The High Court in London has ruled women from Northern Ireland are not legally entitled to free abortions on the NHS in England.
Human rights groups have reacted with fury to the decision, branding the law "outdated and restrictive."
The law on abortion is stricter in Northern Ireland than in England and Wales, where the 1967 Abortion Act liberalised the position.
In Northern Ireland, the termination of pregnancies generally remains unlawful unless carried out to preserve the life of the mother.
Subsequently, more than 1,000 women each year travel from NI to have an abortion in other parts of the UK.
Amnesty International's Northern Ireland Campaigner, Grainne Teggart said the ruling "puts the spotlight on the outdated and restrictive laws on abortion in Northern Ireland."
"It is unacceptable that women in Northern Ireland are designated second-class citizens of the UK in terms of their right to access healthcare," she said.
"Northern Ireland's laws are out of step with international human rights obligations, including women’s rights to non-discrimination, health, life, and physical integrity.
"The Northern Ireland Executive must step up to the mark and address the human rights impact of the current laws on abortion."
In his judgement, Mr Justice King, said the differences in the legal position had "not surprisingly led to a steady stream" of pregnant women from Northern Ireland to England to access abortion services not available to them at home.
But he ruled that Health Secretary Jeremy Hunt's duty to promote a comprehensive health service in England "is a duty in relation to the physical and mental health of the people of England", and that duty did not extend "to persons who are ordinarily resident in Northern Ireland".
Ann Furedi, chief executive of the British Pregnancy Advisory Service, said the ruling was a signal that the time had come for the women of Northern Ireland to be entitled to get the care they needed "at home".
She said she was "saddened but not surprised" by the decision. "But let this ruling serve as a reminder of the appalling fact that women from Northern Ireland are forced to travel to England every day to access a fundamental healthcare service that they should be able to obtain at home, or take their chances by illegally buying abortion medication online," she added.
"Outlawing abortion does not prevent women having abortions, it simply increases the physical, financial and emotional burden of obtaining the care they need.
"If women from Northern Ireland cannot get NHS-funded abortion care in England, then surely the time has come to ensure they can get that care at home."
Liam Gibson, from the Society for the Protection of Unborn Children, welcomed the ruling, the BBC reported.
"This decision had it gone the other way would certainly have led to more abortions taking place which would have been a bad thing for both women and children. It would also have had serious implications for the value of our devolved institutions," he said.