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Decriminalising Abortion in the Uk the in Abortion Poli Sally Sheldon and Kaye Wellings Kaye and Sheldon Sally “Abortion plays a fundamental Available Open Access under Decriminalising Abortion UK the in role in women’s health but is CC-BY-NC licence. often shrouded in myth and hyperbole. This lucid and The public and parliamentary accessible text provides robust debate about UK abortion law and reliable evidence on this reform is often diverted away important issue.” from key moral and political Professor Dame Lesley Regan questions by disputes regarding DBE, MD DSc, Royal College of basic questions of fact. And all Obstetricians and Gynaecologists too often, claims of scientific ‘fact’ are ideologically driven. “This excellent book steps aside from the heat of debate What effect would Edited by Sally Sheldon and Kaye Wellings in order to provide an accurate decriminalisation be likely to account of the evidence about have on women’s health? What clinical safety, public opinion and would be the impact on the legal regulation. It provides an incidence of abortions? Would essential reference point for all decriminalisation equate to those seeking to approach the deregulation, sweeping away reform of abortion law with moral necessary restrictions on integrity.’’ dangerous or malicious conduct? Professor Sir Jonathan Montgomery, University College With each chapter written by London leading experts in the fields of medicine, law, reproductive health and social science, this book offers a concise and Sally Sheldon is Professor of authoritative account of the Law at the University of Kent and University of Technology, Sydney. evidence regarding the likely impact of decriminalisation of POLICY PRESSPOLICY & PRACT ICE Kaye Wellings is Professor of abortion in the UK. Sexual and Reproductive Health Research at the London School of Hygiene and Tropical Medicine. DECRIMINALISING ABORTION IN THE UK POLICY PRESSPOLICY & PRACT ICE ISBN 978-1-4473-5401-7 What Would It Mean? EDITED BY @policypress@policypress PolicyPress policy.bristoluniversitypress.co.uk 9 781447 354017 SALLY SHELDON AND KAYE WELLINGS SHELDON_Decriminalising aborton_pbk2.indd 1 05/02/2020 10:08:06 EDITED BY SALLY SHELDON AND KAYE WELLINGS DECRIMINALISING ABORTION IN THE UK What Would It Mean? POLICY PRESSPOLICY & PRACTICE First published in Great Britain in 2020 by Policy Press North America office: University of Bristol Policy Press 1- 9 Old Park Hill c/ o The University of Chicago Press Bristol 1427 East 60th Street BS2 8BB Chicago, IL 60637, USA UK t: +1 773 702 7700 t: +44 (0)117 954 5940 f: +1 773- 702- 9756 pp- [email protected] [email protected] www.policypress.co.uk www.press.uchicago.edu Selection, editorial matter and introduction © Sally Sheldon and Kaye Wellings 2020 Individual chapters © their respective authors 2020 The digital PDF version of this title is available Open Access and distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 license (http://creativecommons. org/licenses/by-nc/4.0/) which permits adaptation, alteration, reproduction and distribution for non-commercial use, without further permission provided the original work is attributed. The derivative works do not need to be licensed on the same terms. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging- in- Publication Data A catalog record for this book has been requested ISBN 978- 1- 4473- 5401- 7 paperback ISBN 978- 1- 4473- 5403- 1 ePub ISBN 978- 1- 4473- 5402- 4 ePdf The right of Sally Sheldon and Kaye Wellings to be identified as editors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of Policy Press. The statements and opinions contained within this publication are solely those of the editors and contributors and not of the University of Bristol or Policy Press. The University of Bristol and Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by David Worth Front cover image: Alamy Printed and bound in Great Britain by CMP, Poole Policy Press uses environmentally responsible print partners Contents List of figures and tables iv List of cases, statutes and statutory instruments vi Notes on contributors ix one Introduction 1 Sally Sheldon and Kaye Wellings two Is public opinion in support of decriminalisation? 17 Ann Marie Gray and Kaye Wellings three How would decriminalisation affect women’s health? 37 Patricia A. Lohr, Jonathan Lord and Sam Rowlands four Would decriminalisation mean deregulation? 57 Jonathan Herring, Emily Jackson and Sally Sheldon five The effects of decriminalisation in Northern Ireland 77 Marie Fox and Goretti Horgan six What would be the likely impact of decriminalisation on the 99 incidence, timing, provision and safety of abortion? Brooke Ronald Johnson Jr, Louise Keogh and Wendy V. Norman Notes 127 References 129 Index 155 III List of figures and tables Figures 1.1 Age standardised abortion rate per 1,000 women aged 15– 44, 10 England and Wales, 1970 to 2018 1.2 Abortion rate per 1,000 women by age, England and Wales, 11 2008 and 2018 2.1 Proportion indicating the law should allow an abortion in different 25 scenarios, 1983– 2016 3.1 Number of deaths from abortion (all causes), England and Wales, 38 1931– 1951 3.2 Trends in UK deaths from three categories of abortion before and 40 after the Abortion Act came into force in 1968 3.3 Comparison of maternal mortality and abortion mortality in Britain, 41 2003– 2014 and other mortality comparisons, 2017/ 2018 3.4 Extract from joint statement by 12 organisations, including three 55 Royal Colleges, in their briefing to the House of Lords, July 2019 6.1 Proportion of births that are male in Canada: trends over time for 110 mothers born in Canada vs mothers born in India, 1990– 2011 6.2 Canada’s health services distribution challenge 113 6.3 Victorian abortion services listed on the 1800 My Options website 118 6.4 Number of prescriptions for mifepristone and misoprostol in 121 Victoria and New South Wales 6.5 Trend in the number of abortions performed at 20 weeks 121 or later by reason in Victoria Tables 6.1 Authors’ own summary of progress on decriminalisation in each 115 state and territory in Australia IV LIST OF FIGURES AND TABLES 6.2 Abortion rate per 1,000 Victorian women aged 15– 44 years 120 (including data for planned and unplanned abortions, for all reasons, from public and private hospitals and day procedure centres) 6.3 Male- to- female ratio in Victorian births by time period, 1999– 2015 123 V List of cases, statutes and statutory instruments Cases AB, Re (Termination of Pregnancy) [2019] EWCA Civ 1215 67 AMNH, Re [1994] NIJB 1 80 An NHS Trust v D [2003] EWHC 2793 (Fam) 66 Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 60, 61 Bolitho v City and Hackney Health Authority [1998] AC 232 61 Dulgheriu v LBC [2019] EWCA Civ 1490 9, 15 Ewart, Re an Application for Judicial Review by [2019] NIQB 88 95 Gillick v West Norfolk and Wisbech Area Health Authority (1986) AC 112 66 Greater Glasgow Health Board v Doogan [2014] UKSC 68 75 Janaway v Salford Area Health Authority [1989] AC 537 75 Montgomery v Lanarkshire Health Board [2015] UKSC 11 64 NIHRC, Re an Application for Judicial Review by the; In the matter of the 90 law on termination of pregnancy in Northern Ireland [2015] NIQB 96 NIHRC, Re an Application for Judicial Review by the [2015] NIQB 102 90 NIHRC, Re an Application for Judicial Review by the [2017] NICA 42 29, 80, 89–90 NIHRC, Re an application for Judicial Review by the [2018] UKSC 27 90 R (Axon) v Secretary of State for Health [2006] EWHC 37 (Admin) 66 R (A and B) v Secretary of State for Health [2017] UKSC 41 82 R (Smeaton) v SS Health and others [2002] EWHC 610 (Admin) 4, 71 R v Adomako [1994] 3 WLR 288 61, 65 R v BM [2018] EWCA 560 Crim 63 R v Bollom [2003] EWCA Crim 2846 70 R v Bourne [1938] 3 All ER 615 72, 79–80 VI LIST OF CASES, statutes AND statutorY INSTRUMENTS R v Brown [1993] UKHL 19 72, 74 R v Catt [2013] EWCA Crim 1187 6 R v Chan Fook [1994] 1 WLR 689 74 R v Magira [2008] EWCA Crim 1939 70 R v Misra [2004] EWCA Crim 237 61 R v Wilson [2016] EWCA Crim 1555 40, 72 Royal College of Nursing of the United Kingdom v Department of Health 7, 8 and Social Security [1981] 1 All ER 545 Re X (A Child) [2014] EWHC 1871 66 Western Health and Social Services Board v CMB [1995] (NI High Court, 80, 90 unreported 29 September 1995) Non- UK cases R v Morgentaler [1988] 1 SCR 30 (Canada) 105 R v Davidson [1969] VR 667 (Vic, Australia) 114 Statutes Abortion Act 1967 3, 7–10 Adults with Incapacity (Scotland) Act 2000 66–7 Age of Legal Capacity (Scotland) Act 1991 66 Care Standards Act 2000 59–60 Criminal Justice Act (Northern Ireland) 1945 6, 7, 70, 75, 94 Family Law Reform Act 1969 65, 93 Female Genital Mutilation Act 2003 3–4 Fraud Act 2006 69–72 Health and Social Care Act 2008 63 Human Rights Act 1998 68, 90, 92 Human Tissue Act 2004 94 Human Tissue Act (Scotland) 2006 127 Infant Life (Preservation) Act 1929 6–7, 70, 71, 72, 79 Medical Act 1983 60 Mental Capacity Act 2005 66–7 National Health Service (Scotland) Act 1978 60 Offences Against the Person Act 1861 6, 70–3, 77–8, 94 VII DECRIMINALISING ABORTION IN THE UK Non- UK statutes Access to Abortion Services Act 1995 (British Columbia) 107 Criminal Law Amendment Act, 1968– 69 (Canada) 105 Constitution Act (1982) (Canada) 105 Canada Health Act 1985 (Canada) 106 Public Health and Wellbeing Amendment 117 (Safe Access Zones) Act 2015 (Vic, Australia) Statutory instruments Abortion Regulations 1991 (SI No.
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