Abortions at record level, despite better contraception services

The number of abortions in England and Wales rose to a record 181,600 last year, raising doubts about the effectiveness of the government's strategy for improving contraceptive services.

Figures from the Department of Health showed the abortion rate increased in every age group during the childbearing years, including the under-16s.

There were 17.5 abortions per 1,000 women residents of England and Wales aged 15 to 44. This was 3.2% more than in 2002 when the rate declined slightly.

The rate was highest among women aged 20 to 24. They had 51,124 terminations - an abortion rate of 31.4 per 1,000. There was also a high number of teenage abortions. A total of 37,043 terminations took place among girls aged 15 to 19, higher than the 36,018 recorded for the 25 to 29 age group. The under-16 abortion rate rose from 3.7 to 3.9 per 1,000.

Three-quarters of the abortions were carried out on single women. There were also 9,100 pregnancies terminated among visiting non-residents in England and Wales, mostly from Northern Ireland and the Irish Republic.

The Department of Health acknowledged: "The figures are disappointing. However, no contraception method is 100% effective and there will always be women seeking an abortion as they are legally entitled to do.

"A key aim of the government's sexual health and HIV strategy, and the teenage pregnancy strategy, is to reduce unintended pregnancy rates. Provision of good contraceptive services is key in achieving this." But the department was unable to explain why the abortion rate was rising when contraception services were supposed to be improving.

Anne Weyman, the chief executive of FPA (formerly the Family Planning Association) said: "It is good news that more abortions are taking place under 10 weeks and that there are higher rates of medical abortion. It is encouraging to see access to abortion speeded up and women being given a choice of methods.

"But again we see more figures exposing the desperate need for investment in NHS contraceptive services, including support for the professionals trying to run them.

"Access to good-quality, widely available services is essential in preventing unplanned pregnancies. However, despite saving the NHS an estimated £2.5bn a year, contraception is still treated as the Cinderella service of public health.

Ann Furedi, the chief executive of the British Pregnancy Advisory Service, Britain's largest abortion provider, said: "We don't see abortion as a problem, we see abortion as a solution to the problem of unwanted pregnancy for many.

"It may very well be that an increase in abortion rate represents the fact that more women feel that it's acceptable to take control of their lives by ending pregnancies that weren't planned."

The department's statistical report showed that four-fifths of abortions were funded by the NHS - half in NHS clinics and half in the independent sector under NHS contract.

The proportion carried out medically - using pills instead of surgical procedures - rose from 14% to 17%.

There were 1,950 abortions performed because of a risk the child would be born handicapped - about 1% of the total. About 87% were carried out under 13 weeks gestation and 58% under 10 weeks.

The department withheld much of the information that was released in previous annual reports on abortion, including data on abortions over 24 weeks gestation and the medical conditions involved in abortions performed due to foetal abnormality.

This included controversial material that may have contributed to legal action by Joanna Jepson, a Church of England curate, to challenge a decision by police not to prosecute doctors who carried out an abortion on a foetus with a cleft lip and palate.

Julia Millington of the ProLife party said: "We reiterate our concerns over the very high numbers of abortions in 2003 ... We are extremely concerned that the government has deliberately omitted the breakdown of medical conditions allowing abortion for foetal abnormality."

· Drug-taking among 11 to 15 year olds increased slightly last year, rising from 20% to 21% of the age group. About 8% of 11-year-olds used drugs in 2003, compared with 38% of 15-year-olds. Cannabis was the most frequently reported illicit drug, but 1% of young people used heroin and 1% cocaine.