Abortion is healthcare. It should be treated as routine healthcare, as defined by the World Health Organisation1. For this to be the case, it must be fully decriminalised, which means that women can access abortions, and healthcare providers can deliver them, without criminalisation.
But right now, that couldn’t be further from our reality in Britain. Abortion is still illegal under Section 58 of the Offences Against the Person Act2 and prosecutions are rising.
Since its introduction in 1861, three women had been prosecuted under the law. That was until 2022. Since November 2022, six women have appeared in court charged with ending or attempting to end their own pregnancy outside of the terms of the 1967 Abortion Act, which made abortion legal in certain, fixed circumstances.
Now, police are being encouraged to search for abortion pills, seize digital devices, and check data on period tracking apps if they suspect someone intended to end their pregnancy3.
Why is this happening?
Prosecutions for ending a pregnancy are rising because a well-funded international anti-abortion lobby is taking advantage of our current political moment. Funding and strategies flow freely between anti-abortion groups in Britain and the US. They’re emboldened by Donald Trump’s presidency in the US and the growing popularity of Nigel Farage, the Reform party leader who’s already talking about rolling back abortion laws in Britain.
The power of the anti-abortion movement relies on the fact that, culturally, we don’t publicly talk abortion as healthcare. Instead, it’s still understood as a moral debate between two opposing ‘sides’.
This won’t change until we shift our cultural norms around abortion, to treat it as an essential healthcare intervention. We also need to address the real, tangible ways that people may be blocked from accessing an abortion, even if it were fully decriminalised, by:
- Mainstreaming abortion care inside all hospitals and primary care settings across the UK.
- Ensuring consistent funding and resources to maintain the availability and quality of care.
- Changing how the media reports on abortion to shift the culture of shame and stigma that prevents access.
Treating abortion as healthcare, by decriminalising it, means that both the person having the abortion and the person providing it are protected. There are two recent cases which prove why this is important:
Nicola’s case
Nicola Packer had a traumatic stillbirth after taking abortion pills, believing she was less than 10 weeks pregnant. A senior midwife reported her to the police and she spent 24 hours in a police cell, having had major surgery following the birth4.
There’s no legal duty for medics to report suspected crimes, and the midwife was in breach of patient confidentiality for reporting Nicola. A senior Metropolitan police officer even expressed concern about whether the developing investigation was best for Nicola. The CPS proceeded. She endured four years of investigation and trial while the media dissected her life – and was found not guilty in April 2025.
This happened because the midwife stepped outside her role as a healthcare professional and became an agent of the state, reinforcing criminalisation despite having no legal responsibility to act. The Royal College of Obstetricians and Gynaecologists have since issued guidance to discourage midwives from doing this.
Adriana’s case
Meanwhile in the US, Adriana Smith, a 30-year-old Black pregnant woman, is being kept alive on a ventilator and treated as a human incubator for a foetus after being declared brain dead following a medical emergency5. It’s an extreme violation of her bodily autonomy. And it’s happening because healthcare professionals are once again stepping outside of their role and reinforcing criminalisation, citing their feelings and beliefs.
Hospital staff determined that ending Adriana’s life support would be in breach of the state of Georgia’s abortion law. Their decision conflicts with the legal opinion of the state Attorney General’s office, which said that “removing life support is not an action with the purpose to terminate a pregnancy,” therefore not breaching the law.
Interconnected attacks on abortion care and transition care
Healthcare professionals acting as agents of the state are also impacting trans people’s access to gender-affirming care. In the UK, the NHS is increasingly withdrawing or refusing trans people’s access to hormone replacement therapy (HRT).
HRT is a key part of gender-affirming care that aligns a person’s gender identity with their physical appearance6. A lack of funding, uncertainty from GPs, and the impact of the Cass Review were all cited as reasons for this rollback7.
Then, in April this year, the Supreme Court ruled that the legal definition of a woman is based on biological sex, and institutions immediately interpreted this restrictively. Within days, the British Transport Police amended its strip-searching policy, allowing male officers to search trans women8.
These connected attacks on abortion and transition care are happening against a cultural backdrop of intensifying efforts to reassert control over our bodies. They serve a clear purpose: to constrain us into performing gender in narrow and specific ways, according to the sex we were assigned at birth. And they have the legal scope to punish us when we don’t.
It’s an example of what social theorist Michel Foucault calls “biopower”: the mechanisms that governments use to manage and regulate human bodies and populations9. Reproduction – everything from who reproduces, to when and how – becomes a key site of control. It is sinister.
Full decriminalisation must include healthcare workers
When Level Up says “abortion is healthcare”, we mean that abortion should be treated exactly like any other medical procedure – available in hospitals and GP surgeries, delivered by healthcare professionals without fear of prosecution, and accessible to patients without criminal investigation. This requires full decriminalisation: removing abortion entirely from the criminal code, including protections for healthcare providers.
As Edem Ntumy, CEO of Reproductive Justice Initiative, says, “The continued criminalisation of abortion services separates it from other reproductive healthcare. It disrupts the patient-clinician relationship, delays access, and contributes to stigma.”10
In the cases of Nicola and Adriana, healthcare providers were, at best, being risk-averse about their own legal accountabilities. At worst, their decisions reflected personal moral and political influences. This is exactly why even well-intentioned attempts at partial decriminalisation aren’t enough.
Culture must change before the law
The current amendments proposed to decriminalise abortion in England and Wales11 wouldn’t have helped Nicola, since her pregnancy was dated past 24 weeks. They also wouldn’t remove healthcare providers from the criminal scope, meaning that this midwife may have been compelled to make the same decision again.
If full decriminalisation was in place, there would be no ambiguity about how these situations should be handled.
Level Up knows that culture change always precedes policy change. That’s why we take a pop culture approach to campaigning for the full decriminalisation of abortion. Until we shift public understanding of abortion as healthcare, there won’t be enough public support to achieve the full decriminalisation that we need.
This cultural shift requires concrete action.
Our strategy works on two fronts: we’ve created media guidelines that encourage journalists to treat abortion as healthcare, not a moral debate. People in the Level Up community are taking action when they see harmful reporting: using email tools to message news editors and calling it out on social media.
We’re also challenging our culture of shame and stigma by mobilising public solidarity with people who have abortions, and encouraging people to tell their stories, normalising the full spectrum of experiences around ending pregnancies.
- https://www.who.int/news-room/fact-sheets/detail/abortion
↩︎ - Under the Offences Against the Person Act 1861, as well as the Infant Life (Preservation) Act 1929 (which criminalises later abortions), having or providing an abortion remains a crime that carries a life sentence. This is despite these laws having being repealed for Northern Ireland by Westminster in 2019 and 2020. Women accessing abortion in Great Britain do so under the Abortion Act 1967. But this law did not decriminalise abortion – it simply made it legal in certain, fixed circumstances. ↩︎
- https://observer.co.uk/news/national/article/police-could-search-homes-and-seize-phones-after-sudden-pregnancy-loss ↩︎
- https://www.theguardian.com/uk-news/2025/may/08/uk-woman-who-took-pills-during-lockdown-cleared-of-abortion ↩︎
- https://www.npr.org/2025/05/21/nx-s1-5405542/a-brain-dead-womans-pregnancy-raises-questions-about-georgias-abortion-law ↩︎
- Cisgender women also routinely access HRT during menopause – and cisgender boys and men also access other gender-affirming care like breast-tissue reduction – without issue. ↩︎
- https://www.independent.co.uk/news/uk/home-news/gp-nhs-transgender-hormone-treatment-b2658721.html ↩︎
- https://www.theguardian.com/uk-news/2025/apr/17/trans-women-uk-railways-strip-searched-male-officers
↩︎ - https://sites.brown.edu/publichealthjournal/2021/12/13/reproductive
↩︎ - https://reprojusticeinitiative.org/rji-calls-for-a-comprehensive-holistic-approach-to-abortion-decriminalisation/ ↩︎
- https://bills.parliament.uk/publications/53621/documents/4252 and https://bills.parliament.uk/bills/3511/stages/18470/amendments/10013618 ↩︎
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