Conceptions in England and Wales: 2023

• There were 871,050 conceptions for women of all ages in England and Wales in 2023, which is the third consecutive annual increase, with a rate of 72.7 conceptions per 1,000 women.
• The percentage of conceptions leading to abortion was 32.1%; rising from 29.7% in 2022 and the highest proportion on record.
• The number of conceptions leading to abortion has increased by 35.2% since 2019, having previously been stable for more than a decade.
• The number of conceptions leading to maternities has continued on the downward trajectory that began in 2012, declining by an average of 1.5% per year in that time period.
• Teenage conception rates have remained below pre-coronavirus (COVID-19) levels, with 28.0 conceptions per 1,000 women aged under 20 years in 2023.
• Women aged 30 to 34 years had the highest number of conceptions (260,810) and conception rate (118.9) for the seventh year in a row and the lowest percentage of conceptions leading to abortion (22.4%).
• The West Midlands had the highest conception rate (80.9 per 1,000 women) and the South West the lowest (64.8 per 1,000) of all the English regions and Wales.

The number of conceptions for women of all ages in England and Wales rose by 4.4%, from 834,260 conceptions in 2022 to 871,050 in 2023 (Figure 1).

The number of conceptions leading to maternities saw a marginal increase of 0.8%, from 586,555 in 2022 to 591,085 in 2023.

The number of conceptions terminated by abortion saw a much greater increase of 13.0%, from 247,705 in 2022 to 279,970 in 2023 (see Section 3: Conceptions leading to abortions).

The conception rate per 1,000 women was 72.7 in 2023, the highest rate since 2018. Before 2018 there had been a downward trend in conception rates since the peak of 80.5 per 1,000 women recorded in 2010.

The coronavirus (COVID-19) pandemic national lockdowns and restrictions started in 2020 and gradually eased during 2021. This is likely to have influenced the overall number of conceptions and conception rates from 2020 onwards.

The conception rate was 72.8 conceptions per 1,000 women in England in 2023, an increase from 71.3 in 2022. The conception rate in Wales was 69.4 in 2023, an increase from 68.5 in 2022.

The percentage of conceptions leading to abortion reached a record high of 32.1% in 2023. This percentage has generally been increasing for all age groups since 2015 (Figure 2).

Between 2015 and 2019, the proportion of conceptions leading to abortion was gradually increasing, largely because of declining conceptions leading to maternities (the number of conceptions leading to abortion was relatively stable).

Since the onset of the coronavirus (COVID-19) pandemic, conceptions leading to maternities have continued to decline, but this has been accompanied by rising numbers of conceptions leading to abortions. This trend was consistent across different age groups.

There were 279,970 conceptions leading to an abortion in 2023. This is 13.0% higher than the 247,705 recorded in 2022. The number of conceptions leading to abortion has increased by 35.2% since the last pre-coronavirus year (207,045 conceptions leading to abortion in 2019).

For comparison, the number of conceptions leading to maternities did not see a dramatic change in this period, following on the same downward trajectory recorded since 2012 (declining by an average of 1.5% per year).

Figure 2: The percentage of conceptions leading to abortion has generally been increasing for the majority of age groups

Percentage of conceptions for women of all ages leading to abortion by age group, England and Wales, 2013 to 2023

There had been a long-term decreasing trend in conception rates among those aged under 20 years before the coronavirus (COVID-19) pandemic. There were 30.1 conceptions per 1,000 women aged under 20 years in 2019. There was a sharp fall in the rate in 2020 (the first year of the pandemic), to 25.8 per 1,000 women. Rates increased again once restrictions were lifted.

The rate in 2023 was 28.0 conceptions per 1,000 women aged under 20 years, the same as the previous year, and still below pre-pandemic levels. In 2023, the number of conceptions leading to maternities for women aged under 20 years was the lowest on record (19,820).

Women aged 30 to 34 years had the highest number of conceptions (260,810) and the highest conception rate (118.9 per 1,000 women) in 2023.

The conception rate for this group exceeded the rate for those in the 25 to 29 years age group for the first time in 2017 and has remained higher ever since.

This reflects the trend of increasing ages at which women are having children.

For more information, please see our Fertility for those born in different years, England and Wales statistical bulletin.

Women aged over 40 years had a conception rate of 17.6 per 1,000 women in 2023. This was a new record high for this age group, surpassing the rate of 17.3 per 1,000 women recorded in 2021.

This continues the trend of increasing conception rates for this age group; the rate has increased by 31.3% since the 2010 rate of 13.4 conceptions per 1,000 women (the beginning of our data time series).

The West Midlands had the highest conception rate of all the English regions and Wales, with 80.9 conceptions per 1,000 women in 2023. The South West had the lowest conception rate, with 64.8 conceptions per 1,000 women in 2023.

Compared with the previous decade, the conception rate has fallen in every region. The largest decrease was in London. The conception rate in London fell by 12.6%, from 83.1 conceptions per 1,000 women in 2013 to 72.6 per 1,000 women in 2023.

Figure 5: There are significant regional variations in conception rates among women aged under 18 years

Conception rates for women aged under 18 years, by local authority, England and Wales, 2023

Notes

1. To preserve confidentiality, counts for City of London and Isles of Scilly have been combined with those for Hackney and Cornwall, respectively.

Abortion

The legal termination of a pregnancy under the 1967 Abortion Act. The information presented is based on abortion notification forms (HSA4) submitted by clinics and hospitals to the Chief Medical Officer (CMO) at the Department of Health and Social Care (DHSC) together with forms submitted to the Welsh CMO.

Births

Includes live births and stillbirths unless otherwise stated.

Conception

A pregnancy that leads either to a maternity or a legal abortion. We do not hold data on pregnancies that lead to miscarriage or pregnancies ending in illegal abortions.

Conception rate

Conception rates are calculated by dividing the number of conceptions to women in an age group by the female population in the same age group.

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).

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 that 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 2022 may have resulted in maternities or abortions in 2022 or 2023. Maternities that result in one or more live births or stillbirths are counted once only. Conception statistics do not include miscarriages or illegal abortions.

Coronavirus (COVID-19) and conceptions statistics

In response to the coronavirus pandemic, birth registration services in England and Wales were suspended in March 2020. From June 2020, birth registrations restarted where it was safe to do so. However, the 2020, and to some extent the 2021, birth registration data used in this release were delayed.

Abortion coherence and comparability

Abortion data used in conception statistics are not directly comparable with abortion statistics published by the Department of Health and Social Care (DHSC). This is because DHSC abortion statistics are published by date of abortion, whereas we use abortion data based on the date of conception. Some abortions will relate to conceptions that occurred in the previous calendar year.

Disclosure

Figures in conception statistics have been rounded to the nearest five to adhere to updated disclosure rules. Rates and percentages are based on rounded numbers. Figures have been supressed with counts under three for conceptions and maternities, and under six for abortions.

More quality and methodology information

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

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