Conceptions in England and Wales: 2018

• In 2018, there were an estimated 839,043 conceptions to women of all ages in England and Wales compared with 847,204 in 2017, a decrease of nearly 1.0%.

• The conception rate for women under 18 years decreased for the 11th year in a row, the longest continued decrease since records began.

• The percentage of conceptions leading to a legal abortion among all women resident in England and Wales increased from 22.7% in 2017 to 24.0% in 2018, the highest percentage since records began in 1990.

• In 2018, the conception rate for women under 18 years was higher in the 50% most deprived areas in England, while the percentage of conceptions leading to a legal abortion was higher in the 50% least deprived areas in England.

• For the third year in a row, women aged 40 years and over were the only age group to see an increase in conception rates; in 2018, there were 16.3 conceptions per 1,000 women aged 40 years and over.

Statistician's comment

"In 2018, the conception rate in England and Wales fell to its lowest level since 2004, while the proportion that led to a legal abortion increased to its highest point since records began in 1990.

"Although conception rates for women under 18 years have more than halved in the last decade, they remain twice as high in more deprived areas of England than less deprived areas. However, analysis shows that a smaller proportion of these conceptions lead to abortions for under 18s living in more deprived areas."

David Corps, Vital Statistics Outputs Branch, Office for National Statistics.

Follow Vital Statistics Outputs Branch on Twitter @NickStripe_ONS.

For the third consecutive year, the estimated number of conceptions in England and Wales decreased in 2018, falling by nearly 1.0% to 839,043 from 847,204 in 2017 (Figure 1). The number of conceptions indicate that births and birth rates, available later this year, are likely to have continued to decline in 2019.

This trend is mirrored in conception rates for all women resident in England and Wales. Conception rates provide a better measure than the number of conceptions as they account for the size and age structure of the female population.

In 2018, the overall conception rate fell from 76.1 conceptions per 1,000 women aged 15 to 44 years, to 75.4 conceptions, a 0.9% decrease. This rate has been decreasing almost every year since 2011, with the exceptions of 2014 and 2015. The overall conception rate has not been this low since 2004 when there were 74.9 conceptions per 1,000 women aged 15 to 44 years.

For the third consecutive year, women aged 40 years and over was the only age group where the conception rate increased. In 2018, there were 16.3 conceptions per 1,000 women aged over 40 years. Compared with 1990, conception rates for women aged 30 years and over have increased while rates for women aged under 30 years have decreased (Figure 2). This reflects the trends in birth rates discussed in our Births in England and Wales publication. Women are progressively delaying childbearing until older ages.

In 1999, the government announced its 10-year Teenage Pregnancy Strategy for England, which aimed to reduce the conception rate for women aged under 18 years. This was driven by relatively high conception rates in England and Wales compared with the rest of Europe (PDF 429KB), and the potential adverse consequences of teenage pregnancy; for example, the risk of infant mortality is higher in younger mothers.

These initiatives, along with other factors such as a shift in aspirations of young women towards education (PDF, 439.98KB), led to a decline in conception rates for women aged 15 to 17 years. This decline has been particularly evident since 2007, which also coincided with the start of the global financial crisis (Figure 3). Since our records began in 1969, there has not been such a prolonged decrease in conception rates for women aged under 18 years.

In 2018, conception rates for under 18-year-olds in England and Wales declined by 6.1% to 16.8 conceptions per 1,000 women aged 15 to 17 years. Since 1999, conception rates for women aged under 18 years have decreased by 62.7%.

Similarly, conception rates declined from 2.7 conceptions per 1,000 women aged under 16 years in 2017 to 2.5 in 2018, a 7.4% decrease. The conception rate for women under 16 years has fallen every year since 2007, and has decreased by 69.9% since 1999.

The percentage of conceptions leading to a legal abortion among women of childbearing age increased from 22.7% in 2017 to 24.0% in 2018. This is the highest percentage since records began (Figure 4).

For the first time since 2013, the percentage of conceptions leading to a legal abortion increased for every age group. In 2018, the highest increase was recorded among women aged 20 to 24 years (1.8 percentage points) and the lowest among those under 16 years (0.9 percentage points).

The Index of Multiple Deprivation (IMD) is an overall measure of deprivation based on factors such as income, employment, health, education, crime, the living environment, and access to housing within an area. Deprivation measures are derived differently for England and Wales and are not, therefore, directly comparable.

Conception rates for the most deprived areas in England have decreased more than the least deprived areas since 2010 (Figure 5). In 2018, there were 82.4 conceptions per 1,000 women usually resident in the 50% most deprived areas in England, a decrease of 8.8% compared with 2010. In contrast, there were 67.5 conceptions per 1,000 women usually resident in the 50% least deprived areas, a decrease of only 2.2% compared with 2010.

Since 2010, the conception rate for women under 18 years has halved in both the most and least deprived areas in England (Figure 5). As a result, conception rates for women under 18 years remain more than twice as high in the most deprived areas. In 2018, there were 23.6 conceptions per 1,000 women aged 15 to 17 years usually resident in the most deprived areas of England, whereas there were 9.5 conceptions per 1,000 women aged 15 to 17 years in the least deprived areas of England.

Despite the conception rate being higher for women under 18 years in the 50% most deprived areas in England, the percentage of conceptions leading to a legal abortion for women under 18 years is higher in less deprived areas. Since 2015, the percentage of conceptions leading to a legal abortion has been increasing for women of all ages (Figure 6).

It is difficult to draw conclusions from rates and percentages in Wales because of the relatively small number of conceptions to women under 18 years.

Since 2009, conception rates have declined in Wales and all English regions apart from the North West, where the rate increased from 79.2 conceptions per 1000 women of childbearing age to 79.8 in 2018. Although London still has the highest conception rate at 80.0 conceptions per 1,000 women aged 15 to 44 years, it is also the region where conception rates have declined the most over the last decade (Figure 7).

The percentage of conceptions leading to a legal abortion increased in all regions over the last decade. In 2018, the South West had the lowest percentage of conceptions leading to a legal abortion (21.6%), while London remained the region with the highest percentage of conceptions leading to a legal abortion (27.1%).

Although the North East had the third lowest overall conception rate in 2018, it has had the highest rate of conception to women under 18 years among English regions since 2003. In 2018, it increased to 24.9 conceptions per 1,000 women aged 15 to 17 years.

The South West replaced the South East as the region with the lowest rate, with 13.3 conceptions per 1,000 women aged 15 to 17 years in 2018. The difference between regions with the highest and the lowest conception rates increased for the second year in a row and is the largest since 1998 when comparable data were first available.

Teenage conception rates vary at the local level and over time (Figure 8). When looking at rates for areas with small populations, it is important to consider the numbers involved. If there is a small change in the number of conceptions in these areas, there can be large changes in the rates. Other population characteristics can also have an impact, for example, the level of deprivation, ethnicity, and educational attainment.

Figure 8: Conception rates for women under 18 years have decreased across all local authorities compared with 1998

Conception rates for women under 18 years by local authority, England and Wales, 1998 and 2018

Notes:

1. Conception rates have been calculated using 2018 population estimates.

Download this chart

.xlsx

The conception rate for women under 18 years in Middlesbrough fell by 10.0% in 2018. Despite this decrease, Middlesbrough remained the local authority of England with the highest conception rate for women under 18 years for the second year in a row. The conception rate is 40.8% lower than in 1998.

Abortion

The legal termination of a pregnancy under the 1967 Abortion Act.

Conception

The Office for National Statistics (ONS) uses the definition of conception as a pregnancy of a woman that leads either to a maternity or an abortion.

Live birth

A baby showing signs of life at birth.

Maternity

Maternity refers to a pregnancy resulting in the birth of one or more live-born or stillborn children. The number of maternities represents the number of women giving birth rather than the number of babies born (live-born and stillborn).

Notification

A notification is a document completed by the doctor or midwife present at the birth. The notification provides certain data items, such as the birthweight, to the birth record.

Conception statistics bring together records of birth registrations collected under the Births and Deaths Registration Act 1953 and of abortion notifications supplied under the Abortion Act 1967.

They include all the pregnancies of women resident in England and Wales which lead to one of the following outcomes:

• a maternity at which one or more live births or stillbirths occur, which is registered in England and Wales

• a termination of a pregnancy by abortion under the 1967 Act, which takes place in England and Wales; pregnancies that lead to miscarriages are not included

Conceptions in 2018 may result in maternities or abortions in 2018 or 2019. Maternities that result in one or more live births or stillbirths are counted once only.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the Conception statistics QMI.

Our User guide to conception statistics provides further information on data quality, legislation and procedures relating to conceptions, and includes a glossary of terms.

National Statistics status for Conceptions in England and Wales

National Statistics status means that our statistics meet the highest standards of trustworthiness, quality and public value, and it is our responsibility to maintain compliance with these standards.

Date of most recent full assessment: May 2012

Most recent compliance check which confirms National Statistics status: May 2012

Improvements since last review:

• we revised the disclosure control protocol for abortion statistics in June 2015 ensuring confidentiality is sufficient to protect privacy of individual information, but not so restrictive as to limit unduly the practical utility of official statistics

• we have clearly commented on the availability of information on illegal abortions in our User guide to conception statistics"

Methods and sources used to produce the conceptions data

Conceptions data are derived from combining numbers of maternities and abortions using information recorded at birth registration and abortion notification; there is a legal requirement to record these data, making them the best and most complete data sources available.

Miscarriages and illegal abortion

Conception statistics do not include miscarriages or illegal abortions. It is impossible to determine the extent of illegal abortions, for example, by women using drugs bought from the internet. The only statistics available are where complications arise from illegal abortions resulting in illness or death. Given the steady rise in numbers of legal abortions since 1968, and the improvements in access to abortion, it can be assumed that the vast majority of abortions carried out in England and Wales today are legal.

Date of conception

Information on the exact date of conception cannot be obtained from the birth registration or abortion notification, so formulae are used to estimate the date based on whether the conception resulted in a live birth, stillbirth or abortion. The formulae are published in our User guide to conception statistics.