Coalition must improve post-abortion contraception provision, says provider

Posted on May 29, 2012

The Guardian, May 29, 2012 by Lizzy Davies

Marie Stopes International speaks out after rise in terminations for women who have already ended at least one pregnancy

A leading abortion provider has called on the government to help improve contraception provision for those who have had terminations, as new figures revealed a rise in the number of terminations being carried out for women who have already ended at least one pregnancy.

Some 189,931 women had abortions in England and Wales last year, an increase of 0.2% on 2010, according to the annual statistics released on Tuesday by the Department of Health. There were falls in the number of girls aged under 16 and under 18 having terminations compared with both 2010 and 2001.

Of those women having abortions, the proportion who were ending an unwanted pregnancy for at least the second time went up from 34% in 2010 – and 31% in 2001 – to 36%, a repeat rate that prompted Marie Stopes International (MSI) to call for the government to support efforts to ensure more post-abortion contraception.

“We believe we need to radically change the way we provide post-abortion contraception to women, if we’re going to reduce the number of abortions by any great number,” said Tracey McNeill, European director of MSI.

“We’re conducting new research [that] will look at how we can reduce the number of women we see more than once for an abortion, by working closely with them to understand exactly why it is that we’re seeing them two or more times,” she said. “We look to the government to support us in our efforts, by transforming contraception provision in the UK.”

McNeill said MSI would like to be able to “check in” with women at regular intervals after abortions to see if they were still using the contraception it had provided to them. “At the moment, the way the system works means we aren’t allowed to do that, which I think directly correlates with the large number of repeat abortions we see in this country,” she said.

The figures – according to which the greatest number of “repeat” abortions were performed on women over 25 – are not surprising, says the British Pregnancy Advisory Service (BPAS), another leading abortion provider. It said the rate remained lower than both Sweden and the US.

Ann Furedi, chief executive of BPAS, said: “Abortion is a fact of life, because contraception fails and sometimes we fail to use it properly. It is a service that one third of women will need in the course of their reproductive lifetimes so they can plan the timing and size of their families, and play a full role in society.”

She echoed MSI’s call for the government to focus on contraception as a key means of curbing the number of unwanted pregnancies. “There has been much focus on problematising abortion, while safeguarding robust contraception services appears low down the list of government priorities. We urge the government to publish its sexual health policy document, which is now more than a year overdue.”

Julie Bentley, chief executive of the Family Planning Association (FPA), said that although the stable rate of abortions in recent years was to be welcomed, the “cracks” appearing in contraception services were not. “If we are going to bring down abortion numbers, this needs to change,” she said. “Contraception is an essential not a luxury.”

Responding to the calls for better provision of contraception, the public health minister Anne Milton said: “More women are using long-acting contraception and there are many types of contraception available to suit women’s needs, from the pill to long-acting, reversible contraception such as the contraceptive implant. All women should be able to get the contraception they need and it is up to the local NHS to ensure this is happening.”

The number of abortions in England and Wales has remained stable since 2009, when 189,100 terminations were recorded. That number rose to 189,574 in 2010. For every 1,000 resident women aged 17-44, last year saw 17.5 of them having abortions, the same as in 2010. The under-16 abortion rate was 3.4 a 1,000 women, down on the previous year’s 3.9; and the under-18 rate was 15 a 1,000, down on 2010’s 16.5.

But, while indicating a fall in the number of younger women having abortions, the figures showed an increase in the number of women aged 31-39 ending pregnancies compared with 2010, a rise which BPAS said could be attributed, among other things, to warnings about infertility that lead some women to believe they are unlikely to become pregnant.

The figures showed that the vast majority of abortions (91%) were carried out at under 13 weeks, with 1,118 carried out at 22 or 23 weeks and 146 at the current limit of 24 weeks or more.

They also recorded that 6,151 terminations were carried out on non-resident women, the lowest number since 1969. Two-thirds were from Ireland, and 16% from Northern Ireland, the only part of the UK to which the Abortion Act 1967 does not apply. But many women had come from much further afield, including 102 from the United Arab Emirates, 169 from Italy, 63 from Malta and six from Saudi Arabia.

The figures come amid increasing tensions over abortion in the UK, as providers such as BPAS warn that their work is coming under ever greater scrutiny and pressure from the anti-abortion movement. Earlier this week Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said that US-style protests and vigils outside clinics were causing distress to women and could even deter younger doctors from opting to perform terminations.

Rebecca Mallinson, of the ProLife Alliance, said: “Very sadly, the abortion statistics for 2011 give little cause to justify our continued optimism, except thankfully in the under-16 and under-18 groups.”

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