More than half of women who had an abortion last year were using contraception that had failed, a new report suggests.
According to data released by the British Pregnancy Advisory Service (bpas), 51.2% of women who had an abortion at bpas clinics in 2016 reported using a method of contraception.
Of the 60,592 women, a quarter (24.1%) reported using either a user-dependent hormonal method of contraception (pills, patches or rings) or a long-acting reversible contraceptive (injections, implants, IUD and IUS) when they presented for treatment. These are among the most effective methods of contraception.
Others were using non-hormonal methods such as condoms and diaphragms.
No method of contraception is 100% effective, yet public discourse and some family planning initiatives frequently imply that abortion can always be avoided through the use of contraception, bpas said.
However, each year nine in every 100 women using the contraceptive pill, the most popular method of contraception in the UK, six in every 100 using the contraceptive injection and nearly one in every 100 using the IUD (copper coil), will become pregnant.
A bpas spokesperson told HuffPost UK failures in contraception, such as the pill, are a combination of in-built failure rate of the drug and failure rate of someone taking any medication correctly.
“The point is generally women aren’t being haphazard with their method - women try very hard to avoid unwanted pregnancy, but contraception can let them down and they need abortion as a back-up for when that happens,” they said.
The bpas report, titled ‘Why women present for abortions after 20 weeks’ also indicates that the use of hormonal contraception is a factor in delaying identification of pregnancy, which in turn increases the likelihood that women will present for abortion care at a later gestation.
Hormonal contraception can cause side effects which may mask the symptoms of pregnancy, including suppressing menstrual bleeding completely, or causing irregular or light periods.
Women using a method of contraception may also not identify their pregnancy at an earlier stage because they, unlike those not using any method of contraception, had not anticipated falling pregnant.
Long-acting reversible contraceptive methods (LARCs) such as the contraceptive implant are routinely promoted due to their efficacy. While it is true that failure rates for LARCs are extremely low, they are not non-existent, bpas said.
Unplanned pregnancies can also occur in the event that the method was not correctly inserted, moves or falls out. Bpas data from 2015 shows that women who had abortions at later gestations were more likely to have been using LARCs than those ending a pregnancy at an earlier stage, with 5.3% of those having at abortion at 20+ weeks reporting using a LARC compared to 3.4% of those between 0-19 weeks of pregnancy.
Next week, policymakers, healthcare professionals and advocates will meet in London for Family Planning 2020.
This international summit is based on the principal that “all women, no matter where they live, should have access to life-saving contraceptives” to protect their health and empower women to “decide whether and when they wish to become pregnant as well as how many children they wish to have”.
However, bpas said the new data demonstrates that these goals cannot be achieved through better access to contraception alone and that safe, legal abortion services are vital in order to enable women to control their fertility and protect their reproductive health.
Ann Furedi, bpas chief executive, said: “The answer to unsafe abortion is not contraception, it is safe abortion. When you encourage women to use contraception, you give them the sense that they can control their fertility – but if you do not provide safe abortion services when that contraception fails you are doing them a great disservice.
“Our data shows women cannot control their fertility through contraception alone, even when they are using some of the most effective methods. Family planning is contraception and abortion. Abortion is birth control that women need when their regular method lets them down.”