Record number of abortions

Years of cuts to funding of sexual health services causing issues

A RECORD number of abortions were performed in Leicestershire last year, following years of cuts to sexual health services.

Experts warn that women are struggling to access effective contraception, and say the problem is getting worse under lockdown.

New figures from the Department of Health and Social Care have revealed that 3,583 abortions took place across our area in 2019.

That’s up from 3,177 the year before, and is the highest number ever recorded.

While 122 abortions were performed on girls under the age of 18, women aged 20-24 were the most likely to terminate a pregnancy, with 948 abortions recorded among this age group.

There were also 302 abortions performed on 18-19 year olds, 843 on 25-29 year olds, 747 on 30-34 year olds, and 621 on those aged 35 and over.

Councils have only been in charge of sexual health services since April 2013, when the responsibility and funding for many public health services were transferred from the NHS to local authorities.

Between 2013/14 and 2018/19, spending on sexual health services across Leicestershire fell by 25% in real terms.

Councils across the area were spending £11.8 million on these services in 2013/14 (in 2019 money, adjusting for inflation) – falling to £8.8 million in 2018/19.

That fell again to £7.9 million in 2019/20, and while £8.1 million is budgeted for 2020/21, that’s still far lower than seven years ago.

Katherine O’Brien, associate director of communications and campaigns at the British Pregnancy Advisory service, said: “Cuts to sexual health services have had a real impact on women’s ability to access contraception, and in particular the most effective long-acting reversible methods (LARCs), such as the copper coil or contraceptive implant, which often are not available from GP surgeries.

“In some areas, sexual health services have had to restrict access to their clinics, such as reducing their hours or making their services age-restricted. Because there is still a concerted drive to reduce teenage pregnancy rates, it can mean that older women miss out on services. We regularly hear from women in their late twenties and thirties who have fallen pregnant while on a waiting list for a LARC.

“During the lockdown, the situation has worsened. Women who are shielding or living with a family member who is shielding have not been able to attend appointments, and sexual health services were forced to close to prevent transmission of COVID-19. We have seen an increase in the numbers of women accessing abortion care at BPAS since the lockdown began.

“Aside from barriers to contraception, we also know that the huge economic and financial uncertainty caused by the pandemic is having a significant impact on some women’s decisions regarding continuing or ending a pregnancy.”

Across England and Wales, 209,519 abortions were performed in 2019 – up from 205,295 in 2018, and more than ever before.

The rate has also increased from 17.4 abortions for every 1,000 women aged 15 to 44 in England and Wales in 2018 to 18.0 per 1,000 last year, which is again the highest on record.

While there have been steep declines in the rate of abortion among younger women, the rate has increased among older women in the last decade – particularly in women over the age of 34.

In 2009, there were 17,916 abortions performed on girls under the age of 18 (17.6 per 1,000), more than halving to 7,487 abortions in 2019 (8.1 per 1,000).

At the same time, the number of abortions undertaken by women aged 35 and over increased from 26,949 in 2009 (6.6 per 1,000) to 36,525 in 2019 (9.7 per 1,000).

There are concerns that the figure will increase yet further in 2020, due to the coronavirus pandemic.

Jonathan Lord, Marie Stopes UK’s Medical Director said: “Through our clinics, we regularly speak to women who have experienced difficulties accessing contraception and this has deteriorated still further during the Covid-19 pandemic.

“Not only have many services been shut down, but when women do manage to find a clinic many are being denied the full range of contraception, including some of the most effective long acting methods. Men have also been affected with vasectomy services only recently resuming.

“I also work in an NHS Trust and in that service we have already seen eight women who needed two abortions during lockdown as they were not able to access contraception. It’s been incredibly frustrating as until now Marie Stopes UK has only ever been commissioned to provide contraception to women already in need of an abortion, but knowing how critical the situation has become we have worked with Hertfordshire County Council to launch the sector’s first ever standalone contraception clinic offering fitting and removal of IUD, IUS and implants.

“We hope that this clinic will be the first of many, as unless action is taken, the progress we have made over the last 10 years will be under serious threat and it is the most vulnerable who will be worst affected.”