Accredited official statistics

Abortion statistics, England and Wales: 2022

Updated 18 December 2024

Applies to England and Wales

Key events

Date	Key event
October 1967	The Abortion Act 1967 was passed. Introduced by David Steel and supported by the government under a free vote. It legalised abortion on certain grounds, by legalised practitioners, in England, Wales and Scotland. The act came into effect on 27 April 1968.
November 1990	The Human Fertilisation and Embryology Bill lowered the gestation limit for abortions from 28 weeks to 24 weeks. This is the currently accepted point at which the fetus is considered viable outside the woman’s body. The Human Fertilisation and Embryology Act 1990 came into effect on 1 April 1991.
June 2017	Northern Ireland funding scheme introduced, to provide funded abortions in England and Wales, for residents of Northern Ireland. In cases of hardship, travel costs are also covered. Funding is provided by the Government Equalities Office and HM Treasury. This provision for Northern Irish women remained in place throughout 2022 despite the decriminalisation of abortion in Northern Ireland and ended on 31 March 2024. Northern Irish residents are therefore included in this 2022 abortion statistics publication.
June 2018	Women in Wales and, from 28 December 2018, women in England can take the second of the 2 abortion pills, misoprostol, at home. This brought England and Wales in line with Scotland, which allowed the second pill to be taken at home from October 2017.
December 2018	Abortion legalised on certain grounds, in the Irish Republic, up to 12 weeks’ gestation and later if the woman’s life or health is at risk. The law came into effect on 20 December 2018.
October 2019	Abortion in Northern Ireland decriminalised after a free vote by Westminster MPs in July 2019. The suspended Northern Ireland Executive did not return by 21 October 2019, meaning the amendment introduced by Stella Creasy was passed into law through the Northern Ireland (Executive Formation etc) Act 2019 on 22 October 2019.
March 2020	Women in England and Wales can take both abortion medications, mifepristone and misoprostol, at home for early medical abortion (up to 9 weeks and 6 days’ gestation), without the need to first attend a hospital or clinic. This was temporarily approved by the Secretary of State for Health and Social Care to limit the transmission of COVID-19 from 30 March 2020 and by the Welsh government’s Minister for Health and Social Services from 31 March 2020.
March 2020	The Abortion (Northern Ireland) Regulations 2020 came into force on 31 March 2020. The regulations introduce a new legal framework for abortion services in Northern Ireland.
February 2022	The temporary measures, put in place in March 2020 to allow women in Wales to take both abortion medications at home, were made permanent from 24 February 2022.
March 2022	On 30 March 2022, Parliament voted in favour of an amendment to the Health and Care Bill, making the temporary approval allowing home use of both pills for early medical abortions permanent in England and Wales. These provisions will supersede the arrangements made permanent in Wales in February 2022.

Key points in 2022

There were 251,377 abortions for women resident in England and Wales in 2022 - the highest number since the Abortion Act was introduced and an increase of 17% over the previous year.

Figure 1: number of abortions, England and Wales, 2012 to 2022

The age-standardised abortion rate for residents is 20.6 per 1,000 women - the highest rate since the Abortion Act was introduced.

Figure 2: age-standardised abortion rate per 1,000 women aged 15 to 44, England and Wales, 2012 to 2022

The crude abortion rate for those aged under 18 has decreased in previous years (from 12.8 in 2012 to 6.4 per 1,000 women in 2021) but has risen to 7.7 per 1,000 women in 2022. The trend for those aged under 18 over the last 10 years is still downwards. The rate has also increased for those aged 35 or over (from 10.5 to 11.3 per 1,000 women between 2021 and 2022).

Figure 3: crude abortion rates for under 18 and over 35, England and Wales, 2012 to 2022

In 2022, 99% of abortions in England and Wales were funded by the NHS, with 80% of abortions taking place in the independent sector.

Figure 4: percentage of abortions that were NHS funded and performed in the independent sector, England and Wales, 2012 to 2022

In 2022, 86% of abortions were medically induced, similarly to 87% in 2021. Medical abortions have increased by 38 percentage points since 2012 (48%).

Figure 5: percentage of abortions by procedure type (medical or surgical), England and Wales, 2012 to 2022

Introduction

This report provides statistics on abortions recorded in England and Wales in 2022. 

The information presented is based on abortion notification forms (HSA4) submitted by clinics and hospitals to the Chief Medical Officer (CMO) at the Department of Health and Social Care (DHSC) together with forms submitted to the Welsh CMO. 

DHSC monitors the forms to ensure that there is full compliance with the legislation set out in the Abortion Act 1967. 

Note that the commentary in the ‘Abortion rates by index of multiple deprivation deciles’ section is different to the commentary in the original publication, released on 23 May 2024.

As of 18 December 2024, figures for the rate of abortions by index of multiple deprivation in tables T14a, T14b and T14c of ‘Abortion statistics 2022: data tables (amended)’ have been revised. This is due to a small error found in the calculations used in the tables that were originally published.

The updated commentary reflects the corrected data and the removal of data on abortion rate by index of multiple deprivation and age for residents of Wales in table T14c.

Further information

Further details on the legislative context of the Abortion Act, in addition to methodological and technical information on the data can be found in the ‘Guide to Abortion statistics’ in Abortion statistics for England and Wales: 2022. 

Previous publications

DHSC has published abortion statistics annually since 2002. Statistics for years from 1968 to 1993 were published by the Office of Population Censuses and Surveys, then their successor, the Office for National Statistics (ONS), from 1994 to 2001. Reports up to and including 2001 are available electronically on request by emailing [email protected]. 

The most recent versions of the publication (2002 onwards) are available in the Abortion statistics for England and Wales collection.

Abortion statistics cover the period January to December and are published annually. As an exception to this, in August 2023, DHSC published provisional abortion statistics for 2022, covering January to June 2022. This was due to a backlog in the processing of HSA4 forms upon which these publications are based. The next publication will cover January to December 2023.

For further information or to provide any feedback on the publication, contact us at [email protected].

Commentary

Unless otherwise specified, the following commentary, charts and tables relate only to abortions in England and Wales, for residents of England and Wales, in 2022. Similarly, unless otherwise stated, the rates presented in this publication are based off abortions per 1,000 women aged 15 to 44.

Overall number and rate of abortions

252,122 abortions were reported in England and Wales in 2022 - the highest number of abortions since records began. The vast majority of these abortions (251,377) were to residents of England and Wales. This represents an age-standardised abortion rate (ASR) of 20.6 per 1,000 resident women aged 15 to 44. This is the highest rate recorded, exceeding the previous peak in 2021 (18.6 abortions per 1,000 resident women aged 15 to 44). (See Table 1 and Figure 6.)

Figure 6: age-standardised abortion rate per 1,000 women aged 15 to 44, England and Wales, 1969 to 2022

Age

The crude abortion rate in 2022 was highest for those aged 22 (at 37.6 per 1,000 women). The same was the case in 2021 (31.0 per 1,000 women aged 22). In 2012 it was highest for those aged 21 (at 31.0 abortions per 1,000 women). (See Table 3b and Table 4ab.)

Figure 7: crude abortion rate per 1,000 women by single year of age, England and Wales, 2012, 2021 and 2022 

Figure 8: crude abortion rate per 1,000 women by single year of age, England and Wales, 2012 to 2022 

There has been an increase in the crude abortion rates for all ages 19 and above from 2012 to 2022. This is compared with an increase for all ages 22 and above from 2011 to 2021. The largest increases in abortion rates from 2012 to 2022 by age are among those aged 25 to 29, increasing from 21.8 per 1,000 to 31.4 per 1,000.

Abortion rates for those aged under 18 have declined (or stayed the same) each year since 2007. However, the rate has not decreased further between 2021 and 2022 and instead has increased from 6.4 to 7.7 per 1,000 women aged under 18 (see Figure 3). This increase was particularly marked in 17 year olds, where the rates increased from 10.2 per 1,000 in 2021 to 12.9 per 1,000 in 2022. The increase in the rates for those aged 16 and under are smaller (increased by less than 1 abortion per 1,000 women of that age).

Marital status

In 2022, 82% of abortions were for those whose marital status was given as ‘single’ - a proportion that has remained roughly constant for the last 10 years. Fifty one percent were to those whose marital status was given as ‘single with a partner’. This proportion has remained similar in recent years. (See Table 3a(v).)

Ethnicity

Ethnicity was recorded on 91% of the forms received for 2022 (see Table 3a(vi)), as in 2021 (91%). Where ethnicity was recorded, 77% of those having abortions reported their ethnicity as ‘white’, 9% as ‘Asian’, 8% as ‘black’, 5% as ‘mixed’ and less than 1% as ‘other’. 

Figure 9: percentage of abortions by ethnicity, England and Wales, 2022

Area of residence within England and Wales

By region of residence, rates of abortion are highest in the North West (24.2 per 1,000 women aged 15 to 44) and lowest in the South West (17.6 per 1,000 women aged 15 to 44). (See Figure 10.) Between 2021 and 2022, the ASR of abortions increased for all regions of England and for Wales.

Figure 10: age-standardised abortion rate, per 1,000 women aged 15 to 44, by English regions and Wales, 2022

Location and funding of abortions

In 2022, 19% of abortions were performed in NHS hospitals compared with 21% in 2021. In 2022, 80% of abortions were performed in approved independent sector clinics under NHS contract compared with 77% in 2021. Similarly to 2021, this makes a total of 98% of abortions funded by the NHS in 2022 (99% in 2021). The remaining 2% were privately funded. (See Table 3a(i) and Figure 11.) 

The proportion performed in the independent sector under NHS contract has increased almost every year since this information was first collected in 1981, while the proportions of NHS hospital and private abortions has fallen over this period.

Figure 11: percentage of abortions by purchaser and provider, England and Wales, 1981 to 2022

Statutory grounds for abortion

Under the Abortion Act 1967, a pregnancy may be lawfully terminated by a registered medical practitioner, in approved premises, if 2 medical practitioners are of the opinion, formed in good faith, that the abortion is justified under one or more of grounds A to G. (See Table A below.) 

For more information about the grounds for abortion, see the glossary below and the ‘Guide to Abortion statistics’ in Abortion statistics for England and Wales: 2022. 

Table A: grounds for abortion 

Ground	Definition
Ground A	That the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated.
Ground B	That the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
Ground C	That the pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.
Ground D	That the pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing child (or children) of the family of the pregnant woman.
Ground E	That there is substantial risk that, if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.
Ground F	To save the life of the pregnant woman.
Ground G	To prevent grave permanent injury to the physical or mental health of the pregnant woman.

The proportion of abortions performed under different grounds has remained similar to previous years. In 2022, 98% of abortions (247,440) were performed under ground C. A further 1% were carried out under ground E alone or with A, B, C or D, (3,124 abortions), with 0.3% (692 abortions) under ground D (alone or with C). The remaining grounds account for very few abortions: 121 in total across grounds A, B, F and G. (See Table 2.) 

The vast majority (99.9%) of abortions carried out under ground C alone were reported as being performed because of a risk to the woman’s mental health. These were classified as F99 (mental disorder, not otherwise specified) under the International Classification of Disease version 10 (ICD-10). 

Legal abortions performed under ground E

Ground E abortions are those performed because of fetal abnormality at any gestation. There were 3,124 abortions performed under ground E in 2022. This is a slight decrease since 2021, when there were 3,370 abortions performed under ground E. (See Table 3a.) 

In 2022, 65% of ground E abortions were performed medically and 86% of all abortions were performed medically. This aligns with 2021 when 65% of ground E and 87% of all abortions were performed medically. (See Tables 9c and 7a.)

There were 545 (17%) ground E abortions at 22 weeks and over, and 256 (8%) ground E abortions at 24 weeks and over. (See Table 9b.) 

The age group with the highest proportion of abortions performed under ground E (alone or with A, B, C or D) is 35 and over (3% of abortions for this age group were performed under ground E). (See Table 2.)

There was a total of 4,729 conditions mentioned on ground E forms in 2022. This is a decrease from 5,096 in 2021. The medical diagnoses are coded to the ICD-10. For more information on issues with the reporting of ground E abortions see the ‘Guide to Abortion statistics’ in Abortion statistics for England and Wales: 2022.

Congenital malformations (see glossary below) were the most common medical condition mentioned on HSA4 forms, making up 53% of conditions mentioned. Chromosomal abnormalities counted for 27% of conditions mentioned. (See Table 9a.)

Gestation period

Figure 12: percentage of abortions by gestation, England and Wales, 2012 to 2022

Over the last 10 years, the proportion of abortions performed at under 10 weeks has increased from 77% in 2012 to 88% in 2022. Over the same period, the percentage performed at 20 weeks has remained between 1 to 2%. (See Table 3a(iii).) 

The legal limit for an abortion is 24 weeks’ gestation. This is the point at which the fetus is viable outside the woman’s body. Abortions may be performed after 24 weeks in certain circumstances - for example, if the woman’s life is at risk or the fetus would be born severely disabled. Abortions where gestation is 24 weeks or over account for a very small number of abortions (0.1% of the total). There were 260 such abortions in 2022. (See Table 5.)

Method of abortion

Different methods can be used to terminate a pregnancy, depending on the gestation, and other circumstances relating to the individual. There are medical methods which involve the use of drugs (for example, mifepristone) and there are surgical methods, such as vacuum aspiration or dilatation and evacuation. 

See glossary below and ‘Guide to Abortion statistics’ in Abortion statistics for England and Wales: 2022 for more information. 

Figure 13: total number of abortions and number of abortions by method, England and Wales, 2012 to 2022

Medical abortions accounted for 86% of total abortions in 2022 - a decrease of one percentage point from 2021. However, there has been an upward trend in medical abortions since 1991, when mifepristone was first licensed for use in the UK. (See Table 3a(iv).) There was an additional effect during 2020 and 2021 due to the COVID-19 pandemic - more information on this is set out later in this commentary.  

Early medical abortions are defined as taking place within the first 10 weeks of the pregnancy using medical methods. Until late March 2020, the first stage of treatment had to be administered at an NHS hospital or independent sector abortion clinic approved by the Secretary of State for Health and Social Care. Since June 2018 for Wales and December 2018 for England, the second stage of treatment for early medical abortions can be administered at home. 

From 30 March 2020 for England and 31 March 2020 for Wales, temporary measures were put in place to limit the transmission of COVID-19 by approving the use of both pills for early medical abortion at home, without the need to first attend a hospital or clinic. These were made permanent in Wales from 24 February 2022. On 30 March 2022, Parliament voted in favour of an amendment to the Health and Care Bill, making the temporary approval allowing home use of both pills for early medical abortions permanent in England and Wales.

The percentages of different methods used to administer abortions have changed since the approval of both pills for early medical abortion without needing to first visit a hospital or clinic (although it is worth noting the general increase in medical abortions over time).

Taking both medications at home is the most common procedure, accounting for 61% of all abortions in 2022 - an increase of 9 percentage points since 2021. 

Medical abortions where mifepristone is taken in clinic and misoprostol is taken at home decreased from 21% of abortions in the first quarter (January to March) of 2022 to 8% in in the last quarter (October to December) of 2022. 

Taking both mifepristone and misoprostol at a hospital or clinic has become a less common method of abortion, decreasing from 37% of abortions in the first quarter (January to March) of 2020 to 12% in the fourth quarter (October to December) of 2021. This trend has continued in 2022, where taking both mifepristone and misoprostol at a hospital or clinic decreased from 13% in the first quarter (January to March) of 2022 to 10% in the last quarter of 2022 (October to December).

Figure 14: number of abortions performed by method, residents of England and Wales, quarterly, 2020 to 2022

For abortions at 22 weeks and over, feticide is recommended by the Royal College of Obstetricians and Gynaecologists to stop the fetal heart prior to the evacuation of the uterus. In 2022, of the 1,952 abortions performed at 22 weeks and over, 54% were reported as being preceded by a feticide and a further 44% were performed by a method whereby the fetal heart is stopped as part of the procedure.

Previous abortions

In 2022, 41% of those undergoing abortions had had one or more previous abortions. This rate has increased steadily from 37% in 2012. (See Table 3a(ix) and Table 4b.)

The percentage of those aged under 18 who had one or more previous abortions has remained consistent at 8% and 7% in 2012 and 2022 respectively. The percentage of those aged 30 or over who had one or more previous abortions has increased from 46% in 2012 to 50% in 2022. (See Table 4b.)

There is not a great deal of variation in rates of repeat abortions across local authorities. Of those women having an abortion in 2022, the proportion having had one or more previous abortions in the past ranged from 25% to 50%. However, most local authorities did not vary significantly from the average rate of 41% repeat abortions. See Tables 10 and 11 for a wide range of additional analysis at local authority and integrated care board (ICB) level.

Previous obstetric history

Over the last 10 years, the percentage of those undergoing abortions who have had one or more previous pregnancies that resulted in a live or stillbirth was rising steadily from 52% to 58% between 2012 and 2020. Since then, the percentage has decreased to 54% in 2022. (See Table 3a(vii).) In 2022, 21% of women had a previous pregnancy resulting in a miscarriage or ectopic pregnancy - slightly higher than 17% in 2012. 

Complications

Data on complications should be treated with caution. It is not possible to fully verify complications recorded on HSA4 forms and complications that occur after discharge may not always be recorded. This means that, for medical terminations where either both or the second stage was administered at home, complications may be less likely to be recorded on the HSA4. 

The Office for Health Improvement and Disparities (OHID), part of DHSC, undertook a project to review the system of recording abortion complications data to address this and released the statistical publication Complications from abortions in England, 2017 to 2021, a comparison of Abortion Notification System (ANS) data and Hospital Episode Statistics (HES) for the years 2017 to 2021.

This was a one-off publication and explores whether HES can be used as a supplementary source for data on abortion complications recorded in the ANS held by DHSC. The publication found a higher rate of abortion complications when using HES compared with the ANS for abortions in England for residents of England. Abortion complications are recorded differently in HES compared with the ANS, and there are different strengths and limitations associated with using either data source.

According to 2022 HSA4 notifications recorded in the ANS, complications were reported in 300 out of 251,377 cases - a rate of 1 in every 838 abortions (1.2 per 1,000 abortions). This is a decrease from 2021 (1.4 per 1,000) and also when looking at the last 10 years (1.5 per 1,000 in 2012). 

Between 2021 and 2022, the surgical complication rate decreased from 3.8 to 3.5 per 1,000 surgical abortions. The medical complication rate decreased over the same period, from 1.0 to 0.8 per 1,000 medical abortions. (See Table 8.)

More information on complications from medical and surgical abortions can be found on the NHS website.

Selective terminations

In 2022, there were 72 abortions that were selective terminations (0.03% of all abortions) (see glossary below) - a decrease from 88 abortions in 2021. Of those 72 selective abortions, 88% were performed under ground E. 

Residents outside England and Wales

This section covers abortions carried out in England and Wales for those who are residents of other countries.

In 2022, there were 745 abortions to women recorded as residing outside England and Wales - an increase from 613 in 2021. Most non-residents came from the Irish Republic (27%), Scotland (24%) and Northern Ireland (23%).

In recent years, the number of abortions for residents outside of England and Wales has tended to decrease. For example, from 4,687 in 2018 down to 2,135 in 2019, 943 in 2020 and 613 in 2021. These decreases may be explained by fewer people travelling from both Northern Ireland and the Irish Republic due to access and legislative changes in their respective countries. (See Table 12a.)

Abortions for residents of Northern Ireland

On 29 June 2017, the government announced that it would fund, via the Government Equalities Office (GEO), abortions for women ordinarily resident in Northern Ireland, where abortions were only available in very limited circumstances.

This provision for residents of Northern Ireland currently remains in place despite the decriminalisation of abortion in Northern Ireland. On 19 May 2022, the Abortion (Northern Ireland) Regulations 2022 were laid, which removed barriers to commissioning abortion services. If the Northern Ireland Department of Health does not commission and fund abortion services, the regulations give the UK government power to do anything that a Northern Ireland minister or department could do for the purpose of ensuring that abortion services are provided.

In 2022, there were 172 abortions for residents of Northern Ireland - a slight increase from 161 abortions in 2021. Current levels remain substantially lower than the peak of 1,855 Northern Ireland resident abortions in 1990, and also lower than 10 years ago, in 2012, when there were 905 abortions.

Abortions for residents of the Irish Republic

In May 2018, the ban on abortion in the Irish Republic was overturned, repealing the eighth amendment of the constitution. The law came into effect on 20 December 2018 meaning that abortion is permitted in the first 12 weeks of pregnancy and in later cases where the woman’s life or health is at risk, or in cases of fatal fetal abnormality.  

As a result of this change and travel restrictions during the COVID-19 pandemic, in 2021, the number of women travelling to England and Wales for abortions declined from 2,879 in 2018 to 206 in 2021 - a decrease of 93%. The number has remained low at 201 in 2022. (See Table 12a.)

In 2022, the proportion of abortions for residents of the Irish Republic performed under ground C was 63% - an increase of 13 percentage points from 50% in 2021. The proportion of abortions performed under ground E decreased from 50% in 2021 to 37% in 2022. (See Table 12e.) The proportion of abortions performed at less than 10 weeks’ gestation remains similar between 2021 and 2022 at 3%.

Figure 15: number of abortions for residents of Northern Ireland and the Irish Republic, 1970 to 2021 

Abortion rates by index of multiple deprivation deciles

Note that some figures quoted in this section have been corrected and the index of multiple deprivation (IMD) analysis for Wales was removed on 18 December 2024. See the ‘Revisions’ tab in the accompanying spreadsheet ‘Abortion statistics 2022: data tables (amended)’ for more information.

The index of multiple deprivation is the single official measure of relative deprivation available for England and Wales, and provides the most effective way of understanding the differences in levels of deprivation between areas.

Note that the Welsh Index of Multiple Deprivation and English Index of Multiple Deprivation methodology differ, and their deciles are not comparable. 

The English IMD is based on deprivation across 7 weighted domains (or types) of deprivation, while the Welsh IMD is based on deprivation across 8 weighted domains of deprivation. These combine to create the IMD by ranking each small area (known as lower layer super output areas (LSOAs)) from most deprived to least deprived, typically dividing areas into 10 equal groups (or 10 deprivation deciles). Decile 1 is the most deprived and decile 10 the least deprived.

In 2022, those living in the most deprived areas of England were almost twice as likely to have an abortion than those living in the least deprived areas. The crude rate in the most deprived decile was 29.4 per 1,000 women, compared with 15.2 per 1,000 women for those living in the least deprived decile. This is true across different age groups and different regions of England. (See Table 14.) The ASR for all English residents is 20.7 per 1,000 women.

Between 2021 and 2022, there has been an increase in the crude abortion rate across all IMD deciles in England, with the largest increases being for those living in the least deprived areas. For example, from 2021 to 2022 there was a 21% increase in the crude abortion rate in the least deprived decile, compared with a 7% increase in the most deprived decile. From 2021 to 2022, this represents a decrease in the difference in abortion rates between those living in the least and most deprived deciles in England.

Figure 16: crude abortion rate per 1,000 women by IMD decile, England, 2021 and 2022

Note that IMD analysis for Wales was removed on 18 December 2024. This is due to an error with the methodology used for aligning IMD 2019 scores with 2021 LSOAs. Figures will be updated once a robust solution has been implemented.

Age range analysis by index of multiple deprivation deciles

The pattern of abortion rates increasing from being lowest for the least deprived to highest for the most deprived is also consistent across all age groups in England. Across every age group in England, as deprivation increases, abortion rates increase. (See Figure 17.)

The greatest difference in abortion rates between the most and least deprived deciles are for those aged 20 to 24 and 25 to 29, where crude abortion rates are also highest. Conversely, the age groups with the lowest rates of abortion (those aged 15 to 19, 35 to 39 and 40 to 44) have smaller differences in rates between the most and least deprived deciles.

Figure 17: crude abortion rate per 1,000 women, by age and IMD decile, England, 2022

Regional analysis by index of multiple deprivation deciles

The pattern of abortion rates being lowest in the least deprived deciles and increasing for the most deprived is also consistent across all regions in England. (See Figure 18.)

Figure 18: crude abortion rate per 1,000 women, by region and IMD decile, English regions, 2022

Glossary

Age-standardised rate 

A method to standardise the comparison of rates within populations where there are structural differences in age. (See the ‘Guide to Abortion statistics’ in Abortion statistics for England and Wales: 2022 for more details.)

Chief Medical Officer (CMO) 

The CMO is the most senior government adviser on health matters in the UK. The CMO advises government on public health issues. This extends to recommending policy changes affecting the law governing abortion, and advising doctors who perform abortions regarding the interpretation of that law.

There are 4 in total, each one advising either His Majesty’s Government (CMO for England and medical adviser to the UK government), the Northern Ireland Executive, the Scottish government or the Welsh Government. 

Congenital malformation

Congenital malformations are also known as birth defects, congenital disorders or congenital anomalies. They are separated into 2 main types:

• structural disorders, which affect the shape of a body part
• functional disorders, which affect how a body part works

Congenital malformations may include both structural and functional disorders. 

Crude rate 

The number of abortions in a specified population per year, divided by the total number of women in that population. 

Grounds 

The grounds for abortion are specified in Table A above and in the Abortion Act 1967. 

Feticide 

An abortion is a procedure to end a pregnancy. Feticide is the destruction of a fetus in the uterus. 

Medical abortion

Two medicines are taken:

• the first is mifepristone and is taken at the clinic
• the second is misoprostol, which may be taken at the same time or within 3 days of the first medicine. It may be taken either at the clinic or at home under amendments to the Abortion Act

From 30 March 2020 for England and 31 March 2020 for Wales, temporary measures have been put in place to limit the transmission of COVID-19 by approving the use of both pills for early medical abortion at home, without the need to first attend a hospital or clinic. These were made permanent in Wales from 24 February 2022. On 30 March 2022, Parliament voted in favour of an amendment to the Health and Care Bill, making the temporary approval allowing home use of both pills for early medical abortions permanent in England and Wales.

Selective terminations

Pregnancies may result in more than one embryo being implanted 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 and is referred to as selective termination. 

Surgical abortion 

The pregnancy is removed in an operation by a doctor. There are 2 types: 

• vacuum or suction aspiration, where the pregnancy is removed using suction, which can be used up to 14 weeks’ gestation
• dilatation and evacuation, where the pregnancy is removed using forceps, which can be used after 14 weeks’ gestation