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A report prepared by an Expert Group commissioned by the Scottish Government to review the law on abortion in Scotland.

Executive Summary

Abortion in Scotland is regulated by the 1967 Abortion Act. Before 1967, although abortion was illegal and could lead to a prison sentence for both the woman and the abortionist, thousands of women in the UK had an abortion each year and some of them died.

Clinical medicine has evolved significantly since 1967, as has the social and political context in which abortion is sought. This has changed the way that abortion is regarded and, most importantly, the way it is provided. In 1967, all legal abortions were done using a surgical procedure. In Scotland in 2024, 96.8% of abortions were medical abortions (using medicines), and 79.3% were early medical abortions carried out at home. Recognising the need for the law to be modernised and made fit for purpose, the Scottish Government’s Programme for Government 2023-2024 committed to undertake a review of abortion law by the end of the parliamentary term (May 2026). The overall aim was to identify potential proposals for reforms to ensure that abortion services are first and foremost a healthcare matter.

An Expert Group was established comprising clinical, legal, academic and reproductive rights experts. The Group was tasked with reviewing the current law; considering whether any aspects of the existing law should be changed; if so, assessing the various options for reform; and providing recommendations on what a reformed legal framework could look like. The Scottish Government established the Group with the remit:

“to provide recommendations to ensure that abortion services are first and foremost a healthcare matter and Scottish Ministers made clear their wish to ensure that patients in Scotland can continue to access abortions.”[1]

The Group has carefully considered where it is appropriate to shift the regulation from abortion-specific criminal law to other, general provisions of healthcare law and clinical guidance. An overarching recommendation stemming from this review process is that a new Scottish Abortion Care guideline should be produced to ensure that best practice and patient safety remains at the core of service provision, following any changes to the legal framework.

The Expert Group structured its review around three key areas of Scotland’s current abortion law: gestational limits and grounds; pathways to abortion care (including patient and provider pathways, data and reporting, and conscientious objection); and offences (including patient and provider offences and third-party offences).

For each topic, the Group began by reviewing the current law in Scotland. examining how the law operates in practice and the extent to which it aligns with the Group’s agreed overarching principles, set out on page 26-27 of this report. The Group assessed the strengths and limitations of the current legal framework in relation to these principles and determined for each topic whether the existing law should remain in place or whether consideration of proposals for reform should be recommended.

The Group then considered stakeholder input. The Group recognises that abortion can be a polarising topic that attracts strongly held, sincere, and often competing views, which should be respected. The views of many organisations which campaign for restrictions to abortion in the UK were sought. In advance of each meeting around 50 organisations were contacted and invited to submit written evidence pertinent to the specific topic being discussed. The Group reviewed the perspectives put forward, and the quality and relevance of the supporting evidence presented. Alongside this stakeholder consultation, the Advisory Group of reproductive rights, women's and equalities organisations was convened to ensure that a concern for universal reproductive rights and gender equality was central to all stages of the Group's work, together with ensuring that the lived experience of pregnancy and abortion were represented throughout the process.

The Group also undertook a comparative review of international approaches to abortion law in order to identify instances of best practice focusing particularly on jurisdictions that had recently reformed or reviewed their abortion laws to treat abortion as a healthcare issue. These international examples were assessed both in terms of how they function in practice and how well they reflect the principles adopted by the Group.

Importantly, the Group sought and considered relevant evidence from peer-reviewed academic publications and other respected sources. Taking into account all the information and opinions gathered, the Group finally discussed potential models for legal reform. The manner of working and the justification for each of the recommendations made by the Group – and in some cases, alternative proposals offered – is presented in detail in the report.

The recommendations listed below reflect the Expert Group’s position throughout this process. The Group argues for a reformed abortion law that removes any oversight that has no medical justification and reflects the reality of current clinical practice where abortions are safely provided in the best interests of women. To this end, this report sets out 36 recommendations, among which the most significant are to remove the requirement for any grounds to be met and for two doctors to agree to an abortion before 24 weeks gestation, to enable any appropriately trained healthcare professional to provide an abortion, to amend the Grounds for an abortion over a 24 week gestational limit (while still requiring two doctors to agree), and to remove women from any criminal law relating to abortion. The evidence used to arrive at all the recommendations and the thinking behind them is laid out in detail in the appropriate section of the report.

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