What is it like in Scotland for women accessing abortion? We are delighted to welcome Hannah Pearson to the Abortion Rights Committee Scotland blog. Hannah is a postgraduate researcher based at the University of Glasgow. She has written this excellent overview of the Scottish abortion access situation based on her current research.
You may not even be aware of Scotland’s limited access to abortion. Not only incomers from England like myself, but also many Scottish women I’ve spoken to are oblivious of the situation. Given the media focus on the punitive ban on abortion in Northern Ireland, it’s not surprising that awareness of Scotland’s situation is low. And, while the situation here is not as restrictive as in Northern Ireland, Scottish women are nevertheless facing significant barriers to abortion access, effectively curtailing their reproductive rights.
The 1967 Abortion Act, which allows women to have an abortion up until 24 weeks gestation, is a UK law inclusive of Scotland. However, as the recent study by Purcell et al highlighted, abortion for non-medical reasons is not usually permitted in Scotland after 18-20 weeks. Earlier academic studies uncovered similar findings: Beynon-Jones (2012) found unofficial time limits for abortion ranging from 15-20 weeks gestation at different Scottish hospitals, which was consolidated by Cochrane and Cameron (2013) who reported that abortion at gestations over 16 weeks varies considerably in Scotland, often dependent on individual GPs and local NHS boards. Importantly, all time limits are significantly lower than the UK’s legal threshold.
This obstruction in Scotland means that women seeking a late term abortion in the country are forced to travel to England, in much the same way as their Northern Ireland sisters. Women are required to pay their own travel costs upfront, and although their local Scottish NHS board offer a reimbursement, this process is far from simple, involving a great deal of onerous paperwork. Some women are not even aware that they can claim their money back. The Purcell study found that none of the women they interviewed who had travelled to England for an abortion knew how to claim reimbursement from the health service.
This current idiosyncratic application of the 1967 Act north of the border is somewhat ironic when bearing in mind that, before 1967, Scottish abortion law was considered to be more liberal and flexible than its English counterpart. Indeed, before 1967, all abortions were effectively legal in Scotland, and Scottish doctors who performed an abortion ‘in good faith’ were protected from prosecution under Scots Common Law.
So why the change of heart? A central difficulty for abortion rights campaigners is the lack of clarity surrounding precisely why late term abortion provision is not generally available in Scotland. A number of reasons have been suggested, including the strong Catholic tradition in the country, as well as negative attitudes towards abortion from medical professionals, particularly late term abortion (the 67 Act’s conscience clause is frequently invoked in Scotland, as demonstrated in the prominent case of the Glasgow midwives), and general public antipathy.
A lack of training for medical staff in late term abortion and the absence of independent abortion providers in Scotland have also been proposed as reasons for the absence of late term abortion provision. Indeed, practically all abortions performed in Scotland take place on the NHS, making Scottish women almost entirely reliant on NHS pathways. Although training may indeed be a factor, a lack of medical resources certainly isn’t. As Vivienne, a woman from the Purcell study pointed out, if a foetal anomaly had been detected her pregnancy could have been terminated within five miles of her home, yet because she chose to have an abortion she had to travel several hundred miles. Rachel, another woman from the study, was also aware of this: ‘Women [who] unfortunately have a miscarriage at that stage, they’re not being sent [to England] to have a baby removed. So it’s not really a huge difference… Having to travel that far just to have a termination because they don’t do it in Scotland – it’s not fair.’
Whatever the reason for the lack of provision, the focus and strategy of pro-choice activists should now be to raise public awareness of the inequality women in Scotland are facing when seeking late term abortion, and to actively lobby political parties. We need to change the culture of stigma and discrimination, and campaign for the implementation of abortion provision up to the legal limit.
Hannah Pearson is @mshjp on Twitter.