A guide to getting an abortion

No woman in Britain has the right to an abortion. Amanda Macintosh and Jane Wilde look at the hurdles a woman with an unwanted pregnancy has to jump

1 The Law

Abortion is regulated by the Abortion Act 1967 as amended by the Human Fertilisation and Embryology Act 1990. Subject to the agreement of two doctors, abortion is legal in the following circumstances:

i. Your life is at risk if the pregnancy continues
ii. Your physical or mental health will be damaged if the pregnancy continues
iii. The physical and/or mental health of any existing children will be injured if the pregnancy continue
iv. There is a substantial risk that the child will be mentally or physically handicapped.

2 The time limits

Twenty-four weeks sounds like a long time to organise an abortion - but don't get lulled into a false sense of security. Doctors calculate the date of your pregnancy from the first day of your last period. So if you have the usual four week cycle, by the time your period is two weeks late you are officially already six weeks pregnant.

Within the NHS, many hospitals only offer an abortion service up to the twelfth week. This is because after that time the method used to carry out the abortion changes, and many hospitals and clinics are loath to redirect extra resources from meagre budgets to provide the necessary resources, unless you or the fetus have a serious medical problem.

Even if you get to your doctor early, and he refers you to a hospital immediately, you can still fall at the time-limit hurdle. Often hospital waiting lists are so long that, by the time you get your appointment, you are too far gone to have the operation.

Many early abortions are done by private clinics, because at least that way you're certain to get an appointment. But a private early abortion will cost you around £225.

3 The problem doctor

Your doctor does not have to agree to refer you for an abortion even if you unequivocally meet the legal criteria. Under the conscientious objections section of the 1967 Act, he does not have to 'participate in any treatment' to do with abortion and that includes agreeing that you can have one.

If he is a conscientious objector he should refer you to another doctor. But many don't. Some anti-abortion doctors have been known to lie to patients about reasons for NHS refusal. Some have simply 'forgotten' to pass on referral letters.

Anti-abortion doctors are not obliged to make their views known. So if you suspect that your doctor might be deliberately slowing things down, make an emergency appointment to see somebody else.

4 The problem health authority

Local authorities are not legally required to provide an abortion service, although a 1979 NHS Royal Commission recommended that they should aim to provide 75 per cent of the abortions in their area on the NHS. A quick look at the official figures shows that where you live can make all the difference.

Top of the list is Oxford, where the local authority dealt with 98 per cent of requests for abortion from local women residents in 1991. You could also try Grimsby, Scunthorpe, Leicester or West Suffolk, all of which provided above 90 per cent of services.

But beware of the regional health authorities of South Warwickshire, North and South Birmingham, Coventry or Dudley, where the chance of obtaining an abortion through the local national health service in 1991 was less than 2 per cent. Almost as bad were Huddersfield, Maidstone, Tunbridge Wells, West Birmingham and West Lambeth, which managed a miserable 10 per cent at best. If you are unlucky enough to be in these areas, private clinics are probably your only option (figures from Office of Population Censuses and Surveys Monitor, AB/24, 11 August 1992).

5 Avoid getting pregnant during national emergencies

During the Gulf War, a number of clinics and hospitals announced that abortion services would be deprioritised in order to free beds for returning casualties. A surgeon at the Churchill Hospital in Oxford helpfully advised women 'not to get pregnant in the next six months'. Remember that however urgent it may be to you, abortion fits neatly into the category of what are considered non-urgent operations; if they declare that it's in the greater national interest to hand over the bed, you will be first in the queue for a minicab home.