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Molly Finlay

The Royal College of Obstetricians and Gynaecologists (RCOG) has advised healthcare workers not to report women to the police if they believe they may have illegally ended their own pregnancy. 

The new best practice guidance sets out recommendations regarding the professional and legal obligations of healthcare professionals to respect confidentiality following an abortion, pregnancy loss or unexpected delivery.

The Royal College of Obstetricians and Gynaecologists (RCOG) is the professional body that oversees the medical education, training and examination of obstetricians and gynaecologists in the UK.

Their new guidance comes after growing concerns around the number of women being investigated for procuring illegal abortions in the UK. The issue has risen significantly in the past year.

“Any decisions to disclose personal or confidential patient information must be taken on a case-by-case basis.”

Between 1861 and November 2022, three women were convicted of having an illegal abortion.

Due to their concerns about the prosecution of women “who may be especially vulnerable and have suffered the distress of a later stage loss”, the RCOG will release new ‘best practice guidance’ for healthcare professionals. This comes alongside advice from the Faculty of Sexual and Reproductive Healthcare (FSRH), British Society of Abortion Care Providers and the Faculty of Public Health.

What Is The Current Guidance On Illegal Abortions?

UK healthcare professionals are currently allowed to breach confidentiality rules to give information to the police. This is only if it benefits public interest.

According to the NHS, “Any decisions to disclose personal or confidential patient information must be taken on a case-by-case basis.”

If information is shared with the police, “a clear legal basis must be identified and recorded in line with professional guidance.” 

The General Medical Council has clearly outlined that the benefits of disclosing information must outweigh the public interest in keeping the information confidential. However, the RCOG have stated that “It is never in the public interest to investigate a patient who is suspected of ending their own pregnancy.”

Dr Jonathan Lord, co-chair of the RCOG abortion taskforce and the British Society of Abortion Care Providers told the BBC that he believed some NHS staff had shared patient information with police without fully understanding confidentiality regulations.

Lord said: “We have witnessed life-changing harm to women and their wider families as a direct result of NHS staff reporting women suspected of crimes, and we just don’t think that would happen in other areas of healthcare.”

Is Abortion Illegal In The UK?

Abortion can be accessed in England, Wales and Scotland within the first 24 weeks of pregnancy. 

The 1861 Offences Against the Person Act (OAPA) states that it is a crime to procure or help someone procure a miscarriage. However, newer legislation under the 1967 Abortion Act was introduced to counteract the OAPA. This has made abortion legal as long as it is approved by two doctors and meets the necessary grounds. 

Whilst abortion can be accessed legally in England, Scotland and Wales, the OAPA has never been repealed. This means that women can still technically be prosecuted for procuring an abortion without meeting compulsory requirements. 

“Healthcare professionals are “under no legal obligation to contact the police following an abortion, pregnancy loss or unattended delivery.””

Recent high-profile prosecutions for illegal abortions include a woman who was jailed for procuring her own abortion in 2020. Her sentence was subsequently reduced and suspended. 

Discrepancies in UK law have long encouraged campaign groups and politicians to call for the decriminalisation of abortion.

In 2019, abortion was decriminalised and made lawful in Northern Ireland. 

Despite this, women in Northern Ireland have struggled to access legal abortions due to a lack of functioning services in the region. 

What Have The RCOG Said?

In a statement published ahead of the official new ‘best practice guidance’, the RCOG outlines that healthcare professionals are “under no legal obligation to contact the police following an abortion, pregnancy loss or unattended delivery.”

They said that healthcare professionals “rarely need to liaise with the police” and must abide by their responsibility to justify the disclosure of confidential information “or face potential fitness to practice proceedings.”

Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, stated:

“We firmly believe it is never in the public interest to investigate and prosecute women who have sought to end their own pregnancy.”

“Outdated, antiquated abortion laws mean women who have experienced unexplained pregnancy loss are also vulnerable to criminal investigation, and health professionals are placed under unacceptable and unwarranted scrutiny.”

Criticisms Of The RCOG Guidance

The Society for the Protection of Unborn Children (SPUC) has criticised the RCOG’s new best practice guidance. In a statement they wrote that the guidelines dismiss women who have been potentially coerced into abortions. 

Executive Director of SPUC, Michael Robinson, has said, “By discouraging healthcare workers from reporting violations, the RCOG risk compromising the integrity of the medical profession.”

“By advising against reporting to the police, the RCOG risks undermining the public’s trust in the medical profession and the legal system itself.”

“The RCOG hopes the new best practice guidance will make the obligations of healthcare professionals clearer.”

Catherine Robinson, Spokesperson for Right To Life UK, communicated concerns to the BBC that the new guidance would not protect women who had experienced forced abortion due to coercion or sex trafficking. 

She stated: “This new guidance appears to create a presumption against disclosing information about illegal abortions to the police, and this could leave vulnerable women in these situations being denied the protection of the law.”

The RCOG hopes the new best practice guidance will make the obligations of healthcare professionals clearer. New guidance should ensure they understand what is required and expected of them, as well as the consequences of breaching patient confidentiality. 

The RCOG is currently working to remove abortion care from criminal law, placing it under medical regulation instead. 

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Featured image courtesy of Reproductive Health Supplies Coalition via Unsplash. No changes were made to this image. Image licence found here.

Having recently graduated from an MA in Journalism at Edinburgh Napier University, Molly is a freelance journalist with an interest in politics and current affairs, particularly issues surrounding women and reproductive healthcare. Molly has worked as a BBC Young Reporter during COP26 and has written for Holyrood Magazine as well as Deadline News, with bylines in the Sun, Daily Express and the Mirror.

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