Abortion care across the UK Abortion numbers across England and Wales continue to rise with 2022 recording the highest numbers since the Abortion Act was introduced with medical abortions accounting for 86% of all abortions. The majority of abortions (80%) are carried out by Independent Sector providers (ISPs). 98% of abortions were funded by the NHS in 2022 (99% in 2021). The remaining 2% were privately funded. The proportion performed in the independent sector under NHS contract has increased almost every year since this information was first collected in 1981, while the proportions of NHS hospital and private abortions has fallen over this period. There are regional variations within England by region of residence. Rates of abortion are highest in the Northwest (24.2 per 1,000 women aged 15 to 44) and lowest in the Southwest (17.6 per 1,000 women aged 15 to 44). BPAS has provided late surgical services to women from Scotland for over 20 years. Women travelling to England for abortion were supported to make their arrangements by our unit manager at BPAS Glasgow. All Scottish Trusts now provide medical abortion to 20 weeks. Surgical services are less well-supported with few going beyond 14 weeks. Since 2021, we have actively campaigned for the Scottish Government to provide mid-trimester abortion care within Scotland, and successfully secured a commitment to commission a mid-trimester service centrally to ensure that no woman must travel out of the country for treatment. Abortion care differs between north and south Wales. In Cardiff and the Vale, Aneurin Bevan, Swansea Bay, Hywel Dda, and Cwm Taf Health Boards, abortions are provided primarily by the NHS up to locally determined gestational limits. These limits vary between 10 weeks in Cwm Taf and 20 weeks in Hywel Dda. There is no availability of surgical abortion beyond 12-15 weeks in any of these Health Boards, meaning that significant numbers of women have no choice about the type of abortion procedure they receive. Women in Wales outside of the locally determined gestational limit are referred to BPAS. We provide surgical services from BPAS Cardiff and clinics across England. BPAS provides surgical treatment to approximately 400 women from south Wales every year, of whom 80 are treated outside Wales. BPAS Cardiff also treats a small number of Welsh patients who opt to pay privately to access surgical care not provided by the Health Board. Following the decriminalisation of abortion in Northern Ireland in 2019, for a short period of time BPAS provided a Pills by Post EMA service until local services emerged and the law determined the service had to be delivered from NI. Access to surgical abortion, not immediately available, was supported through the Department of Health (DoH). BPAS was commissioned to provide a Central Booking Service and booked patients into any of the three ISPs and arranged travel and accommodation. This was funded through a DoH grant. Free abortion services in the Republic of Ireland commenced on 1 January 2019, following legalisation which became law on 20 December 2018. Abortion care is managed by the Health Service Executive (HSE). Women can still choose to travel and pay for their abortion care in the UK. The Health (Regulation of Termination of Pregnancy) Act 2018 is the first to make abortion on request legal in Ireland, however it is far from perfect. The Act permits medical practitioners to refuse to care for patients on grounds of conscience except in emergency situations and currently permits abortion up to 12 weeks of pregnancy. Women under 9 weeks pregnant are cared for by GPs. Women between 9 and 12 weeks pregnant are cared for in hospital. 2
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