The U.K. Supreme Court has ruled that midwives in charge of delivery wards are not exempt from assisting in the procurement of abortions — prompting warnings that the decision will have significant consequences for medical personnel opposed to the procedure. “Today's decision sadly makes it likely that senior midwives who refuse to kill babies will be forced to leave the profession,” Paul Tully, general secretary of the Society for the Protection of Unborn Children, said Dec. 17. “This will affect anyone who objects to abortion, of any religion or none. It will create a second-class status in midwifery for those who only deliver babies and don't kill them,” he said. Tully's group helped fund the legal case of Catholic midwives Mary Doogan and Connie Wood, who were coordinators at a labor ward at a Glasgow, Scotland hospital. They challenged the National Health Service Greater Glasgow and Clyde Health Board’s requirement that they delegate, supervise and support staff who were performing abortions. The two women said a right to opt-out of providing abortions was upheld by the U.K.'s 1967 Abortion Act and the European Convention on Human Rights. The Court of Session in Edinburgh in February 2012 initially ruled against them. In April 2013, appeal court judges ruled in their favor, saying “right of conscientious objection extends not only to the actual medical or surgical termination but to the whole process of treatment given for that purpose.” However, the Supreme Court in London sided against the two midwives, BBC News reports. Lady Hale, Deputy President of the Supreme Court, said that Parliament, when it wrote its legal protections, did not have in mind hospital managers or administrators or “the caterers who provide the patients with food and the cleaners who provide them with a safe and hygienic environment.” “Yet, all may be said in some way to be facilitating the carrying out of the treatment involved,” she said about Monday's decision. In the judge’s view, “participation” in an abortion means “taking part in a 'hands-on' capacity.” Doogan and Wood said they were “extremely disappointed” with the verdict, adding that they “can only imagine the subsequent detrimental consequences that will result from today's decision on staff of conscience throughout the U.K.” They said the ruling makes the conscience clause in practice “meaningless for senior midwives in a labor ward.” The number of abortions at their hospital’s labor ward was “a tiny percentage of the workload” and their conscientious objections could have been accommodated “with minimal effort,” they added. Tully warned that the ruling could particularly affect junior midwives. “They could easily be placed in an impossible situation by pro-abortion superiors, and would be unable to receive promotion to a more senior role without fear of being required to violate their consciences,” he said. The Royal College of Midwives (RCM) and the British Pregnancy Advisory Service (BPAS) sided with the NHS board, saying they were “deeply concerned” about extensions of the right to conscientious objection. Tully said that the ruling also declared that the Abortion Act’s conscience clause does not apply to general practitioners or hospital doctors who may be asked to prescribe abortion drugs. “We anticipate that this will lead to renewed efforts by health officials to force doctors who have a conscientious objection to abortion either to compromise their respect for human life or to leave the profession,” he continued, adding that the Society for the Protection of Unborn Children will “support and encourage doctors to resist any such bullying approach.”