Abortions

Statistical Publication Notice

27 May 2008

Abortion Statistics, year ending December 2007

INTRODUCTION

Induced abortion is one of the most commonly performed gynaecological procedures (Royal College of Obstetrics and Gynaecology Guidelines 2004). These procedures are carried out under the terms of the Abortion Act 1967, which applies to England, Wales and Scotland. Doctors have a legal requirement to notify the Chief Medical Officer of all terminations carried out in Scotland. The Information Services Division is responsible for the administration and reporting of these notification of abortions on behalf of the Chief Medical Officer.

Since the Act was passed in 1967 there has been a steady increase in the number of terminations of pregnancy carried out in Scotland. The most significant growth in abortions was in the four years following the introduction of the Abortion Act, from 1,500 in 1967 to over 7,500 in 1971.

KEY POINTS

Provisional figures show that the number of therapeutic abortions carried out in Scotland rose during 2007. For woman aged 15 to 44 years, 13.0 abortions were carried out for every 1000 women compared to 12.5 per 1000 in 2006. NHS Tayside, followed by NHS Grampian and NHS Lothian, show the highest rate of terminations, while the Islands Boards and Borders have the lowest rates.

As seen in previous years rates of abortions are higher in areas of high deprivation and higher in the 16-19 and 20-24 age groups. The use of medical methods for early terminations continues to increase in line with Royal College of Obstetrics and Gynaecology guidelines.

INTERPRETATION

The Royal College of Obstetrics and Gynaecology Guidelines (2004) recommend that termination of pregnancy should be carried out early since this reduces the risk of physical complications. Prior to 1991, most terminations were performed surgically. In 1991 medical methods of termination were licensed for use in the United Kingdom for abortion under 10 weeks gestation. Medical methods of termination are carried out using drugs such as mifepristone with or without the addition of prostaglandin. The Abortion (Scotland) Regulations 1991 reflect this change in abortion provision and also place an upper limit of 24 weeks on most abortions. Two doctors must agree that termination of pregnancy is necessary for one of the reasons specified in the 1991 Regulations; these are classified by the letters A to F:

Non Emergency

A - the continuance of the pregnancy would involve risk to the life of the pregnant women greater than if the pregnancy were terminated.
B - the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
C - the pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.
D - the pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the existing child(ren) of the family of the pregnant woman
E - there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

Emergency

F - it was necessary to save the life of the woman.
G - it was necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.

DETAILED FINDINGS

In 2007 there were 13,703 therapeutic abortions performed compared to 13,163 in 2006. This is consistent with the pattern seen in recent years. In 2007, the rate for women aged 15-44 was 13.0 for every 1000 women compared to 11.1 for every 1000 women in 2000.

The rate of terminations is highest in NHS Tayside at 17.1 per 1000 women (aged 15-44). In NHS Grampian the rate is 14.7 and in NHS Lothian the rate is 14.3 per 1000 women. The Island Boards (Orkney, Shetland and Western Isles) have the lowest rates of 6.1 per 1000 women.

As seen in previous years, the rate of terminations, in 2007, was highest in women aged 16-19 (24.9 per 1000) and those aged 20-24 (24.5 per 1000). Lower rates are seen in women aged 25-29 (17.8 per 1000) and in women aged over 40 (2.1 per 1000).

In 2007, the rate of abortions continues to show a clear link with the level of deprivation. In areas of high deprivation the rate is 17.4 per 1000, nearly double the rate of 9.6 per 1000 for the least deprived areas of Scotland. The differences in rates in deprivation vary across NHS boards, but can be as much as three fold between (most and least deprived) areas, as in NHS Highland (25.2 and 7.7), NHS Fife (25.6 and 8.1) and NHS Grampian (31.3 and 11.1) per 1000 terminations.

The proportion of early terminations has been rising steadily in recent years, with 69.1% of all terminations performed at less than 10 weeks in 2007. This compares to 55.8% of terminations performed at less than 10 weeks in 1992 when medical terminations were introduced.

The use of medical methods continues to increase, with 61.8% of all terminations performed medically in 2007 compared to 16.4% in 1992. 68.1% of terminations of less than 10 weeks gestation are carried out by medical methods and 31.9% are carried out surgically.

Just over a quarter (26.3%) of the 13,703 women having a termination in 2007, have had a previous termination. This varies across boards from 19.2% in the Island boards to 30.3% in NHS Grampian.

In 2007, 13,104 the vast majority (95.6%) of terminations were undertaken under Ground C. There were 167 terminations carried out under Ground E of which 37 were for Down syndrome, 66 for other chromosomal conditions, 15 for anencephaly, less than 11 for spina bifida and the remaining 38 for other conditions.

Of the 13,703 therapeutic abortions performed in Scotland during 2007, 99.3% were carried out in NHS premises.

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MAIN CONTACTS:

Etta Shanks
Maternity and Neonatal Team Leader
Tel: 0131 275 6761
Etta.Shanks@isd.csa.scot.nhs.uk

Dr Jim Chalmers (Consultant in Public Health Medicine)
Head of Programme
Women & Children's Health Information Programme
Tel: 0131 275 6136
Jim.Chalmers@isd.csa.scot.nhs.uk

Alastair Philp
Programme Principal
Women & Children's Health Information Programme
Tel: 0131 275 6679
Alastair.Philp@isd.csa.scot.nhs.uk

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GLOSSARY:

Abortions - refers to therapeutic abortions notified in accordance with the Abortion Act 1967.
Approved place - defined as in Section 1 (3) of the Abortion Act 1967.
Parity - the number of preceding completed pregnancies.
Medical termination - involves termination of a pregnancy without a surgical procedure. It usually involves administration of a drug followed 1-3 days later by vaginal administration of another drug.

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