The narrative surrounding abortion – even in the UK, where it’s mostly legal and accepted – often implies that the woman seeking one is at fault. That she (you’ll notice the man is never blamed) was “stupid” enough not to take precautions.
It’s never assumed that, actually, she may have got pregnant due to failed contraception. But according to a new report by the British Pregnancy Advisory Service (BPAS), a shocking proportion of women seeking abortions do so for this very reason.
More than half (51.2%) of the 60,592 women who sought an abortion at BPAS clinics in 2016 were using at least one form of contraception when they became pregnant, including condoms and diaphragms. Which, we think you'll agree, is terrifying.
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What's more, around a quarter (24.1% or nearly 15,000 women) were using contraceptive methods purported to be the most effective – either hormonal contraception, such as the pill, or a long-acting reversible contraceptive method (LARC), such as implants, injections or IUDs.
No contraceptive method is 100% effective, but the discourse and public health initiatives encouraging us to use contraception often imply that it's a foolproof way of avoiding pregnancy, BPAS said. Long-acting reversible methods are said to be 99% effective, the pill is estimated to be 91% effective and condoms 82% effective, the BBC reported.
However, BPAS's worrying findings suggest this is far from the case. The pill may be the most popular contraceptive method in the UK, but almost 10% of women who use it fall pregnant each year (nine in every 100). Six in every 100 using the contraceptive injection, and nearly one in every 100 using the IUD, will find themselves in the same situation.
Unplanned pregnancies can happen if the method isn't used correctly, such as if it's not inserted properly, moves or falls out, BPAS said. Women using hormonal contraception may also find themselves needing an abortion because the symptoms of pregnancy are masked – either their periods are suppressed completely or have become light or irregular.
When contraception fails it can mean women identify their pregnancy at a later stage because they hadn't anticipated it, said BPAS.
Ann Furedi, chief executive of BPAS, said contraception was no substitute for the provision of safe abortion. "When you encourage women to use contraception, you give them the sense that they can control their fertility – but if you do not provide safe abortion services when that contraception fails you are doing them a great disservice."
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The report shows women can't control their fertility through contraception alone, even when they are using the most effective methods, she added. "Family planning is contraception and abortion. Abortion is birth control that women need when their regular method lets them down.”
The sexual health charity FPA said it's crucial that people have high-quality information about contraception and emergency contraception as there are "many myths and misconceptions" surrounding it. Natika Halil, the charity's chief executive, said some of the most effective methods, such as the the IUD (copper coil), IUS (hormonal coil) and the implant, aren't always made as available as they should be.
"Many general practices are unable to offer them, due to lack of training and funding. A survey by FPA last year found that only 2% of GPs questioned offer the full range of contraceptive methods."
She advised anyone using contraception who believes they might be pregnant to see a healthcare professional as soon as possible.