Abortions at record high in England and Wales ‘driven by cost of living’

Original article by Hannah Al-Othman

The rising cost of living and a lack of access to contraception have driven another rise in abortion rates in England and Wales, providers and doctors said.

Government statistics released on Thursday showed that abortions increased by 11% in 2023 compared with the previous year.

The age-standardised abortion rate for women was 23.0 abortions per 1,000 residents, the highest rate since the Abortion Act was introduced in 1967.

“These figures reflect the first full year of abortion care during the cost of living crisis, which is essential context for understanding the rise in abortion rates,” said Katie Saxon, the chief strategic communications officer at BPAS, one of the country’s largest abortion providers.

“No woman should have to end a pregnancy she would otherwise have continued purely for financial reasons. Equally, no woman should become pregnant because she is unable to access the contraception she wants, when she needs it.”

She added: “There is no right number of abortions, but there is much more that the government can do to ensure women are able to make the choice that is right for themselves and for their families.

“Women continue to tell us about long waits for contraceptive appointments, difficulties securing repeat prescriptions, and limited choice in the methods available to them. Emergency contraception also remains an important but underutilised backup option.”

Dr Alison Wright, the president of the Royal College of Obstetricians and Gynaecologists, said: “This new data highlights how access to high-quality abortion care is essential for women’s health and reproductive autonomy.

“There is likely to be a range of factors behind the rise in abortion rates over recent years. Economic pressure and the rising cost of living are shaping women’s reproductive choices, with many choosing to delay or have smaller families.

“At the same time, overstretched GP and sexual health services are making it harder for many women – particularly in more deprived communities – to access contraception when they need it, increasing the risk of unplanned pregnancy.”

The data showed the abortion rate for women aged 35 and over had continued to increase, from 7.1 per 1,000 women in 2013 to 12.3 per 1,000 women in 2023. The lowest rate was among under-18s, at 7.8, and abortions were most common among those aged between 20 and 24.

Over the past decade, the percentage of abortions performed at the lowest gestation, of up to nine weeks, increased from 79% to 89%, while there was a downward trend in terminations carried out between 10 and 19 weeks.

The number of abortions carried out beyond 20 weeks, for which strict conditions must be met, such as a fatal foetal abnormality or a risk to the mother’s life, remained stable at between 1% and 2%.

Since the Covid pandemic, when legislation was introduced to allow abortion medication to be dispatched by post, at-home abortions made up 72% of all terminations in 2023.

Over the same period, the number of abortions for all other methods generally decreased, with the two required pills taken in a clinic now the least common method of termination.

“This data also provides further evidence of the positive impact of at‑home early medical abortion, which has enabled women to end pregnancies at the earliest possible gestation,” Saxon said. “One in three women will have an abortion in their lifetime, and services must continue to evolve in line with best clinical practice.”

Wright added: “Taking both medications at home remains the most common method of abortion, indicating that the telemedicine pathway is working as intended by enabling women to access safe, regulated care earlier.

“Telemedicine removes practical barriers for women who may otherwise struggle to attend in-person appointments, including those in rural areas, women with disabilities, and those experiencing coercion or abuse.”