Is the DHSC counting prescriptions rather than abortions

Don’t panic, it’s just an increase in prescriptions, not abortions. This has been the response from some, including in an article published by the Academy of Ideas, to the 30% increase in reported abortions in 2023 compared to 2021, as in the following quote:

If a woman finds herself pregnant, and is considering what to do, she may well ‘risk manage’ the situation by requesting pills by post as soon as possible. This gives her time to think, consider, decide, in the knowledge she can act fast when she is clear. This does, of course, mean that the almost vertical uptick will include a proportion of unused pills.[i]

The suggestion is that in those two years, much of the reported increase in the total number of abortions was because the abortion providers are reporting, and the DHSC is counting, the number of pills-by-post packages prescribed and posted to women, without knowing if all of these were self-administered at home, as agreed in the telephone consultation.

So, are women stockpiling abortion pills received from an NHS provider but not proceeding with the abortion?

For healthy women with healthy pregnancies there are two possible outcomes, a live birth or an induced abortion. The Office for National Statistics (ONS) reports annual numbers of live births and these, unlike the abortion data, are based on fact, registrations of babies born.

Now if as is being suggested, a pregnant woman ‘risk manages’ and orders the pills-by-post, but then decides not to proceed with the abortion, the most likely outcome will be a registered live birth. In which case, that particular woman will have been double counted, appearing in the DHSC register of abortions and in the ONS register of live births. If the number of women doing this is at all significant and worthy of consideration, then we should find an uptick in the total number of live births plus abortions.

There is no uptick. In 2018, the last year in which all medical abortions had to be clinically managed in an abortion facility, the live birth rate was 57.6 per 1,000 women of reproductive age (WRA), the abortion rate was 17.4 per 1,000 WRA, and the total of these 75.0. There has been a decline in the total in the years since 2020, when telemedicine and pills-by-post was introduced. 2023 is the most recent year for which we have official abortion data, and in that year the rates were 49.4, 23.0, and a total of 72.4. The totals in the four years 2020 to 2023, remain about 72, no significant uptick at all — so no double counting.

What’s being suggested by the authors of the above mentioned article, is that a significant number of women are making the effort and taking the time to have at least two phone calls with an abortion provider, lasting about 45 – 60 minutes each, a few days apart, just to ‘risk manage’ and have the abortion pills in case they decide to go ahead with an abortion but actually after reflection decide not to proceed. Somewhat similar to the 1-in-6 in Ireland who do not proceed after the mandatory three-day waiting period. Now that would be interesting, but I don’t think that is happening, at least not to that extent. Even if just 10% of women stockpiled their pills-by-post rather than going ahead with their DHSC reported abortion, then we would find the overall total at over 74, which would be easy to spot.

I think we need to face up to the facts that the birth rate is in decline and the abortion rate is increasing — women are not stockpiling.

---

[i] Lee, E., & Whelan, E. (2026, February 1). Abortion: understanding new approaches to women’s freedom. Academy of Ideas. https://www.academyofideas.uk/p/abortion-understanding-new-approaches