Contraception trends among women seeking abortion in England and Wales show a shift away from more reliable hormone-based methods to other methods, such as ‘natural contraception’ over the last five years.
Research published in the journal BMJ Sexual & Reproductive Health found the use of the Pill, mini Pill, implants, patches, and vaginal rings has given way to other methods, such as period tracking apps, that highlight monthly peak fertility or ovulation time.
The findings correlate with a rise in abortion rates, and the researchers state there are wider implications for healthcare services.
In the UK, the use of the Pill has been steadily declining since 2010, when around half of women of reproductive age in the UK were on the Pill. The researchers suggest that social media is having an impact on the choices of contraception, with many women opting for more natural methods as a result. The failure rate of ‘natural’ methods is, however, much higher, with between 2 and 23 women in every 100 falling pregnant compared to 7 in 100 women using the Pill or implants and less than 1 in 100 for women using the coil.
The researchers analysed data collected in 2018 and 2023 by the British Pregnancy Advisory Service (BPAS), an independent charity providing abortions and pregnancy testing throughout England and Wales.
During patient consultations for abortion, midwives and patients recorded the methods of contraception, and the researchers applied statistical analysis to the findings. Details for 33,495 women were collected between January and June 2018, and 55,055 women between January and June 2023.
The data showed a significant shift in reported contraception methods between 2018 and 2025. In 2018, just 0.4 per cent of women coming to the BPAS clinics were using fertility awareness methods, compared to 2.5 per cent in 2023. The age of those using ‘natural’ methods also decreased, from nearly 30 to 27, between the two time periods.
There was a significant decrease in the use of hormonal methods of contraception among patients consulting about abortion, falling from just under 19 per cent in 2018 to just over 11 per cent in 2023. The use of long-acting reversible contraceptive implants also dropped, from 3 per cent to 0.6 per cent over this period.
In 2023, 70 per cent of women at the clinics reported using no contraception when they became pregnant, compared with 56 per cent in 2018.
The researchers acknowledged that the study population of women seeking abortions may not accurately represent the sexually active population of women in the UK but suggested that the trend observed has important implications for UK healthcare.
The researchers concluded: ‘While the rise in abortion rates is multifactorial, one aspect that needs scrutiny is any change in contraceptive use, and particularly this surge in the use of ehealth, including fertility apps, period tracker apps, and natural family planning apps.’
They added: ‘The possible relationship between these less effective methods of contraception and unplanned pregnancy requires further investigation. However, informing the public about the efficacy of such methods in order to facilitate informed contraceptive choices is needed.’
