The aim of this study was to assess the effectiveness of the different referral pathways to accessing abortion services. It was a retrospective observational study comparing abortion referral processes in two district hospitals. The results showed that 149 patients self-accessed the NHS abortion service in group A compared with group B of 365 formally referred patients. Half of the patients in each group had an appointment within 5 days of referral and nearly all within 2 weeks. However, 74% of patients in group A had their termination request met within 7 days of the initial appointment, compared with only 37% in group B (p = 0.0011). A total of 70% of terminations performed in group A were undertaken at less than 10 weeks' gestation, compared with only 31% in group B (p < 0.0001). It was concluded that the open referral pathway to accessing NHS abortion services, where available, appears to be effective in allowing more abortions to be undertaken at an early gestation.