A study has indicated a “significant increase” in the number of women seeking abortions who rely on natural pregnancy prevention methods, such as period tracking apps. The research also noted a 14% rise from 2018 to 2023 in those who did not use any contraception.
Experts are pointing out a “shift” over the past five years in contraceptive practices, moving away from “more reliable” hormonal options like the pill towards “fertility awareness-based methods”. These natural techniques involve monitoring menstrual cycles or ovulation signs, often through smartphone applications, to identify the fertile days when couples should abstain from intercourse to avoid pregnancy.
However, the University of Edinburgh researchers warn that these methods could be “less reliable” and may lead to an uptick in unintended pregnancies. The study examined data from the British Pregnancy Advisory Service (Bpas), comparing contraceptive use among women requesting abortions during two timeframes: January to June 2018, with 33,495 women, and January to June 2023, with 55,055 women.
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It was found that the reported use of fertility awareness-based methods at the time of conception rose from 0.4% in 2018 to 2.5% in 2023. For the latest health and Covid news, sign up to our newsletter here
The demographic of women employing fertility awareness-based contraception methods has seen their average age drop from almost 30 to 27, the data indicates. Analysis demonstrates a significant decrease in the usage of hormonal contraceptives such as the pill, the mini pill, patches, and vaginal rings – from 18.8% in 2018 down to just 11.3% by 2023.
Similarly, the use of contraceptive implants – tiny rods inserted under the skin to prevent ovulation – dipped from 3% to a mere 0.6% throughout this window. Notably, the proportion of women not using any form of birth control at the time of conception rose sharply from 56% in 2018 to 70% in 2023.
Published in BMJ Sexual & Reproductive Health, the research indicates a “shift in contraception use from more reliable hormonal methods of contraception to less reliable fertility awareness-based methods of contraception among abortion patients”. The researchers noted: “There appears to have been a significant increase in the proportion of individuals attending Bpas for abortion who use fertility awareness-based methods as a form of contraception and are using no method of contraception.”
They suggested that this trend might be due to personal choice or could be tied to barriers accessing more effective contraception prior to pregnancy and following an abortion. Furthermore, there were concerns raised that “hormone hesitancy attributed to the influence of social media has been reported in other European countries”.
The researchers have called for further exploration into this trend, but warned: “The decline in use of effective contraception and increase in abortion rates have wider implications for healthcare services.” The study highlighted a notable increase in the number of women who were under seven weeks pregnant when they sought an abortion from Bpas services, with the figure jumping to 59.4% in 2023 from 35.6% in 2018. Additionally, the research discovered that fewer women under 25 years old opted for an abortion in 2023 than in 2018, whereas there was an upturn in the proportion of ethnic minority women and those selecting medical abortions.
According to the study’s authors, “further research is required to investigate the underlying driving forces of this shift” in contraceptive methods, while also emphasizing: “In the interim, investment will be needed for accessible abortion and contraception services to meet demand.”
Dr Patricia Lohr, Bpas’ director of research and innovation, commented on the findings, remarking: “This study of abortion patients showed a rise in the use of fertility awareness-based methods and a decline in hormonal contraception.”
She suggested this might reflect a change in contraceptive preferences or possible challenges in obtaining preferred methods. Furthermore, she added that a separate survey conducted by Bpas found that a significant portion of women, nearly half (49%), encounter obstacles to accessing contraceptive services, such as delays in securing appointments, which limits their options and the efficacy of their chosen contraception methods.
“In this context, abortion remains a vital option, whether as a back-up when contraception fails or as an alternative when contraception is unavailable or unsuitable. Ensuring access to abortion care is crucial to supporting women in making the choices that are right for them.
“At the same time, it’s vital to push for modern, innovative contraceptive methods that fit seamlessly into women’s lives and address concerns about side effects. Women deserve a full range of options that meet their needs without compromise.”