Friday June 13 2014
Some women may want to focus on their career rather than family
Media sources have reported on the "career girl" abortion (Daily Mail) or "lifestyle" abortion (The Daily Telegraph) after figures released by the Department of Health showed that increasing numbers of women aged 25 to 29, or who have long-term partners or children already, are having abortions.
The media stories follow the release of government abortion statistics in England and Wales for 2013. This provides information on abortion (medically known as "termination of pregnancy") rates and characteristics about the women having abortions.
While the total number of abortions in England and Wales has increased, the rate of abortions has actually decreased. And encouragingly, rates among teenagers have fallen. The highest abortion rate is now among those aged 22 in 2013 (up from 21 in 2012).
The Department of Health report provides us with facts only, not explanations. It does not discuss the possibilities for the changes in trends seen, and all media reports of "career girl" or "lifestyle" abortions suggesting abortion is sometimes used as a method of contraception are pure speculation only, with no foundation in this report.
What do the statistics show?
Any doctor performing an abortion is legally required to notify the chief medical officers (CMOs) within 14 days of the abortion. The statistics in this Department of Health report come from abortion notification forms returned to the CMOs of England and Wales, and can therefore be considered reliable.
The total number of abortions in 2013 was 185,331, an increase of 0.1% on 2012 (185,122) and a 2.1% rise from 2003 (181,582). But despite the increase in the overall number of abortions, rates among women have actually decreased.
The age-standardised abortion rate was 15.9 per 1,000 women aged between 15 and 44 years old resident in England and Wales. This was 0.8% lower than in 2012 and 4.7% lower than in 2003 (16.7). It is the lowest abortion rate for 16 years.
However, the age group with the highest abortion rate seems to be getting older. In 2013, it was highest for women aged 22 (at 30 per 1,000 women). The previous year, it was highest for women aged 21 (at 31 per 1,000).
Teenage abortion rates in 2013
The abortion rates among the teenage population are lower and have been falling: in 2013, the rate among under-16s was 2.6 per 1,000, and the rate among under-18s was 11.7 per 1,000.
These figures are both lower than the previous year (3.0 and 12.8 per 1,000 respectively) and 10 years ago (3.9 and 18.2 per 1,000 respectively).
What are the reasons for these abortions?
As the Department of Health report states, the Abortion Act 1967 permits the termination of a pregnancy (abortion) by a registered medical practitioner subject to certain conditions.
A legally induced abortion must be certified by two registered medical practitioners and is carried out on the grounds of one of five reasons (A to E):
- A: risk to the life of the woman if the pregnancy is continued
- B: risk of serious permanent injury to the physical or mental health of the woman
- C: risk of injury to the physical or mental health of the woman (and the pregnancy had not exceeded its 24th week)
- D: risk to the physical or mental health of any existing children in the family (and the pregnancy had not exceeded its 24th week)
- E: risk that the child would be born with physical or mental abnormalities such that they would be seriously handicapped
Most abortions related to unwanted or unplanned pregnancy will usually be carried out on grounds C or, rarely, grounds D (for example, if the woman has other children who she feels she wouldn't be able to care for adequately if she had another).
As the report demonstrated, in 2013 97% of abortions (180,680) were carried out on grounds C. Virtually all of these (99.8%) were carried out specifically on the grounds of threat to the woman's mental health, rather than her physical health.
Meanwhile, only 1% of abortions in 2013 were carried out on grounds E – that the child would be born disabled. Nearly half of the 2,732 abortions carried out on grounds E were because of identified congenital abnormalities, a third of these being caused by chromosomal abnormalities (most commonly, Down's syndrome).
Where do the media reports of 'career girl abortions' come from?
The study reported varied information about the lifestyle characteristics of women undergoing abortion in 2013. The media has made sweeping statements about women's motivations and needs for abortion loosely based on these findings.
Facts that may have influenced the headlines include:
- Most abortions (81%) were carried out for single women, a proportion that has risen since 2003 (76%). More than 60% of these "single" women were reported to be with a partner. Sixteen percent of women having an abortion were reported to be married or in a civil partnership.
- Just over a third of women (37%) having an abortion had had one or more previous abortions. The number of women this applied to increased with age, for obvious reasons: 18% of women aged 18 or 19 had had one or more previous abortions, increasing to 34% of 20-24 year olds, 44% of 25-29 year olds, and 47% of 30-34 year olds, and 45% of those over 35.
- Just over half of women (53%) undergoing abortion had had previous pregnancy resulting in birth, while 18% had had previous pregnancy resulting in miscarriage.
- Presumably the most important factor influencing the tone of the headlines was the finding that 43,578 women aged between 25 and 29 had an abortion in 2013, compared with 41,882 in 2012. The number of women who had an abortion who had previously given birth in this age group increased from 52% in 2012 to 53% in 2013.
However, the report provides figures only. The Department of Health report does not discuss possibilities for changes in trends, and all media reports of "career girl" or "lifestyle" abortions suggesting abortion is sometimes used as a method of contraception are pure speculation, with no foundation in this report.
As the figures show, while the total number of abortions in England and Wales has increased, the rate per 1,000 women has actually decreased.
Teen pregnancy rates have also fallen, which is encouraging. The reason for this decrease is not known – it could be the result of improved sexual health awareness and education, but again this is pure speculation.
The fact that the number of women who have had previous abortions increases with age group is, as the report says, likely just a result of increasing age increasing the exposure time for possible pregnancy.
The information on the proportion of women having an abortion who are single, with a partner or married similarly tells us little about women's lifestyle choices.
Overall, the report only provides us with facts, not explanations.
Where can I get advice on abortion and pregnancy?
You can get help and advice on contraception, pregnancy and abortion from various sources, including your GP or local sexual health clinic.
Online support services include FPA and Brook, or you can call the sexual health advice line on 0300 123 7123.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.