Abortion Statistics, England and Wales: 2019 Summary information from the abortion notification forms returned to the Chief Medical Officers of England and Wales. January to December 2019. Published 11 June 2020, an annual update. Abortion Statistics, England and Wales: 2019 Contents Contents .............................................................................................................................. 2 Key events ........................................................................................................................... 3 Key points in 2019 ............................................................................................................... 4 1. Introduction ................................................................................................................... 5 Further information ........................................................................................................... 5 Previous publications ........................................................................................................ 5 2. Commentary .................................................................................................................. 6 Overall number and rate of abortions ............................................................................... 6 Age ................................................................................................................................... 6 Marital status .................................................................................................................... 7 Ethnicity ............................................................................................................................ 8 Area of residence within England & Wales ....................................................................... 8 Location and funding of abortions ..................................................................................... 9 Statutory grounds for abortion .......................................................................................... 9 Legal abortions performed under ground E .................................................................... 11 Gestation period ............................................................................................................. 11 Previous abortions .......................................................................................................... 12 Previous obstetric history ............................................................................................... 12 Method of abortion .......................................................................................................... 12 Complications ................................................................................................................. 14 Selective terminations .................................................................................................... 15 Women resident outside England and Wales ................................................................. 15 Abortions for women from Northern Ireland .................................................................... 15 Abortions for women from the Irish Republic .................................................................. 15 Abortion rates by Index of Multiple Deprivation, (IMD), deciles ...................................... 16 Age range analysis by Index of Multiple Deprivation, (IMD), deciles .............................. 17 Glossary ......................................................................................................................... 18 2 Abortion Statistics, England and Wales: 2019 Key events Date Key event October Abortion Act 1967 passed. Introduced by David Steel and supported by the 1967 government under a free vote. It legalised abortion on certain grounds, by legalised practitioners, in England, Wales and Scotland. The act came into effect on 27 April 1968. November The Human Fertilisation and Embryology Bill lowered the gestation limit for 1990 abortions from 28 weeks to 24 weeks. This is the currently accepted point at which the fetus is considered viable outside the mother's body. The act came into effect on 1 April 1991. June Northern Ireland funding scheme introduced, to provide funded abortions in 2017 England and Wales, for residents of Northern Ireland. In cases of hardship, travel costs are also covered. Funding is provided by the Government Equalities Office and HM Treasury. June Women in Wales, and from 28 December 2018 women in England, can take 2018 the second of the two abortion pills, misoprostol, at home. This brought England and Wales in line with Scotland, which allowed the second pill to be taken at home from October 2017. December Abortion legalised on certain grounds, in the Irish Republic, up to 12 weeks 2018 gestation and later if the woman's life or health is at risk. The law came into effect on 20 December 2018. October Abortion in Northern Ireland decriminalised after a free vote by Westminster 2019 MPs in July. The suspended Northern Ireland Executive did not return by 21 October 2019, meaning the amendment introduced by Stella Creasy was passed into law through The Northern Ireland (Executive Formation etc) Act 2019 on 22 October 2019. March The Abortion (Northern Ireland) Regulations 2020 came into force on 31 2020 March 2020. The regulations introduce a new legal framework for abortion services in Northern Ireland. 3 Abortion Statistics, England and Wales: 2019 Key points in 2019 Chart Key point 210,000 Abortions, numbers, England and Wales, 2010-2019 There were 207,384 abortions for women 200,000 resident in England and Wales, the highest Numbers 190,000 number since the Abortion Act was 180,000 introduced. 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 19 Abortions, rates, England and Wales, 2010-2019 The age standardised abortion rate for 18 residents is 18.0 per 1,000 women, the 17 highest rate since the ASR ASR perrates 1,000 women1,000 Abortion Act was 16 introduced. 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 21 Abortions, rates, under 18 and over 35, England and Wales, The abortion rate for 2010-2019 women aged under 18 16 Under 18 is the same as in 2018 (8.1 per 1,000), but has 35 or over increased for women women 11 over 35 (from 9.2 to 9.7 Crude rate per 1,000 1,000 per rate Crude per 1,000 between 6 2018 and 2019). 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 99% of abortions in Abortions, purchaser, percentages, England and Wales, 2010-2019 100 England & Wales were NHS Funded: Independent Sector 90 funded by the NHS in 80 2019, with 74% of all 70 abortions taking place in the independent Percentage 60 50 sector. 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Abortions, procedures, percentages, England and Wales, 2010- 73% of abortions were 2019 medically induced; 100 All surgical All medical which increased from 71% in 2018, and 60 increasing by 33 percentage points since Percentage 2009. 20 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 4 Abortion Statistics, England and Wales: 2019 1. Introduction 1.1 This report provides statistics on abortions recorded in England and Wales in 2019. The information presented is based on abortion notification forms (HSA4) submitted by clinics and hospitals to the Chief Medical Officer (CMO) at the Department of Health & Social Care (DHSC). DHSC monitor the forms to ensure that there is full compliance with the legislation set out in the Abortion Act, 1967. Further information 1.2 Further details on the legislative context of the Abortion Act, in addition to methodological and technical information on the data can be found in the ‘Guide to Abortion Statistics’, in Abortion statistics for England and Wales: 2019. Previous publications 1.3 The Department of Health & Social Care (DHSC) has published abortion statistics annually since 2002. Statistics for years from 1974 to 2001 were published by the Office for National Statistics (ONS) in their Abortion Statistics Series AB, Nos 1 to 28. The reports for 1991 to 2001 are available electronically on request to [email protected]. Statistics for years from 1968 to 1973 were published in the Registrar General’s Statistical Review of England and Wales, Supplement on Abortion. 1.4 The most recent versions of the publication are available from the GOV.UK website. 1.5 Contact us at [email protected]. 1.6 Abortion statistics cover the period January to December 2019 and are published annually. The next publication will be in June 2021, and will cover January to December 2020. 5 Abortion Statistics, England and Wales: 2019 2. Commentary Unless specified, the following commentary, charts and tables relate only to abortions in England and Wales, for residents of England and Wales, in 2019. Overall number and rate of abortions 2.1 Of the 209,519 abortions notified as taking place in England and Wales, 207,384 were to residents of England and Wales. This represents an age-standardised abortion rate (ASR) of 18.0 per 1,000 resident women aged 15-44. The ASR rate has increased since 2018, (17.4 per 1,000 resident women aged 15-44). This is the highest rate recorded, exceeding the previous peak in 2007, (17.9 abortions per 1,000 resident women aged 15-44). (Table 1 and Figure 1). Figure 1: Age Standardised abortion rate per 1,000 women aged 15-44, England and Wales, 1970 to 2019 Age 2.2 The abortion rate in 2019 was highest for women aged 22 (at 31.6 per 1,000 women).