Intended for healthcare professionals

Feature Abortion

The “abortion trail” to England from the rest of the British Isles is on rocky ground

BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2719 (Published 23 November 2023) Cite this as: BMJ 2023;383:p2719
  1. Sally Howard, freelance journalist
  1. London
  1. sal{at}sallyhoward.net

England has become a later stage abortion provider of last resort for vulnerable women from Ireland, Northern Ireland, Scotland, and beyond. With England’s service commissioners underfunding surgical abortion and a staffing crisis looming, this provision is at risk—and also for women in England, reports Sally Howard

Earlier this year Kelly, 35, contacted the Abortion Support Network (ASN), a charity headquartered in Coventry that provides information, financial assistance, and other practical support to people in Europe who are forced to travel for abortions. Kelly (name changed to protect identity), who was based in Ireland, had been told at her 22nd week of gestation that the fetus she was carrying had a severe anomaly.

Although second trimester abortions (in weeks 13 to 26) are permitted in Ireland in cases of fatal fetal anomaly, Kelly was told by a clinician that in her case the fetus’s abnormality wasn’t deemed “fatal enough” under Ireland’s laws for her to get an abortion there. Grieving the loss of a planned pregnancy and unable to fund the full cost of a private procedure and travel, Kelly resorted to contacting ASN after an online search.

The charity made an appointment for Kelly at a clinic in England run by the British Pregnancy Advisory Service (BPAS), an abortion service provider charity that charges £1410 for the procedure—a discounted rate for Irish residents.1 Kelly paid for the procedure herself with contributions from family and friends, and ASN supported her with a grant of £988 towards the costs of her travel and accommodation.

Kelly’s situation is far from unusual: thousands of women every year travel to England for later stage abortions (second trimester onwards) from Ireland and other parts of the EU, as well as from Scotland and Northern Ireland, other UK home nations. However, providers and …

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