Claire can still recall the panic that ran through her mind as she stared in shock at the pregnancy test.
Just about meeting her rent while saving for a house, the 24-year-old, who is going by a pseudonym, knew she couldn’t afford children; she was even on the contraceptive pill to avoid an accidental pregnancy.
Fearing what she describes as the ‘ticking clock’, the retail worker from Lanarkshire, just outside Glasgow, contacted her GP who referred her for an ultrasound.
‘When they sat me down and showed me the results of the scan, my face dropped,’ she recalls. ‘The doctor told me I was 17 weeks pregnant and I knew from that moment on there was no turning back.
‘I was terrified. I had no idea how I could’ve been that far along without any sign. I was sobbing because I knew my life could change instantly.’
By then in the second trimester stage of her pregnancy, Claire discovered she was eligible for a medical abortion. However, what her doctor told her next only heightened her distress.
Although she could proceed with a termination, the NHS board operating the clinic was unable to carry out the procedure due to a lack of capacity and training.
‘I’m served by of one of the biggest health boards in Scotland. I remember thinking that if this clinic couldn’t provide me with the help I needed, no one could,’ Claire tells Metro.co.uk. ‘I felt alone because it was a case of going elsewhere or having to continue with the pregnancy.’
‘Was I was doing the right thing?’
She eventually registered for an abortion at the British Pregnancy Advisory Service (BPAS), who offered her a face-to-face appointment to discuss her pregnancy and the options available.
However, because Claire had now exceeded the 20-week limit for abortion care across most of Scotland’s 14 NHS health boards, she was forced to travel more than 400 miles to undergo the procedure at a BPAS clinic in London.
‘My partner and I went all through the night on the train and got to London in the early morning in time for my first appointment,’ she recalls. ‘The whole time I was questioning whether I was doing the right thing. By the time we arrived, we’d been going for 12 hours.’
Although her termination was a straightforward procedure which included taking a pill to induce birth, the experience was still incredibly traumatic.
‘I was crying and screaming, and I remember coming out and feeling as though I’d be drained of all my energy,’ Claire recalls.
A growing problem
According to BPAS, women from Scotland have been forced to travel as far as 700 miles to access abortion, with high demand and a lack of appointments increasing pressure on pregnancy services, according to figures published by the group.
Between January 2019 and May 2023, a total of 282 women travelled from Scotland to England to undergo the procedure. In 2022, 65 women were forced to cross the border to access abortion care, a 55% increase from 2021.
It follows shocking NHS statistics which found more than 2,000 women living in Scotland had abortions carried out in England or Wales between 2010 and 2020, due to a lack of provision for services after 15 weeks of pregnancy.
In England, the majority of surgical abortions are carried out by independent providers such as BPAS and MSI Reproductive Choices. In Scotland, the procedures are carried out by 14 NHS health boards.
According to Lucy Grieve, co-founder of the campaign group Back Off Scotland, which campaigns for the right to harassment-free access to abortion services in Scotland, this creates a barrier for women to access terminations up to the legal limit of 24 weeks.
‘There’s no centrally-commissioned service with central guidelines, and no health board that provides care up to the legal limit,’ she explains.
‘Health boards are essentially left to their own devices when it comes to providing mid-trimester abortion care after 20 weeks, which can make access incredibly difficult for women.
A legal dilemma
‘One board may provide a service up to 20 weeks, and then because of long waitlists another may not be able to treat a woman who presents at 15 weeks, for example, and that results in them having to travel to England more than two months before the legal limit,’ adds Lucy.
‘This is a fundamental denial of women’s rights and we can’t claim to be a pro-choice nation if we don’t provide care up to the legal limit. We need to see regional sites where people can access second trimester abortions so they aren’t forced to travel outside of Scotland to seek care.’
However, the inadequate provision of abortion care doesn’t just impact women in Scotland.
The Abortion Act 1967
The Abortion Act 1967 – amended by the Human Fertilisation and Embryology Act 1990 – legalised abortion in the UK under certain conditions. The act was originally passed to end dangerous and illegal abortions, and to establish safeguards for women. It allows registered medical practitioners to terminate a pregnancy if two doctors certify that it’s justified by one or more of the following grounds:
- Continuing the pregnancy would endanger the pregnant woman’s life
- Terminating the pregnancy would prevent serious physical or mental damage to the pregnant woman
- There’s a significant risk that the child would have serious physical or mental abnormalities if born
However, Sarah Salkeld, associate clinical director at MSI Reproductive Choices, believes that a termination shouldn’t fall under criminal law.
‘It needs to be viewed as routine healthcare,’ she tells Metro. ‘At the moment [the act says] you have to get two doctors to sign to say you can undergo the procedure, and that immediately adds barriers. You don’t have that in any other parts of healthcare.’
When Naomi Connor discovered she was pregnant in 2011, she faced an impossible choice: continue with the pregnancy, or risk the possibility of a life sentence for undergoing a procedure freely available on the NHS.
With her doctor unable to offer any medical advice due to the total ban on abortion in Northern Ireland, where she lived, the 41-year-old was forced to travel more than 300 miles to receive care.
Until 2019, women in Northern Ireland faced life in prison for terminating a pregnancy, even if it resulted from rape, incest, or when a foetus has no chance of surviving.
‘After looking online, I found out I could legally travel to England to end the pregnancy,’ she Naomi tells Metro. ‘But I had to pay for the procedure, the flights and all the other expenses myself. Luckily, I managed to put the cost on my credit cards.’
With the help of the Family Planning Association, Naomi spent close to £900 on the procedure, which involved flying to a Manchester-based clinic.
But it wasn’t the cost that impacted Naomi the most.
‘The difficulty was not having the abortion itself, but the shame that you pack up and carry with you.’ she explains. ‘Luckily, I had a supportive partner, but I travelled in secrecy and I didn’t want anyone to find me at the airport.
‘I can remember on the plane home noticing a woman from the clinic sat near me- but we didn’t speak to each other. In any other circumstance, we would’ve smiled and chatted.
‘It was after that silence and the sense of shame we clearly both felt that I resolved to get involved in abortion rights and activism because it was so significant to me that women have had to do this for so long.’
A postcode lottery
Although abortion was eventually decriminalised, bringing Northern Ireland in line with the rest of the UK, women continue to face significant barriers to access, says Naomi, who co-convened Alliance for Choice, a group campaigning for abortion rights.
Northern Ireland has seen more than 2,550 abortions since March 2020, according to the Department for Health. But women more than 10 weeks pregnant are still forced to travel to England to undergo the procedure.
‘There’s a lack of provision in Northern Ireland, and it sends a message that we don’t care about the fact one in three women are pregnant people,’ Naomi adds.
‘It says that somehow abortion is not normal, when in fact the procedure is common. We’re more than four years post decriminalisation, and although clinicians are working tirelessly to bring around the service, they’re doing it in the absence of support.’
Last year, Amnesty International warned of a ‘postcode lottery’ for abortion care in the region, after some health trusts providing interim care closed due to limited resources and a failure of the power-sharing executive at Stormont to fully commission services.
Meanwhile, in England, Amelia Loulli was forced to travel over 100 miles for a surgical abortion and spent more than a week in hospital when the procedure went wrong.
The mother-of-three from Cumbria was told she would have to wait up to two months for an appointment if she went through her local hospital and decided to undergo the procedure through BPAS at its Liverpool clinic.
‘It was a totally unexpected situation and as soon as I started to figure out what to do it was clear it was not an easy system,’ she recalls. ‘I wanted to be as close to home as possible because I was suffering from terrible sickness, but the nearest appointment I could get was more than two hours away.’
With the help of a friend, Amelia, 37, arrived for her appointment at 10:30am but, after a power cut and hours stuck inside the clinic waiting room, she didn’t make it into the theatre for her procedure until 4.30pm.
Dealing with the stigma
‘It was a strange and traumatic process,’ she tells Metro.co.uk.
Although the procedure was successful, the experience left Amelia feeling constantly isolated. Despite remaining staunchly pro-choice, she was afraid of telling her family out of fear of how they would react.
In fact, according to research from MSI Reproductive Choices, despite 92% of women in the UK identifying as pro-choice, only 33% would tell their family if they were considering an abortion. Just 62% would tell their sexual partner.
It wasn’t until Amelia – who has since been accepted onto a PhD programme focusing on abortion – was rushed to hospital with serious complications following the procedure that she began to share her journey.
‘I couldn’t speak to anyone about my experience. It was hard because I hadn’t told anybody and yet here, I was in hospital for almost a week because I was so unwell,’ she recalls. ‘That was a turning point for me, and I realised that it was causing me great pain to hide my story.
‘Once I started talking to people, I realised that even friends I’ve known for a long time have been through similar experiences. The fact is, we all know somebody who has been through an abortion, but have been too worried to speak openly about it.
‘But, there’s a long way to go before we’re at a point where women are able to access abortion as health care, in a way where they feel respected, and cared for and validated in their right to make a choice.’
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