The overturning of Roe v Wade has thrown the topic of abortion rights into the limelight recently – not just in the US, but also in the UK. It has highlighted just how fragile, yet important this vital service is to women worldwide.
Recently we have seen that rates of abortion have been increasing steadily since 2016. In fact, 2021 (the latest Government figures) has seen an increase for abortion services at a level not seen since Abortion Act was introduced in 1967. Official statistics show that 214,256 abortions took place in 2021 in England and Wales – 4,000 more than the previous year.
So why are abortion rates rising? And what is driving this recent increase in abortion rates? Could this be a reflection of the wider economical landscape?
There is no clear reason for pregnancy termination rates rising. Abortion is, naturally, a very sensitive topic. The decision to go ahead with termination is a decision that is driven by a huge variety of factors that are individual for each woman. For a long time we have understood that foetal abnormalities, rape, contraception failure, fear of penalisation and harassment, careers, and financial insecurities are all significant factors in decisions around abortion.
Data shows that a considerable 82% of abortions in 2021 were from women whose marital status is ‘single’. This suggests that relationship status plays a large part in the decision. And of course, we’d be remiss if we didn’t acknowledge that the economic downturn and cost of living crisis is likely to factor into this too.
Could women be struggling to access contraceptive services? With cuts to funding and capacity challenges (ever struggled to book an appointment with your GP?), it seems that impartial access to contraception remains a problem across local authorities.
The Royal College of Obstetricians and Gynaecologists (RCOG) reports in its Better for Women report that “Missed opportunities and barriers to women accessing contraception, in particular long-acting reversible contraception (LARC), and contraceptive advice and counselling needs to be addressed.”
The good news is that teen pregnancy rates are dropping. Government figures show that the abortion rate for under 18s has reduced from 6.9 per 1,000 in 2020 to 6.4 per 1,000 in 2021. This suggests that younger women have better access to contraception. But for older women this doesn’t seem to be the case. According to Office For National Statistics (ONS) figures, the average age of mothers in England and Wales has increased from 30.6 per 1,000 in 2018 to 30.9 per 1,000 in 2021. Indeed, the largest increase in abortion rates has been for women aged 30-34 – which has increased from 17.2 per 1,000 in 2011 to 22.1 per 1,000 in 2021.
We know that there has been a gradual trend toward women starting families later in life – women in their early thirties tend to have greater responsibilities and work commitments so it is likely that this also plays a part.
Historically, a face-to-face consultation would happen at the clinic or hospital and the first pill, mifepristone, would be taken in the clinic. The patient would be given the second pill(s), misoprostol, to be taken at home.
Changes to abortion laws in March 2020 saw temporary approval of telemedicine abortions during COVID-19 pandemic. This meant that both pills – mifepristone and misoprostol – could be taken at home, meaning that women no longer needed to attend a clinic or hospital in-person before having an abortion. This was a big step forward in making abortion more accessible. Then in February 2022 this change was made permanent.
The rules as to what is required by healthcare providers to prescribe the abortion pills are still unchanged – a consultation is still needed (albeit this can be done by phone or video) as the healthcare provider needs to safeguard and feel confident that there is no coercion. In addition, two doctors will need to sign off on the procedure.
This law change brings with it so many benefits for women, making abortion not only more convenient, but also a more comfortable experience in the privacy of their own home. Abortion pills by post can be used to terminate pregnancies up to 10 weeks. Although the majority of pregnancy terminations are carried out through the NHS, there are a few private clinics that offer this service. Abortions through the NHS are free but the cost of abortion pill in the UK via a private clinic can vary. Some women prefer to go with a private abortion clinic as it allows more privacy, and flexibility in terms of appointments and locations – some clinics even offer next day appointments.
The exact reason pregnancy terminations are increasing is unknown; but what is crystal clear is that it is more important than ever before to protect women’s rights to choose abortions and ensure that they are always safe and easily accessible.
