Women who end their own pregnancy shouldn’t be investigated or prosecuted, a global medical body has stated in new abortion guidelines.
Healthcare professionals have no legal obligation to contact the police following a suspected illegal abortion, according to new guidance from the Royal College of Obstetricians and Gynaecologists (RCOG).
“It is never in the public interest to investigate and prosecute women who have sought to end their own pregnancy,” Ranee Thakar, president of the global organisation for women’s health, said.
“These women should be treated with care and compassion, without judgement or fear of imprisonment,” she added.
The RCOG’s new guidelines emphasise the professional and legal duty of doctors and nurses to respect the confidentiality of patient information.
According to the new guidance, healthcare workers should only report a woman’s abortion, pregnancy loss, or unassisted childbirth to the authorities if she gives explicit consent, if it’s in her best interests because there are concerns about her safety, or if they need to protect others from, for example, a risk of death or serious harm.
In any case, medics must be able to justify any disclosure of confidential patient data. Otherwise, they may have to face an aptitude test.
Growing number of police investigations
RCOG has shown concern over “the increasing number of police investigations following later gestation abortion and pregnancy loss”.
According to the latest official data for England and Wales, recorded crimes for abortions have risen in recent years – up from 27 between April 2021 and March 2022, to 35 between April 2022 and March last year.
The UK-based association worries about the impact that these police investigations can have on women who may be particularly vulnerable and distressed by the loss of their child at a later stage.
“We are working towards removing abortion care from criminal law and placing it instead under medical regulation,” Thakar said.
In the UK, the legal framework varies depending on the country you are in.
According to the National Health Service, in England, Scotland, and Wales, an abortion is legal if is performed by a registered doctor and authorised by two doctors. Most abortions are carried out before 24 weeks (around 6 months) of pregnancy.
They can be performed after 24 weeks in very limited circumstances – for example, if the mother’s life is at risk or the child would be born with a profound disability.
In Northern Ireland, the maximum gestation period drops to 12 weeks (around 3 months). Abortions beyond this limit are allowed only in severe circumstances.
Abortion laws across the EU
According to a report published in October last year by the Center for Reproductive Rights (CRR), almost every country in the EU has legalised abortion on request, meaning without the need for doctors to certify a particular reason for the abortion.
Ultimately, the decision to seek an abortion belongs to the pregnant woman.
The exceptions to this are Poland and Malta, which maintain highly restrictive legislation.
Poland allows abortion only when a patient’s life or health is at risk, or when the pregnancy is the result of sexual violence.
Malta allows it when a patient’s life is at immediate risk, or when a patient’s health is seriously threatened by a medical complication that can lead to death.
Most EU countries – including Germany, Belgium, and Italy – have a time limit for abortion on request of 12 weeks of pregnancy.
Four member states have a more restrictive timeframe: Portugal, Croatia, and Slovenia prevent abortions after 10 weeks, and Estonia after 11 weeks.
A gestation limit over 12 weeks is applied in five EU countries, such as the Netherlands (24 legally, but 22 in practice), France, and Spain (14).
When the patient’s health or life is on the line, the standard practice across Europe is to not impose time limits, according to the CRR.
Some countries have additional barriers to access. A waiting period between the request for an abortion and the abortion itself is mandatory in Germany, Italy, and Ireland, for example.
Others, like Germany and the Netherlands, require women to undergo counselling or receive compulsory information from their doctors prior to an abortion.
In Hungary, Italy, and the Netherlands, women must explain that they are seeking an abortion because of their social or family circumstances, or because continuing the pregnancy would cause them distress.