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BPAS comment re: abortion statistics 2021

Government inaction on folic acid fortification leading to hundreds of preventable abortions, as new data also shows increase in overall abortion rate in England and Wales

  • Statistics released today show that in 2021, there were hundreds of terminations due to the diagnosis of neural tube defects such as spina bifida and anencephaly – fetal anomalies related to folic acid deficiency.
  • There is clear evidence from other countries including the US, Canada and Australia that fortifying flour with folic acid leads to a decrease in the numbers of pregnancies affected by neural tube defects, yet the UK government has yet to take any meaningful action to bring forward similar measures here despite making a commitment on the issue in 2021.
  • The charity the British Pregnancy Advisory Service, BPAS, has warned the government that that “for every year of delay… hundreds of women will face the heartbreak of ending a wanted pregnancy due to a diagnosis of a neural tube defect.”
  • The data also shows that in 2021, there were 214,869 reported in England and Wales in 2021, the highest since records began. The largest increases in abortion rates by age are among women aged 30 to 34 which have increased from 17.2 per 1,000 in 2011 to 22.1 per 1,000 in 2021. 57% of those undergoing an abortion in 2021 were already mothers.
  • BPAS state “the pandemic has clearly impacted upon women’s pregnancy choices and this is reflected in the figures. Faced with economic uncertainty and job insecurity, women and their partners have been making sometimes tough decisions when faced with an unplanned pregnancy.”

Abortion statistics released by the government today show that government inaction on the fortification of flour with folic acid, a straightforward public health intervention which could prevent neural tube defects, is leading to hundreds of terminations of wanted pregnancies. The data also shows an increase in the numbers and rates of abortion in England and Wales, which the charity the British Pregnancy Advisory Service, BPAS, has said reflects the “difficult decisions” women and their partners have faced due to the pandemic and government policies.

The report, Abortion Statistics for England and Wales: 2021, shows that in 2021 there were hundreds of terminations due to the diagnosis of neural tube defects such as spina bifida and anencephaly – fetal anomalies related to folic acid deficiency.

The UK has one of the highest rates of neural tube defects like spina bifida and anencephaly in Europe, with around 1,000 pregnancies affected each year. The majority of women (80%) make the painful decision to end what is often a much wanted pregnancy after such a diagnosis.

In 2006, the UK’s Scientific Advisory Committee on Nutrition (SACN) first recommended flour be fortified with folic acid. After years of delay, the government finally launched a public consultation on the issue in 2019, and in September 2021 announced that they would “proceed with the mandatory fortification of non-wholemeal wheat flour” with the stated aim of reducing “the risk and number of NTD-affected pregnancies in the UK.” Almost a year later, there is no evidence of any progress, and BPAS is concerned that government plans for a further consultation on the “implementation of government plans to introduce folic acid fortification to flour” as part of an ongoing review of The Bread and Flour Regulations 1998 will cause further delays.

It is recommended that women take folic acid supplements prior to conceiving in order to prevent neural tube defects. As 46% of pregnancies in the UK are not actively planned, and many women are unaware of the need to take folic acid, most pregnant women even with the best of intentions will start taking folic acid too late in pregnancy to protect their baby from avoidable harm.

Other key statistics:

  • In 2021, there were 214,869 abortions reported in England and Wales in 2021, the highest since records began. The largest increases in abortion rates by age are among women aged 30 to 34 which have increased from 17.2 per 1,000 in 2011 to 22.1 per 1,000 in 2021.
  • 57% of those undergoing an abortion in 2021 were already mothers, and 65% were in a relationship.
  • The abortion rate for women aged under 18 has continued to decrease (from 15.0 in 2011 to 6.9 in 2020 and further decreased to 6.4 per 1,000 in 2021). The largest increases in abortion rates by age are among women aged 30 to 34 which have increased from 17.2 per 1,000 in 2011 to 22.1 per 1,000 in 2021.

Commenting on the statistics, Clare Murphy, Chief Executive of the British Pregnancy Advisory Service, BPAS, said:

“As the data released today shows, for every year that the government continue to delay the introduction of folic acid fortification, hundreds of women will face the heartbreak of ending a wanted pregnancy due to a diagnosis of a neural tube defect. Most fetal anomalies sadly are not preventable, but those related to folic acid deficiency can and must be reduced. To continue to delay plans for fortification would be morally reprehensible.

“We hope that the data released today can finally shame Ministers in to finally taking this woefully overdue action in order to get the best pregnancy outcomes for as many women as possible.

“The pandemic, and the policies adopted by the government in response, have had a clear impact on women’s pregnancy choices. Faced with economic uncertainty and job insecurity, women and their partners have been making sometimes tough decisions around continuing or ending a pregnancy. While there is no right number of abortions, we know that there is much more the government can do to ensure that women are able to make the decisions that are right for them when faced with an unplanned pregnancy.”

There were 961 mentions of malformations of the nervous system among abortions performed under Ground E of the 1967 Abortion Act, which allows women to undergo a termination following the diagnosis of a fetal anomaly, including 225 mentions of a diagnosis of anencephaly, a condition in which a baby’s skull and brain do not form properly, and 171 mentions of spina bifida, a condition which causes lifelong disability.

ENDS

Notes to Editor

The full report, Abortion Statistics for England and Wales 2021, is available online here.

For further information, please contact Katherine O’Brien, BPAS Associate Director of Campaigns and Communications, on katherine.o’brien@bpas.org or 07881 265276.

Abo ut BPAS

BPAS is a charity that sees over 100,000 women a year for reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception at clinics across Great Britain. It supports and advocates for reproductive choice. BPAS also runs the Centre for Reproductive Research and Communication, which seeks to develop and deliver a research agenda that furthers women’s access to evidence-based reproductive healthcare, driven by an understanding of women’s perspectives and needs. You can find out more here: https://www.bpas.org/get-involved/centre-for-reproductive-research-communication/

In 2021, BPAS launched BPAS Fertility, England’s first not-for-profit fertility service, to provide ethical, evidence-based, person-centred care that supports patients. We provide a safe, high-quality, and accessible service, without profiteering from patients. Our service gives those ineligible for NHS funding an affordable option to access the care they need.