Investigating women over potentially illegal abortion is “never in the public interest,” and can lead to “life-changing harm,” senior doctors have warned Britain’s healthcare workers.
The Royal College of Obstetricians and Gynaecologists told its members this week they shouldn’t refer patients to police following abortion, pregnancy loss or unattended delivery.
The professional body issued guidance in response to an “increasing number of police investigations following later gestation abortion and pregnancy loss.”
At least six women have been taken to court for under suspicion of illegal abortion since 2022, according to The Guardian, with dozens more investigated by police.
Dr Jonathon Lord, a gynecologist who co-chairs the college’s abortion taskforce, told the newspaper on Friday that women under investigation had received death threats, been arrested and refused entry to their own homes.
Some had racked up tens of thousands of pounds in legal debt, while some had been separated from their children. Some of the investigations themselves have lasted years, he added.
“We’ve had patients lose everything — lose their home, lose their children, lose their relationship with their partner — purely as a consequence of the investigation,” he said.
In some cases, women may have believed their pregnancies were at an earlier stage than they were when seeking an abortion, he added. In others, women were investigated after experiencing late-stage miscarriages.
Is abortion legal in the U.K?
Pro-choice attitudes are the norm in the U.K., with some 87% of the British public in favour of allowing abortions. But the country’s laws are still relatively restrictive.
In England, Scotland and Wales, lawful abortion requires signatures from two doctors, who must agree the procedure falls within the scope of the 1967 Abortion Act.
The 1967 Act allows terminations up to 24 weeks for several reasons, including preventing injury to a woman’s physical or mental health — the reason for 98% of the country’s abortions. These rules become much stricter later in a pregnancy.
It’s largely women whose pregnancies have ended after 24 weeks who are investigated under suspicion of illegal abortion, which carries a maximum sentence of life in prison.
The law is the country’s oldest piece of healthcare legislation and one the college argues should be reformed to decriminalize women who want to end their pregnancies.
Several attempts have been made to amend the law, but none have been successful.
Rules differ in Northern Ireland, which decriminalized abortion in 2019.
Patient confidentiality and consent
By law, medical staff are only allowed to share confidential patient information with police if it is in the public interest.
RCOG argues investigating patients over abortion is not, and says some 60 other organisations and professionals around the U.K. agree.
This is why it has urged its members not to contact police over cases of suspected illegal abortion.
It published its “best practice” guidance for healthcare staff in collaboration with the U.K.’s Faculty of Sexual and Reproductive Healthcare (FSRH), Faculty of Public Health and the British Society of Abortion Care Providers on Monday.
The guidance outlines how it says healthcare professionals should respect patient confidentiality and consent around police investigations, as well as the rare cases in which it might be best practise to disclose information.
If they share information outside of this guidance, the college says, their fitness to practise may come under question.
“Breaking confidentiality not only harms the woman but also brings healthcare into disrepute,” Lord, who is medical director for contraception and abortion provider MSI Reproductive Choices UK, told The Guardian.
“There is a big danger that the most vulnerable patients will be too scared to then present to regulated healthcare, which means we’ll never be able to safeguard and help them.”
RCOG president Dr Ranee Thakar said in a statement that “these women should be treated with care and compassion, without judgement or fear of imprisonment.
“Outdated, antiquated abortion laws mean women who have experienced unexplained pregnancy loss are also vulnerable to criminal investigation, and health professionals are placed under unacceptable and unwarranted scrutiny.”
‘Complex and traumatic’
Anti-abortion groups like Right to Life UK have been quick to criticize the new guidance, arguing it is “innappropriate” for the organisations to “usurp” the country’s lawmakers by releasing guidance related to criminal investigations.
Spokesperson Catherine Robinson also said the guidance could put vulnerable women at risk of coerced abortions.
RCOG itself, however, says it wants non-consensual abortion to be recognized under a reformed criminal law.
A spokesperson for England and Wales’ Crown Prosecution Service said that although illegal abortion investigations were “exceptionally rare,” they were “complex and traumatic.”
“We carefully consider the personal circumstances of those who end their pregnancy outside the legal parameters and address these as sensitively as possible,” they told The Guardian.
“Our prosecutors have a duty to ensure that laws set by parliament are properly considered and applied when making difficult charging decisions.”
