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Sign in or register for an accountUnplanned pregnancy is a key public health indicator. On average, women in Britain spend about 30 years of their lives needing to avoid an unplanned pregnancy. Faculty of Sexual and Reproductive Health research shows that 45% of pregnancies in England are unplanned or ambivalent, with three in ten pregnancies ending in termination in England and Wales. According to certain estimates, unplanned pregnancies lead to direct healthcare costs of £193 million per year in the UK.
Access to contraception to avoid the risk of unintended conceptions is not only widely recognised as a highly cost-effective public health intervention, but is also described by the World Health Organization (WHO) as “fundamental to the health and human rights of all individuals.” Correct and consistent use of a regular method of contraception is important to avoid unintended pregnancies, and it is crucial that the full range of contraception is available to all, either at the point of care or through a referral pathway.
Barriers to accessing contraception can include:
There are different types of method of contraception available through GPs, community pharmacies and from sexual health services. User-dependent methods, that rely on being taken daily include the combined hormonal contraceptive pill and progesterone-only pill. Most people want to use a method of contraception that is safe, reliable, and does not require too much thinking about. Long-acting reversible contraception (LARC), also known as “fit and forget”, is a longer-term method to avoid pregnancy, and once fitted, these methods are over 99% effective.
Having access to barrier methods of contraception, such as condoms, and advice on how to use them is also essential for prevention of sexually transmitted infections (STIs) and HIV.
Salford has higher-than-average rates of unintended pregnancies, abortions, and teenage conceptions, pointing to poor reproductive health outcomes for the city’s child-bearing population, and an unmet need for access to contraceptive options.
Despite national efforts to reduce these rates, the city continues to face challenges linked to deprivation, which is a key factor influencing higher rates of teenage pregnancy.
In 2022, Salford ranked 10th highest out of all local authorities in England and Wales for its abortion rate per 1,000 female population aged 15-44 years. (Although women aged over 44 are often still fertile and capable of childbearing, women aged 15 to 44 years represent the majority of conceptions in England.) In the same year, the North West saw the highest number of abortions out of all England regions, with Salford having the second highest rate in Greater Manchester, after Rochdale.
In Salford, the under 18s conception rate in 2022 was 50% higher than the England rate and the under 18s birth rate in 2023 was 76% higher than the England rate. These rates have been consistently higher than the national averages, with Salford’s under 18 conception rate being 16th highest out of all England’s 153 local authorities based on the latest data, an improvement from third highest the previous year. The under 18s birth rate is 23rd highest out of all local authorities in England, again this is an improved position from 10th the previous year.
The rate of under-18 conceptions is less than a third of the peak seen in 2005.
[Download contraception chart data (csv format, 2kb)]
For contraception, data from the Office for Health Improvement and Disparities (OHID) for Salford tells us that, in 2024:
Between October and December 2024, there were 466 interactions in Salford’s community pharmacies for supply of emergency hormonal contraception, also known as “the morning after pill.” Over 76% of these were due to no contraception being used in the first place.
Sexual and reproductive health outcomes are not equally distributed within the population. Strong links exist between STIs, teenage conceptions and abortions, and levels of deprivation.
At-risk groups for unintended pregnancies can include:
Access to LARC within Salford, which is provided by General Practices, is varied across the five Primary Care Network footprints, with some areas having no registered clinicians to provide the service.
The local areas of Walkden North West and Langworthy Buile Hill have under-18 conception rates higher than Salford, whilst Broughton Park is lower.
[Download contraception map data (csv format, 4kb)]
Ensuring access to the full range of contraception methods – with an emphasis on LARC – including emergency contraception and barrier methods such as condoms, making these readily available in healthcare settings. The delivery of emergency hormonal contraception in selected pharmacies in Salford means individuals do not have to attend sexual health clinics or their GP surgery to obtain the morning after pill. The council is also working to increase access to and uptake of LARC with primary care partners.
Prevention of unintended pregnancies should focus on education and behaviour change campaigns targeted towards young people to increase awareness of contraceptive options, and reduce stigma around discussing sexual and reproductive health. Work should be undertaken to ensure children receive good quality, evidence-based relationships and sex education at school, at home, and in the community.
Engagement and collaboration with voluntary and community organisations that are most likely to be in regular contact with at-risk groups, to understand level of need, and identify both barriers and facilitators to accessing services.
The expansion of remote and online services has improved accessibility for some, however a combination of face-to-face and digital services is essential to accommodate the diverse needs of various groups. Utilising different settings to provide contraceptive care is important to broaden its reach, including the Pharmacy Contraception Scheme which some Salford pharmacies are registered for.