Numbers of abortions performed in England and Wales are the highest ever, reports the Department of Health. Data released in a report by the department on 27 July show that 185 400 abortions were done in England and Wales in 2004, an increase of 2.1% on the 2003 figure. The age standardised rate of abortions in 2004 was 17.8 per 1000 resident women aged between 15 and 44, up from 17.5 in 2003. The overall numbers show a continuing upward trend in rates of abortion in England and Wales. Although the rate dipped below 15 per 1000 women in the early 1990s it has risen steadily since. However, the rate among teenagers fell slightly from 18.2 per 1000 women aged under 18 in 2003 to 17.8 in 2004. The under 14 group, though, showed an increase: the number of abortions rose by 6% to a total of 157 in 2004. The British Pregnancy Advisory Service said that the report indicates that British women in the 21st century increasingly see abortion as a solution to unplanned, unwanted pregnancy. "Women today want to plan their families, and when contraception fails they are prepared to use abortion to get back in control of their lives. Motherhood is just one among many options open to women, and it is not surprising that younger women want to prioritise other things. We should stop seeing abortion as a problem and start seeing it as a legitimate and sensible solution to the problem of unwanted pregnancy," said Ann Furedi, the service’s chief executive. She continued: "It’s futile for us to imagine that abortion can be eliminated by increasing awareness of contraception or through sex education or even improving access to contraception, because there are a significant cohort of women for whom abortion will always be needed as a backup to their contraceptive methods. "I think that if we’re honest then we need to accept that if women are to regulate their fertility and be able to plan their families, then abortion needs to be accepted as a backup to contraception in much the same way that emergency contraception is seen as a backup to regular contraception." However, the Royal College of Obstetricians and Gynaecologists called the data "disappointing." "We do feel that this requires further investigation—and, in particular, the availability of fertility control in the UK. On the other hand, the teenage rates are slightly lower, and this is encouraging," said a spokesperson. Rates of abortion in England and Wales are now similar to rates in the United States. Although the US abortion rate is lower than that in the UK, at 16 per 1000 women in 2001, according to the Atlanta based Centers for Disease Control and Prevention (CDC), the rate in the US has been declining in the past 20 years from a high of 25 per 1000 women in the mid-1980s (www.cdc.gov/mmwr/preview/mmwrhtml/ss5309a1.htm#fig1). Rates of teenage pregnancy in the US and the UK have been declining recently, but teenagers in the US are increasingly giving birth, according to data from the CDC (www.cdc.gov/reproductivehealth/Products&Pubs/DatatoAction/pdf/DataToAction.pdf). The NHS Health Development Agency 2003 review reports that the UK still has the highest rate of teenage pregnancy in Western Europe. In 2000 in England 38 690 teenagers under 18 became pregnant, and 45% of these pregnancies ended in legal abortion. The Nordic countries have much lower rates of abortion than England and Wales. Historically Germany, Switzerland, and Holland also have lower abortion rates. Rates in Asia, Russia, and Eastern Europe remain among the highest in the world, sometimes reaching 70 or 100 abortions per 1000 women.
1. Council of Europe. Demographic yearbook 2002 . www.coe.int/T/e/social_cohesion/population/demographic_year_book/ 2. Knudsen LB, Gissler M, Bender SS, Hedberg C, Ollendorff U, Sundstrom K, et al. Induced abortion in the Nordic countries: special emphasis on young women. Acta Obstet Gynecol Scand 2003;82(3):257-68. 3. Council of Europe, Demographic yearbook 2003 . www.coe.int/T/e/social_cohesion/population/demographic_year_book/ 4. Centers for Disease Control and Prevention. Abortion surveillance—United States, 2001. MMWR CDC Surveill Summ . 2004;53(SS9):1-32. www.cdc.gov/mmwr/PDF/SS/SS5309.pdf 5. Department of Health. Abortion statistics, England and Wales: 2004 . www.dh.gov.uk/PublicationsAndStatistics 6. Council of Europe. Demographic yearbook 2001 . www.coe.int/T/e/social_cohesion/population/demographic_year_book/ Abortion statistics, England and Wales: 2004 is available at www.dh.gov.uk/PublicationsAndStatistics
Table 1.
Rates of abortion in some European countries and the US
| Country | Year of most recent available figures | Total number of legal abortions | Abortion rate |
|---|---|---|---|
| Germany1 | 2000 | 134 609 | 8.0 per 1000 women aged 15-44 |
| Finland2 | 2000 | 10 932 | 9.0 per 1000 women aged 15-49 |
| Italy3 | 2002 | 126 164 | 9.3 per 1000 women aged 15-49 |
| Denmark2 | 2000 | 15 681 | 12.5 per 1000 women aged 15-49 |
| Iceland2 | 1999 | 947 | 13.4 per 1000 women aged 15-49 |
| Norway2 | 2000 | 14 655 | 13.7 per 1000 women aged 15-49 |
| Sweden2 | 2000 | 30 980 | 15.6 per 1000 women aged 15-49 |
| US4 | 2001 | 853 485 | 16.0 per 1000 women aged 15-44 |
| UK5 | 2004 | 185 400 | 17.8 per 1000 women aged 15-44 (age standardised to the European population) |
| Ukraine6 | 1999 | 495 800 | 45.4 per 1000 women aged 15-44 |