Cross-national differences in the use of contraception and abortion services between England, Wales, and Scotland

Dear Editor,

Overall levels of childbearing are significantly higher in England and Wales (total fertility rate of 1.62 and 1.49, respectively, in 2021) than in Scotland (1.31), but few studies have investigated the role of abortion or contraception as proximate determinants of fertility, leaving a key gap in knowledge. This is largely due to a paucity of continuously collected comparable data, since surveys that have historically collected such data (ie, the Omnibus Survey, General Household/Lifestyle Survey) have been discontinued. Existing administrative data on abortion rates collected from 2009 to 2020 show that abortion rates are consistently lower in Scotland than in England and Wales—by approximately eight abortions per 1000 women per year—meaning use of abortion cannot account for the persistently lower fertility levels in Scotland. Our analysis thus focuses on contraception and is the first to identify and quantify the extent of cross-national differences in Britain in contraceptive use, as well as method mix. The mix of contraceptive methods used is important because methods vary in their effectiveness at preventing pregnancy and may thus influence fertility.

читать целиком, это 1й абзац, including Predicted probabilities from multinomial logistic model of contraceptive use using NATSAL surveys 1990–2010, sexually active men and women aged 16–49 years. Baseline outcome is ‘no method used’. Adjustments: survey year, age, parity, partnership status, education, religiosity, ethnicity, and sex. LARC, long-acting reversible contraception; NATSAL, National Surveys of Sexual Attitudes and Lifestyles. (это далее)