At-home pill sees abortion rates rise to highest on record, new data shows

More than half of all abortions that took place in 2021 were carried out at home following changes to the accessibility of treatment during the pandemic, new figures show.

Data from the Office for Health Improvement and Disparities, published on 21 June, reveals that there were 214,896 terminations in England and Wales during 2021 – the highest number on record since the procedure was legalised through the 1967 Abortion Act.

Of these abortions, 52 per cent involved women taking mifepristone and misoprostol pills in their homes.

At the start of the Covid-19 pandemic in March 2020, the government introduced temporary measures to allow the use of the two pills for early medical abortion at home, without needing to attend a hospital or clinic.

Early medical abortions are defined as taking place withint he first 10 weeks of pregnancy.

Following calls from campaign groups, in March 2022 parliament voted in favour of amending the Health and Care bill to make the change permanent across England and Wales.

MSI Reproductive Choices, a charity which provides contraception and safe abortion in countries across the world, said the figures for 2021 were reassuring “that women continue to access care earlier in their pregnancy”.

“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,” Jonathan Lord, UK medical director of the charity said.

“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.”

Figures show that last year’s abortion rate was highest for women aged 22, up from age 21 in 2020 and age 20 in 2011.

The abortion rate for women under the age of 18 has continued to decrease, while it has remained stable for women aged 35 or over.

Over the last decade, the largest increases in abortion rates by age are among women aged 30-34, which have increased from 17.2 per 1,000 in 2011 to 22.1 per 1,000 in 2021.

Charity and abortion provider British Pregnancy Advisory Service (BPAS) said the data shows that the pandemic and the policies adopted by the government in response “have had a clear impact on women’s pregnancy choices”.

“Faced with economic uncertainty and job insecurity, women and their partners have been making sometimes tough decisions around continuing or ending a pregnancy,” Clare Murphy, chief executive of BPAS said.

“While there is no right number of abortions, we know that there is much more the government can do to ensure that women are able to make the decisions that are right for them when faced with an unplanned pregnancy.”

Almost all abortions (98 per cent) were carried out before 24 weeks on the grounds of a risk to women’s mental health.

A small number of abortions, 1.6 per cent, were carried out under ground E due to fetal abnormalities.

BPAS is calling on the government to act on fortifying flour with folic acid, a move which it says could prevent hundreds of abortions.

More than 300 terminations were due to neural tube defects such as spina bifida and anencephaly, which are related to a folic acid deficiency.

Both the NHS and the US Centres for Disease Control and Prevention recommend that women should consume folic acid tablets prior to and 12 weeks into pregnancy.

“For every year that the Government continue to delay the introduction of folic acid fortification, hundreds of women will face the heartbreak of ending a wanted pregnancy due to a diagnosis of a neural tube defect,” Murphy said.

“Most fetal anomalies sadly are not preventable, but those related to folic acid deficiency can and must be reduced. To continue to delay plans for fortification would be morally reprehensible.

“We hope that the data released today can finally shame Ministers in to finally taking this woefully overdue action in order to get the best pregnancy outcomes for as many women as possible.”

Lynn Murray, spokeswoman for the Don’t Screen Us Out campaign on Down’s syndrome, said the figures also showed a rise in abortions for Down’s, up to 859 in 2021.

“As a mother of a 22-year-old daughter who has Down’s syndrome, I see every day the unique value she brings to our family and the positive impact she has on others around her,” Murray said.

“It is deeply concerning that despite the leaps that advocacy groups have made in raising awareness in support of people with Down’s syndrome, abortion in the case of Down’s syndrome is still so commonplace and widespread in the UK.”

Additional reporting by PA