Page last updated: 26-MAY-2009

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 in Scotland of all terminations carried out in Scotland. The Information Services Division is responsible for the administration and reporting of these notifications of abortions on behalf of the Chief Medical Officer in Scotland.

 

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.

In 2008 there were 13,817 abortions performed compared to 13,738 in 2007. This is consistent with the pattern seen in recent years. In 2008, the rate for women aged 15-44 was 13.1 for every 1000 women compared to 11.1 for every 1000 women in 2000.

 

The rate of terminations is highest in NHS Tayside at 15.7 per 1000 women aged 15-44. In NHS Lothian the rate is 14.4 and in NHS Grampian the rate is 14.3 The Island Boards (Orkney, Shetland and Western Isles) have the lowest rate at 5.7.

 

As in previous years, the rate of terminations in 2008 was highest in women aged 16-19 (24.5 per 1000) and those aged 20-24 (24.9 per 1000). Lower rates are seen in women aged 25-29 (17.1 per 1000) and in women aged over 40 (2.2 per 1000).

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 abortions for most reasons. This year we have included data on abortions carried out on gestations less than 9 completed weeks (63 days). 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 E:

 

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.

 

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.

In 2008 there were 13,817 abortions performed compared to 13,738 in 2007. This is consistent with the pattern seen in recent years. In 2008, the rate for women aged 15-44 was 13.1 for every 1000 women compared to 11.1 for every 1000 women in 2000.

 

The rate of terminations is highest in NHS Tayside at 15.7 per 1000 women aged 15-44. In NHS Lothian the rate is 14.4 and in NHS Grampian the rate is 14.3 The Island Boards (Orkney, Shetland and Western Isles) have the lowest rate at 5.7.

 

As in previous years, the rate of terminations in 2008 was highest in women aged 16-19 (24.5 per 1000) and those aged 20-24 (24.9 per 1000). Lower rates are seen in women aged 25-29 (17.1 per 1000) and in women aged over 40 (2.2 per 1000).

 

In 2008, the rate of abortions continues to show a clear link with the level of deprivation. In areas of high deprivation the rate is 18.1 per 1000, double the rate of 9.0 per 1000 for the least deprived areas of Scotland. The differences in rates between most and least deprived areas vary across NHS boards, but can be as much as three fold; for example in NHS Grampian (34.6 and 10.2), NHS Fife (28.1 and 8.7) and NHS Tayside (25.0 and 8.5) per 1000 women aged 15-44.

 

The proportion of early terminations has been rising steadily in recent years, with 56.8% of all terminations performed at gestation of less than 9 completed weeks in 2008.

 

The use of medical methods continues to increase, with 64.6% of terminations at all gestations performed medically in 2008, a rise from 6.4% in 1992. Of terminations at gestation of less than 9 completed weeks, 78.4% are now carried out medically.

Just over a quarter (27.3%) of the 13,817 women having a termination in 2008 have had a previous termination. This varies across boards, from 17.9% in the NHS Borders to 32.0% in NHS Tayside.

 

In 2008, the vast majority (13,276; 96.0%) of terminations were undertaken under Ground C. There were 152 terminations carried out under Ground E, of which 28 were for Down Syndrome, 86 for other chromosomal conditions, and 13 for anencephaly, with the remaining 25 being for spina bifida and other conditions.

 

Of the 13,817 abortions performed in Scotland during 2008, 99.6% were carried out in NHS premises.

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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.

Gestation is based on completed weeks i.e. under 9 weeks refers to up to 9 completed weeks (63 days).

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Under terms of the ?Pre-Release Access to Official Statistics (Scotland) Order 2008?, ISD are obliged to publish information on those receiving Pre-Release Access (?Pre-Release Access? refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.

 

Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads

 

Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).

 

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