The Department of Health released their annual abortion statistics on Wednesday, an event always greeted with interest by media and the sexual and reproductive health sector alike.
After a high of 198,500 abortions in England and Wales in 2007, the general trend in subsequent years has been for numbers to fall or remain relatively unchanged. And so it proved on Wednesday morning, when it was announced that the number of abortions in 2011 had risen only slightly by 0.2% to 189,931, up from 189,574 in 2010.
However the age-standardised abortion rate, which looks at procedures per 1000 women in order that the role played by population change can be excluded, was 17.5 per 1,000 resident women aged 15-44 - exactly the same as in 2010.
There was other good news in the report: abortions amongst teenagers are down, at 15 per 1000 young women under 19 years, compared to 16.5 in 2010 and 18.0 in 2001. We were also pleased to see that the vast majority of abortions are still taking place before nine weeks (the proportion remained at 91%), while the number of abortions taking place at 20 weeks and over again remained the same, at just 1%.
These are the headline numbers people are usually interested in. Those working in the sector need to delve a little deeper though, to look at other statistics drawn out in the report. This can help us identify more clearly what we need to do to reduce the number of women having abortions a year by more like tens of thousands, rather than the current fluctuations of 500 or so year on year.
For Marie Stopes International, the issue is clear. For more than a third (36%) of women who had an abortion in 2011, it was not the first time they'd had the procedure, up from 34% in 2010.
We of course recognise that many women have multiple unwanted or unplanned pregnancies for reasons beyond their control, and it goes without saying that we believe women should have the same access to non judgemental high quality care whether it is their first abortion or their third.
But imagine if that third of women didn't need abortion number two or three in 2011; if they never came to see us for another abortion again? Each and every year, we could be dramatically reducing the numbers of women having to go through what, for many, can be a very difficult experience.
We think the key to doing this is working more closely with these women, to understand exactly why they are requesting an abortion more than once, and - based on what they tell us - coming up with a better way to support them. We see around 60,000 women each year for an abortion, and we can say absolutely categorically that immediately after an abortion is not always the best time to talk contraception. Might it be better to talk about it two weeks after? Four weeks after?
We aren't sure at the moment, but we hope much needed new research we are funding and conducting at the moment will tell us more. What we do know for certain is that women trust us with their sexual health needs: 99% of those we see say the level of care we provided to them was excellent, and this is what makes us think there's a role for us to play in helping them prevent another unwanted or unplanned pregnancy.
At Marie Stopes International, we ask each and every woman why they have found themselves with an unwanted or unplanned pregnancy, at the time they request an abortion.
Many tell us they haven't found a method of contraception that works for them, one with no side effects that fits in with their lifestyle, and one which their partner supports. Others tell us it was due to contraceptive failure, or that they forgot to take their pill and either couldn't access emergency contraception, didn't know about it, or thought they'd risk it.
We then ask them about their plans for contraception after they have the abortion, if they choose to proceed. Our healthcare professionals give advice about the full range of contraception so they know that there are 16 types out there, including long term reversible options like the implant, injections or the coil.
We also tell them about the huge range of contraceptive pills now on offer. No longer do women have to forfeit contraception because one brand of pill made them gain weight, or suffer mood swings. When they leave us, we can make sure they have a supply of their chosen method, at no cost to them.
But what we can't do is, with the woman's agreement, follow up with them in the long term after their abortion to check if they're still using the contraception we provided, or if they want to try and find one which suits them better.
At the moment, we are funded by the NHS to provide high quality abortion services and aftercare along with a one off offer of contraception free of charge, and we also provide non directive, non judgmental counselling as part of our care for women.
The NHS funding for trusted organisations such as ourselves simply doesn't allow us to provide women with continuity of care over a longer period. We call on the government to help us in our efforts to do this.
When they leave our centres most women say to us: "Thank you for looking after me, but you won't see me here again." Something is going wrong somewhere, and we want to help put it right.
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