"How to get rid of a pregnancy"

Having seen people tweeting about the weird and wonderful ways readers reach their blogs, we decided to delve into our own statistics to see what people have been typing into Google to end up at this blog. 

Although of course plenty reached the EFC blog through links on other sites, or searches like 'abortion education in schools', one of the most common searches was the phrase 'how to get rid of a pregnancy'. Other popular searches included variations on 'pills to get rid of pregnancy'. Further investigation showed that quite a few people reached the EFC blog through a link on Ask.com which lead to this Mythbusting Monday post about medical abortion, explaining why the phrase 'abortion pill' can be misleading (Early Medical Abortion is actually a process involving two lots of medication, and two to three visits to a clinic, rather than just 'taking a pill').

It was sobering to realise that many people visiting this blog are not just looking for general information related to work or study but are likely themselves facing an unwanted pregnancy and unable to access the medical support they need to have an abortion. Sobering, but not all that surprising when you know that a decent proportion of visitors to this blog are from the USA and Ireland.

As you may know, although abortion is legal in the United States, access is severely restricted in some areas, meaning that those seeking abortion (especially poorer women) may look for 'cheaper' methods of ending a pregnancy, such as buying medication online. This graphic shows the varying levels of abortion access in the U.S - with mandatory waiting periods or insurance restrictions being enforced in many States, access to safe, legal abortion can be difficult.

Ireland, in turn, has one of the world's most restrictive abortion laws. Abortion is only available to save a pregnant person's life. Last year, almost 4000 women travelled from Ireland to England and Wales to have an abortion. Again, these women will have needed the financial means to pay for the procedure itself as well as transport and associated costs. Although the Abortion Support Network has been set up to help these women pay for the procedure, it can't support everyone. A recent article in Vice argued that more and more Irish women are turning to the internet to purchase abortion medication to administer themselves. The article points out that women taking this route are not recorded in the official statistics, although with hundreds of packages of such medication being seized every year, the number is clearly significant. 

Of course, ordering and using this medication is illegal in Ireland. But it seems that some are desperate enough to try to end a pregnancy even via methods which could put them in prison. And this is not just true of women in Ireland, or the U.S, but anywhere where abortion is illegal or restricted. And as the Guttmacher Institute makes clear, this method can be safer than traditional 'backstreet abortions' performed in unsanitary conditions: "In settings where abortion is illegal or highly restricted, it (abortion medication) has provided many women for the first time with a safe and discreet means for early termination of unwanted pregnancy." Safe Abortion Hotlines in places such as Chile, Poland and Kenya show that  where abortion is illegal or very severely restricted, there will still be women who find ways to end their pregnancies.

Unfortunately we were not surprised to see that some of these women had found their way to our site through searches for information on unwanted pregnancies which they cannot end in registered medical establishments, either due to legal, practical or economic constraints.

2012 Abortion Statistics

The latest statistics on abortions carried out in England and Wales were released today. The main findings are summarised below but you can view full information (including data tables) here. This year, the Department of Health also carried out a consultation on changes to the publication of abortion statistics, the results of which can be found here.

•    The 2012 abortion rate for all ages is 16.5 per 1,000 women – the lowest rate since 1997 and 6% lower than in 2011. The abortion rate was highest for women aged 21 (31 per 1000 women).

•    The under 16 and under 18 abortion rates were slightly lower than in 2011 (3 per 1000 and 12.8 per 1000 respectively).

•    The number of abortions taking place under 13 weeks gestation remains at 91%, and 97% of abortions were funded by the NHS. The percentage of medical abortions also remains consistent, at 48% (47% in 2011).

•    In 2012, 52% of women undergoing abortions had one or more previous pregnancies that resulted in a live or stillbirth.

A significant difference from 2011’s data is the number of non-resident women accessing abortion in England and Wales:

•    In 2012, there were 5,850 abortions for non-residents versus 6151 in 2011. The 2012 total is the lowest in any year since 1969.

The majority of non-residents accessing abortion in England and Wales are from the Republic of Ireland and Northern Ireland (making up 83.6% of the total number of non-residents in 2012). It’s unclear as to why this figure is lower than it has ever been but it’s possible that more women in Ireland are accessing medical abortion online; rising awareness of services like Women on Web through public campaigns may mean that more Irish women are using illegal methods to end their pregnancies rather than face the cost and difficulty of travelling abroad to do so.

Another interesting statistic which deserves to be unpicked is the over-representation of certain ethnic groups in the abortion statistics, particularly with regards to those women who have more than one abortion.

As you can see from the table, women who are of Black or Mixed ethnicity are more likely to have had one or more previous abortions than women of other ethnic backgrounds. The statistics do not tell us why this is, but we might question if the information provided to particular communities on contraception and abortion is relevant and accessible. We know that there are links between ethnicity and deprivation, and between deprivation and unintended pregnancy so this too might be a factor. More research is clearly needed  into the intersections between ethnicity, unintended pregnancy and abortion, but in the meantime, it is crucial to note that women from all backgrounds can and do experience unintended pregnancy and abortion and we should not shy away from providing culturally appropriate, evidence-based information in every setting.

As a result of the consultation on the publication of abortion statistics a few changes have been made, the most significant of which being local level statistics being presented by CCG (clinical commissioning groups) rather than PCT (primary care trust) data due to the changes to the health system.

One interesting aspect of the consultation was to see the number of anti-abortion groups which had responded, a number of whom requested information on fetal sex to be represented in the abortion data. This is presumably a response to recent scaremongering suggesting that 'sex selective abortions’ were taking place in the UK (despite the Department of Health’s own 2013 report finding that the UK’s ‘gender ratio’ is "well within the normal boundaries for populations").

The response to the consultation gives a firm response to this request:

"Information about the sex of the foetus and NHS number are not currently collected on  the HSA4 form. To collect such information would require changes to the  legislation, in  particular the Abortion Regulations 1991, as well as to clinical practice. This is not in the scope of this consultation. The majority of abortions take place before 10 weeks gestation and it is not currently possible to identify a foetus’s gender at that stage. Identifying the gender of aborted foetuses over 10 weeks’ gestation raises ethical and clinical issues. The Government has no plans to introduce such a practice."

There’s a pill you can take to get rid of a pregnancy

Every Monday EFC busts myths and takes names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts

Early medical abortion (EMA) is an abortion method available to women who are under 9 weeks pregnant. This method is also known as “the abortion pill”, but this is not a very accurate description, as it does not involve simply taking a pill. During an early medical abortion, two different drugs are used to cause an early miscarriage. The first pill works by blocking the action of the hormone that makes the lining of the uterus (womb) hold onto the fertilised egg. The other, given 24 - 48 hours later, causes the uterus to cramp. The lining of the uterus breaks down and the embryo is lost in the bleeding that follows, as happens with a miscarriage.

An EMA normally requires that the woman visit the clinic three times - once to arrange for the abortion, once to take the first medication and finally to take the second medication. She may also be asked to make a follow up visit.

Some women choose this method because it can be done as early as 5 weeks into pregnancy and is non-invasive, but others dislike that it is a more drawn out process than an early surgical abortion (or vacuum aspiration).

It is not helpful to call EMA the 'abortion pill' as it does not adequately describe the process involved and can lead to people confusing it with emergency hormonal contraception (a.k.a. the “morning-after pill”). There is more on abortion methods on the EFC website.