In the 19th century and early part of the 20th century, a succession of laws was brought in to reduce access to legal abortion. These laws effectively controlled women's lives until 1967. But they did not, of course, prevent unwanted pregnancy, or the need for abortion. Thousands of women resorted to back-street abortionists, permanently damaging their health or dying. Newspapers advertised cures for ‘menstrual blockages', but women knew they were abortifacients. Many of these were ineffective and were also poisonous; one of the cheapest, a lead-based potion, poisoned and blinded many women.

During the 1930s, women's groups and MPs were deeply concerned about the great loss of life and damage to health resulting from unsafe, illegal abortion. The Conference of Co-operative Women was the first organisation to pass a resolution (1934) calling for the legalisation of abortion. The Abortion Law Reform Association was established in 1936.

Two years later, in a landmark case, Dr. Alex Bourne was acquitted of having performed an illegal abortion. He believed that abortion should be legal in exceptional circumstances and, most courageously, admitted having performed an abortion for a gang-raped 14-year-old who was suicidal. He argued that the law did permit abortion before 28 weeks and did allow abortion when a woman's mental or physical health was in danger. The court agreed that this was a life-threatening situation and acquitted Dr Bourne. As a result some women were able to get a safe abortion. However, uncertainty remained as a psychiatrist's approval was needed. It was usually only educated and/or relatively wealthy women who had the resources to find, and pay for, a compliant psychiatrist.

In 1939, the Birkett Committee was set up by the government to clarify whether doctors could perform an abortion to save a woman's life, but their work was interrupted by the outbreak of World War II.

In the fifties, support for reform grew. During the 1960s, fertility control became more widespread with the growth of the women's movement and availability of the contraceptive pill. However, illegal abortion was still killing, or ruining the health of many women. ALRA led the campaign in support of David Steel MP's private member's bill to legalise abortion.

Since its passage in 1967 the Abortion Act has been unsuccessfully challenged several times by anti-choice ("pro-life") organisations which aim to restrict access to abortion.

In 1974, the Abortion Act was threatened by James White's private member's bill, sponsored by an anti-choice organisation. ALRA and other pro-choice groups combined to defend the 1967 Act against this, and successive attacks. Whilst ALRA and others made more formal representations, women's groups organised demonstrations and meetings, many brandishing wire coat-hangers, symbolic of dangerous back-street abortion methods. The campaign led to the formation of the National Abortion Campaign (NAC) in 1975. The first meeting was held in the House of Commons on 10th March.

In 1990, the Human Fertilisation and Embryology Act introduced controls over new techniques which had been developed to help infertile couples and to monitor experiments on embryos. Despite attempts to use this law to restrict abortion rights, the 1990 Act lowered the legal time limit from 28 to 24 weeks, which is the currently accepted point of viability. It also clarified the circumstances under which abortion could be obtained at a later stage.