A note on language
These articles use the term ‘pregnancy endings’ to encompass pregnancy outcomes like abortion, miscarriage and stillbirth.
For many communities, colonialism and its impact on obstetric and gynaecological health created an intense categorisation and differentiation between pregnancy endings. This is why, in many languages, it can be really hard to directly translate ‘abortion,’ ‘miscarriage’ and ‘stillbirth’ into different words.
Similarly, many people experience pregnancy endings that cannot be neatly categorised into either abortion or miscarriage, such as abortion due to medical reasons or a miscarriage that requires medical intervention. Words like abortion and miscarriage might work for some people, and others might not find these terms to be affirming.
Equally, the care required for pregnancy endings is often the same, if not highly similar. This is why criminalising abortion also harms people who have miscarriages because – from a medical perspective – the care needed to manage these outcomes safely is exactly the same.
Regarding the term ‘criminal’ used about UK abortion laws, at Spark, we recognise this term as a label that reinforces punitive systems of control and oppression – preferring to use the term “harm” instead of “criminal” to focus on the action rather than labelling individuals.
All pregnancies come to an end, and all pregnancy endings are deserving of support, care and compassion. Pregnancy endings is a more neutral term that we hope holds space for this care and allows people to define their experiences further
At the end of this post, you’ll also fund a full glossary of terms.
What is an abortion?
An abortion is a way of ending a pregnancy. In the UK, abortions are legal when they are carried out by pills (medical abortion) or a procedure (procedural/surgical abortion).
Abortions are carried out by abortion providers (typically doctors and nurses), and most take place at:
- NUPAS (National Unplanned Pregnancy Advisory Service)
- BPAS (British Pregnancy Advisory Service)
- MSI (Medical Services International)
Most people will self-refer to these services, but you can also request support from your GP or at a sexual health clinic.
Abortions are free for people who are not subjected to immigration control. Migrants who are not entitled to free NHS services do have to pay for their abortions. This can include:
- Migrants on a visitor visa
- Migrants who have not paid the Immigration Health Surcharge (IHS)
- Undocumented migrants (healthcare providers may ask to see information or documentation on your visa or legal status)
This is typically a small number of people, but it’s important to know.
Overview of UK Abortion Laws and Historical Context
What does the law say?
In England, Wales and Scotland, abortion has been legalised but not decriminalised. In Northern Ireland/The north of Ireland, abortion has been decriminalised up until 12 weeks. After 12 weeks, the law is essentially the same as the rest of the UK.
This means that abortion is legal under certain circumstances but is still a part of the Criminal Code. People who have abortions outside of these circumstances can be and still are subjected to criminal penalties.
Our guiding piece of legislation on abortion is the Abortion Act of 1967.
It says that:
A person shall not be guilty of an offence under the law relating to abortion when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith:
(a) that the pregnancy has not exceeded its twenty-fourth week and 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
(b) that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman; or
(c) that the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated; or
(d) that there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.
You can find the legislation here.
NB: The language used in this bill is very outdated and has not been updated to reflect the fact that people of all genders have abortions and that ‘handicapped’ and ‘mental abnormalities’ are ableist and offensive terms.
Telemedicine
In 2020, abortion law expanded to allow for medication abortions to be done entirely from home. Before this, people had to attend clinics to pick up and take their abortion medication.
Abortion law says that abortions are legal when they are ‘performed only in an NHS hospital or a place approved by the Secretary of State.’ In 2020, a person’s home address was added to the ‘place approved by the Secretary of State.’
Telemedicine (the practice of providing healthcare services remotely using technology) has improved access and comfort for many people during their abortions, as passing a pregnancy at home is often preferable to doing it in a clinic. Some people prefer to be in a safe, familiar space near things that comfort them.
However, unhoused people and people who are unsafe at home and, therefore, have their abortions outside of the home technically fall outside of the law. This is important to be aware of as abortion investigations rise.
What does the law mean?
The most important thing to note about British abortion law is that we do not have ‘abortion on demand’ in the UK, i.e., a person cannot have an abortion just because they want one. Their reasons for having an abortion have to fit within the outlined criteria for it to be legal.
Most abortions do fit into this criteria, but the additional barrier of these extra reasons can make seeking abortion more challenging and distressing for people. The ease at which someone can access an abortion is also very dependent on individual providers and their ability to read between the lines.
For example, if someone seeking an abortion says their reason is that ‘they don’t want to be pregnant,’ one provider might interpret this as outside of the legal reasons, but another might understand this to mean that terminating the pregnancy is necessary to prevent the person’s mental health from being harmed. In both instances, the individual would likely be able to access an abortion, but the additional questioning can be traumatic. This is particularly true for communities who experience medical racism over-policing and face additional barriers when navigating statutory services.
Unpacking the law
Over the last few years, we have seen a drastic increase in police power due to changes in the law. This has trickled down to abortion access, and more people have been investigated for their pregnancy endings in the last 2 years than in the last 50 years since the Abortion Act was passed.As with all police intervention, there are concerns that this will impact those most harmed by police violence, of which include racialised people, as well as those with precarious and complex life situations. Abortion and miscarriage care are almost identical from a medical perspective and undoubtedly, these investigations will impact all those who experience pregnancy endings. This is why it’s crucial to understand the law and your legal right to an abortion.
Legal terminology
Good faith
Abortion is the only medical procedure that requires two doctors to approve it. ‘Good faith’ is also a challenging concept to grasp, especially when many racialised communities are subjected to medical racism from people in the NHS and wider healthcare systems. It is meant to mean that two doctors are satisfied that you can safely pass a pregnancy and that an abortion is what a person wants, needs, and is fully consenting to.
Injury to the physical or mental health
Most people’s legal justification for having an abortion comes under injury to physical and mental health. For some people, this might be the language they are already using when talking to a provider, e.g. ‘I don’t mentally feel ready or willing to have a child’. For others, this might not be the case, e.g. ‘I don’t want to be pregnant’.
All reasons for wanting an abortion are valid, but the constraints of the law do mean that some people might have to explain their reasons further or show their provider how their reason is included in the legal definition. Arguably, not wanting to have a child or being made to continue a pregnancy that you don’t want can be considered an injury to someone’s mental health.
Twenty-four weeks
Abortion is also only legal until 24 weeks unless there is a serious risk to the pregnant person’s life. For an abortion to be legal after 24 weeks, a person will need to show that the pregnancy could endanger their life and/or is likely not to result in the birth of a live child.
Although most abortions do happen within the first 12 weeks, there are many reasons why people might need abortions later than this. These include, but are not limited to, changes in health, relationships, socio-economic status, coercion and abuse, not wanting to be pregnant anymore, and not knowing you were pregnant in the first place.
Confidentiality
You have a right to confidentiality when accessing NHS care. This includes abortion care. Your abortion does not have to be disclosed to anyone – this includes friends, family, GPs and other medical practitioners. You should be asked if you want your abortion disclosed to your GP, but you can also explicitly state your wishes. The only time this confidentiality will be broken is if an abortion provider feels that you or somebody else is in immediate harm. They need to breach this confidentiality to keep you safe.
Confidentiality also extends to young people as people under the age of 16 (legal age of sexual consent) can confidentially access abortions, too. It is likely that a provider will ask a young person more questions to ensure that they are safe, but age is not a reason to deny someone an abortion. Currently, under 18s cannot access telemedicine and have to go to clinics to access abortion.
Advocating for yourself and your community
Abortions can be stressful. The legal and time constraints enforced by the law can add to this stress, especially when coupled with preexisting medical racism and unfamiliarity with the NHS.
The following tips are helpful to know for yourself or anyone in your community who might need support accessing abortion.
Your legal right to abortion – Knowing abortion law is a crucial part of advocating for yourself during your abortion. It can help to write down what you want to say before your appointment and to note down your ‘reason’ for an abortion in the legal terms covered by the Abortion Act. e.g. ‘I am requesting an abortion because I am not ready for a child right now and feel that continuing with this pregnancy would severely impact my mental health’.
Last menstrual period – Pregnancies are measured from a person’s last menstrual period. Many people who have reported pushback and investigations into their abortion have said they experienced extra questioning around their last period. You must know when your last period was and, if needed, can demonstrate on a calendar, encrypted period tracking app, or through text conversations when your period was.
NB: If you have irregular periods or gynaecological conditions that cause irregular periods, you will likely be asked to come to a clinic for a scan to confirm how pregnant you are.
Know Your Rights – If the police investigate your pregnancy, a person needs to interact with the police with the same caution as they would in other circumstances. This includes not disclosing any personal information until you have legal representation, not being interviewed when in heightened states, not accepting a duty solicitor and more.
Glossary of Terms Related to Pregnancy and Pregnancy Endings
Legal Terminology
- Abortion Act: The UK law that governs abortion, setting out when and how it is legally permitted.
- Confidentiality: Your right to privacy means that abortion care is confidential, and no one (including family, friends or doctors) will be informed unless there is an immediate risk of harm to you or someone else.
- Good faith: In the context of abortion, ‘good faith’ means that two doctors must agree that continuing the pregnancy would harm a person’s physical or mental health and that they genuinely want and consent to the abortion.
- Injury to the physical or mental health: Most people seeking an abortion qualify under this legal reason, which acknowledges that forcing someone to continue a pregnancy they don’t want or aren’t ready for can harm their well-being.
- Twenty-four weeks: In the UK, abortion is legal for up to 24 weeks unless continuing the pregnancy seriously endangers the person’s life or the baby is unlikely to survive after birth.
Medical Terminology
- Antenatal: The care and support given during pregnancy to monitor health and prepare for birth.
- Consultant-led care: A model where an obstetrician (doctor specialising in pregnancy and birth) oversees the pregnancy and birth, usually recommended for those with high-risk pregnancies due to medical conditions, previous complications, or multiple pregnancies.
- D&E (Dilation and Evacuation): A surgical procedure used to remove pregnancy tissue after the first trimester (13-24 weeks of gestation).
- Early-term miscarriage: A miscarriage that happens in the first 12 weeks of pregnancy.
- Ectopic pregnancy: A pregnancy that develops outside the uterus, usually in a fallopian tube.
- Gynaecological: This refers to healthcare related to the reproductive system, including menstruation, fertility, contraception and conditions like fibroids or endometriosis.
- Late-term miscarriage: A miscarriage that occurs between 12 and 24 weeks.
- Midwife: A trained healthcare professional who provides care and support during pregnancy, labour, and postnatal recovery, focusing on natural birth and holistic care while ensuring medical needs are met.
- Midwife-led care: A model where midwives provide all routine pregnancy, birth, and postnatal care, often in cases of low-risk pregnancies, supporting a more natural approach with fewer medical interventions.
- Mifepristone: The first medication in a medical abortion, which blocks pregnancy hormones so the process can begin.
- Misoprostol: The second medication in a medical abortion, which causes the uterus to contract and safely expel the pregnancy.
- Obstetric: Anything related to pregnancy, childbirth and postnatal care falls under obstetric care.
- Postpartum: The period after being pregnant, which can bring physical recovery, emotional changes and the need for support.
- Prenatal: This refers to the period before birth, covering the time from conception to delivery when the baby is developing in the womb.
- Stillbirth: The loss of a baby after 24 weeks of pregnancy, meaning it is legally considered a stillbirth rather than a miscarriage.
Pregnancy Endings Terms
- Abortion doula: A person who offers non-medical support to someone going through an abortion, helping with emotional well-being, information and aftercare.
- Abortion provider: A doctor, nurse, or clinic that offers abortion care, ensuring people can safely access the services they need.
- Bereavement midwife: A specialist midwife who supports individuals and families experiencing pregnancy loss, stillbirth, or neonatal death, offering emotional care, guidance, and practical support during and after their pregnancy loss.
- Doula: A trained companion who provides emotional, physical, and practical support before, during, or after pregnancy, including for abortion and loss.
Types of Pregnancy Ending (Abortion)
- Manual Vacuum Aspiration (MVA): A form of early procedural abortion using gentle suction to remove a pregnancy, usually done under local anaesthetic.
- Medical abortion: A safe and effective way to end a pregnancy using two medications (Mifepristone and Misoprostol) usually taken at home.
- Procedural abortion: A method of abortion where a medical procedure is used to remove the pregnancy from the uterus.
- Surgical abortion: A term sometimes used interchangeably with procedural abortion, although technically, no incisions are made.
- Surgical Abortion (Dilation and Evacuation or D&E): A second-trimester abortion method that uses dilation and medical instruments to remove the pregnancy.
- Telemedicine: The use of phone or video consultations to provide abortion care remotely, allowing people to access services without visiting a clinic in person.
Other Terms
- Over-policing: When certain communities, often Black and other racialised groups, are disproportionately monitored, criminalised and subjected to excessive surveillance, including in reproductive healthcare.
- Medical racism: The systemic and individual biases in healthcare that lead to racialised people receiving poorer treatment, less pain relief or having their concerns dismissed.
This post was written by AZ in partnership with Ad’iyah.; a organisation supporting Muslims and their communities through pregnancy endings.
Disclaimer
This article was developed in March 2025. At the time of writing, the details about the content and author were accurate. The next revision is scheduled for April 2026.
The information provided in this guide is for general informational purposes only and does not constitute legal, medical, or professional advice. While we strive to ensure accuracy, laws and healthcare guidelines may change, and individual circumstances vary. We strongly encourage you to seek advice from qualified legal or healthcare professionals regarding your specific situation. Spark & Co. is not responsible for any actions taken based on the information provided in this guide.