How common are repeat abortions?

The NHS “spends £1m a week on repeat abortions”, the Daily Mail reported. The newspaper claimed that single women are using terminations “as another form of contraceptive”, and that some will have “seven, eight or even as many as nine terminations in their lifetime”.

The Mail’s coverage seems to be a response to a request for data on repeat abortions that was made in parliament in April 2012. The article appears to draw on 2010 abortion statistics available from a Department of Health report. The annual report provides data on the number of abortions (medically termed “termination of pregnancy”) performed in the UK, and includes a section on repeat abortions.

Despite the Daily Mail's headline, the report does not provide any data or information on women’s reasons or motivations for seeking an abortion. The “abortion as contraception” claim appears to be an interpretation of the data provided by campaign groups and abortion legislation critics. Also, the data suggest that only a tiny fraction of abortions were in women who have had seven or more previous abortions – 85 procedures out of the 189,574 performed in 2010.

What is a repeat abortion?

Much as the term implies, a repeat abortion is an abortion in a woman who has had one or more previous abortions. The Department of Health has recorded the rate of repeat abortions for many years, and includes a section on repeat abortions in its annual report on abortion statistics.

How many repeat abortions are happening each year?

According to the Department of Health’s abortion statistics report, in 2010 there were 189,574 abortions in England and Wales (data are available on residents of England and Wales only). Approximately 64,445 (34%) of these were repeat abortions. The percentage of repeat abortions was found to increase with age: 8% of those under 18 years old had a repeat abortion compared with 44% of women over the age of 35. While it may initially seem puzzling why older women have more repeat abortions, a logical, cumulative effect of ageing is responsible. Put simply, the longer a woman has been alive, the greater time she has had to undergo a repeat abortion.

The Department of Health report also provides data on the percentage of abortions that are repeat abortions in women aged under 25. In 2010 in England and Wales, this figure was 24.8%, with the figure varying across difference primary care trusts (range 15% to 41%).

The Department of Health reports that “repeat unintended pregnancy and subsequent abortion is a complex issue associated with increased age”, as increasing age allows for a longer time at risk for becoming pregnant.

Are repeat abortions increasing?

Full sets of annual data have so far been published up to 2010, with figures for 2011 scheduled for publication in the near future. Between 2000 and 2010, there was a small rise in the number of total abortions, up from 175,542 to 189,574. The 2010 figure was, however, slightly lower than the peak number seen in 2007, when there were 198,499 abortions.

The Department of Health data also indicate that the proportion of all abortions that are considered repeat abortions has increased from 30% to 34% since 2000. In absolute terms, this was estimated to equate to 52,663 repeat abortions in 2000 and 64,445 in 2010.

Why have these figures come to light now?

It is not immediately clear from the Mail’s coverage why these figures are making headlines today. On April 16 2012, the Labour MP Diane Abbot asked the secretary of state for health to provide estimates on the number of repeat abortions performed in 2010, 2011 and 2012. She asked that these figures be provided based on the marital status and age of the women across each primary care trust.

However, as abortion figures are published a year in arrears, the 2012 figures will not be published until 2013. Also, the 2011 figures are not scheduled for official publication until the end of May 2012, meaning that only figures up to 2010 are available at this time. The House of Commons website also reports that the 2010 statistics provide information on the number of repeat abortions by age, but not marital status. The Daily Mail, however, quoted statistics based on both age and marital status, and it is unclear how these have been derived.

Is abortion used as a 'form of contraception'?

In the UK, abortion is legal if one of several conditions apply:

• continuing the pregnancy would involve risk to the life of the woman
• termination of the pregnancy is required to prevent serious permanent injury to the woman
• the pregnancy has not gone beyond 24 weeks, and continuing would involve risk to the physical or mental health of the woman, greater than if the pregnancy was terminated
• the pregnancy has not gone beyond 24 weeks, and continuing would involve risk to the physical or mental health of any existing children, greater than if the pregnancy was terminated
• there is a significant risk that the child would suffer physical or mental abnormalities leading to serious handicap
• emergency situations to save the life of the woman
• emergency situations to prevent serious permanent injury to the woman

The Department of Health report on abortion statistics provides information on which of these conditions applies to each registered abortion. It does not, however, provide any specific data on the reasons why women decided to seek an abortion. The idea that abortion is used “as contraception”, as reported in the Daily Mail, appears to be an interpretation of the abortion statistics data by critics of the current legislation, with the newspaper quoting pro-life campaign groups and critics of current abortion legislation.

Who can give advice about reproductive health and contraception?

People seeking advice on reproductive health and contraception can speak with their GP or a community family planning clinic. GUM (genitourinary medicine) clinics, which are often located in hospitals, can also provide contraceptive services and sexual health advice. For younger adults in particular, voluntary organisations such as Brook advisory centres also provide a wide range of sexual health services.