There is a stark contrast in how women needing one key treatment are dealt with depending solely on whether they live in England or Wales
Two women in Cardiff want abortions. One has a GP in England while the other’s is in Wales – and this difference determines whether they wait one day or three weeks.
Beda (not her real name), a 26-year-old Cardiff woman, got unexpectedly pregnant in January 2024. With her GP in Cthe Welsh capital she went through Cardiff and Vale University health board. Four weeks later she had her abortion.
In this time Beda’s pregnancy developed past the 10-week limit on a medical abortion. Her body was changing, her mental health was suffering, and she had to get a surgical procedure instead.
“I found out I was pregnant at eight weeks. It was four weeks later that I had the procedure,” she said.
“I wanted to have an at-home experience but by the time I got to the appointment I was too far along.
“Things change week to week. Your body can do the craziest things. I got hungrier, I felt out of control, I gained a lot of weight at a fast pace.
“I didn’t feel energetic or happy about life.
“I feel quite angry about it. I have come to expect it with NHS care.”
Long wait times like this are causing women to travel to England as Welsh health boards struggle to provide care.
About 11,500 women have abortions each year in Wales. But Wales has the slowest provision of surgical abortions in the UK. Stay informed on the latest health news by signing up to our newsletter here.
“There’s always been a lack of provision in Wales as a whole.
“If you’re funded by anyone in England we can see you straightaway. You can just ring us.
“You can self-refer to us,” said Vivienne Rose, clinic manager of the British Pregnancy Advisory Service (BPAS) in Cardiff.
A disparity in waiting times between those with English GPs and those with Welsh GPs is apparent. And it is all to do with who pays for it.
In England the majority of abortions are performed by the third sector with the biggest provider being BPAS.
In Wales most abortions are provided by NHS hospitals where provisions are stretched and waiting times are long.
This means that if you have an English GP NHS England will pay for BPAS to perform your abortions at your nearest clinic.
For many women this is in Cardiff.
“Women are saying to me: ‘It’s growing inside me. It’s making me feel much worse knowing that I’m leaving it later’,” said Vivienne.
Waiting time for an abortion is important. In Wales after 12 weeks and six days most NHS hospitals will not provide an abortion.
While the BPAS clinic in Cardiff usually offers abortion up to 18 weeks it has had to temporarily suspend its surgical procedures until March.
This means that if you get to 13 weeks in Cardiff you will have to go to London, Birmingham, or Liverpool. Beda was just days away from this.
As a result of this wait some women in Wales are travelling to England for abortions. This was the case for 30-year-old Rachel (not her real name) from Carmarthenshire.
Rachel was backpacking in Denmark when she found out she was pregnant. She went to the Red Cross who told her they could help her – but in five days’ time.
With this news she decided to go home.
“When I came back to Wales I was told I could not have an abortion for two and a half weeks,” she said.
“So I used my friend’s address to access an abortion in England. There were just so many hoops you had to jump through.
“It is crazy that the Red Cross in another country would have been more efficient,” said Rachel.
Using her friend’s address in Bristol Rachel was able to access a medical abortion within two working days.
But because of being away from home she went through her abortion on her own.
“I got the abortion alone. I took the first pill on the train home.
“All of it was a bit depressing – being at the clinic on my own and the train on my own.
“If I had got it in Wales my mum or my sister could have come with me,” said Rachel.
Having to travel to England puts additional barriers up for women.
It means, like Rachel, often they have to travel alone.
“Some people haven’t got an escort to go to England with them. They’re like: ‘I can’t tell my mother – and my husband has to look after the children’, so it’s horrible,” said Vivienne.
For some women the wait is too much and they opt to pay for their own abortions.
Within the Cardiff and Vale University Health Board area 10% of abortions are privately funded. This is the highest rate of self-funded abortions across all of England and Wales.
“Some people are paying thousands because they don’t want to wait – they want it out of the way.
“They’re worried that if they wait for the NHS they’re not going to get the tablets so they pay,” Vivienne said.
In the BPAS clinic prices for abortions range from £622 to £3,044.
Attempts have been made to improve access to NHS abortions in Wales.
The Welsh Government launched its Women’s Health Plan in December 2024. It states: “Abortion care should be available locally and without delay.”
However, with BPAS temporarily suspending its surgical procedures, abortion care in Wales has only got worse.
“With the Women’s Health Plan there is more awareness but there is such a lack of funding. It can feel a little bit like their full heart’s not in it.
“With the [Senedd] election [in May] we are uncertain of what will happen with abortion care,” said Lucy Ward, chair of the cross-party women’s health group in the Senedd and policy and engagement manager at BPAS.
Also, in Wales, a number of healthcare professionals object to performing abortions, causing delays to care.
Conscientious objection is the right for healthcare professionals to opt out of doing an abortion procedure due to personal beliefs.
In a survey by Mia Squires and Dr Adam Tyler at Hywel Dda University Health Board 59% of Welsh healthcare professionals said they had encountered cases where conscientious objection led to delayed or denied patient care.
“Because I have so many (conscientious) objections in my health board I cannot get a surgical theatre list … so when I do surgical abortions, I have to sit women in the waiting areas, in corridors, because I can’t get a bed,” one consultant said
during the women’s health group meeting in the Senedd on December 4.
Another added: “Some services rely on a small number of non-objecting clinicians and this creates unsustainable pressures.”
While charities like BPAS are the biggest providers of abortions in England in Wales, it falls to over-stretched health boards under “unsustainable pressures”. As a result Welsh women are receiving poorer abortion care.
The Welsh Government said: “Health boards are responsible for the provision of abortion services which meet the needs of their population.
“We are working with NHS Wales to identify and address barriers to providing surgical abortion services locally and are exploring the development of a robust, sustainable service for the future.”
Cardiff and Vale University Health Board declined to comment.
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