To mark Safe Abortion Day, we invited Professor Gayle Davis to share her research and analysis of abortion law in Britain.
The current turmoil of American abortion politics invites us to reflect on how abortion law has been interpreted in Britain, with its very different political landscape. Britain’s 1967 Abortion Act – the legal framework through which abortion is still provided in Britain today – succeeded where six previous bills had failed. It did not decriminalise abortion, but carved out a series of ‘therapeutic’ exceptions that made abortion lawful under certain conditions. These include instances where the pregnancy was terminated by a registered medical practitioner, once two registered medical practitioners had agreed that the continuance of the pregnancy would involve risk greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family, or where there was ‘substantial risk’ of serious foetal anomaly. The terms of the Abortion Act were left deliberately imprecise to prioritise medical autonomy, with politicians welcoming the chance to devolve responsibility for this highly divisive issue.
Image: Scottish Abortion Campaign poster, obtained from Glasgow Women’s Library.
As we mark International Safe Abortion Day, it is worth noting that safety was a central concern for the Act’s political architect, Liberal MP David Steel. Steel was inspired to fight for abortion law reform in part by Alice Jenkins’ novel, Law for the Rich (1960), which described the ‘plight of desperate women who are faced with the prospect of an unwanted birth’ while ‘safe surgical termination remained the prerogative of the rich’. Steel’s primary stated aim was to eradicate dangerous back-street abortions by unqualified persons, with all the public health benefits that would entail. Doctors were judged uniquely qualified to determine ‘risk’, with women initially characterised in parliament as irrational and ill-equipped to make their own reproductive decisions, and thus left dependent on medical goodwill. With no increase in NHS resources, and doctors’ personal attitudes to abortion varying as widely as the rest of the country’s, early statistics differed widely regarding who obtained the NHS abortion they sought: what kind of women (married and middle-class women looked upon more sympathetically), and with what conditions imposed (simultaneous sterilisation made a condition in some earlier cases, despite the much greater risk to health). Perhaps most crucial was where the request was made, with a marked regional disparity: senior doctors in cities like Birmingham and Glasgow were most resistant to abortion requests, and appointed or trained junior colleagues in their own image. While both ‘sides’ would continue to stress the centrality of health and safety concerns, over time support grew for access to abortion as a fundamental prerequisite for women’s liberty and equality.
With over 60 attempts to revise the 1967 Abortion Act since it came into force, it is surely one of the most fiercely contested laws in British history. Yet the Act’s text has barely altered in the intervening decades – only the 1990 attempted amendment was successful, in reducing the time limit from 28 to 24 weeks – making it among the most resilient of laws. Nonetheless, experiences of accessing abortion services have evolved considerably, within a radically changing social and medical context. Doctors have tended towards a more liberal interpretation of the legislation over time, with significant support from the charitable sector (particularly the Birmingham Pregnancy Advisory Service) so that affordable alternatives to the private sector could be found even where NHS provision was lacking. As the Act was approaching its 50th birthday, one by one the most relevant major medical bodies – including the Royal College of Midwives, British Medical Association, and Royal College of Obstetricians and Gynaecologists – voted in support for abortion to be regulated in line with other medical procedures, rather than criminal sanctions. Wider recent campaigns to decriminalise abortion have employed the phrase ‘we trust women’ as an attempted corrective to the historical deference to medical opinion.
The story of the 1967 Abortion Act involves the declining authority of the church in framing moral debates, and a corresponding rise in belief in science as a way of ordering the world; medical advance, including refinements of in utero visualisation technologies, and abortion technologies becoming safer and less technically demanding, no longer requiring surgical expertise or hospital facilities; shifting relationships between doctor and patient; changing political ideologies and devolved administrations; changing patterns of childbearing and family structures; and a growing acceptance of both women’s rights and disability rights. While the implications of ‘medicalised’ abortion law in Britain have been problematic for the reproductive rights of women themselves, the decision to contain abortion within a medical framework has somewhat defused conflict and depoliticised abortion, in stark contrast to the United States.
Professor Davis is a Professor of the History of Medicine at the University of Edinburgh. This blog is based on research conducted for the forthcoming book by Sally Sheldon, Gayle Davis, Jane O’Neill and Clare Parker, The Abortion Act 1967: A Biography of a UK Law (Cambridge University Press, 2022).