Hundreds of women have been forced to travel from Scotland to England to access abortion care in just over four years, according to official data, with pregnancy services claiming numbers are growing year-on-year.
Figures from the British Pregnancy Advisory Service (BPAS), which has arrangements with all Scottish health boards to provide abortions that cannot be offered locally, showed 240 women have travelled to England for abortion care since 2019.
Women who made the journey did so to access surgical abortions. In Scotland 99 percent of abortions are medical – in which a woman is given two pills either to take at home or in hospital. Surgical abortions – operations carried out in healthcare settings – are generally only offered up to 13 weeks.
Though surgical abortions can still be difficult to access in England, they are more widely available – 13 percent of procedures are carried out this way there and they are performed by doctors up to 24 weeks. In exceptional circumstances, they can be carried out later in pregnancy.
The largest number of women who made the journey from England to Scotland between January 2019 and May 2023 – 67 – were from NHS Greater Glasgow and Clyde area but eight travelled the long distance from the Highlands. In the same time period, 33 women had to travel south from Fife, 38 women from NHS Lanarkshire and 35 women from the Lothian health board area.
The numbers are increasing. In 2022, 65 women travelled from Scotland to England in order to access abortion care from BPAS alone – a 55 per cent increase from 2021. In the first five months of this year it had already provided care to 35 women making the journey across the border.
Campaigners said the figures highlighted the struggles women still face in getting help to terminate a pregnancy in Scotland – despite abortion being legally available here until 24 weeks – two years after the Scottish Government’s Women’s Health Plan listed improving access to abortion as a “priority”.
Reproductive rights organisations supporting women who are having to travel to England to access abortions said women requiring surgical intervention in a clinic or hospital are more likely to be younger, have vulnerabilities or complex health issues.
In England, most surgical abortions are carried out by independent providers, such as the British Pregnancy Advisory Service (BPAS) and MSI Reproductive Choices. But in Scotland they are provided by health boards.
Campaigners argue this can create a barrier to care, as many health boards lack availability and skills to carry out surgical abortion and do not do so after 13 weeks. Stigma surrounding relatively late abortions means finding staff willing to practise abortions can be challenging, they added.
Monica Lennon, MSP for Scottish Labour, said the figures were “concerning” and called on the Scottish government to improve access to abortion healthcare. Women’s organisations said the current situation, which meant women sometimes had to travel hundreds of miles, was “unacceptable”.
But the Scottish minister for public health and women’s health, Jenni Minto, insisted the Scottish Government was working hard to ensure women had access to surgical abortion after 13 weeks. Women in Scotland can access medical abortion up to 20 weeks in pregnancy.
The British Pregnancy Advice Service (BPAS) said surgical abortions should be made available in Scotland, with the lack of available abortion services adding stress and confusion at what can be a distressing time.
“There has not been a drive from either health boards or politicians to improve access for abortion in Scotland, because there has always been the option to send women and girls to England [for surgical abortions],” BPAS chief of staff Rachael Clarke told the Ferret.
“But this ignores the vulnerability of those who need surgical abortions, who often come from marginalised backgrounds, may never have travelled outside of Scotland before, or are teenage girls.”
Clarke said she expected to see numbers continue to rise, as people made difficult choices about whether they could afford to bring up children in the cost of living crisis.
Access issues are not confined to Scotland. Data published by BPAS in 2018 revealed how women across Britain were being forced to continue with unwanted pregnancies, as they could not access an abortion before the 24 week upper time limit. Women in England also sometimes have to travel to different parts of the country to access abortions.
Women’s organisations raise concerns
But in Scotland the gap between policy and practice is particularly stark according to women’s organisations. “Women have the right to enjoy high standards of sexual and reproductive health, including abortion care,” Catherine Murphy, executive director of feminist advocacy organisation Engender Scotland, said in response to the figures.
“It is completely unacceptable that women are having to travel long distances to access routine healthcare, and it’s likely that [the need for travel] is causing a barrier to timely abortion care for women in Scotland”.
In January 2023, the Scottish Government formally commissioned National Services Division (NSD) – which is part of NHS National Services Scotland – to develop a specification to provide a service for abortions up to 24 weeks gestation to be provided within Scotland, to ensure that women can access all forms of abortion services as locally as possible. However, campaigners are frustrated by slow progress.
“We have countless women getting in touch with us to share their stories of having to travel so far to get such basic care, and we are at a loss as to what the government is actually doing to rectify this issue,” said founder of Back Off Scotland Lucy Grieve. “How is it possible that they have only just started putting together a national service spec almost a decade after research they commissioned found that the establishment of a mid-trimester service was ‘a necessity’.”
Monica Lennon, Scottish Labour MSP for Central Scotland, told the Ferret: “Improving access to the abortion healthcare that women are legally entitled to must be a higher priority for the Scottish Government. It is concerning that hundreds of women have had to travel from Scotland to England, with all the additional stress, travel and financial strain that journey can bring”.
The Ferret also heard from women who say they have faced barriers to access abortion in Scotland due to the continued protests outside clinics by anti-choice organisations. The latest protests by the 40 Days for Life group – a US organisation with branches in Scotland and the rest of the UK – started on 27 September, and will continue outside reproductive healthcare providers, including in Edinburgh and until 5 November.
It is now a year since MSP Gillian McKay committed to implementing anti-abortion buffer zone legislation “as soon as possible”. In May, First Minister Humza Yousaf said “no one should doubt my commitment to buffer zones”. However, legislation has yet to be tabled. Women have warned the delay was having real and serious impacts on their health and wellbeing.
“Unfortunately, safe access to abortion services continues to be undermined by anti-choice campaigners, who have no regard for the privacy or dignity of the women and people they are harassing,” Monica Lennon added. “It is high time that we had buffer zone legislation in Scotland”.
Lily attended a clinic where she was confronted by protesters. “I went into hospital first thing in the morning and was faced with a group of protestors holding up placards,” she described. “They remained there seven hours later when I left the clinic. My privacy and safety were threatened, and it was a deeply intimidating experience.”
Because the protesters target clinics where a wide range of health services are on offer, women are targeted even when they are not accessing abortion. “I was a victim of sexual assault and had to book an appointment,” said Tara (not her real name).
“A small group of individuals, mostly male, were standing on the other side of the road. I was repeatedly called out to by one of the men, and when I glared at him and ignored him, he called me a ‘teenage murderer’. I have never been pregnant, I have never had an abortion, and I’ve never even used a contraceptive medication. I felt threatened and terrified”.
Anti-abortion groups claim their presence outside clinics is legitimate. Reasons given include that they are showing the “reality” of abortion, or praying, or offering counselling to dissuade women from having an abortion.
Pro-choice campaigners also warned that the lack of doctors qualified to carry out surgical abortions is partly fuelled by the stigma involved in specialising in a medical area that remains governed by criminal law.
Abortion is the only form of healthcare that remains criminalised, with women accessing terminations outside of the exemptions laid out in the 1967 Abortion Act at risk of life imprisonment.
This was brought into the spotlight by the recent Carla Foster case in England, who obtained abortion pills late on in her pregnancy and was later arrested and sentenced to 28 months in prison. The mother of three children was later released on appeal.
Five women have been in court in England for illegally obtaining an abortion in the past nine months, after only three trials in the previous 160 years.
Scottish minister for public health and women’s Health, Jenni Minto, said the Scottish Government was working with health boards “to try and ensure that services up to 24 weeks are established here so that women can access all forms of abortion services in Scotland”.
Funding was available to staff looking for specialist training to provide later stage abortions, she noted, and where abortions were required to take place outside Scotland, care should be paid for by the NHS.
She added: “Where an NHS Board cannot offer abortion services up to 24 weeks’ gestation locally, they must work to provide an appropriate and person-centred care pathway for all patients seeking abortions up to the legal limit.
“The Scottish Government is working to deliver actions in the Women’s Health Plan, which includes a range of measures to ensure all women have access to timely abortion care should they require it, and to increase choice for women accessing this essential care, including access to surgical or medical terminations.”
This Ferret story was also published with the Sunday National. Our partnerships with other media help us reach new audiences and become more sustainable as a media co-op. Join us to read all our stories and tell us what we should investigate next.