Review of Abortion Law in Scotland Expert Group: report

Foreword

In the 2023-24 Programme for Government, the Scottish Government committed to undertaking a review of abortion law in Scotland ‘to identify potential proposals for reforms to ensure that abortion services are first and foremost a healthcare matter’.

Today abortions carried out in Scotland are regulated by a law passed in Westminster almost 60 years ago. The 1967 Act states that abortion can only be carried out legally if two doctors agree that a woman has grounds for terminating her pregnancy. Women in Scotland attempting to terminate their pregnancy without permission from two doctors can still be convicted of a criminal offence under common law criminal offences that date back hundreds of years.

Before 1967, abortion was illegal in the UK and, if discovered, could lead to a prison sentence for both the woman and her abortionist. Making abortion illegal does not prevent it. Before 1967 women in the UK knew that it was illegal, and they knew that they might die from having an abortion, yet they still did it. And it wasn’t just a few women, but thousands upon thousands every year. And they were women from all walks of life, rich and poor, married and single. The 1967 Act was a significant step for Parliament to allow abortion to take place at all. It brought an end to the widespread practice of illegal abortion that endangered women’s health and, sometimes, their lives, and so it was also a very positive step.

Today safe abortion is available throughout Scotland. It is a straightforward medical procedure that is a widely accepted part of our healthcare system. For some decades it has been regarded by the great majority of the public as an aspect of healthcare that should be available to women if it is in their best interests. The most recent British Social Attitudes Survey shows that 76% of people support allowing abortion if the woman does not want the child. In a recent study of healthcare professionals, more than 90% supported abortion being a woman’s choice and fewer than 9% of respondents felt that abortion should remain a legal issue. Most people in Scotland (including many healthcare providers), however, don’t know that abortion remains illegal except under the tightly controlled conditions of the 1967 Act.

Society has changed since 1967. The norm for women in the 1960s was marriage and children but in 2025, in contrast, one in five women choose not to have children. Medicine has changed. In 1967, it was felt that two - predominantly male - doctors, often one of them a psychiatrist, were needed to judge the mental fitness of women to have an abortion. In the 21^st century, the paternalistic model of medicine has gone, replaced by a model aiming to put the patient at the centre of decisions. Most importantly, abortion care has changed. In 1967 all abortions were done surgically with women staying in hospital for up to a week after the procedure. In 2024, some 97% of abortions in Scotland were done using medical methods and the majority of those took place in the woman’s home.

There are no other medical conditions for which there is a law that proscribes exactly who can provide treatment, nor where it can occur. It is rightly assumed that registered healthcare practitioners who are appropriately trained and competent to perform the procedures will do them. In 2025 many medical procedures previously undertaken only by doctors are now routinely done by highly skilled nurses. Reflecting these changes in medical practice, in recent years there have been changes, not in the Abortion Act itself, but in how it is implemented. The requirement for authorisation by two doctors remains, but in practice may be based on information conveyed to clinicians by other healthcare staff. The requirement that abortions must be performed by a doctor is interpreted to permit other appropriately trained nurses and midwives to carry out early medical abortion under the doctor’s supervision.

In following the Scottish Government’s instructions to ensure that ‘abortion services are first and foremost a healthcare matter’ an independent Expert Group comprising lawyers with expertise in medical/abortion law, clinicians responsible for delivering abortion services in Scotland and academics and representatives of women’s groups representing the voice of ‘lived experience’ met monthly over the course of one full year. In reaching the recommendations presented in this report the Group took into account the complexities of the current law, examples of recently revised abortion laws from other countries, a wealth of evidence published in academic journals and other reliable sources and paid careful consideration to the views of around 50 stakeholders including many who believe that access to abortion in the UK should be more restrictive. It has been a complex process and in this report the Group presents the detailed justification for every recommendation that they make.

It is beyond time for the abortion law to catch up with the 21^st century. While society and medicine have moved with the times, the abortion law has not. It is time for the Scottish Parliament to take a very positive step to modernise the abortion law for Scotland so that it reflects current practice and is fit for purpose.

Professor Anna Glasier OBE

Chair