Abortion Statistics, England and Wales: 2014
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- Gestation (weeks) % of those requiring a length of stay of one or more nights (Total = 100%)
- Abortion Statistics, England and Wales: 2014
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Age 1 or more Under 18 7% 18-19
17% 20-24
34% 25-29
45% 30-34
47% 35 or over 45%
2.34 In 2014, there was some variation across Local Authorities in England in the proportion of women undergoing abortions who had one or more previous abortions (see Table 11d). The proportion of women undergoing repeat abortions ranged from 27% in Devon to 49% in Croydon.
2.35 This variation across Local Authorities is likely to be due to differences in local practice relating to post-abortion contraception advice. Previous obstetric history
2.36 In 2014, 54% of women undergoing abortions had one or more previous pregnancies that resulted in a live or stillbirth, up from 47% in 2004 (See Table 3a.vii). 18% of women had a previous pregnancy resulting in a miscarriage or ectopic pregnancy, up from 14% in 2004, when the information was first collected (See Table 3a.viii).
Abortion Statistics, England and Wales: 2014
17 2.37 Obstetric history, especially for young women is of interest generally and to those working to reduce unplanned pregnancies however, data provided on the Abortion Notification form is not detailed enough to do further analysis.
Method of abortion 2.38 Different methods may be used to terminate a pregnancy, depending on the duration of gestation, and other circumstances relating to the individual woman. There is one principal medical method, involving the use of the abortifacient drug Mifegyne (mifepristone, also known as RU486).
2.39 The main surgical methods are: I.
vacuum aspiration, recommended at up to 15 weeks gestation II.
dilatation and evacuation (D&E) recommended where gestation is greater than 15 weeks
D&E may be used in combination with vacuum aspiration; such cases are recorded in the statistics as D&E. Figure 6: Abortions by method, England and Wales, 2004 to 2014 2.40 Medical abortions accounted for 51% of the total in 2014. The proportion of medical abortions has more than trebled in the last ten years from 20% in 2004 and 2014 is the first year where more medical abortions than surgical abortions took place. There has been a continuing upward trend in medical abortions since 1991 when Mifegyne was licensed for use in the UK, when only 4% of abortions were undertaken using a medical 18
procedure (See Table 3a.iv and Table 5). In 2014, 62% of abortions under nine weeks were medical abortions compared with 28% in 2004. See Figure 6 above.
2.41 The choice of early medical abortion as a method of abortion is likely to have contributed to the increase in the overall percentage of abortions performed at under ten weeks gestation (60% in 2004 compared with 80% in 2014). Early medical abortion is less invasive than a surgical procedure and does not involve use of anaesthetics.
2.42 The surgical procedure vacuum aspiration was used for 44% of all abortions in 2014; and Dilatation and Evacuation (D&E) alone in about 4% (See Table 3a.iv).
2.43 For abortions at 22 weeks or beyond, feticide is recommended by the Royal College of Obstetricians and Gynaecologists prior to the evacuation of the uterus to stop the fetal heart. In 2014, of the 1,193 abortions performed at 22 weeks and over, 58% were reported as preceded by a feticide and a further 37% were performed by a method whereby the fetal heart is stopped as part of the procedure. 4% of abortions at 22 weeks or beyond were confirmed as having no feticide. For the remaining 12 cases, at the time of publication, we had not been able to confirm whether feticide had been performed. See Figure 7)
Figure 7: Abortions performed at 22 weeks gestation and over, England and Wales, 2014
Length of stay in hospital/clinic
2.44 In 2014, 317 women (0.2%) were reported as having duration of stay of one or more nights in a hospital or clinic after their abortion. More than two thirds of these stays were for abortions performed at later gestations of 20 weeks and over (See Table C).
Abortion Statistics, England and Wales: 2014
19 Table C: Abortions requiring a length of stay of one or more nights, percentage breakdown by gestation weeks, England and Wales, 2014
Complications
2.45 Complications were reported in 330 cases in 2014, a rate of about one in every 550 abortions, slightly lower than the rate in 2013 (about one in 800) and 14 per cent lower than in 2004 (See Table 8).
2.46 There were no deaths following abortion reported on form HSA4 in 2014. Deaths related to pregnancy and abortion will be published in the MBRRACE-UK: Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK https://www.npeu.ox.ac.uk/mbrrace-uk/programme-of-work
Selective terminations
2.47 Pregnancies following fertility treatments such as in vitro fertilisation (IVF) may result in more than one embryo implanting in the womb. In such cases, the outcome of the pregnancy may be more successful if the number of fetuses is reduced. This reduction usually occurs at about 12 weeks’ gestation.
2.48 In 2014, there were 132 abortions which involved selective terminations. In 80 cases, two fetuses were reduced to one fetus. In 35 cases, three fetuses were reduced to two fetuses and in 14 cases three fetuses were reduced to one fetus. Over three quarters (83%) of the selective terminations were performed under ground E.
2.49 The number of selective terminations has increased from around 50-80 in each of the last 10 years to 125 in 2013 and to 132 in 2014. The proportions of reductions, for example, 3 fetuses reduced to 2 or 3 fetuses reduced to 1, over the years has stayed roughly the same, see Table D.
Gestation (weeks) % of those requiring a length of stay of one or more nights (Total = 100%) % of all abortions (Total = 100%) Under 10 11% 80%
10-12 9%
12% 13-19
40% 7%
20 or over 40%
2% 20
Table D Selective reduction abortions by number of original fetuses, residents
of England and Wales, 2010 to 2014.
Original number of fetuses
2 reduced 1 3 reduced to 2
3 reduced to 1 4 *
5 *
2010
85
51 20
9
3
2 2011
72
37 18
9
7
1 2012
82
38 28
11
5
0
2013 125
74 28
10
10
3
2014
80
35
14
3
0
*Represents the original number of fetuses prior to any selective reduction.
2.50 Abortions that are selective abortions are more likely to be for women who are married (75%), aged 30 and over (83%) and who are less likely to have had a previous abortions: only 6% of cases reported a previous abortion.
Chlamydia screening 2.51 The revised HSA4 forms introduced in 2002 allowed for the recording of whether chlamydia screening was offered. The Royal College of Obstetricians and Gynaecologists recommend that all women undergoing an abortion should be screened for C. trachomatis and undergo a risk assessment for other STIs. Chlamydia is the most commonly diagnosed STI in England. Infection of varying degrees of severity may occur after medical or surgical abortion and is usually caused by pre-existing infection. Prophylactic antibiotic use and bacterial screening for lower genital tract infection reduces this risk. Analysis of returned data for 2014 shows that 87% of women having abortions in 2014 were offered chlamydia screening, up from 69% in 2004. (See Table 3a.x). The figure for women aged under 25 is slightly higher (91%)
Place of residence within England and Wales 2.52 The place of residence details provided on the HSA4 form are used to allocate each record to a Clinical Commissioning Group (CCG) for analysis. For Wales, records are allocated to their equivalents, Local Health Boards. Tables 10a, 10b, 11a and 11b show information for these areas.
2.53 Similarly the place of residence details are used to allocate each record to a Local Authority (LA) and tables 10c, 10d, 11c and 11d show information by LA.
Abortion Statistics, England and Wales: 2014
21 2.54 Rates vary by region with London showing the highest rate at 22 per 1,000 women. See Figure 8.
England and Wales, 2014
Women resident outside England and Wales 2.55 In 2014, there were 5,521 abortions to women resident outside England and Wales, compared with 5,469 in 2013. Principally, these non-residents were from the Irish Republic (68%) and Northern Ireland (15%). See Tables 12a, c, d and Figure 9.
2.56 The number of abortions to non-residents has fallen each year since 2003, when the figure was 9,078. The 2014 total is slightly higher than 2013 which was the lowest in any year since 1969 (See Table 1 and Table 12a).
22
Figure 9: Abortions to non-residents in England and Wales, 2004 to 2014
Abortions carried out in Great Britain
2.57 There were 201,567 abortions carried out in Great Britain in 2014, of which 94% took place in England and Wales and 6% took place in Scotland (See Table 13). Scotland perform the majority of abortions medically 80% compared to those performed in England and Wales where the proportions were surgical 50% and medical 50%. The proportion of women undergoing abortions who had one or more previous abortions was higher for women having abortions in England and Wales (37%) than those having abortions in Scotland (32%).
Abortion Statistics, England and Wales: 2014
23 Index of Tables The complete datasets are available at https://www.gov.uk/government/statistical-data-sets/abortion-statistics- england-and-wales-2014
Table Description
Table 1
Legal abortions: resident status and purchaser, 1968 to 2014
Table 2 Legal abortions: age by (i) purchaser, (ii) statutory grounds, (iii) gestation weeks,
miscarriages,
(ix) previous abortions, (x) chlamydia screening, residents of England and Wales, 2014
Table 3a Legal abortions: by (i) purchaser, (ii) statutory grounds, (iii) gestation weeks,
miscarriages,
(ix) previous abortions, (x) chlamydia screening, residents of England and Wales, 2004 to 2014
Table 3b Legal abortions: totals, rates and percentages by age group, residents of England and Wales,
2004 to 2014
Table 4a
Legal abortions: by age, residents of England and Wales, 2014
Table 4b Legal abortions: number of previous abortions by age, residents of England and Wales, 2014
Table 5
Legal abortions: gestation weeks by purchaser and method of abortion, residents of England
and Wales, 2014
Table 6
Legal abortions: gestation weeks by age and purchaser, residents of England and Wales, 2014
Table 7a
Legal abortions: procedure by gestation weeks, residents of England and Wales, 2014
Table 7b
Legal abortions: grounds by gestation weeks, residents of England and Wales, 2014
Table 8 Legal abortions: complication rates by procedure and gestation weeks, residents of England
and Wales, 2014
Table 9a
Legal abortions: principal medical condition and all mentions of medical conditions,
for abortions performed under ground E, residents of England and Wales, 2014
Table 9b Legal abortions performed under ground E by gestation weeks, residents of
Table 9c Legal abortions performed under ground E by gestation weeks, residents of 24
England and Wales, percentages, 2014
Table 10a Legal abortions: numbers by Clinical Commissioning Groups (England) and Locality Office
(Wales) of residence, by age, 2014
Table 10b
Legal abortions: rates by Clinical Commissioning Groups (England) and Locality Office (Wales)
of residence, by age, 2014
Table 10c
Legal abortions: numbers by age and Local Authority, England residents, 2014
Table 10d Legal abortions: rates by age and Local Authority, England residents, 2014
Table 11a Legal abortions: purchaser, gestation weeks and Sexual Health Indicator by Clinical
Table 11b Legal abortions: method of abortion and repeat abortions, all ages, aged under 25 and 25 and
over, by Clinical Commissioning Group (England) and Locality Office (Wales) of residence, 2014
Table 11c Legal abortions: purchaser, gestation weeks and Sexual Health Indicator by Local Authority,
England, residents, 2014
Table 11d
Legal abortions: method of abortion and repeat abortions, all ages, aged under 25 and 25 and
over by Local Authority, England, residents, 2014
Table 12a
Legal abortions: non residents of England & Wales by country of residence, 2014
Table 12b Legal abortions: non residents of England & Wales by (i) age, (ii) statutory grounds and
(iii) gestation weeks, 2014
Table 12c
Legal abortions: country of residence by age and gestation weeks, 2014
Table 12d Legal abortions: residents of Irish Republic by county, 2014
Table 13 Legal abortions: countries of Great Britain by (i) age, (ii) gestation, (iii) procedure, (iv) parity,
(v) previous abortions, (vi) grounds and (vii) principal medical condition for abortions performed
under ground E, 2014
Abortion Statistics, England and Wales: 2014 Annex A: Data Quality and Methods
Validation
i. The Department of Health use a thorough process for inspecting and recording the information received on the forms in order to monitor compliance with the legislation and the extent to which best practice guidance from the Department of Health is followed. Selected forms are scrutinised by a medical practitioner who may request further detail from the patient’s medical record via the terminating doctor. Further details of the checks that are made on the data are available on the GOV.UK web site at:
https://www.gov.uk/government/publications/abortion-notification-forms-for-england-and- wales
• Data collected
Not all the information collected on form HSA4 is necessary for statistical purposes and some of the information that is used to monitor the Abortion Act is not stored electronically other than on scanned images of the forms. The scanned images of the forms are part of the system for processing the forms and they are kept for three years.
The following information is not stored: • Terminating and certifying doctors’ names • Terminating and certifying doctors’ addresses • Terminating doctor’s GMC number • Patient name • Patient reference including NHS number • Patient address • Detail about any medical conditions other than ICD10 Codes
• Derived fields
Some of the data used in the tables are derived variables. More detail about these calculations is shown below:
•
medical abortions, the date of prostaglandin or other medical agent. If a feticide is used, this date takes priority. • Age at Termination is taken from Reported Date of Termination (see above) minus date of birth. Age at termination is collected in whole years. • Purchaser is derived from information given about how the abortion was funded (NHS or Privately) together with clinic type (NHS hospital, Independent Sector, Private hospital). For example, a privately funded abortion within an Independent Abortion Statistics, England and Wales: 2014
ii Sector organisation will be ‘privately funded’ and an NHS funded abortion within an Independent Sector clinic will be ‘NHS Funded: Independent Sector’. • Area of residence (CCG/LA/region) is derived from postcode of the woman’s residence. • Duration of stay is derived from date of discharge minus date of admission.
• Forms returned after the publication cut-off date
ii. The 2014 figures in this annual bulletin are based on a snapshot of the records taken about eight weeks prior to publication. A small number of notifications have been, and will continue to be, received after this cut-off date. Whilst these additional notifications are processed and the information retained in line with our retention policy, they are not included in future statistical releases. So, for example, figures for 2013 published in the 2013 bulletin have not been revised in this year’s bulletin. This policy of not revising statistics is taken for three main reasons:
• to prevent the disclosure of personal information arising from small differences in published tables; • to ensure consistency in published outputs over time; and • because the revisions would be small in scale and therefore of little value.
iii.
The scale of the effect is illustrated below for 2013. A further 480 notifications were received after the cut-off, equating to a quarter of one per cent of the published total. 3 of these late notifications were for abortions over 23 weeks. As the table below shows, the inclusion of this information would have resulted in no change in the percentage breakdowns by age group, gestation and grounds to one decimal place.
Table: Examples of the effect on the statistics of forms returned after the publication cut- off date, 2013
Published 2013 figures 2013 figures incorporating notifications received after the publication cut-off
Total abortions 185,331
185,811
Gestation (weeks)
79.2% 79.1%
10 to 12 12.4%
12.4% 13 to 19 7.0% 7.0%
20 or over 1.5%
1.5% Not known N/A 0.0%
Grounds
E 1.5%
1.5% Other
98.5% 98.5%
Age
Under 20 15.6%
15.7% 20 to 34 69.6% 69.6%
35 or over 14.7%
14.7% Abortion Statistics, England and Wales: 2014
iii • Incomplete information and imputation iv.
Incomplete and incorrectly completed forms are returned to practitioners for completion and clarification. In a very small number of cases (about one-quarter of one percent), the information remains unavailable at the time of publication. Date of birth was missing from 5 records in 2014, gestation information from 37, postcodes from 32 and grounds from 10.
For the purposes of constructing statistics, values for missing items are imputed. Records with missing ages were assigned pro-rata to the 20-24 age group, as this is the modal age group, accounting for 29% of abortions. Missing gestations were imputed as 6, 7, 8, 9 or 10 weeks in equal distribution unless the method of abortion or diagnosis suggested otherwise. Missing postcodes were imputed with a random postcode from within the main local authority of other residents attending the same hospital or clinic. Missing grounds were imputed as ground C
• Population estimates used for rates of abortion vi.
Abortion rates are calculated using the conventional age range for women in their child bearing years, 15 – 44.
vii. Abortion rates per 1,000 women for 2014 at a national level and at CCG level were calculated using the mid-2013 population estimates for England, Wales, England and Wales, Clinical Commissioning Groups and Locality Office, as published at 26 th June
2014 1 . Rates for earlier years were calculated using the latest population estimates available at the time the relevant annual reports were produced and have not been revised, either by using population estimates for the year in question or by using updated population estimates.
• Deriving age standardised rates of abortion
viii. Age standardised rates allow comparison between populations which may contain different proportions of people of different ages. The European Standard Population (ESP) is a widely used artificial population structure for the calculation of directly age standardised rates. The replacement of the ESP first used in 1976 with an updated version published in 2013 resulted in an increase of all-cause mortality rates for England and Wales by 85% and all-site cancer incidence rates for England by some 48%. Figures using the 1976 and 2013 ESPs are therefore not comparable. Information about this change in methods can be found on the ONS website at: http://www.ons.gov.uk/ons/guide-method/user-guidance/health-and-life-events/revised- european-standard-population-2013--2013-esp-/index.html
1 Available at http://www.ons.gov.uk/ons/rel/pop-estimate/population-estimates-for-uk--england-and-wales-- scotland-and-northern-ireland/2013/stb---mid-2013-uk-population-estimates.html
Abortion Statistics, England and Wales: 2014
iv ix. The effect of implementing the 2013 ESP for abortion age standardised rates is small. The vast majority of abortions occur within the age range 15-44. The 1976 ESP assumed equal populations at each single age between 15-44 (see Annex table 1 below). The 2013 ESP has made only a small change to the populations within age range 15-44 such that although not equal, it remains fairly uniform. Thus, the 2013 ESP brings the abortion age standardised rates down by about 4% in recent years and 2% in earlier years. The time series using 2013 ESP age standardised rates back dated to 1968 is presented in table 1 of the detailed tables.
x. The formulae used to calculate the age-standardised abortion rates are given below.
For the analysis of trends in abortion rates for England and Wales:
?????????????????? ???????????????????????????????????????????????????????????????????????? ???????????????????????? = ∑ ???????????????????????? ?????? ?????????????????? ?????? ?????????????????? ???????????????????????? ?????? ∑ ?????????????????? ?????? 44 ??????=15
Where ‘rate i ’ is the crude rate for women aged i and ESP i is the population of women aged i in the 2013 European Standard Population.
For the area analyses in table 10b:
?????????????????? ???????????????????????????????????????????????????????????????????????? ???????????????????????? = ∑ ???????????????????????? ?????? ?????????????????? ?????? 44 ??????=15 ∑ ?????????????????? ?????? 44
where the rate for women aged under 16 (rate 15) =
???????????????????????????????????? ???????????? ?????????????????????????????????????????????????????? ???????????? ?????????????????????????????? ?????????????????????????????? 16 ???????????????????????????????????????????????????????????? ???????????? 15 ???????????????????????? ????????????????????????
and the rate for women aged 44 and over (rate 44) =
???????????????????????????????????? ???????????? ?????????????????????????????????????????????????????? ???????????? ?????????????????????????????? ???????????????????????? 44 ?????????????????? ???????????????????????? ???????????????????????????????????????????????????????????? ???????????? 44 ???????????????????????? ????????????????????????
Abortion Statistics, England and Wales: 2014
v Annex table 1: European Standardised Population
Age group 1976 ESP
2013 ESP
Under 1
1,600
1,000
1-4
6,400
4,000
5-9
7,000
5,500
10-14
7,000
5,500
15-19
7,000
5,500
20-24
7,000
6,000
25-29
7,000
6,000
30-34
7,000
6,500
35-39
7,000
7,000
40-44
7,000
7,000
45-49
7,000
7,000
50-54
7,000
7,000
55-59
6,000
6,500
60-64
5,000
6,000
65-69
4,000
5,500
70-74
3,000
5,000
75-79
2,000
4,000
80-84
1,000
2,500
85 and over 1,000 -
85-89 - 1,500 90-94
- 800 95 and over
-
Total
100,000
100,00
Source: Eurostat
• Confidence intervals
xi. The figures recorded in this report are the outcome of a stochastic process – that is, they are influenced by chance or random processes such as fertilisation. Each recorded figure is only one of a range of results that could have occurred under the same circumstances if those random processes had led to different outcomes. It is often the underlying circumstances or process that is of interest and the actual value observed gives only an imprecise estimate of this ‘underlying risk’. For example, users are often interested in understanding whether there has been a change in rates of abortion, perhaps reflecting a change in the prevalence of risky sexual behaviour, a change in attitudes towards the options available in pregnancy or a change in access to services. To assess this, it is necessary to determine if the observed change is one that is unlikely to be the result of random fluctuation and therefore offers evidence that a real change has occurred.
xii. A confidence interval can be calculated around each observed value, which gives a range in which the expected or average value resulting from the underlying process is likely to fall. The 95 per cent confidence intervals have been calculated for some of the observed values in tables 10a, 10b, 10c and 11. These are known as such, because if it were
Abortion Statistics, England and Wales: 2014
vi possible to repeat the underlying process under the same conditions a large number of times (that is, ‘rerun’ the year over and over again), 95 per cent of the confidence intervals calculated in this way would contain the average value from those runs. When assessing the observed results for the year, it is usual to assume that there is only a 5 per cent chance that the expected or average value falls outside the 95 per cent confidence interval.
xiii. The confidence interval may be used to compare an estimate against a target or benchmark value. If the target or benchmark value is outside the confidence interval it can be inferred that the difference between the estimate and the target is statistically significant at the 95 per cent confidence level.
xiv. Confidence intervals are also often used to compare two observed values (for example, abortion rates within two regions.) Sometimes in such cases statistical testing is undertaken by seeing if the two confidence intervals overlap. This is quick and easy to do, but not necessarily conclusive: whilst it is safe to assume that non-overlapping confidence intervals indicate a statistically significant difference, it is not always the case that overlapping confidence intervals do not.
xv. The method for estimating a confidence interval varies depending on whether it is for a percentage, count, crude rate or standardised rate. The methods used are those detailed in the Association of Public Health Observatories’ Technical Briefing 3: Commonly used public health statistics and their confidence intervals.
xvi. For example, the 95 per cent confidence interval associated with: • The figure of 184,571 for the total number of abortions of residents in England and Wales is 183,730 – 185,415 (Table 10a);
• The age standardised rate of 15.92 abortions per 1000 resident women aged 15-44 in England and Wales is 15.9 to 16.0 (Table 10b); • The figure of 84.5 per cent for the percentage of NHS funded abortions in NHS Eastern Cheshire CCG undertaken within 10 weeks gestation is 80.5 per cent to 87.7 per cent (Table 11).
•
xvii.
The Data Protection Act 1998 places a statutory obligation on the Department of Health to ensure that the statistics we release on abortion do not relate to a living individual who can be identified from those data alone or in conjunction with other available information, unless the conditions laid out in the Act are met. In recent years, the Department has attempted to meet this obligation by following the disclosure guidance for abortion statistics developed by the Office for National Statistics in July 2005. A judgment was handed down in 2011 by the High Court in a case relating to the release of information on principal medical condition for abortions performed under Ground E, showed that the disclosure controls set out in the guidance were overly cautious in some circumstances. The format of the tables in the annual report have therefore been revised, with a more limited degree of suppression applied, where still necessary to avoid the disclosure of personal data.
xviii. The Department published the Disclosure Control Protocol for Abortion Statistics in June 2015 which can be found at: Abortion Statistics, England and Wales: 2014
vii https://www.gov.uk/government/collections/abortion-statistics-for-england-and-wales
• Geographical coding and naming
xix. On 1st January 2011, the Government Statistical Service introduced a new coding and naming policy for statistical geographies. Nine-digit codes have been developed to ensure consistency when comparing geographical areas as the geographical area covered by an NHS organisation is susceptible to change. These unique markers have been added to the relevant tables within this publication.
xx. On the 1 st April 2013 Clinical Commissioning Groups assumed commissioning of termination of pregnancy services under the health system reforms. Further information on the Coding and Naming for Statistical Geographies is available at:
http://www.ons.gov.uk/ons/guide-method/geography/geographic-policy/coding-and- naming-for-statistical-geographies/index.html
• Rounding xxi. Percentages are subject to rounding and totals may not agree with the sum of the component figures shown. Rates are also rounded.
• Symbols
xxii. The following symbols are used in the tables: . = not applicable .. = suppressed value to protect patient confidentiality
Abortion Statistics, England and Wales: 2014
viii Annex B: Further Information
• Enquiries Enquiries about the data or requests for further information should be addressed to:
Abortion Statistics Department of Health Richmond House 79 Whitehall London
SW1A 2NS e-mail: abortion.statistics@dh.gsi.gov.uk
Extracts from this publication may be reproduced provided a reference to the source is given. • Links This bulletin for 2014, and previous bulletins for 2002 to 2013, can be found on the Department of Health website: https://www.gov.uk/government/collections/abortion-statistics-for-england-and-wales
http://transparency.dh.gov.uk/category/statistics/abortion Data for 1991 to 2001 can be sent by email on request.
Information about disclosure control protocol published 9 th June 2015 can be found at: https://www.gov.uk/government/publications/abortion-statistics-protocols-on-disclosing- personal-data
http://www.isdscotland.org/Health-Topics/Sexual-Health/Abortions
Information about the release of abortion statistics in Scotland can be found at: http://www.isdscotland.org/Products-and-Services/Data-Protection-and-Confidentiality/Disclosure- Protocol-Version-2-2-WEBversion.pdf
Facts and figures about abortion in the European Region can be found at: http://www.euro.who.int/en/what-we-do/health-topics/Life-stages/sexual-and-reproductive- health/activities/abortion/facts-and-figures-about-abortion-in-the-european-region
Information on the incidence and recent trends in legal abortion worldwide can be found at: http://www.guttmacher.org/pubs/journals/3310607.html
http://www.ons.gov.uk/ons/search/index.html?newquery=conception
Statistics on the National Chlamydia Screening Programme are available at: http://www.chlamydiascreening.nhs.uk/ps/data/index.html
pregnancy for fetal anomaly;
http://www.binocar.org/Publications/Reports Abortion Statistics, England and Wales: 2014
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