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. “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.”

Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecology, said: “We welcome this important report from BPAS and are deeply saddened by the shocking number of women who are being denied access to abortion care even though their pregnancy threatens their health and potentially their lives.

The college is working with NHS England to develop a specialist pathway for women who can’t access abortion care in stand-alone clinics, but said “alone, this is not enough.”

A Department for Health and Social Care spokesperson said: “We are working with NHS England and the Royal College of Obstetricians and Gynaecologists to improve abortion services for women with health co-morbidities – ensuring that NHS hospitals can expand their capacity and that staff have the right skills to provide appropriate care for these complex cases.”