The UK reached its highest levels of abortion on record in 2023, with an 11% increase on the previous year – according to the latest statistics released in early January.
Whilst most reporting has focused on the increasing role that the cost-of-living crisis is playing in rising abortion rates, experts claim that this is just one part of a complex picture.
Dr Anatole Menon-Johansson, Clinical lead at Brook sexual health charity, explained how this rise is being driven by a mixture of contraception budget cuts, the pandemic, changes to societal norms on having children, fear around hormonal contraception and big changes in abortion delivery.
He said: “A lot of women are having their first baby at 35, which is 20 years older than it would’ve been in Victorian period.
“And women are often tying it to when it’s a good break in their career to take maternity leave and- with the rising cost of living- when they have enough money to have a child,” he added.
The most recent statistics show that 31% of conceptions led to abortion in England and Wales in 2023, when compared with the live birth rate (excluding stillbirths and miscarriages).
In 2012, number of births peaked at 729,674 in England and Wales, and since then birth rates have declined year-on-year, with an overall fall of 19% between 2012 and 2024.
However, 2023-2024 saw a small increase in birth rates; the first rise seen in 11 years.
Meanwhile, abortions rates have increased by 50% from 185,122 annual abortions in 2012 to 277,970 in 2023.
Notably, 89% of abortions were very early, at under 9 weeks gestation, and the vast majority (93%) of those were medical abortions (where women will take a combination of pills mifepristone and misoprostol to terminate a pregnancy).
Abortion Rights, the national pro-choice campaign group, urged policymakers and the media “to stop treating abortion rates as a moral barometer” and actually focus on the interconnected causes behind it.
First and foremost- yes -women in the UK are having less children, they’re having them later, or they’re not having them at all.
One in four births (23.9%) are now to mothers aged over 35 years old, according to ONS 2023 data, and the fertility rate now stands at 1.4 (average number of children per woman).
Whilst the crude abortion rate increased for every age group, the biggest rise in abortions between 2022-2023 was found in 25 to 29-year-olds.
This is an age which previously many women would have desired to have children, but now falls below the average age of a woman’s first child at 31.
Meanwhile, there has been a nationwide drop in women and men using contraception services – with new NHS sexual health data pointing to a 47% reduction in contraception-related contacts with Sexual and Reproductive Health (SRH) services over the last 10 years (2015-2025).
Since the commissioning of sexual and reproductive health services was moved to local government in 2013, there have been budget cuts of over a third– which includes cuts in contraception delivery carried out by SRH clinics, GPs, pharmacies, and young people’s services.
It’s not as simple as a lack of clinicians and resources for contraception fitting, Dr Menon-Johansson said, but services actually having the capacity to support women in accessing contraception that works for them.
Sexual Health Charities have also reported growing mistrust in hormonal contraception amongst women and a move towards ‘natural planning’ as a form of birth control.
According to the NHS, 1 to 24 of every 100 women using natural planning get pregnant each year, although many of these more serious apps claim that with proper user data inputs and proper condom usage in women’s fertile periods, their efficacy is actually much higher.
Dr Joanna Copping, consultant in population health and sexual health at Bristol City Council, said:
“There are risk with an abortion. People who are trying to avoid meds are now taking loads of meds to terminate a pregnancy.
“It doesn’t always work, there’s all the emotional impact- and it’s not as straightforward as other forms of contraception.”
Dr Menon-Johansson said that whilst more individual-level data is needed to make this claim, there is certainly a “correlation” between natural cycle uptake and “flying abortion rates”, and that it may be “a very telling negative story”.
Meanwhile, since 2020, both abortion pills became available for home delivery from licensed abortion providers and by 2023 at-home abortions made up 72% of all abortions.
Doortje Braeken, former Senior Advisor for Adolescents at the International Planned Parenthood Federation (IPPF) and long-time advocate for decriminalising abortion, discussed the need to find “a balance”.
“I feel we should do anything to make abortion as easy and accessible and supportive as possible but we should not promote it as nothing.
“And I think for a long time to get abortion on the agenda- we made it in a way- you go to the doctor and whoops done,” she said.
She said that women should be able to have an abortion in the setting they need but the right support should be made available afterwards.
Services are missing a trick in not combining abortion and contraception clinics under one roof, she said, with repeat abortions rising to reach 42% of all abortions in 2023.
National tariffs are currently paid to abortion providers in the UK to incentivise fitting contraception after an abortion, to try and reduce repeat abortions.
There’s also a push in some areas for more accessible post-birth contraception.
Public Health England said that currently an 45% of pregnancies are unplanned or met with feelings of ambivalence.
If almost half of pregnancies are unexpected, women are choosing to delay or avoid having children, and abortion is very accessible, perhaps this rising rate of abortions is unsurprising.
As contraception rates continue to fall and we wait for the collation of 2024 and 2025 data, we have to ask: where are abortion rates going?
However, all experts we spoke with emphasised that whilst it’s important to examine why abortion rates are on the rise, it should not pull into question that access to abortion is a fundamental and hard-fought right for women.
“The longstanding taboo” around abortion remains to be “broken”, said Doortje.
Main image by Maxim Berg on Unsplash
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