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Health

Women in London Are Having More Abortions Than Anywhere Else in England

We asked an expert whether any of the clichés surrounding abortion rates are true.
Hannah Ewens
London, GB

Image via Flickr user Daniel Lobo

Abortion rates among women in London are higher than the rest of the country, a survey by the Office of National Statistics (ONS) has shown, revealing that nine out of the ten areas with the highest abortion rates for 2015 in England are in the capital. Barking and Dagenham had the highest overall abortion rate, at 29 for every 1,000 women aged 15 to 44. This comes just days after the news that the annual number of abortions in the country has hit a five-year high.

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But why London? The answer surely lies in the widening gap between rich and poor. The five areas with the highest number of terminations in England were Barking and Dagenham, Lewisham, Waltham Forest, Croydon, and Enfield—all in London and all on a different planet to Chelsea, Chalk Farm, and Highgate. According to London's poverty profile, four of those five high-ranking regions are among the most impoverished in the capital.

We spoke to Katherine O'Brien, public policy manager at British Pregnancy Advisory Service (BPAS), to find out why.

Dagenham via wiki

VICE: What were your first thoughts when you saw these stats?
Katherine O'Brien: What's interesting is that the overall abortion rates in all of these boroughs is falling. So while they're still significantly higher than the national average, they are still coming down. That's important to remember. These are also areas with high conception statistics too, so it's a case of a lot of conception alongside a lot of abortion.

These boroughs do follow the new national trend in terms of age groups, which is that this is not just a case of thousands of unwanted teenage pregnancies. It's the rates of older women having abortions which is rising, while teens are falling. It's a complicated picture.It's not as simple as saying these are young London women who need better sex education in school—although that will be a part of it. It's not just a younger women's issue.

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In Barking and Dagenham, in fact, there has been a 19 percent reduction in teen abortions on the previous year. All of these boroughs are very poor though—is that the driving factor?
Yes, you'll notice is that the high levels of deprivation are across the board—just looking at Barking and Dagenham, there are high levels of unemployment, high levels of young people not in education or training, levels of poverty, child poverty. While we know that deprivation isn't necessarily a direct cause of unplanned pregnancy or abortion rates, it's certainly a factor and the two are very linked. Deprived areas also have poorer healthcare outcomes across the board. This isn't just an area with higher abortion rates, but with high rates of mental health problems or shorter life expectancies. All these things play into each other.

Some people who read the headline "London has highest abortion rates" might assume that it's rising either due to teen pregnancies, which you say isn't the case, or that other cliché, that high-powered career women are too busy to have children, or more children.
That has been a lot of the media rhetoric around the rise in older women having terminations. Abortion is a part of women's lives now because of changing social aspirations, but then in this case, quite the contrary—it's boroughs with very high levels of unemployment. This is why these statistics paint such a complex picture: on the one hand abortion is linked to women being more involved in the workplace, but on the other hand it's linked to deprivation, poverty and unemployment. London is definitely more a case of the latter.

For the most part, access to contraception is improving—but studies suggest that the contraception itself is the problem. A professor told the BBC that it was health concerns and a dislike of contraception that could be partially to blame for the rise in abortions. Having to fuck around trying different methods of contraception because of bad side effects is an ongoing issue.
Exactly. As any woman will know, every type of contraception comes with potential side effects. Indeed, the effective long-term methods like the implant and the coil are encouraged by healthcare professionals because they're so good at preventing unwanted pregnancy—but these are the ones that will come with difficult and unmanageable side effects, whether mental or heavy bleeding or pain or something similar. For some women, these methods just don't work.

The problem here is that often in areas with high rates of teen pregnancy or abortion women will be encouraged to use these long-lasting methods with side effects, which are seen as a "silver bullet" to reduce these rates. Young people are encouraged to use them, but of course they might not be the right thing for them.

Women don't want to use these methods or stop using these methods altogether. Some women will think, 'You know what, I've had such a terrible time with my implant, I don't want another method right now.' It makes women wary of trying a new one. What's the solution, until a better form of contraception is eventually produced?
It's about allowing women to choose from the whole range of contraceptive options. There are new methods such as the contraceptive patch and the vaginal ring, which don't have the same level of side effects, but are more expensive. We're worried that women might not be being offered the full range of methods at a time when budgets are really tight and everyone is under pressure to cut costs. All options have to be available to all women if these abortion rates are to reduce in these places.

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