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Surgical abortions in the UK decline as at-home medical abortions surge

As Roe v Wade is overturned in the US, the number of legal abortions in the UK hits record figures. 

By Polly Bindman

Friday’s news that the US Supreme Court had overturned the Roe v Wade ruling, signalling an end to the absolute right to terminate a pregnancy, has marked a significant step backwards for abortion rights in the United States.

Meanwhile, here in the UK, annual data released at the end of June shows that the number of legal abortions has reached record figures, underscoring the importance of having free, accessible and safe ways of terminating a pregnancy. 

Figures from the Department of Health and Social Care (DHSC) show there were 214,256 legal abortions undertaken by residents of England and Wales in 2021, a slight increase of 2 per cent on the previous year. The numbers have been slowly increasing every year since 2016. 

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What is most striking about the figures is the decline in surgical abortions, while the number of at-home medical abortions has surged.

In March 2020, in response to the lack of in-person services during the pandemic, the government approved measures to enable patients to take abortion pills at home to terminate their pregnancy. To qualify for such a procedure, otherwise known as the "pills by post" scheme, patients must be within the first ten weeks of pregnancy. 

According to government data, in 2021 just 13 per cent of abortions were undertaken surgically, compared with 27 per cent in 2019. On the other hand, for 52 per cent of all abortions, patients were able to take both abortion medications – mifepristone and misoprostol – at home without needing to visit a doctor. 

Since it first launched in April 2020, a total of 183,266 pregnant people have made use of the scheme. 

Thanks to the scheme, abortions are now occurring earlier, as patients bypass lengthy waiting times. According to the DHSC data, while on average 18 per cent of abortions in 2019 took place ten weeks or more into pregnancy, in 2021 that figure had fallen to 11 per cent. 

Shorter waiting times decrease the sometimes fatal medical risks associated with abortions. In 2018, experts from the US National Academies of Sciences, Engineering and Medicine among others, found that increased waiting times before receiving an abortion can increase the risk of complications for the patient. 

While the "pills by post" scheme was only intended to be temporary, in March 2022, 215 MPs including 72 Conservatives voted to keep the at-home early medical abortion laws in place.

Though the vote was a significant step forwards for abortion rights in the UK, the overturning of Roe v Wade shows that no rights are guaranteed. Following the announcement of the US ruling, Labour MP Stella Creasy warned against complacency on abortion rights in the UK because the “attack on women’s rights won’t stop”.  

Read more: How the pandemic revolutionised abortion access in the UK

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