Published by: Information & Analysis Directorate, Department of Health
Statisticians: Jennifer Hillen, Jenny Finlay & Siobhán Morgan
Contact: statistics@health-ni.gov.uk
Reporting Period: 1 April 2021 – 31 March 2022
Publication Date: 19 January 2023
Date of Next Publication: 18 January 2024
Please note, the date of the next publication has been delayed until 20 June 2024. Following the introduction of ‘The Abortion (Northern Ireland) Regulations 2020’, methodology is being updated for the publication to also include terminations which are not carried out as an inpatient or day case.
Coverage: Northern Ireland
Frequency: Annual
This publication presents information on the number of hospital admissions where there was a diagnosis of medical abortion and/ or termination of pregnancy in Health and Social Care Trust hospitals in Northern Ireland during 2007/08 to 2021/22. It details information by HSC Trust, Country of Residence and Age Band.
The way in which a medical abortion is defined was amended from 1st April 2013, following an update to the National Clinical Coding Standards, which apply across the UK. Definitions currently applicable and those applicable prior to 1st April 2013 are detailed in Appendix 1.
Termination of pregnancy is a sub-set of medical abortion. Medical abortion figures above include readmissions to hospital for treatment of retained products of conception following a termination of pregnancy with the initial termination of pregnancy not necessarily carried out in Northern Ireland. Terminations of pregnancy not commenced in Northern Ireland are not included in the Termination of Pregnancy figures.
*Prior to 1st April 2013 (see previous publications) Medical Abortion figures included re-admissions with retained products of conception, following a missed miscarriage or a spontaneous abortion that had been treated in the first admission with an evacuation of the products of conception. These are no longer part of the definition of medical abortion.
Furthermore, retained products of conception in the same episode as the termination that required surgical treatment are considered a complete termination of pregnancy.
*Due to the small populations of each area, cell counts <5 have been masked in this table to protect patient confidentiality.
On 29 June 2017 it was announced that the UK government would fund abortion services accessed in England and Wales by women who reside in Northern Ireland. Prior to this, women from Northern Ireland could access abortions in the UK but would have to fund the procedure privately.
Following this announcement it was found that there was a large increase in the number of women travelling from Northern Ireland to England and Wales for services in 2018. However, these figures have since significantly decreased by 84% from 1,014 in 2019 to 161 in 2021 following the change in legislation in Northern Ireland. Within this, the number of privately funded terminations fell from 30 (3.0%) in 2019 to 15 (9.3%) in 2021.
Further context to the decline in women travelling to England and Wales in 2021 can be found in section ‘Northern Ireland’ below, considering recent changes to Northern Ireland legislation.
Further information on these figures may be accessed in the ‘Abortion statistics, England and Wales: 2021’ publication:
https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2021
On 6 November 2017 the Scottish Parliament also announced that the NHS in Scotland would provide termination services free of charge to women who reside in Northern Ireland. However they have reported that this made very little impact on the number of abortion services accessed in Scotland by Northern Ireland residents. Over the last decade, the NHS in Scotland dealt with 17 terminations to women from Northern Ireland. It is noted that women from Northern Ireland rarely use the provision of termination services in Scotland.
Further information can be found at:
https://beta.isdscotland.org/topics/sexual-health/termination-of-pregnancy/
On 22 October 2019 abortion in Northern Ireland was decriminalised, although legislation was not passed until 31 March 2020. Over this time frame and continuing is the funded provision for patients to travel to Scotland, England and Wales for treatment. The data contained within this report present figures for the period after legislation was passed. However, only considered are those terminations carried out in HSC Hospitals in Northern Ireland as an inpatient or day case, in line with the definitions and scope of previous iterations of this publication. As there is currently no framework in place to report on all Terminations of Pregnancy carried out in Northern Ireland at time of publishing, we will continue to monitor and report future changes.
The way in which a medical abortion is defined was amended for activity from 1st April 2013, following an update to the National Clinical Coding Standards on termination of pregnancy.
The National Clinical Coding Standards ICD-10 4th Edition reference book provides specific national clinical coding standards to reduce ambiguity and differences in any interpretation. It incorporates all changes notified in the National Clinical Coding Standards ICD-10 4th Edition Addendum 2013. This was published in August 2013 following a public consultation on the changes (carried out by the Health and Social Care Information Centre, England), which closed in January 2013.
All HSC Trusts in Northern Ireland have confirmed that the below definitions have been applied from 1st April 2013 in the identification of medical abortions and terminations of pregnancy.
Within the confines of ICD-10 code O04, this refers to the interruption of a live pregnancy for legally acceptable, medically approved indications. It also includes readmission with retained products of conception following a previous medical termination of pregnancy, not necessarily carried out in Northern Ireland.
These are defined as any patient who has a live pregnancy terminated for indications that are legally acceptable and medically approved in Northern Ireland. Medical termination of pregnancy is a subset of medical abortion.
All HSC Trusts used the below definitions to identify medical abortions and terminations of pregnancy during the period 2007/08 to 2012/13.
Within the confines of ICD-10 code O04, this refers to the interruption of a live pregnancy for legally acceptable, medically approved conditions. It also includes readmissions with retained products of conception following a previous termination of pregnancy, a missed miscarriage or a spontaneous abortion that had been treated in the first admission with an evacuation of the products of conception and a patient who had a termination of pregnancy and had retained products of conception in the same episode that required surgical treatment.
This is defined as any patient who has a live pregnancy terminated for indications that are legally acceptable and medically approved in Northern Ireland. Medical termination of pregnancy is a subset of medical abortion.
Readmissions with retained products of conception following a missed miscarriage or a spontaneous abortion that had been treated in the first admission with an evacuation of the products of conception are no longer part of the definition of medical abortion.
Retained products of conception in the same episode as the termination that required surgical treatment are now considered a complete termination of pregnancy.