Reproductive health charity Marie Stopes UK has launched the findings of the first research in the UK into the contraceptive use of women aged 16-24 having one or more abortions. It found that more than half (57%) of women were using contraception when they became pregnant, with short-term methods like the pill or condoms the most commonly used instead of the more reliable long acting methods.
Researchers analysed five years of the charity's patient data, surveying 430 women - 121 of whom had previously had an abortion - to gain an insight into how post-abortion contraception services can be strengthened and reduce the numbers of women seeking subsequent abortions. Although the total number of abortions in England and Wales has gradually declined in recent years, the number of women seeking abortion who had one or more previous abortions is increasing[i].
Key findings include:
- The majority were using short-term methods, such as the pill (54%) or condoms (40%)
- Only 12% of women had used emergency contraception
- 28% of women had had one or more previous abortions, and the older a women is, the more likely she is to have more than one abortion
- Uptake of contraception at four weeks post-abortion was extremely high at 86%, but 67% used their chosen method for less than a year. Reasons for stopping included menstrual irregularities for long-acting reversible contraception (LARCs) and not renewing supply in time for pills and injections
- 63% of all young women received a post-abortion LARC from Marie Stopes (compared to 30% in England as a whole). Women are more likely to choose a LARC method if they've had a previous abortion, or had a surgical rather than a medical abortion.
Genevieve Edwards, Director of Policy at Marie Stopes UK said:
"Women have three fertile decades to manage, but too many women are being let down by a lack of on-going support in choosing and using the most effective method of contraception.
"If we tackled the lack of sex and relationships education in schools, invested in contraceptive training for health professionals and bridged the gap between abortion, contraception and sexual health services, we'd see the rates of unwanted pregnancies plummet."
Not all methods provide the same protection. With typical use, around 9 in 100 women will become pregnant each year on the pill, while condoms have a failure rate of 18%, compared to less than 1% for long-acting methods like intrauterine contraceptives and implants[ii].
Genevieve added: "We have got to get better at talking about contraception and abortion. One in three women will have an abortion and one in four of them will go on to have another. Our research shows there is no particular demographic group who are more likely to have abortions - it can happen to any of us. But for the majority of women, it was more often the short-term methods that failed them.
"Getting this right is also good for the public purse. Fitting a coil costs about £40 and lasts ten years - that's less than 8p a week and it repays the NHS many times over in abortion or maternity costs[iii]."
The research also found that while uptake of contraception post-abortion was very high[iv], what suits women at one time, may not always be the best option, making an ongoing conversation so important.
Genevieve added: "We are particularly concerned about low awareness of emergency contraception. Family planning doesn't start and stop with condoms or the pill and much more needs to be done to support women on choosing and using the contraception that suits their lifestyle and stage of life."