Abortion rates in England and Wales have reached their highest level on record, with new government statistics revealing an 11% increase in procedures during 2023. Experts from leading reproductive health charities point to the ongoing cost of living crisis and significant barriers to accessing contraception as the primary drivers behind this stark rise.
Financial Pressure and Access Barriers Fuel the Rise
The latest figures show the age-standardised abortion rate for women stood at 23.0 per 1,000 residents last year. This is the highest rate recorded since the Abortion Act came into force in 1967. Katie Saxon of the British Pregnancy Advisory Service (BPAS) stated the data reflects the first full year of abortion care during the severe economic squeeze, providing essential context for understanding the trend.
"No woman should have to end a pregnancy she would otherwise have continued purely for financial reasons," Saxon emphasised. She also highlighted systemic issues in contraceptive provision, noting reports from women about long waits for appointments, difficulties getting repeat prescriptions, and a limited choice of available methods.
Dr Alison Wright, President of the Royal College of Obstetricians and Gynaecologists, echoed these concerns. "Economic pressure and the rising cost of living are shaping women’s reproductive choices," she said, adding that overstretched GP and sexual health services are making it harder, particularly for women in deprived communities, to access timely contraception.
Demographic Shifts and the Rise of Telemedicine
The data reveals notable shifts in the demographics of those seeking abortions. The rate for women aged 35 and over has seen a sustained increase, rising from 7.1 per 1,000 in 2013 to 12.3 per 1,000 in 2023. While the lowest rate was among under-18s (7.8), abortions were most common among those aged 20 to 24.
A significant and lasting change has been the method of abortion delivery. Since pandemic-era legislation allowed abortion medication to be sent by post, at-home abortions accounted for 72% of all terminations in 2023. This telemedicine model has become the dominant method, while the number of abortions conducted via other means, such as taking both pills in a clinic, has generally decreased.
"This data provides further evidence of the positive impact of at‑home early medical abortion, which has enabled women to end pregnancies at the earliest possible gestation," said Katie Saxon. Dr Wright added that telemedicine removes practical barriers for many, including those in rural areas, women with disabilities, and those experiencing coercion.
Earlier Procedures and Stable Later-Term Numbers
Alongside the overall increase, there has been a marked trend towards earlier intervention. Over the past decade, the percentage of abortions performed at up to nine weeks' gestation has risen from 79% to 89%. Concurrently, there has been a downward trend in terminations carried out between 10 and 19 weeks.
The number of abortions conducted beyond 20 weeks, which are only permitted under strict conditions such as a fatal foetal abnormality or risk to the mother's life, has remained stable at between 1% and 2% of the total. This indicates that the rise is primarily in early-stage procedures, facilitated in part by the accessibility of at-home care.
As one in three women in the UK will have an abortion in their lifetime, providers stress that services must continue to evolve. The record figures underscore an urgent need to address the underlying economic and healthcare access issues that are profoundly influencing reproductive choice across England and Wales.
