Select Committee on Science and Technology Twelfth Report

1  Introduction

Background to the inquiry

1. It has been ruled that abortion would fall within the remit of the Human Tissues and Embryos Bill, which is likely to be presented to the House in the 2007/08 session. In 2005, the Science and Technology Committee recommended that a joint committee of both Houses be formed to consider the scientific, medical and social changes in relation to abortion that have taken place since 1967.[1] Despite our best efforts,[2] this has not come about, and so we decided to undertake this considerable task ourselves.

The inquiry


2. Witnesses to this inquiry were invited to submit evidence on the following points:

a)  the scientific and medical evidence relating to the 24-week upper time limit on most legal abortions, including:

i.  developments, both in the UK and internationally since 1990, in medical interventions and examination techniques that may inform definitions of foetal viability; and

ii.  whether a scientific or medical definition of serious abnormality is required or desirable in respect of abortion allowed beyond 24 weeks;

b)  medical, scientific and social research relevant to the impact of suggested law reforms to first trimester abortions, such as:

i.  the relative risks of early abortion versus pregnancy and delivery;

ii.  the role played by the requirement for two doctors' signatures; and

iii.  the practicalities and safety of allowing nurses or midwives to carry out abortions or of allowing the second stage of early medical abortions to be carried out at the patient's home; and

c)  evidence of long-term or acute adverse health outcomes from abortion or from the restriction of access to abortion.

3. As a Committee that examines scientific and technological issues, we decided that the ethical and moral issues of abortion were not within our remit. Therefore, we decided to focus on scientific and medical evidence relating to abortion, and explicitly ruled out ethical or moral issues in the published terms of reference.


4. We selected witnesses to cover a range of scientific issues and views. The emphasis of the inquiry was on seeking scientific evidence—including medical and social science evidence—that would inform debate on abortion law. Therefore, we did not ask witnesses to state their individual moral positions in advance of the inquiry and did not seek to achieve a balance between 'pro-life' and 'pro-choice' personal opinions among our witnesses. However, to ensure that we were informed as to which aspects of the body of scientific evidence are important to the ethical and moral issues, we decided to hear from a balanced panel of campaign groups.

5. We noticed that among the written submissions there were a number[3] from doctors who were furnishing references and citing studies from the published scientific literature and/or providing their judgements or opinions on the scientific evidence in areas (or some of the areas - see SDA 38) where they did not appear to carry out clinical practice, research or to publish. It subsequently emerged that all these submissions except one (SDA 31) were from individuals who were either active members of organisations who had strong views on abortion and who had themselves submitted evidence (SDA 35, 37, 40) expressing this view. Submission SDA 31 was from an individual who was a campaigner against abortion and had publicly expressed very strong moral views on the subject.

6. We welcome all written submissions to all our inquiries and do not believe anyone should be denied the opportunity to make written submissions, or to have their views properly considered on account of their views. However, in keeping with the accepted practice in the scientific community of requesting relevant declarations of interest from those submitting articles for publication or submitting views for consensus statements, we think it is appropriate and important that those individuals contributing data, references or views of a scientific nature to a science committee evaluating scientific questions should declare any competing interests and specify their expertise or experience where this is not already clearly apparent. We note that this is the only approach we can take on this matter which is consistent with the recommendations of our own report on Scientific Advice, Risk and Evidence-based Policy Making.[4]

7. Furthermore, we recognise that for us in producing this report, and for all those MPs and members of the public who will subsequently read and evaluate the report, in the process of weighing up the strength and reliability of scientific evidence and opinions submitted on that evidence, it is necessary to be aware of the level of expertise concerned, and - especially where the expertise is not apparent - any competing interests that are not otherwise apparent. That does not mean that such views are discounted.

8. Finally, in the interests of transparency, even where individuals contest the relevance of such interests, it is far better practice for such interests to be revealed than concealed.

9. It is for these three reasons that, subsequent to the receipt of the written evidence, we requested declarations of interests from everyone who submitted evidence. We did not ask people to state their personal religious beliefs.[5] We reiterate that no one should be expected to declare personal religious or political views when making submissions, nor be deterred from making submissions when they hold such views, but we believe that the previous publication of strong moral or other views on, or active membership of organisations campaigning directly on, the matter being investigated by a select committee do qualify for disclosure.

10. We are grateful to all those contributors who responded to our request and the responses we received are shown in Annex A. We regret that two contributors failed or refused to reveal relevant interests and in the interests of transparency we draw attention to those relating to SDA 31[6] and to SDA 27.[7]


11. Abortion is a complex issue. Legislative decisions are informed by ethical and moral positions, philosophical, religious and political views, case law, clinical practice, and scientific and medical evidence. As a science and technology committee, we have focused only on the scientific, medical and other research evidence. As well as informing the way courts interpret the law, scientific and medical developments can alter the balance of opinion on ethical and moral issues and they often inform legislative decisions. This happened in relation to abortion law in 1990, when evidence of improved outcomes for very premature neonates led to a reappraisal of the threshold of foetal viability and this in turn to the reduction of the then 28 week limit on most abortions to the current 24 week limit. In our inquiry, we have attempted to sift the evidence on scientific and medical developments since the last amendment of the law and since the 1967 Act.

12. In this Report, we set out the key issues that have emerged and the key questions MPs must ask themselves as they consider options for changes in the law. Where we have felt it appropriate and justified, we have drawn conclusions about what the science and medical evidence currently before us tells us. We urge all MPs to study the evidence we have taken and the conclusions we have reached.

13. Because we recognise that what the science and medical evidence can tell us is only one of many factors (see para 11 above) that are taken into account when legislating on this issue, we have not made any recommendations as to how MPs should vote on abortion law.


14. We appointed two Specialist Advisers:

15. We are very grateful for their impartial, expert advice during the course of this inquiry.


16. We also benefited from an informal seminar at the start of the inquiry to inform our thinking on the issues, and we are grateful to Professor Neil Marlow and Professor Emily Jackson, London School of Economics, for participating in this.

History of UK abortion law

17. UK abortion law is based on several Acts of Parliament. They are, in chronological order:

a)  The Offences Against the Person Act 1861 (which only applies in England and Wales), which makes it an offence to intentionally procure a miscarriage, either by self-administering or providing another with "any poison or other noxious thing" or using "any instrument or other means whatsoever".[8]

b)  The Infant Life (Preservation) Act 1929 (which only applies in England and Wales), which makes it an offence to "destroy the life of a child capable of being born alive", but it is a defence to terminate a pregnancy "in good faith for the purpose […] of preserving the life of the mother".[9] If a woman had been pregnant for a period of twenty-eight weeks or more, that "shall be primâ facie proof that she was at that time pregnant of a child capable of being born alive".[10]

c)  The Abortion Act 1967 (which only applies in England, Scotland and Wales), which creates a series of defences in relation to abortion "when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith," - except in an emergency - that one of the stipulated grounds is met. These grounds were originally given a letter, A to G, to which medical practitioners still refer. They are outlined below.

d)  The Human Fertilisation and Embryology Act 1990, which included amendments to the Abortion Act 1967. The most significant amendment was the reduction of the upper time limit on most abortions from 28 weeks of gestation to 24 weeks. The grounds for abortion, although reordered in the Act, are still referred to, in medical practice, by their original designations. Accordingly, the grounds for abortion are:

Either where two doctors in good faith agree that:

A  the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated (Abortion Act 1967 as amended, section 1(1)(c));

B  the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman (section 1(1)(b));

C  the pregnancy has not exceeded its twenty-fourth week and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman (section 1(1)(a));

D  the pregnancy has not exceeded its twenty-fourth week and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing children of the family of the pregnant woman (section 1(1)(a)); or

E  there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped (section 1(1)(d));

Or in emergency, certified by the operating practitioner as immediately necessary:

F   to save the life of the pregnant woman (section 1(4)); or

G  to prevent grave permanent injury to the physical or mental health of the pregnant woman (section 1(4)).

Additionally, abortion must be carried out "in a hospital […] or in a place approved […] by the Secretary of State". The Secretary of State was granted by the 1990 Act the power "to approve a class of places"[11] (see paragraph 113 below for the relevance of this to the question of where drugs used in early medical abortion can be administered).

e)  The Births and Deaths Registration Act 1953 provides for the registration of every baby born in England and Wales. Amended by the Still Birth (Definition) Act 1992, it defines 'still-born child' as "a child which has issued forth from its mother after the twenty-fourth week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life".[12]

Abortion in the UK

18. The Government produces annual statistics on abortion. The headline statistics for women resident in England and Wales in 2006 were:

Table 1. Key Government statistics on abortion in England and Wales in 2006.
Total number of abortions

of which:

abortions funded by the NHS 87%
abortions carried out under 13 weeks of gestation 89%
medical abortions30%
abortions carried out under ground C 97%
abortion carried out under ground E 1%
carried out at 3-9 weeks of gestation 68%
carried out at 10-12 weeks of gestation 22%
carried out at 13-19 weeks of gestation 9%
carried out at 20 weeks of gestation and over 2%

Source: Statistical Bulletin: Abortion Statistics, England and Wales: 2006, Department of Health, January 2007

19. The following figures show various abortion statistics for England and Wales:

  • Figure 1: the age-standardised[13] abortion rate per 1,000 population aged 15-44 between 1970 and 2006;
  • Figure 2: the age-standardised abortion rate per 1,000 conceptions between 1970 and 2006;
  • Figure 2: the rate of abortions by gestation weeks between 1995 and 2006; and
  • Figure 3: the abortion rate per 1,000 population by age in 2006.

Figure 1. Age-standardised abortion rate per 1,000 population aged 15-44, England and Wales, 1970-2006

Source: Statistical Bulletin: Abortion Statistics, England and Wales: 2006, Department of Health, January 2007

Figure 2: Abortions as a percentage of all conceptions (England and Wales) since 1990

Source: SDA 01A

Figure 3. Numbers of abortions by gestation weeks, England and Wales, 1995-2006

Source: Statistical Bulletin: Abortion Statistics, England and Wales: 2006, Department of Health, January 2007

Figure 4. Abortion rate per 1,000 population by single year of age, England and Wales, 2006

Source: Statistical Bulletin: Abortion Statistics, England and Wales: 2006, Department of Health, January 2007

1   Science and Technology Committee, Fifth Report of Session 2004-05, Human Reproductive Technologies and the Law, HC7-I, para 308 Back

2   HC Deb, 3 July 2006, cols 528-584 Back

3   SDA 24, 27, 28, 29 and 39 Back

4   Science and Technology Committee, Seventh Report of Session 2005-06, Scientific Advice, Risk and Evidence Based Policy Making, HC 900-I Back

5   See Annex B for the emails sent to witnesses. Back

6   Q 105-8 Back

7   Dr Gardner is an active member of the Medical Ethics Alliance. Back

8   Section 58 of the Offences against the Person Act 1861 Back

9   Section 1(1) of the Infant Life (Preservation) Act 1929 Back

10   Section 1(2) of the Infant Life (Preservation) Act 1929 Back

11   Section 1 (3) of the Abortion Act 1967 Back

12   Section 41 of the Births and Deaths Registration Act 1953 Back

13   Age-standardisation removes the effects of changes in the age distribution of the female population on overall abortion rates. Age-standardised rates can also be used to compare abortion rates in areas with different age compositions. (Statistical Bulletin, The National Assembly for Wales, 11 March 2002) Back

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