What London’s 2023 Abortion Data Really Tells Us - by Dr Janet Barter
The 2023 abortion statistics paint a clear picture of reproductive health in London and I am struck by both the scale of need and the stark inequalities behind the numbers. London recorded 51,810 abortions in 2023, more than any other region, reflecting not just population size but the deep social and economic pressures shaping reproductive decision making across the city.
One of the most encouraging findings is how early most people are able to access care. Nearly 9 in 10 abortions happen before 10 weeks, a testament to the effectiveness of telemedical pathways and strong provider capacity. But this picture isn’t uniform. In some boroughs - like Westminster and Kensington & Chelsea - early access is over 90%, while others lag behind. These differences often mirror wider inequalities: in income, housing stability, and access to digital tools.
Medical abortion continues to dominate in London (84% of procedures), but the variation in surgical rates tells its own story. Places such as Hackney and Tower Hamlets have significantly higher surgical activity, which may reflect later gestation at presentation or more complex safeguarding needs. Ensuring surgical provision remains strong is vital; a resilient system must accommodate everyone, including those for whom medical pathways aren’t appropriate.
Repeat abortions make up 43% of all procedures - a figure often misinterpreted. In reality, it’s a window into unmet contraceptive needs, relationship instability, reproductive coercion, and the churn of poverty. Boroughs like Croydon, Enfield, Havering and Bexley report some of the highest repeat rates, particularly among those aged 25 and over. This isn’t about “failure” - it’s about the environment in which people make choices.
Young people’s data is equally telling. With 1,935 abortions among under 19s, boroughs such as Croydon, Southwark, and Enfield stand out. These are communities where child poverty, mental health needs and school exclusion are consistently high - and sexual health outcomes track closely with these wider determinants.
What emerges from the dataset is a reminder that London is not one reproductive health system but many. Croydon, Newham, Lambeth and Ealing see some of the highest overall numbers, while the City of London sits at the opposite extreme. Such variation demands localised commissioning - strategies tailored to neighbourhood realities, not broad regional averages.
Ultimately, the 2023 figures show a system performing well under pressure. People are accessing care early, safely and overwhelmingly within NHSfunded pathways. But the numbers also highlight where we must go next: strengthening contraception access in primary care especially, protecting surgical capacity, investing in young people’s sexual health, and designing services that genuinely reflect London’s diversity and complexity.
Abortion is a hugely important part of women’s health care, and we must protect access and choice for all women who need this service. I am thrilled that the London sexual Health Programme is taking this issue seriously and collaborating with commissioners and providers to ensure high quality provision. It is also important to recognise the story behind the statistics and continue to improve access to advice and contraception for all women across London.
Behind every statistic is someone navigating their reproductive choices in the context of their life and our responsibility is to build a system that supports them with dignity, equity, and compassion.