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Young women in deprived areas in Britain are less likely to have an abortion

BMJ 2004; 329 doi: (Published 01 July 2004) Cite this as: BMJ 2004;329:14
  1. Susan Mayor
  1. London

    Women under the age of 18 who live in more deprived areas of Britain have higher rates of conception than women in wealthier areas but are less likely to opt for an abortion, a report published this week says.

    The study investigated the relation between abortion and wider social factors in women aged 17 years or less. It was based on research that included national data on geographical variations in rates of conception and abortion and in-depth interviews with 103 young women.

    The results showed that between 1999 and 2001 in England and Wales, 44% of conceptions among women aged 15 to 17 years were terminated. However, the figure varied considerably between different local authorities, ranging from 18% to 76%. In areas with higher levels of deprivation, rates of conception in women aged under 18 were higher, and a lower proportion of these pregnancies ended in abortion. The authors, from the Centre for Sexual Health Research at the University of Southampton, considered that this had implications for service capacity.

    Statistical analysis, as well as interviews, showed that young women generally made decisions about whether to continue or terminate a pregnancy before visiting a health professional.

    The interviews, which were conducted individually, showed that women's decisions tended to depend on economic and social factors rather than moral views. Young women who saw their lives as insecure were more likely to view motherhood as something that might change their lives in a positive way. Women who were more certain that their lives would develop through education and employment were more likely to opt for abortion.

    Other data showed associations—independent of levels of deprivation—between a high proportion of abortions in an area and more extensive provision of local family planning, a higher proportion of female GPs, and greater provision of abortion services by the independent sector.

    The women who took part in the study were more likely to regard family planning services, rather than GP services, as the place to go for referral for an abortion. NHS abortion services were almost always available where women requested abortion. However, in some areas local services were struggling to meet demand. In a small number of cases waiting times were longer than the three weeks recommended by the government.

    The researchers concluded that policy should take account of the fact that young women's decisions about pregnancy were shaped by social circumstances and personal relationships. Many young women got satisfaction from motherhood and needed medical services that accepted their choices. However, to reduce the stigma associated with abortion, services should make it clear that abortion is an aspect of reproductive health care and family planning, the authors said.

    The report was funded by the Joseph Rowntree Foundation, an independent social policy research and development charity that supports a wide programme of research and development projects in housing, social care, and social policy.

    A Matter of Choice? Explaining National Variations in Teenage Abortion and Motherhood is available at or from York Publishing Services, 64 Hallfield Road, York YO31 7ZQ (price £14.95, plus £2 postage and packaging).

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