Abortions in England and Wales Reach Record High in 2023 Amidst Rising Use of Abortion Pills

Record Number of Abortions Reported

New statistics released by the Department of Health and Social Care (DHSC) reveal that abortions in England and Wales reached a record high in 2023. A total of 277,970 abortions were performed for residents, marking the highest number since the Abortion Act was introduced in 1967. This represents a significant 11% increase compared to 2022, with 26,593 more abortions recorded.

The age-standardised abortion rate for women aged 15 to 44 also reached an unprecedented level of 23.0 abortions per 1,000 residents. This surge follows a 17% increase between 2021 and 2022, indicating a continuing upward trend in recent years.

Dominance of Medical Abortions and At-Home Care

The data highlights a significant shift towards medical abortions, which constituted 87% of all procedures in 2023. A substantial portion of these were performed using the 'pills by post' method, where both medications are taken at home. This method accounted for 72% of all abortions, totaling 200,745 procedures, an increase of 48,340 since 2022.

The majority of abortions, 89%, occurred at an early gestation of 2 to 9 weeks. While medical abortions continue to be the most common method, the number of surgical abortions also saw an increase in both 2022 and 2023, reversing a two-decade-long decline.

Contributing Factors and Expert Commentary

Healthcare providers and experts have attributed the rise in abortion rates to a combination of factors. The cost of living crisis is frequently cited as a significant influence on women's reproductive choices, with many opting to delay or have smaller families due to economic pressures. Additionally, challenges in accessing contraception and overstretched GP and sexual health services are believed to contribute to unplanned pregnancies.

The expansion of the telemedicine pathway, which allows for remote consultations and at-home administration of abortion pills, has also played a role. This pathway is seen as improving access to care, enabling women to end pregnancies earlier and with greater privacy. Dr. Alison Wright, President of the Royal College of Obstetricians and Gynaecologists, noted that telemedicine removes practical barriers for women who might struggle with in-person appointments, including those in rural areas or experiencing coercion.

Demographic Trends and Repeat Abortions

The statistics indicate an increase in abortion rates across all age groups. The crude abortion rate for women aged 35 and over has steadily risen, from 7.1 per 1,000 women in 2013 to 12.3 per 1,000 women in 2023. Similarly, the rate for women aged under 18 increased from 7.6 to 7.8 per 1,000 women.

A notable trend is the increase in repeat abortions, which reached 117,165 in England and Wales, accounting for 42% of all abortions among residents. The majority of abortions, 81%, were provided by the independent sector rather than NHS settings. The rate of reported complications remained low, at 1.1 per 1,000 abortions, a slight decrease from 1.2 in 2022.