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Women’s access to abortion care threatened by ruling on conscientious objection

The UK’s highest court will hear appeal tomorrow (November 11th) against Scottish court ruling which vastly broadened scope of conscientious objection in abortion care

The Royal College of Midwives (RCM) and British Pregnancy Advisory Service (bpas) warn ruling has implications for abortion care across the UK

The RCM and bpas are intervening in the case of two Scottish midwives who are attempting to extend legal protections for healthcare workers who have a conscientious objection to abortion. The two women's health organisations believe the case has serious implications for women's care in NHS settings across the UK.

The Inner House of the Court of Session in Scotland last year found in favour of Mary Doogan and Concepta Wood’s claim that their hospital breached their right to conscientious objection by requesting that, as labour ward co-ordinators, they delegate to, supervise or support staff on their ward involved in the care of women who were primarily having abortions for fetal anomaly. The midwives were not asked to participate in the abortion, or provide any care or emotional support for the woman before or after the procedure. NHS Greater Glasgow & Clyde Health Board are appealing the decision of the Inner House in the Supreme Court. The case is being heard on Tuesday, November 11th.

The 1967 Abortion Act includes a clause that allows healthcare professionals to refuse to participate in abortion care, provided it is not an emergency situation. The initial Outer House of the Court of Session on the case in 2012 rejected the midwives' case, ruling that participation in treatment meant direct involvement in the ending of a pregnancy. That decision was overturned in 2013 by the Inner House, which judged Doogan and Wood had legal protection from delegating to, supervising and supporting others involved in abortion care on their wards. The Inner House said of conscientious objection: ‘The right is given because it is recognised that the process of abortion is felt by many people to be morally repugnant. It is in keeping with the reason for the exemption that the wide interpretation which we favour should be given to it.’ In fact the vast majority of the British public support women's access to abortion and a YouGov poll for Westminster Faith Debates in 2013 showed fewer than one in 10 people wanted to see abortion banned - including those who identify with a religion.

The RCM and bpas are deeply concerned that this judgment extends the right of conscientious objection beyond the provisions intended by the Abortion Act. If this decision is upheld it will require all professional guidance to be rewritten (including that of the General Medical Council, the Nursing and Midwifery Council as well as that of the RCM), and will enable a tiny number of staff opposed to abortion to make women’s care undeliverable in some NHS settings in the UK.

Ann Furedi, bpas chief executive, said:

"bpas supports the right of healthcare professionals to conscientious objection, not least because women deserve better than being treated with contempt by those who think they are sinners. But ultimately a balance needs to be struck between that exercise of conscience and women’s access to legal services.

"There may be a small number of healthcare workers who have a conscientious objection to providing abortion care. There are far more who have a conscientious commitment to helping women who need to end a pregnancy. It would be grossly unjust if an interpretation of conscientious objection was allowed to stand which would disrupt services to the point that those committed to helping women were unable to do so."  

Gillian Smith, RCM Director for Scotland, said:

"We absolutely support midwives’ rights to conscientious objection. The RCM position has always been and will remain that we support women’s choice within the law. We also want to ensure that women undergoing this procedure, for whatever reason, get the best possible care, which we feel could be compromised if the current laws are changed.

"Whilst recognising the rights of healthcare professionals to conscientious objection as described in the 1967 Abortion Act, we will be encouraging our members to continue to provide professional care to women who require this type of treatment."


For more information please contact bpas at press@bpas.org and 07788 725185 or the RCM on 020 7312 3456.

About bpas

bpas is a charity which provides reproductive healthcare services including pregnancy  counselling, abortion care, miscarriage management  and contraception from more than 40 centres across the UK. It supports and advocates for reproductive choice. More information can be found at bpas.org 

About the Royal College of Midwives

The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team.