In a quiet clinic outside London, a young Scottish woman named Ashley was met by anti-abortion protesters waving leaflets. She had just traveled more than 400 miles from Glasgow — not for a job or holiday, but because Scotland’s NHS told her it couldn’t help.
She was 19 weeks pregnant.
“I just remember her face dropping,” Ashley recalled of her first scan. “She said, ‘There’s nothing we can do for you in Scotland.’”
Ashley is one of dozens of Scottish women forced to travel to BPAS (British Pregnancy Advisory Service) clinics in England each year to access later-term abortion care — legally permitted across the UK up to 24 weeks, but effectively inaccessible beyond 20 weeks in Scotland.
“Explicit Inequality”: A Promise Undelivered
Not one of Scotland’s 14 regional health boards offers routine abortion care after 20 weeks, except in narrowly defined cases like fetal anomaly or immediate threat to the woman’s life.
This gap has persisted despite repeated promises from the Scottish Government to close what its own internal documents describe as an “explicit inequality in service provision.”
Campaigners say this failure isn’t logistical — it’s ideological.
“There is systemic stigma around later abortion in Scotland,” said Lucy Grieve, co-founder of Back Off Scotland. “This isn’t about demand or ability — it’s about willingness.”
At the heart of the problem is a silent standoff between the Scottish Government, NHS boards, and medical professionals, with none stepping forward to offer comprehensive care. Despite BPAS offering to co-develop a Scottish service, no partnership has materialised.
Vulnerable and Alone
Later-term abortions are rare, but essential. Many involve women facing:
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Domestic abuse
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Addiction or mental health crises
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Youth and fear of disclosure
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Cryptic pregnancies, where symptoms don’t appear until very late
Ashley’s case falls into the last category. She was in a stable relationship, using contraception, and had no idea she was pregnant until she was nearly 20 weeks along. Her local NHS board — the largest in Scotland — offered no options. She was told to call a charity.
The journey to a BPAS clinic in Middlesex was “overwhelming,” she said, especially while in pain, scared, and navigating a foreign city. The presence of protesters only worsened her anxiety.
“I’m at peace with my decision,” she said. “But I can’t believe I had to leave my country to make it.”
A Health System in Retreat?
In 2024, at least 88 Scottish women were treated by BPAS for later abortions in England, up from 67 in 2023 — numbers that likely understate the true extent, given the taboo and logistical barriers involved.
“Scotland has the worst provision for later abortion care in the UK,” said Heidi Stewart, BPAS CEO. “We’ve offered to help fix it. The government hasn’t taken us up.”
Across the UK, abortion is governed by the 1967 Abortion Act, and the procedure is permitted up to 24 weeks on broad health and social grounds. But in practice, access depends on local health boards’ willingness to offer services, and trained clinicians willing to perform them.
In Scotland, there are reportedly only two doctors with the necessary training — and no health board willing to host them.
“This is a dangerous and unusual situation,” Grieve said. “What happens when a woman can’t travel? What happens if something goes wrong in the delay?”
Political Stalemate and Rising Pressure
The Scottish Government acknowledges the gap — but change remains slow.
“This work has taken much longer than any of us would have wished,” said Jenni Minto, the minister for women’s health. She confirmed that NHS boards are required to fund travel and accommodation for patients forced to seek care in England.
Campaigners say that’s not enough. “The right to abortion doesn’t mean much if it’s not available where you live,” said Stewart. “Scottish women are being left behind.”
The issue is now becoming politically volatile.
Earlier this year, STV News revealed internal NHS communications admitting the problem amounts to service inequality. Meanwhile, US Vice President JD Vance spread false claims about Scotland’s abortion policies — part of a broader trend where UK abortion rights have become fodder for American-style culture wars.
Protesters, Buffer Zones, and Backlash
The fight over access is happening not just in hospitals, but on the streets.
Anti-abortion groups — including the Texas-based 40 Days for Life — have recently ramped up their activity across Scotland. Earlier this year, a protester was arrested for breaching a buffer zone near Glasgow’s Queen Elizabeth University Hospital.
Grieve’s group, Back Off Scotland, successfully campaigned for these buffer zones to shield patients from harassment. But the issue has since sparked international attention, with one activist’s conviction in England cited by the US State Department over “freedom of expression” concerns.
“Unjust and Unnecessary”
The central message from campaigners remains consistent: Scotland’s failure to offer later abortion care is not a legal problem, but a political and cultural one.
“Across the rest of the UK, women can access this care closer to home,” said Stewart. “That is not the case in Scotland — and it’s deeply unjust.”
Back in Glasgow, Ashley reflects on the trauma of her experience. “No woman should have to go through what I did,” she said. “It would have been so different if I’d been able to stay here — near home, with support.”
