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Ahead of a major review of Jersey's quarter-century-old abortion law, Express investigated how far behind other jurisdictions the island has fallen...
A review of the Termination of Pregnancy (Jersey) Law was announced by Health Minister Karen Wilson last week.
Deputy Wilson described it as “really quite clear” that Jersey's abortion legislation needs reviewed, as many other countries have revised their legislation since the island introduced its own back in 1997...
Before the introduction of the 1997 law, termination of pregnancy in Jersey constituted the crime of murder or manslaughter unless performed “in good faith for the purpose only of preserving the life of the mother" or "when the continuance of the pregnancy would make the woman a physical or mental wreck”.
Pictured: Before 1997, approximately 300 local women travelled to England each year for a termination to avoid potential prosecution in Jersey.
Every year, approximately 300 Jersey resident women travelled to England for a termination to avoid potential prosecution in Jersey.
The 1997 Law, when introduced, permits termination of pregnancy in Jersey on the following grounds only:
It is a criminal offence for a woman to have a termination in Jersey on grounds not listed above. Both the woman and any person carrying out the termination could be liable for criminal prosecution.
The 1997 Law permits termination in Jersey up to the following gestational limits:
The law counts gestational age from the beginning of the woman’s last menstrual period.
It is a criminal offence for a woman to have a termination in Jersey later than the gestational limits set out above.
Both the woman and any person carrying out the termination, could be liable for criminal prosecution.
The World Health Organisation recommends that termination should be available at the request of the pregnant woman and without justification of need. This is commonly referred to as a ‘termination on request’.
Termination on request is permitted in 50 jurisdictions including Canada, the Isle of Man, the Republic of Ireland and most states in Australia.
However, it is not permitted in Jersey, Guernsey, or the UK.
Whilst termination on request is not technically permitted in Jersey – the law requires a woman to state that her condition is causing ‘distress’ – there is no requirement for the woman to evidence her distress or for the doctor to confirm her distress.
Termination on the grounds of distress in Jersey is, therefore, often likened to termination on request, despite this not being the case in law.
Last year, 97% of the 240 women who had a termination in Jersey did so before the end of the 12th week.
However, the 12-week gestational limit can be problematic for women who may not initially know they are pregnant. This may be due to irregular periods or contraceptive methods that stop or mask periods.
Pictured: The 12-week gestational limit can be problematic for women who use contraceptive methods which stop or mask periods.
A woman seeking a termination on the grounds of ‘distress’ after the 12 week gestational limit cannot legally do so in Jersey.
Termination after 12 weeks in only legal in Jersey in cases of foetal abnormality, or if necessary to save a women’s life or prevent grave permanent injury to her physical or mental health.
Therefore, Jersey women wanting an abortion after the 12-week limit on the grounds of distress must travel away from the island to a jurisdiction with less restrictive limits. This is usually the UK where the gestational limit is up to the end of the 23rd week (or more in the event of risk to the woman or the child if born).
The Jersey General Hospital does not provide the specialist procedures required for terminations that take place on or after 22 weeks of gestation even though Jersey law permits a termination before the end of the 24th week in cases of foetal abnormality.
In these cases, Jersey General Hospital will refer the woman to the UK and will fund the procedure. The woman will then return to Jersey General Hospital for aftercare.
It remains the case that termination on any grounds, except where necessary to save the woman’s life or prevent grave permanent injury to her physical or mental health, remains illegal in Jersey from 25 weeks onwards, including in cases of foetal abnormality.
Some jurisdictions specifically restrict termination for reasons of sexual selection, meaning someone is not allowed to intentionally abort a foetus due to it being male or female.
This is not currently outlined in Jersey law, as, in any case, the 12-week gestation limit means that the sex of the child would not be known before the 12 week limit.
‘Viability of life’ is understood to be point in gestation at which a baby, if born, could survive outside the womb.
However, it is not clear cut. The survival of a premature baby is dependent on a range of factors in addition to gestational age including availability of care, birth weight, gender, underlying medical conditions or whether the pregnancy is a single or multiple pregnancy.
International consensus cites the end of 22nd week as the ‘cut–off’ for viability of life, but this does not equate to life always being viable from the beginning of the 23rd week.
Whilst advances in medical technology have made it possible for some babies to survive at, or around 23 and 24 weeks gestation, it is the case that few severely premature babies survive without permanent disability.
For this reason some jurisdictions have determined that the gestational limits for termination of pregnancy should be around 24 weeks to balance the need to protect the mother as well as the unborn child.
The World Health Organisation recommends that laws should not prohibit termination based on gestational limits.
The UK and Guernsey permit termination up to the end of the 23rd week if the continuation of pregnancy would involve risk of injury to the physical or mental health of the woman (or to any existing children of her family) that is greater than the risk to the woman (or to existing children) if the pregnancy were terminated.
No gestational limits are applied on any other grounds in the UK and Guernsey, so, for example, termination on the ground of foetal abnormality is lawful throughout the full 40 weeks.
Australia and New Zealand permit ‘termination on request’ up to 20-24 weeks, depending on which state you area in. After that, termination is still lawful if the doctor determines it is appropriate based on the woman’s medical, physical, psychological, economic and social circumstances.
The 1997 law requires a woman who wants a termination on the grounds of ‘distress’ to consult with a doctor (for example, her GP) in-person. The woman must, by law, then have a second consultation with an approved doctor (who is approved by the Minister for Health and Social Services to carry out terminations).
The law requires a woman who is obtaining a termination for any other reason than ‘distress’, to be examined by two approved doctors. This does not apply if the termination is immediately necessary to save the woman's life.
Pictured: Jersey law requires women seeking an abortion to be examined by at least two doctors.
It is a criminal offence for a woman to have a termination in Jersey without having consulted with or been examined by the necessary doctors or approved doctors. Both the woman and any person carrying out the termination, could be liable for criminal prosecution.
In Jersey, the first consultation is typically carried out at the woman's GP surgery or specialist contraceptive service (for example, at Le Bas Centre). There can be a cost to the woman to access these services.
The woman is then referred to the Jersey General Hospital for the second consultation, where an ultrasound scan is usually carried out.
The National Institute for Health and Care Excellence recommends that providers should allow women to self-refer to termination services, and that services should work together to avoid the need for women to repeat assessments or investigations.
In 2007, the UK’s House of Commons Science and Technology Committee concluded that the requirement for consultation with two doctors, particularly in the first 12 weeks, did not safeguard women or healthcare professionals “in any meaningful way, or serve any other useful purpose” and instead caused delays in access to abortions.
In the UK, a woman is required to consult with two registered health professionals at any point in the pregnancy.
Some jurisdictions, such as Australia and New Zealand, allow consultation with one registered health professional only up the point they deem life to be ‘viable’ (around 20-24 weeks) and then two after.
The Guernsey law requires a consultation with one doctor only throughout the full 40 weeks gestation.
A termination in Jersey costs £185, if the woman is entitled to access Government of Jersey health care or £511 for a woman who is not, because she has not lived or worked in Jersey for long enough.
Pictured: The NHS provides for free termination to UK residents, but this does not extend to Jersey residents.
A termination in the UK costs around £480 to £1,510 depending on the clinic.
The NHS provides for free termination to UK residents, but this does not extend to Jersey residents.
Abortions that are carried out before the end of the ninth week are referred to as ‘early medical terminations’.
They involve a woman taking two different medicines, usually within a 48-hour period to terminate the pregnancy.
In England, France and New Zealand early medical termination can take place entirely at home.
A consultation is available via phone or video link, after which both medicines are sent to the woman for her to self-administer.
In Guernsey, the law requires an in-person consultation with one doctor but after this women can have an early medical termination at home with both drugs self-administered.
Pictured: In Jersey, the General Hospital is currently the only place approved in the 1997 law where terminations can be carried out – meaning that early medical terminations cannot take place at home.
However, in Jersey, the General Hospital is currently the only place approved in the 1997 law where terminations can be carried out.
This requirement means that anyone wanting an early medical termination in Jersey is required by law to:
The 1997 Law makes it a criminal offence for a termination to be carried out in Jersey if it does not follow certain conditions.
These include, but are not limited to:
Both the woman and any person carrying out the termination (including the administering of any drug for the purpose of inducing a termination), could be liable for criminal prosecution.
Of the 2,131 terminations carried out in Jersey between 2012 and 2022:
over 97% were on grounds of ‘distress’,
2% were on the grounds of foetal abnormality, and
less than 1% were to save the woman’s life or prevent grave injury to her physical or mental health.
The most current Jersey annual termination of pregnancy report shows that:
240 terminations took place in Jersey in 2022, which is 12% higher than in 2021 (210) and highest since 2002, and
less than 10 terminations were provided to Jersey residents in England and Wales in 2022 – this has remained at a similar level since 2008.
In addition to an online consultation, discussions will be held with previous and potential service users, health professionals, and those involved in providing care and support services.
“Termination of pregnancy is a highly emotive and complex issue but, regardless of individual perspectives, it is imperative that compassionate and high-quality care and support is available," Deputy Wilson said.
Pictured: The Minister for Health and Social Services, Deputy Karen Wilson.
"We also need to make sure that we have a clear and fit-for-purpose legal framework that takes account of changes in medical practice.
“In considering the changes that may be required, I am committed to considering all feedback received.”
The public consultation is seeking input from all islanders – regardless of gender and personal perspectives – and can be found online until the end of October.
What elements of the law would you like to see updated? Do you have an experience you wish to share? You can contact Express to share your thoughts, in confidence, by emailing editor@bailiwickexpress.com.
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