Introduction

An unplanned pregnancy at any age can be devastating but is particularly so for women aged 40 years or over. At this age, women are thought to be in control of their lives, with contraception organised and effectively used. Unfortunately, the facts do not support this statement and the number of abortions in this age group continue to rise. In England and Wales in 2007, 8644 women aged 40 years or over had an abortion, with 710 women being aged 45 years or over and 19 aged 50 years or over. In the UK, over 50% of pregnancies in women approaching their 50s are unplanned.

So, are contraceptive choices reduced for the older woman? The answer should be ‘no’, yet in practice older couples are far more reliant on permanent, surgical methods and are less likely to use pills and condoms. The Omnibus Survey for 2006/07 asked just over 5000 people in Great Britain aged 16—49 years about their contraceptive usage. The most popular methods were oral contraceptives (35%), male and female sterilisation (27%) and condoms (30%). In people aged 40—44 years, male and female sterilisation was the most common choice of contraception (48%), with 20% using condoms, 17% using oral contraceptives and 7% using intrauterine contraception.