Between 2012 and 2022, four women in England were convicted for committing an illegal abortion. In 2023, Carla Foster was jailed and then had her sentence halved and suspended. In December 2022, the case against a woman in Oxford was dropped and the case against Bethany Cox was dropped in January 2024. There are two known cases still awaiting trial.
In 2021, a year-long police investigation into a teenager, suspected of having performed her own illegal abortion, was dropped when the coroner reported that the stillbirth of her baby was due to natural causes.
The latter case, and a few similar investigations, are being cited by those campaigning for abortion decriminalisation. We need to ask if it would be right and proper to set aside the abortion law simply to avoid the very small number of cases in which women are wrongly investigated when their pregnancy loss has been due to natural causes, a miscarriage or a stillbirth. If we let our hearts and emotions lead, then the answer would be a resounding ‘yes’ and we would join with Dame Diana Johnson and her supporters in voting in favour of her Criminal Justice Bill amendment NC1, expected to be debated in the House of Commons in March. But, we need to restrain our emotions and reach a more considered, thoughtful response.
The following are some questions that need to be answered:
- Should medical staff respect a woman’s confidentiality and refrain from reporting their suspicions of an illegal abortion to the police?
- Would a mandated return to in-person medical consultations reduce the number of cases by ensuring that women are not prescribed abortion pills for self-administration after the legal limit of 9-weeks-6-days’ gestational age?
- Could police investigation procedures be improved to reduce the trauma caused to these vulnerable women, perhaps reducing the time taken to complete an investigation?
- Should a woman face a criminal trial and conviction for performing her own illegal abortion – is the threat of such, a sufficient deterrent to cause others to think twice before committing a similar crime?
- Should the sentencing guidelines for these crimes be reviewed to reduce the evident confusion across the judiciary about whether to imprison and for how long.
Sarah Catt
In 2012, a refugee woman was convicted for an illegal abortion and given a community order. That same year, Sarah Catt was imprisoned after being found guilty of having aborted her baby when she was 39 weeks pregnant.[i] Catt and her husband already had two children when she became pregnant by another man; she presented for an abortion but was refused after the examination showed that she was beyond the 24 weeks gestational age limit. A few weeks later, she attended an ante-natal clinic at a hospital in Leeds and her pregnancy was confirmed to be 30 weeks GA. Some weeks later, enquiries were made when it was noted that Catt had yet to register the birth.
Catt claimed that her baby had been stillborn and that she had buried his body, but the body was never found. During the investigation, it was discovered that Catt had procured abortion pills from India. She was initially sentenced to eight years but this was subsequently reduced on appeal to three-and-a-half years.[ii]
Catt’s case shows us how members of the judiciary hold differing views on whether, and for how long, a woman should be imprisoned for committing an illegal abortion. Emotions are stirred when we think about the deliberate killing of a baby just days from full-term and on the other hand hearing that Catt’s obstetric history was characterised by ‘disturbance, personal misery and entrenched problems’ and that she was a good mother. In the abortion decriminalisation debate, we must grapple with this dilemma, should women like Catt be sent to prison, separated from their children, or alternatively be given a non-custodial sentence; assuming of course that any necessary health and emotional care is provided to her in either situation. MPs should call for a review of the sentencing guidelines for these crimes.
Natalie Towers
In 2015, Natalie Towers, then a 24 year old mother, was imprisoned for two-and-a-half years after being found guilty of performing her own medical abortion at home when she was 32-34 weeks pregnant.
In 2014, Towers procured the abortion pills online and self-administered these in her bathroom at home. Paramedics attended after she called 999 because of heavy bleeding, and on arrival they found the baby in the toilet. Attempts at resuscitation failed and baby Luke died from oxygen starvation. Towers was remorseful and upset during her trial; the judge took account of mitigating factors before sentencing.[iii]
Laura*
In August 2022, The Times published a story about Laura* [iv] who had been imprisoned for two years after being found guilty of an illegal abortion at 30 weeks.[v] [vi] At the time of publishing, Laura had served her two years and after her release, she had finished her university studies and graduated.
Laura was 20, a mother of a two year old daughter, studying at university and living in an abusive relationship, when she discovered she was pregnant. Somewhat fearfully, she told her boyfriend and he insisted that she had an abortion but would not allow her to attend her doctor’s clinic, instead he told her to get abortion pills online.
Laura believed that she was less than ten weeks pregnant when she self-administered the pills in her bathtub at home. She describes the absolute horror that followed: “I almost died. I remember the bath being filled with at least an inch of blood.” She called for an ambulance and was subsequently told by the hospital team that she had given birth to a 30 weeks old fetus, who was stillborn. Laura disclosed that she had used abortion pills and the police were called to her bedside.
Laura’s story reveals the dangers women face when using abortion pills at these later gestations; excessive bleeding is common and very often women need emergency medical attention for the complications arising. It is because of the increasing risk of complications that the World Health Organisation and the Royal College of Obstetricians and Gynaecologists consider self-managed medical abortion to be unsafe from 12 weeks gestational age.[vii] It is because of these complications that women, like Laura, end up in hospital, where sometimes suspicions are raised leading to a subsequent police investigation.[viii]
Her story lays bare the reproductive coercion faced by many women. It is surely a significant failure of her care team, of the police investigators, and of the courts that nobody uncovered the truth of Laura’s abusive boyfriend. In the article by The Times, Labour MP Jess Phillips calls out this failure saying: “The story would be a different one had just somebody with training spoken to her at any point – somebody who was advocating on her behalf and who understood abuse control, coercion, women’s reproductive coercion.”
Zahra* (aka Megan*)
In 2021, Zahra, then 15 years old, was investigated by the police on suspicion of having committed an illegal abortion. She had previously attended an abortion clinic but the providers were unable to proceed because, by then, she was more than 24 weeks pregnant. A few weeks later, in a local hospital, Zahra suffered an unexplained stillbirth at 28 weeks. Staff became aware that she had previously attended an abortion clinic and called the police. The investigation lasted for more than one year, causing Zahra significant emotional distress. The case was dropped after the coroner concluded that her baby had died from natural causes.
When you read Zahra’s story, it is very easy to understand why hers is central to the campaign for abortion decriminalisation. Whilst she was not guilty of having committed an illegal abortion, she was being investigated under suspicion of having broken the abortion laws. Campaigners argue that if women are removed from these laws, then no woman could be investigated when suspected of seeking to end her own pregnancy, and none would suffer the, undoubted, stress and trauma of such an investigation after the heartbreak of a natural miscarriage or stillbirth.
Her story raises the question of whether healthcare workers should report their patients to the police – I have written about this before and lean towards maintaining patient confidentiality.[ix] Other questions that should be asked are whether any safeguarding concerns were raised given her pregnancy at 15 years old and why it took as long as one year for the coroner’s report to be published.
Portuguese woman in Oxford
In December 2022, the case against a Portuguese woman living in Oxford was dropped after the judge said that there was no public interest in continuing with the prosecution.[x]
In January 2021, when she was 25 years old, this woman had an emergency C-section at the John Radcliffe Hospital. She was 31 weeks pregnant at the time; her waters had broken and her placenta was detaching, causing her unborn baby significant distress. The baby was born alive and survived. The medical team discovered some misoprostol tablets in her vagina, she admitted using these but claimed that the tablets had been prescribed to her, in Portugal, as an anti-thrush treatment, and that she had not been attempting to end her pregnancy.
The breakdown of her placenta was caused by the insertion of the misoprostol tablets; the outcome, for her and her baby, could have been very different had she not been able to receive this emergency treatment.
This case raises the issue of what is in the public interest; should we prosecute and imprison women who break the abortion laws as a deterrent to others who might consider doing so, or is it better for either no prosecution or a non-custodial sentence so that the woman and her baby can remain together, and not be in prison.
Carla Foster
In June 2023, Carla Foster, then 44 years old, was found guilty of an illegal abortion, causing the stillbirth of Lily at home, in May 2020, when she was at least 32 weeks pregnant. She was sentenced to 28 months in prison but this was overturned by the Court of Appeal in July 2023, when her sentence was reduced to 14 months and suspended.[xi] [xii]
Foster’s case, like Catt’s, begs the question of whether the courts need to be using a prescribed set of sentencing guidelines for cases like these.
There is no doubt that Foster intended to perform her own medical abortion at home and that she was well aware of her later gestation. She deliberately exploited the systemic flaw in telemedicine abortion by lying to the provider about the dates of her pregnancy; she gave BPAS a date for her last menstrual period that indicated she was below the legal limit of 9-weeks-6-days gestation, and they sent her the abortion pills-by-post.
Had there been the previously mandated in-person medical consultation, BPAS would not have prescribed a self-managed medical abortion. Sure, Foster could have obtained the abortion pills illegally online, but at least then an NHS contracted provider would not have been duped into participation in this breach of abortion laws and regulations.
44-year-old woman (London)
In October 2023, a 44 year old woman attended a London court at which she was accused of using abortion pills in November 2020, to illegally end her pregnancy; she pleaded not guilty. Her case is expected to be heard in September 2024 and the judge has approved an interim order not to name her because of concerns about her safety, especially given the high-profile nature of the case and claims by her legal team that other women accused of the same crime have been subject to death threats.
Sophie Harvey and Elliot Benham
At the end of 2023, Sophie Harvey and Elliot Benham, both 23 years old, pled guilty to having committed an illegal abortion, concealing the birth of a child and disposing of the baby’s body. Notwithstanding these guilty pleas, a trial is still expected at which all of the evidence will be heard, before sentencing.
The abortion was committed in the last quarter of 2018, using abortion pills that the couple had procured from India.
Bethany Cox (aka Jessica*)
In January 2024, because of ‘evidential difficulties’, the prosecution case against Bethany Cox was withdrawn just before the start of further court proceedings. She had been accused of using abortion pills to commit an illegal abortion in July 2020, and after three years of police investigation she pleaded not guilty at a court hearing in June 2023.[xiii]
Cox was 19 years old, when she had a stillbirth in July 2020, just days after the first Covid-19 lockdown.
As part of its abortion decriminalisation campaign, BPAS is using Cox’s story under the pseudonym Jessica*. On its campaign poster, BPAS says Jessica was 19 when she used abortion pills and gave birth at home; when Jessica was interviewed by the police, she told them she had believed she was early in her pregnancy.[xiv]
It is possible that Cox/Jessica obtained the abortion pills using the telemedicine pills-by-post process which had just been introduced at the end of March 2020. It is very likely that had Cox/Jessica attended an in-person medical consultation, the true gestational age of her pregnancy would have been determined and she might not have suffered the subsequent traumas of the stillbirth at home and three years of police investigation and court proceedings.
[i] The Hon. Mr Justice Cooke in the Crown Court, Leeds: R -v- Sarah Louise Catt sentencing remarks 17 September 2012. PDF file accessed from https://www.judiciary.uk/wp-content/uploads/JCO/Documents/Judgments/sarah-louise-catt-sentencing-remarks-17092012.pdf
[ii] REGINA v Catt, [2013] EWCA Crim 1187 | England and Wales Court of Appeal (Criminal Division). Casemine. https://www.casemine.com/judgement/uk/5a8ff70460d03e7f57ea5d5b
[iii] The Telegraph. https://www.telegraph.co.uk/news/uknews/crime/12057229/Woman-who-took-poison-to-terminate-pregnancy-jailed.html.
[iv] Names with an asterisk, e.g., Laura*, are pseudonyms used by abortion campaigners, mainstream media, and some authorities when referring to a particular case
[v] Al-Othman H. Laura’s story: jailed for having an abortion in Britain. The Sunday Times. https://www.thetimes.co.uk/article/lauras-story-jailed-for-having-an-abortion-in-britain-0m06nzrlx. Published August 6, 2022.
[vi] Thornton L. UK woman jailed for taking abortion pills when abusive partner got her pregnant. The Mirror. Published August 7, 2022. https://www.mirror.co.uk/news/uk-news/student-jailed-two-years-uk-27680027
[vii] Duffy K. Criminal Justice Bill Committee – written evidence. Percuity. Published February 26, 2024. https://percuity.blog/2024/01/26/cjb-committee-written-evidence/
[viii] Duffy K. Johnson’s Six represent 0.00015%. Percuity. Published February 25, 2024. https://percuity.blog/2024/02/25/johnsons-six-represent-0-00015/
[ix] Duffy K. Compassion not judgement. Percuity. Published February 24, 2024. https://percuity.blog/2024/01/28/compassion-not-judgement/
[x] Seaward T. CPS drops prosecution of Oxford mum accused of “procuring miscarriage.” Oxford Mail. https://www.oxfordmail.co.uk/news/23181446.cps-drops-prosecution-oxford-mum-accused-procuring-miscarriage/. Published December 9, 2022.
[xi] In the Crown Court at Stoke on Trent, The King v. Carla Foster 12 June 2023: sentencing remarks of the hon. Mr Justice Pepperall. PDF file accessed from https://www.judiciary.uk/wp-content/uploads/2023/06/R-v.-Foster-sentencing-remarks-12.6.23.pdf
[xii] Courts and Tribunals Judiciary. R -V- Foster – Courts and tribunals judiciary. Courts and Tribunals Judiciary. Published November 2, 2023. https://www.judiciary.uk/judgments/r-v-foster-2/
[xiii] Brown M. Teesside woman cleared over lockdown abortion charges after CPS offers no evidence. The Guardian. https://www.theguardian.com/uk-news/2024/jan/09/teeside-woman-cleared-over-lockdown-abortion-charges-after-cps-offers-no-evidence. Published January 10, 2024.
[xiv] BPAS on X; tweet at 7pm on 22 February 2024, Jessica’s* story: https://x.com/BPAS1968/status/1760741286829510675?s=20
Percuity 