The UK is at a “crisis point” in abortion provision, experts say, with rising demand and limited access to care in many areas putting unprecedented pressure on struggling NHS services.
Healthcare professionals described a “terrifying” state of affairs in which women travel hundreds of miles for appointments or wait weeks before being seen.
Dr. Jonathan Lord, the managing director of MSI Reproductive Choices UK, a major provider of abortion services, told the Guardian’s Today in Focus podcast: “There is no question that we are seeing absolutely unprecedented levels of demand at the moment. All providers report that they are busier than ever.”
Lord, who is also an NHS gynecologist, said the rise was driven by “the economic downturn, the crisis in the cost of living and the ability to access good quality contraception” through GPs and sexual health services, affected by the wider NHS crisis.
Clare Murphy, the CEO of the British Pregnancy Advisory Service (BPAS), previously said: “The pandemic and government policies have had a marked impact on women’s pregnancy choices.” Faced with “economic uncertainty and job insecurity,” women were forced to make tough decisions, she said.
According to government data, a record 214,869 abortions took place in England and Wales in 2021. MSI treated 47% more people in the first two weeks of this year than the same period in 2022, and delivered 51% more telephone consultations, according to new data from the Guardian.
MSI, which has more than 60 clinics in England and Wales, says it is only managing to keep waiting times stable by staff working extra shifts and weekends. The number of surgical abortion appointments has increased by 38% to meet demand.
A report from the Royal College of Obstetricians and Gynecologists published in November said the uptake of abortion care and inadequate funding for services had led to poorer standards of care for women and “marked variations across the UK, with women having access to abortion in many areas are being denied the rights they have come to expect from the NHS Constitution”.
The problem has been exacerbated by chronic staff shortages and the closure of sexual health services during the pandemic. Increased private sector demand is putting pressure on NHS services, with only five UK trusts offering specialist surgical abortion services.
Murphy said: “What we are seeing now is the culmination of a series of prolonged pressures that the service has faced for many years. But the pandemic and the current massive pressure on the NHS have brought things to a crisis point.” She said that while negotiations with commissioners continued, BPAS is considering closing some abortion centers.
Tracey Masters, who works at East London’s Homerton University Hospital, in one of only five NHS trusts offering specialist surgical abortion services, said her clinic had received more referrals in the past six months as waiting times in the independent sector were increased. “It can be really traumatic and we see women who have waited weeks and weeks to seek care,” she said.
Nicola (not her real name) made a 500+ mile round trip to Homerton due to lack of availability for an appointment in her area. “I was crying on the phone. The hospital closest to me had no room, and the one two hours away from me couldn’t see me because I was so far away. So I ended up being booked over three hours away,” she said.
An NHS spokesperson said: “There has been an increase in demand for abortion services recently, and as a result NHS England are currently discussing updated payment guidelines for local commissioners to ensure they continue to provide these services in the most effective way and to the highest clinical standards.”
A spokesman for the Ministry of Health and Social Care said: “The government recognizes that there is more work to be done to improve women’s reproductive health. Sexual and reproductive health plans will be put in place later this year, including to ensure that women continue to have access to robust and high-quality abortion services.”