Service access may influence abortion rate, say researchers

Fewer abortions are carried out in the most socially disadvantaged areas, even though these places have the highest pregnancy rate in under 18s, it says.

The Joseph Rowntree Foundation report suggests access to abortion and family planning services is a key factor.

Abortion rates tend to be higher in those areas with more provision.

Ellie Lee and colleagues at Southampton University's Centre for Sexual Health Research looked at abortion and pregnancy data for 15- to 17-year-olds between 1999 and 2001 for the foundation's report.

Regional variations

Overall, 44% of the pregnancies ended in abortion, but there were huge variations throughout the UK.

Abortion rates tended to be higher in areas where there was greater family planning provision, higher percentages of female GPs and easier access to independent abortion services.

For example, in the Derwentside district of County Durham the proportion of pregnancies ending in abortion was below one in five, compared with three out of four in the Eden district of Cumbria.

Abortion rates by area among 15 to 17-year-olds Eden district of Cumbria - 75% Epsom and Ewell - 70% Rochford - 70% Merthyr Tydfil - 28% Torridge - 27% Derwentside district of County Durham - 18%

As well as Eden, other more affluent areas such as Epson and Ewell and Rochford had high rates of abortion - about seven out of every 10.

Socially disadvantaged areas such as Merthyr Tydfil and Torridge had low rates of abortion - about three out of every 10.

Similar trends were seen in Scotland when pregnancies between 13- and 19-years-old were examined.

The researchers interviewed more than 100 of the young women in depth and found other factors that might contribute to the different abortion rates.

The young women's choices tended to be based on their personal circumstances at the time they became pregnant rather than their moral views about abortion, and tended to be made before they saw a doctor.

Young women who choose abortion should have their choice respected and have better access to services of a more consistent quality than currently exists Co-researcher Ellie Lee

Those who saw their lives developing through education and employment were more likely to opt for a termination, for example.

Those who continued with their pregnancy tended to view motherhood as a positive direction for their future.

Family and community views also appeared to influence their decision, with some neighbourhoods accepting early motherhood as the norm.

Most of the young women had been shocked to find out they were pregnant and the half who chose abortion said they had found it stigmatising.

Stigmatising

Most of the women who had an abortion said the services had been good, but a few found doctors' attitudes upsetting when they made their disapproval of teenage pregnancy and abortion apparent.

Co-author Ellie Lee said the findings highlighted the need for more supportive services for young women who become pregnant.

"We believe that young women who choose abortion should have their choice respected and have better access to services of a more consistent quality than currently exists.

"Young women still have a fairly low expectation of services.

"It's a problem if young women are making a decision when they feel that the people are not going to be very nice to them at all," she said.

Anne Weyman, chief executive of the Family Planning Association, said: "It's vitally important young women from all backgrounds receive good information about all their options when they are pregnant, so they can make an informed choice.

"The difference in abortion rates across the social spectrum is not inevitable and it is essential young women receive advice and support from their family, friends and health professionals when making this important decision.

"It is totally unacceptable that some doctors still stigmatise abortion," she said.

A spokesman from the pro-life charity Life said: "It's surprising that attention has been drawn to the fact that abortion is more prevalent in traditionally more affluent areas - this fact is not particularly new or surprising."

He said the authors had interpreted their findings as a call for more abortions.