In the 1950's, abortions were prohibited in England. Because reputable doctors were not allowed to perform the procedure, many women with unwanted pregnancies attempted self-induced abortions. This practice commonly led to infection and even death. In addition, a woman caught attempting a self-induced abortion could be prosecuted. As a result, back-alley abortionists flourished. Many of these black market practitioners used unsafe equipment or charged high fees. Vera Drake began her side career as an abortionist out of a desire to provide a service to women as a way to keep them out of trouble, whether that trouble was their own family, the law or an unscrupulous practitioner. However, viewers must wonder just how close Vera herself was to being one of these unscrupulous medical hacks.
Further blurring the boundary between offering the practice as a medical necessity and the moral compulsion against abortion is the depiction of class conflict. In the film, a wealthy young woman becomes pregnant as a result of a rape, and decides to obtain an abortion through legal means. Her doctor refers her to an expensive psychiatrist, who provides a statement claiming that the young woman ran a risk of potential mental illness, and if not allowed to terminate the pregnancy might potentially take her own life. This statement is sufficient grounds to warrant a legal abortion in a hospital. This incident in the film begs the question of why the rich should be allowed abortions if they are morally taboo.
Though Vera Drake is purporting to help young, poor, women with unwanted pregnancies, the film does raise the question of whether she is, in fact, contributing to an exploitation of these women. Though Vera is always kind, she provides no advice, no consolation, and leaves quickly after the procedure is finished. When one of her patients dies and Vera is arrested, it becomes clear that Vera may have in many cases done more harm than good. In addition, though Vera charges no money for her services, it turns out that her partner, the woman who finds the clients for her, has been charging fees.
Ultimately, the largest ethical dilemma of the movie centers around who is to blame for the sad events. Vera herself is convicted and sent to jail. She has certainly done something illegal, and admits as much. Yet the film also imparts a sense of culpability to the society that has allowed the Vera Drake tragedy to unfold. With availability of medical abortion to the lower classes, there would not have been a market or a need for Vera to do what she has done. Viewers are left to ponder who is the bigger villain: Vera, who in her desire to do good has committed a murder, or the law and social structures which created the opportunity for Vera Drake to exist in the first place?