A record number of women accessed abortion in England and Wales last year, demonstrating a clear need to protect services as reproductive rights are repealed elsewhere.
A total of 214,256 abortions were reported in England and Wales in 2021, the highest since the Abortion Act was introduced. This compares with 210,860 over the same period in 2020.
It’s unclear exactly why the number of abortions is increasing, says Kerry Abel, chair of Abortion Rights. But this is a trend being repeated in the US, despite the rollback of rights.
“It shows that we will always need to keep legal and safe abortions accessible and available,” she says.
The stats do indicate that social deprivation is a factor though, with some charities warning that abortion access will become even more vital as the cost of living crisis worsens.
In 2021, women living in the most deprived areas of England were more than twice as likely to have abortions than women living in the least deprived areas
The largest increase in abortion rates by age was among women aged 30-34. And 57% of women seeking an abortion were already mothers, compared with 51% in 2011.
Jonathan Lord, medical director at abortion provider MSI Reproductive Choices UK, says: “The data shows abortion is an essential choice, and with continuing problems accessing contraception coupled with the cost of living crisis, we would not be surprised to see greater demand over the coming months.”
There is some progress within the stats though. In 2021, 89% of abortions were carried out under 10 weeks. This compares with 88% in 2020 and 78% in 2011, suggesting more women have been able to access appointments sooner.
“Despite the record numbers needing an abortion in 2021, it is reassuring that women continue to access care earlier in their pregnancy,” Lord says.
“This is even more remarkable as in most NHS services access was significantly restricted by the pandemic, demonstrating how well abortion services have adapted using innovations such as telemedicine.”
But we still need to improve access to abortion
The stats show that medical abortion via two tablets is the most common procedure, accounting for 87% of abortions.
In 2018, the law changed to allow women to take both tablets at home, after HuffPost UK and campaigners shared stories of women experiencing the effects of the second pill – including bleeding, nausea, dizziness and occasionally, vomiting – on their way home from clinics on public transport.
Despite the law change and the introduction of telemedicine – allowing women to access ‘pills by post’ after consultations – the stats show that thousands of women are still taking pills at clinics.
“We know how successful and highly rated our telemedicine abortion-at-home care has been. It’s therefore a little concerning that the figures suggest up to 75,000 women, 40% of those having a medical abortion, might not have been offered the option of taking both sets of tablets at home,” says Lord.
“While there may be valid reasons for this in some cases, it suggests many people are not being offered the best, evidence-based care.”
There are also still problems accessing abortion in Northern Ireland.
Despite abortion being decriminalised in Northern Ireland in 2019, 161 women from Northern Ireland travelled to England and Wales for abortions in 2021. This is due to a lack of available services in Northern Ireland.
“Although we are proud to support those travelling from Northern Ireland, it simply is not right that the journey is needed at all,” says Lord.
“Abortion care should be fully available in Northern Ireland, including the option of telemedicine, and we join those calling on the Department of Health in Northern Ireland to commission services as soon as possible.”
In light of the new statistics, Amnesty International has called on the Secretary of State to “move swiftly to bring to an end the denial of this essential healthcare”.
Ruairi Rowan, director of advocacy and policy for Informing Choices NI (ICNI), echoed the concern.
“Since the new abortion framework was introduced, ICNI has spoken with numerous women who have been unable to access local abortion care,” he said. “Being denied access to local treatment has caused those women great distress and anger.
Often women ask why, if the law has changed, are services not in place. We echo the calls for the Secretary of State to ensure local access to abortion services.”