Many British women struggle to get abortions, even though they’re legal

Women in Great Britain are looking for alternatives outside the healthcare system.

Abortion is legal in Great Britain—and covered by the NHS—but many British women still struggle to get one when they need to. So if the procedure is legal, and cost isn’t an issue, what’s standing in the way? A new study, which analyzes correspondence with a women’s health non-profit, identifies a number of barriers, ranging from logistics to social stigma.

Women on Web is an international non-profit that provides abortion medications by mail and online medical consultations in areas where abortion is illegal. While the service is not available in Britain, the organization receives hundreds of messages a year from British women seeking illegal home medical abortions. Public policy researcher Abigail Aiken and her coauthors analyzed their requests to find out what’s keeping traditional abortions out of some women’s reach.

Getting through the clinic door – Nearly half of the women seeking home abortions through Women on Web reported that simply getting to a clinic can be too hard. For some, it was impossible to discretely take time off work or find alternate childcare arrangements. For others, it was a matter of distance. “My nearest clinic is over 100 miles away,” one woman explained. “I do not drive, and cannot afford the public transport to attend the three to four appointments that they require to complete the abortion,” reported another.

Weeks of waiting – Wait times for appointments at medical abortion providers in Britain can be several weeks. “I cannot wait that long,” said a 34-year-old woman living in England. “Every day is feeling like torture.” In some cases, these delays push women over the threshold for a standard medication abortion. One woman who was over seven weeks pregnant was told she could not be seen for three weeks. Medication abortions after nine weeks require additional doses of medication, meaning more clinic visits and an increased likelihood of hospitalization. Sometimes they also require a surgical procedure to complete the abortion. Fearing the trauma and discomfort of surgery and hospitalization, the woman sought to end her pregnancy herself at home before reaching the nine-week mark.

NHS covers most women, but not allWomen who aren’t residents of the UK are not covered by the NHS for non-emergency care. For them, abortions in Britain come with a hefty and often prohibitive price tag—upwards of £545.

Judgemental providers – “I’ve had bad experiences in the past,” one woman told Women on Web. “I’ve had an abortion before, and I know I will be judged for having another one,” said another.

Word travels fastIt’s not only the judgement of clinic staff that women fear. About a third of the women expressed privacy and confidentiality concerns. Some worked in hospitals or clinics themselves and didn’t want their co-workers to find out about their abortions. Others had family and friends who worked at the local hospital. In many parts of Britain, NHS patients can’t choose local service providers, meaning these women have no way to protect their privacy. Other women worried that if they were seen going to an appointment, word would spread through their communities, and they would be judged.

Controlling partners or families – One in six women who wrote to Women on Web said they couldn’t seek abortions in clinics or hospitals because of controlling partners or family members. Concerns ranged from fear of disapproval on religious grounds to domestic violence and honor killings. “I’m in a controlling relationship, he watches my every move, I’m so scared he will find out… he wouldn’t let me go ahead,” one women wrote. “I do not want to defy certain family members,” said another. “That would put my life at risk.”

For some of the women, seeking a home abortion was a matter of comfort or preference. But as Aiken and her co-authors discovered, many others found themselves unable to access Britain’s legal abortion services. “This research shows that some groups of women in Britain find it very challenging or even impossible to access abortion care through current service models,” Aiken said. “Making health care services available does not automatically make them accessible or acceptable.”

Many of the barriers the researchers uncovered would be removed if women could administer medication abortions in their own homes under the guidance of medical professionals online. In other countries, this approach has been found to safely increase women’s access to abortion. It is against the law in Britain for women to cause their own abortions, meaning that for now, the option remains closed to them.

Featured image courtesy of Amanda Graham.