Overview

This commentary discusses the current situation regarding Government policy on abortion in Britain. It begins by setting out the ways in which the policy of the Coalition Government appears to differ from that of the New Labour administration. The article notes that 2012 brought furious debate about abortion services, focusing on counselling, ‘sex-selection’ abortion, signing of HSA1 forms and, most recently, the upper time limit, and discusses what has emerged to date from these furores. Finally, thoughts are offered on how to respond to the problems raised by the current approach of policymakers.

Abortion policy

Under the New Labour government, in a departure from any previous policy modus operandi, an explicit ‘sexual health policy’ emerged. The two central programmes developed were the Teenage Pregnancy Strategy and the National Strategy for Sexual Health and HIV. It would be going too far to say a specific ‘abortion policy’ emerged as part of this, but the framework for abortion provision did evolve as part of this Government interest in ‘sexual health’. Taking the Royal College of Obstetricians and Gynaecologists (RCOG)'s evidence-based guidelines published from 2000 as a reference point,1 policy encouraged a set of linked developments.

There was a shift in the timing of abortion procedures. The distribution of procedures between the first and second trimesters did not change, with the latter consistently constituting around 10% of procedures; but within the first trimester the distribution shifted to an increased proportion at under 9 weeks. The proportion of procedures performed using early medical abortion (EMA) increased. A larger proportion of women accessed abortions funded by the Department of Health; and independent sector providers provided a growing proportion of state-funded procedures under contract.2 While it is important not to overstate the role of policy in shifting abortion provision in these ways (the providers themselves have …