Revealed: How ‘sinister’ lack of access to surgical abortions puts lives at risk

When one 16-year-old girl in Scotland found out she was pregnant at 23 weeks, the “fear and shame” of her situation led her to contemplate suicide. Her family were anti-abortion, so her boyfriend’s mum had to take her to London for treatment at a BPAS clinic.

Another teenager, who discovered she was having a cryptic pregnancy after her contraceptive injection failed, vomited on herself out of shock when told she would have to travel to England to get an abortion. The journey cost her thousands of pounds.

Dozens of women every year make the journey from Scotland to England for abortions – all because of a lack of doctors to perform surgical abortions after 13 weeks north of the border. These stories collected by Back Off Scotland and BPAS (the British Pregnancy Advisory Service) show the experiences of those travelling.

It is a situation which puts women at risk, places them under financial burden, and must be fixed, say campaigners and abortion professionals who spoke to Big Issue.

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Not everybody makes it down in time, said Ed Dorman, a doctor at the BPAS clinic in Richmond who performs surgical abortions. One recent patient, let down by the person who was going to accompany them down from Scotland, missed their booking. “She’s now run out of time and will now be going past the legal limit, so she will be continuing with her pregnancy,” said Dorman. “It’s really hard on a lot of people.”

Dorman, who works at the Richmond clinic one day every fortnight, said there was at least one woman down from Scotland every day he works there. “A lot of them are people who are having to go out of country and travel, and usually spend two nights in hotel accommodation in London in order to access their treatment, which has financial implications in terms of the cost of travel and accommodation, as well as all the social and psychological implications of having to arrange childcare, having to take time off work, having maybe to make up a story why they’ve having to travel to short notice to London, when they might have never been here before.”

The number of women travelling south has been increasing since the pandemic, with 68 women making the journey in 2023. BPAS say it is almost impossible to get a surgical abortion after 13 weeks in Scotland. With just one doctor in the whole nation trained to perform surgical abortion up to the legal limit, women face the choice of having a medical abortion – birthing the fetus – or travelling south for a surgical termination.

Campaigning to change that is BPAS. Abortion has been in force in Scotland for more than 50 years, said Rachael Clarke of BPAS. “In all of that time, there has never been a 24 week service across Scotland. It has been a long term arrangement that women will just have to travel at these gestations,” Clarke told Big Issue. “They think sending women to England is perfectly reasonable.

“For a long time we’ve been focused on trying to get care up and running in Scotland. We’ve offered multiple times to the government and NHS providers to maybe set up a BPAS clinic in Scotland, or to find the location and train them up. All of those have fallen on deaf ears”

Abortion care is largely outsourced by the NHS, with BPAS providing private care at clinics including the Richmond facility where Dorman works. This situation can provide a safer environment, but also keeps thornier issues like travel and finance at arm’s length from the NHS.

To try and ease the financial burden, women making the journey are now offered travel costs up front, provided by Scotland’s health boards through BPAS. “I do think there’s issues where some women aren’t told up front that travel and accommodation will be funded,” said Clarke.

Lucy Ward, a campaigner with Back off Scotland and policy and engagement manager for BPAS, told Big Issue: “I think it’s actually quite sinister that there’s not availability in Scotland, if you’ve got an anomaly diagnosis and to not have a choice to have a surgical, and to have no choice but to literally go through labour”. Ward said BPAS were hoping for the Scottish government to produce a report on the reform of abortion law by the end of 2025.

Dorman warned it is not just a Scottish issue: the capacity of English surgeons to perform surgical abortions is waning. “We are in danger of it getting worse rather than better, because of the lack of sufficient surgeons,” Dorman said, adding this is down partly to a stigma associated with abortion, but also because care is often provided outside hospitals.

“It should be part of the basic training for everybody in obstetrics and gynaecology, because the surgical skills required for abortion care are identical to the surgical skills needed in hospital.

“It poses a risk to the health and life of women in our hospital. There are women who end up tremendously ill, in intensive care, and there have been people who’ve died in hospital because there have been delays in the face of complications in pregnancy.”

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