Official statistics have revealed that abortions in England and Wales reached a record high in 2023, with experts pointing to the severe financial pressures of the cost of living crisis and significant difficulties in accessing contraception as primary causes.
The government data, published on Thursday, shows a substantial 11% increase in abortions in 2023 compared to the previous year. The age-standardised abortion rate for women rose to 23.0 per 1,000 residents, marking the highest level recorded since the Abortion Act came into force in 1967.
Economic Pressure and Contraception Barriers
Leading healthcare providers and medical bodies were quick to contextualise the stark figures. Katie Saxon, Chief Strategic Communications Officer at the British Pregnancy Advisory Service (BPAS), stated the statistics reflect the first full year of abortion care during the ongoing cost of living crisis.
"No woman should have to end a pregnancy she would otherwise have continued purely for financial reasons," Saxon emphasised. She also highlighted systemic failures in contraceptive provision, noting reports of long waits for appointments, problems securing repeat prescriptions, and a limited choice of available methods.
Dr Alison Wright, President of the Royal College of Obstetricians and Gynaecologists, echoed this analysis. "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 contraception, thereby increasing the risk of unplanned pregnancy.
Changing Demographics and Methods
The detailed data uncovers several key trends. The abortion rate for women aged 35 and over has seen a pronounced increase, rising from 7.1 per 1,000 in 2013 to 12.3 per 1,000 in 2023. The most common age group for the procedure remains those between 20 and 24.
A significant shift has occurred in how abortions are administered. Following temporary measures introduced during the Covid pandemic that allowed abortion medication to be sent by post, at-home abortions accounted for 72% of all terminations in 2023. This method, where both pills are taken at home, has now become the dominant form of early medical abortion.
"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 the telemedicine pathway is working as intended, removing practical barriers for women in rural areas, those with disabilities, or those experiencing coercion.
Gestation Trends and Service Evolution
The report also indicates a continued trend towards earlier abortions. Over the past decade, the percentage performed at up to nine weeks' gestation has increased 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 fatal foetal abnormality or risk to the mother's life, remained stable at between 1% and 2%.
The figures have sparked calls for improved reproductive healthcare services. Providers stress that while there is "no right number of abortions," the government must act to ensure women can make genuine choices by improving access to both contraception and supported, safe abortion care. As one in three women will have an abortion in their lifetime, services must continue to evolve in line with clinical need and best practice.
