Conceptions in England and Wales: 2021

• In 2021, there were 824,983 conceptions for women of all ages in England and Wales, this is the first increase in the last six years.
• Women aged 30 to 34 years had the highest number and conception rate for the fifth year in a row and the lowest percentage of conceptions leading to abortion.
• The conception rate for women aged under 18 years in England and Wales has more than halved since 2011 when it was 30.9 conceptions per 1,000 women of the same age; in 2021 it was 13.2 per 1,000 women of the same age.
• Of all the English regions and Wales, London has seen the biggest fall in conception rates over the last decade, decreasing by 20.9% since 2011.
• The latest data suggest that for the first time since records began, women outside of marriage or civil partnership have a higher conception rate than those within marriage or civil partnership; this may be an effect of the differences in population estimates used.

Statistician’s comment

“Today’s release provides further understanding of conception rates during the coronavirus (COVID-19) pandemic, when lockdowns and restrictions may have affected behaviours. We can see that the number of conceptions in England and Wales has increased for the first time since 2015 and were at a record high for women aged 30 to 34 years, and for women aged 40 years and over.

“Interestingly, our data show a higher conception rate among women who were not married or in a civil partnership. Despite a higher percentage of abortions, women who were not married or in a civil partnership, still have a higher number of conceptions leading to maternity. Further work will be needed to establish whether this marks a change in trend.”

Siân Bradford, Senior Research Officer, Child Health, Office for National Statistics

In 2021, the number of conceptions for women of all ages in England and Wales, rose for the first time in six years from 817,515 conceptions in 2020 to 824,983 conceptions in 2021 (Figure 1). The number of abortions and births also increased in 2021.

Over the last decade, the conception rate for women aged 15 to 44 years has decreased by 12.4% from 80.4 conceptions per 1,000 women in 2011 to 71.5 per 1,000 women in 2021. The latest data suggest that this is the lowest overall conception rate seen since 2001 when there were 70.3 conceptions per 1,000 women; this may be an effect of the differences in population estimates used. The coronavirus (COVID-19) pandemic national lockdown and restrictions started in 2020 and gradually eased during 2021. This may have made an impact on the behaviour of certain groups and people living in different regions and so could have affected the overall number of conceptions and conception rates in 2020 and 2021.

Women aged 30 to 34 years had the highest number of conceptions for the fifth year in a row, with a record high of 249,073 conceptions in 2021. This age group also had the highest conception rate of 116.2 per 1,000 women aged 30 to 34 years. The conception rate for women aged 40 years and over has continued to rise and in 2021 was at a record high of 17.3 conceptions per 1,000 women of the same age group; this may be an effect of the differences in population estimates used.

Between 2011 and 2021, women aged 35 to 39 years and aged 40 years and over, were the only age groups to see an overall increase in conception rates (Figure 2). Since 2011, the conception rates have increased by 3.5% for women aged 35 to 39 years and 19.7% for women aged over 40 years.

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 followed by the release of the Teenage pregnancy prevention framework guidance in 2018, which aims to prevent unplanned pregnancy and promote healthy relationships among young people in England. These initiatives may have contributed to the low teenage conception rates we see today when compared with the last two decades.

In 2021, the number of conceptions for women aged under 18 years had a small increase from 12,576 in 2020 to 13,131 in 2021, after a long-term trend of decreasing numbers. The could be because the number of conceptions in 2020 was uncharacteristically low for some quarters after accounting for the trend in decreases over time. This may be because of the coronavirus (COVID-19) pandemic and associated disruptions to births registration services in 2020 and 2021 or changes in the behaviour of certain groups.

The conception rates for those aged under 18 years in 2021 indicate a slight increase since 2020, however this may be an effect of the differences in population estimates used. See Section 10: Measuring the data for more details.

The conception rate for women aged under 18 years has more than halved since 2011 when it was 30.9 conceptions per 1,000 women of the same age, down to 13.2 conceptions per 1,000 women of the same age in 2021 (Figure 2).

Out of all the age groups, those aged under 16 years saw the biggest percentage change in conception rates over the last decade. The conception rate for those aged under 16 years is around a third of what it was ten years ago, with 2.1 conceptions per 1,000 women of the same age in 2021, compared with 6.1 conceptions per 1,000 women of the same age in 2011 (Figure 2).

In 2021, the percentage of conceptions leading to legal abortion reached a record high of 26.5% of conceptions leading to an abortion. This percentage has generally been increasing for all age groups since 2015. Women aged under 16 years and over 40 years were the only age groups to see a decrease in the percentage of conceptions leading to abortion in 2021 (Figure 3). Women aged under 16 years still remain the age group with the lowest number of conceptions and the highest percentage of conceptions leading to abortion, with over half of the conceptions for women aged under 16 years leading to abortion (59.8%). Women aged 30 to 34 years, who had the highest number of conceptions, also had the lowest percentage of conceptions leading to abortion in 2021 (18.3%).

Conception numbers and rates continue to show variation by area of usual residence. In 2021, the West Midlands had the highest conception rate, out of all the English regions and Wales, with 78.1 conceptions per 1,000 women aged 15 to 44 years. The South West had the smallest conception rate in 2021 with 64.6 conceptions per 1,000 women aged 15 to 44 years.

Historically, London had the highest conception rate for women aged 15 to 44 years out of all the English regions and Wales. But over the last decade, London has had the biggest percentage decrease in conception rates out of the English regions and Wales. Since 2011, the conception rate for London has fallen 20.9%, from 89.5 conceptions per 1,000 women aged 15 to 44 years, to 70.8 conceptions per 1,000 women aged 15 to 44 years in 2021. The North West had the smallest percentage change in the conception rate over the last decade, decreasing 5% since 2011 (Figure 4). Conception rate changes, in the most recent years, may be an effect of the differences in population estimates used. See Section 10: Measuring the data for more details.

The North East had the highest conception rate for those aged under 18 years, out of all the English regions and Wales in 2021. In the North East there were 19.8 conceptions per 1,000 women of the same age in 2021. Over the last decade, the North East also had the smallest percentage decrease for those aged under 18 years, despite conception rates having nearly halved since 2011 from 38.4 conceptions per 1,000 women aged under 18 years.

In 2021, London had the lowest conception rates for women aged under 18 years out of all the English regions and Wales. There were 9.5 conceptions per 1,000 women of the same age in London in 2021. London has also seen the largest decrease in the under-18 conception rates since 2011, where it was nearly three times higher at 28.7 conceptions per 1,000 women of the same age.

Figure 5: Conception rates for women aged under 18 years have decreased over the last decade

Conception rates for women aged under 18 years and percentage change between 2011 and 2021 by local authority, England and Wales, 2011 and 2021

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Notes:

1. To preserve confidentiality, counts for City of London and Isles of Scilly have been combined with those for Hackney and Cornwall, respectively.
2. Some rates and percentage changes are not available for reasons of unreliability.

3. To preserve confidentiality, some rates and percentage changes are not disclosed.  

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Since records began in 1998, over half of conceptions occurred outside of marriage or civil partnership. This proportion has been steadily increasing and in 2021 there was a record high of 63.5% of conceptions occurring outside of marriage or civil partnership.

The latest data suggest that for the first time since records began, women outside of marriage or civil partnership had a higher conception rate than those within marriage or civil partnership. This may be an effect of the differences in population estimates used. See Section 10: Measuring the data for more details.

Between 2011 and 2021, the conception rate for women outside of marriage or civil partnership rose from 73.4 conceptions per 1,000 women to 75.1 conceptions per 1,000 women. In comparison, the conception rate for women within marriage or civil partnership decreased from 91.6 conceptions per 1,000 women in 2011, to 72.2 conceptions per 1,000 women in 2021. This could suggest that fewer women are waiting until after marriage to start a family and shows a cultural trend (as explored in our blog post Married by 30? You’re now in the minority) that has emerged over the last few decades.

In 2021, the percentage of conceptions within marriage or civil partnership that resulted in an abortion remained unchanged from 2020 at 10.4%. The percentage of conceptions outside of marriage or civil partnership leading to an abortion was 35.8%, the highest it has been since 2001.

Comparing 2011 and 2021, women aged under 25 years saw a decrease in conception rates outside of marriage or civil partnership. Women aged 25 years and over saw an increase in conception rates outside of marriage or civil partnership compared with 2011. The largest increase in conceptions rates outside of marriage or civil partnership was seen in women aged 30 to 34 years, which increased by 31.6% (Figure 6).

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

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.

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).

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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 2021 may result in maternities or abortions in 2021 or 2022. 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.

Population estimates revisions

In this release, conception rates for 2021 were calculated using provisional mid-year 2021 population estimates. These were the latest population estimates available at the time of production and are Census 2021-based estimates. The 2021 mid-year estimates are due to be revised again in 2023 along with the back series to 2012 in line with normal practice following the decennial Census, as explored in our population estimates article. Care should be taken when comparing rates from 2021 with 2012 to 2020 rates until the back series has been revised, as such most of our comparisons focus on differences between 2011 and 2021. We will update time series data tables in our next release when the final 2012 to 2021 mid-year estimates are available.

Abortion coherence and comparability

Abortion data used in conception statistics are not directly comparable with abortion statistics published by the 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.

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Our User guide to conception statistics provides further 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 QMI.

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