Abortion Law Review Expert Group minutes: January 2025

 

Attendees and apologies

• Professor Anna Glasier – Chair
• Sarah Wallage – Scottish Abortion Care Providers (NHS Grampian)
• Sinead Cook – Faculty of Sexual and Reproductive Health
• Professor Sally Sheldon – University of Bristol
• Dr Lynsey Mitchell – University of Strathclyde
• Andrew Lothian – Law Society of Scotland, Health and Medical Law Sub-Committee
• Professor Anne-Maree Farrell – University of Edinburgh
• Rachael Clarke – British Pregnancy Advisory Service
• Professor Marion Bain – Deputy Chief Medical Officer
• Dr Alastair Campbell – Royal College of Obstetrics and Gynaecology
• Professor Sharon Cameron – Scottish Abortion Care Providers (NHS Lothian)
• Cat Murphy – Engender – Stand in to represent Advisory Group of reproductive rights groups

Secretariat

• Sam Baker – Scottish Government
• Harriet Rogerson – Scottish Government
• David McIlhinney – Scottish Government, note of meeting

Apologies

• Dr Carrie Purcell – The Open University
• Jill Wood – Engender – Representing Advisory Group of reproductive rights groups
• Sean Reid – Scottish Government

Items and actions

Welcome and last meeting recap

• the Chair welcomed the attendees to the meeting
• the Chair noted apologies, and that Cat Murphy was deputising for Jill Wood as the Advisory group representative

Agreement of minutes from meeting 4

• the note of the previous meeting was agreed with no amendments.=

Discussion of current law on pathways

• the expert group discussed how the current law impacts on the patient pathway for abortion care, as well as who can approve an abortion and the issues around approval

• the group discussed the current role of nurses and midwives in providing abortion care
• the group also discussed what was possible within the limits of the present law
• the expert group noted that there had been significant changes is the delivery of abortion, particularly with the use of multi-disciplinary teams in modern services. It was felt that it was problematic that the law was based on 1960s surgical practice
• there was a discussion of the changes made in response to the pandemic, around the use of Ministerial approvals to change service delivery
• the expert group considered that the law was most limiting around innovation and discussed thoughts about what changes could be made to service delivery
• reporting and data collection were also discussed. The group considered that the UK has a lot of data available compared to many international examples
• the expert group discussed legal reporting and how abortion data is being provided
• the expert group considered that the data was useful in showing where improvements can be made and can also provide evidence about the safety of abortion services
• the group also discussed conscientious objection. The group noted that the present law was well understood. The group discussed how conscientious objection could be balanced with the need to provide a service

Review of International Examples

• the chair noted the international examples provided and the group provided comments
• the expert group looked at examples of how international laws worked in practice for people who provide abortion care
• the group considered potential pre-abortion requirements such as mandatory counselling and a reflection period not currently required in Scotland, noting that the NICE guidelines do not recommend either of these
• the expert group also considered several examples of how laws balanced conscientious objection with provision

Discussion on views provided by stakeholders and evidence

• the advisory group representative provided an update on their conversation around models of service, with the organisations on the advisory group generally supporting the model used in Canada
• the expert group considered a number of papers provided by stakeholder groups
• the expert group noted that coercion was an issue that would need to be addressed, although they discussed the distinction between coercion and pressure
• the expert group felt that reproductive coercion was broader than just abortion coercion and so the issue should be considered more broadly
• the group noted concerns around data on complications and considered that, while the availability of data could be improved, details of what data should be collected relating to abortions may not be required in primary legislation
• the expert group noted submissions on telemedicine and acknowledged that not ultrasound scanning all patients does result in a small number of extra complications. The expert group considered the balance of risks in healthcare against the ability of women to access abortion more quickly and flexibly.
• finally, the expert group noted that some professional bodies do extend conscientious objection beyond where the law states

AOB

• the expert group discussed formalising a request for feedback as part of standard abortion care. The expert group noted that the Scottish early medical abortion at home evaluation surveyed women and the responses noted that EMAH is highly valued
• the expert group noted that there had been criminal investigations around concealment of pregnancy. This would be discussed in more detail under offences
• Secretariat asked the group to e-mail them if they had any further specific requests for evidence
• the next meeting will be on 3 February 2025