Left ‘in agony’ – why Scottish women are being forced to travel to England for abortion healthcare

More and more Scottish women are being forced to travel across the border with England to access abortion healthcare, echoing the “stolen generation” of unmarried women who were shunned and made to travel south to give birth and relinquish their children in the 1960s and ‘70s. Against a backdrop of rising abortion numbers – blamed on the UK’s cost-of-living-crisis by campaigners – The Scotsman spoke to women who have had an abortion to talk through the state of women’s healthcare in Scotland. The legal limit for abortion in Scotland is 24 weeks, but the local ‘time limit’ across different health boards varies from under 16 weeks to 20 weeks. The week limit is now said to be 20 weeks across all mainland health boards, but the British Pregnancy and Advisory Service (BPAS) said it continues to receive referrals from boards which don’t have capacity in the service to treat women before they reach 20 weeks, so may in practice be as early as 17 weeks. For Stephanie, whose real name has not been used to protect her identity, this meant she had to make the “overwhelming” and expensive journey to England to access abortion healthcare. “When I went to the Sandyford clinic and they told me I was 16 – basically 17 – weeks I was shocked, and when they told me there was no provisions in Scotland, again I was just completely shell-shocked,” Stephanie said. “Although there were still choices when they first told me, I felt like I had none and that was it.” Stephanie was left out of pocket, even though some expenses were refundable, and left “in agony, on and off”. “I was told I could claim back up £100 to £150 of expenses and was given all the relevant info, but after everything I couldn’t really face it,” she said. “Now that’s not to say if I had emailed my receipts, which I had, that it wouldn’t have been straightforward. But at that point I was home, straight back at work and didn’t want to deal with it anymore. I was just trying to move on the best I could.” Stephanie’s story echoes the experiences of the about 60,000 Scottish mothers who were forced to travel outside their communities after falling pregnant, and give up their babies for adoption between the 1950s and 1970s due to social and religious judgement. In 2023, 68 women travelled from Scotland to England for second trimester abortions. In 2021 and 2022, that number was 42 and 65, respectively. A spokesperson for BPAS said having to cross the border for abortion within the legal time limit was “unacceptable for many reasons”. “Women who need later access often have more complex reasons for seeking care than women earlier in pregnancy such as being unaware of their pregnancy, concealing a pregnancy, being the victim of domestic or sexual abuse, or having a sudden change in circumstances such as the death of a partner or loss of their job or home,” the spokesperson said. “Having to then travel hundreds of miles for care to an unfamiliar city can be exceptionally distressing and create a sense of shame or guilt at seeking an abortion beyond the time limit which can be provided locally. “This is particularly true for women who are aware that women with a foetal anomaly diagnosis can access care throughout pregnancy within Scotland. So it is very much a kind of social judgement from the NHS that their care is not similarly available.” Grace – also not her real name – faced domestic abuse at home and judgement in Scotland. After falling pregnant in an abusive relationship aged 16, Grace ended up traumatised by her experience of abortion in Scotland. “There is no autonomy – you have to give reasons why you want an abortion in the first place,” she said. “You need approval from two doctors, not the person who is asking for an abortion. “In the circumstances, there’s no way I could have a baby, because the father was abusive. I had so much shock, shame and guilt over what I did. I didn’t realise I was pregnant until six, seven weeks, and I was displaying symptoms. I had just started college.” Pressure from religious groups in Scotland has led to conflict between pro-life protesters and women seeking abortions. Protesters from the Christian fundamentalist network ‘40 Days for Life’ hold placards featuring images of in utero foetuses, join in silent prayer and light lanterns along the road to Glasgow’s Sandyford sexual health clinic, and outside of the Queen Elizabeth University Hospital. The 40 Days for Life campaign takes place twice a year, first during the Christian season of Lent – starting on Ash Wednesday and ending on Palm Sunday – and then from the fourth Wednesday of September. However, the group has been accused of harassing women and chanting at them as they try to access healthcare, and has ultimately led to the campaign to introduce no-protest buffer zones around healthcare clinics. A Bill introduced by Scottish Greens MSP Gillian Mackay was backed in the Scottish Parliament in a vote on Wednesday. The legislation will stop anti-choice protests from taking place within 200 metres of medical facilities, and has now cleared stage three in Holyrood after the regulations were passed by 66 votes to 47, with five abstentions. “The ‘forced-birthers’ don’t understand the circumstances, or why people might want an abortion,” said Grace. “They don’t know people and shouldn’t be judging. They are intimidating and trying to silence women. If I had come across them at 16-years-old, I don’t think I would have gone through with it. “They don’t care for the pregnant women whatsoever, just the baby. The foetus is part of the body, it wouldn’t survive without it. Their input can be crumbled within a matter of seconds. “The scaremongering is the worst thing – they have graphic foetus pictures. I was still torturing myself by looking at scans because I felt so much shame, influenced by forced-birthers appearing in the media and forcing their judgement on people who have had an abortion. “There’s a turmoil that people don’t understand. For some people it can be very traumatic, like for me, but that doesn’t mean I made the wrong choice.” A recent rise in abortion numbers has troubled pro-life groups in general. Statistics released by Public Health Scotland (PHS) show the number of abortions carried out in Scotland in 2023 (18,207) was the highest number on record. This represents an increase of 1,600 abortions – nearly 10 per cent – in one year, with numbers rising from 16,607 in 2022 to 18,207 in 2023. A spokesperson for Right To Life UK, Catherine Robinson, described the number as “a great tragedy”. “Every one of these abortions represents a failure of our society to protect the lives of babies in the womb and a failure to offer full support to women with unplanned pregnancies,” she said. Ms Robinson said the rise had “accompanied” the third full year that at-home abortions services had been available in Scotland, which Right To Life lobbied against. “Since then, we have seen these concerns confirmed, with women such as Carla Foster performing at-home abortions well beyond the 24-week time limit, putting their health at serious risk,” Ms Robinson said, In June 2023, Ms Foster was sentenced to a 28-month prison term for inducing an abortion in a gestational range the coroner estimated at 32 to 34 weeks of pregnancy, using pills provided by BPAS for a home abortion. The Court of Appeal later reduced the term to 14 months suspended. Ms Robison said: “If Carla Foster had been given an in-person consultation where her gestation could have been accurately determined, she would not have been able to access abortion pills and this tragic case would have been prevented.” Ms Robinson said the “clear solution here” would be the “urgent reinstatement” of in-person appointments for home abortions. A spokesperson for BPAS said the UK’s cost-of-living-crisis was having “a particular impact” on the decisions of women to have abortions, leading to an increase in the number of women being forced to travel south to England for healthcare. “Women must always have the choice to end a pregnancy if they want it, but we should also listen to what national statistics are telling us about the pressures facing women and families across Scotland – and government should work to ensure real reproductive choice where no woman feels pressured by circumstance to end a pregnancy she would otherwise have wanted to continue,” the spokesperson said. Lucy Grieve, the co-founder of the Back Off Scotland campaign, which grew out of the backlash to the pro-life protests outside abortions clinics, said: “It is unacceptable that after years of virtue signalling in the Scottish Parliament and media, the number of women having to travel to England to access abortion care continues to increase year on year. “The Government said that interventions made by them in 2022 would mean less women having to make the journey. But the opposite has happened and the numbers are on the increase again. “We have countless women getting in touch with us to share their stories of having to travel so far to get such basic care, and we are at a loss as to what the Government is actually doing to rectify this issue. These women are being badly let down by successive governments and we will continue to advocate for them until services are rightly provided locally.” Rachael Clarke, chief of staff at BPAS, said: “It has been five years this week that I first met with the Scottish Government to discuss the need for a national service that enabled women to access abortion care in Scotland – and we’re still no further forward. “It is unacceptable that despite warm words, women are still bearing the brunt of the Government’s unwillingness to force action. BPAS will always be here for women to need us no matter where in the country they’re from, and as we’ve said for years, we will always be here to help Scottish providers establish these essential services.” Public and women’s health minister Jenni Minto said: “While the vast majority of abortion services carried out in Scotland takes place prior to 14 weeks gestation, the Scottish Government completely understands concerns raised regarding women travelling to access abortion services up to 24 weeks gestation. “National Services Scotland has done significant work to consider the available delivery options for this service, and a short-life working group has been established to consider these alongside NHS boards. The Scottish Government is committed to establishing a service within Scotland once an agreement can be reached with health boards on the best way forward. “The Scottish Government is working to understand this significant increase in demand for abortion services in recent years and address the reasons behind it, including improving access to contraception. All women should be able to access essential services, such as contraception and abortion care, in a timely, safe and equitable manner.”