Contraception clinics cancelled in Scotland as doctors 'flooded' with thousands of STI and abortion cases

Contraception clinics are being cancelled because doctors and nurses are overwhelmed by the soaring number of sexually-transmitted infections (STIs) and abortions, it can be revealed.

Since the coronavirus pandemic, STIs and abortion rates have been on the rise in Scotland. This has led to sexual and reproductive health services having to cancel clinics providing long-action reversible contraception such as IUDs and implants, because staff are too busy dealing with STIs and abortions.

There has been a 6 per cent increase in gonorrhoea cases in Scotland between 2022 and 2023, with 5,999 recorded cases.

Last year there were 13,400 diagnoses of chlamydia in Scotland, which is higher than 2022, but lower than the 17,336 cases in 2019.

Professor Anna Glasier, who is Scotland’s women’s health champion, and an expert in sexual and reproductive medicine, said sexual health clinics were getting busier and waiting lists for contraception were getting longer.

She told The Scotsman: “When Covid came along, virtually all sexual health clinics were closed except for emergencies, and people didn’t want to go out. So hardly anyone got an implant or an IUD [intrauterine device].

“Since Covid, sexual and reproductive health services are busier - the abortion rate has increased and the rate of STIs has increased perversely. IUD clinics, for example, in sexual services have been cancelled to provide abortion clinics instead.

“Well, IUDs prevent abortions, that’s why I use the word perversely - you’re cancelling the preventative steps because abortions can’t wait.”

Implants are small plastic rods which release progestogen to stop the ovaries releasing eggs. They are fitted under the skin in a person’s arm and are 99 per cent effective for three years.

Intrauterine devices, also known as IUDs or copper coils, are inserted into the womb and stop pregnancies by releasing copper. They are also 99 per cent effective, and last for between five and ten years.

Prof Glasier said IUDs and implants were among the “most effective” methods of contraception and were “proven to reduce abortion rates”. However, the numbers of people receiving these have “fallen considerably” below pre-pandemic levels, and demand is not being met.

She said: “STIs have increased as well. Sexual and reproductive health services provide abortion clinics and contraception clinics, but they’re flooded out with people with acute gonorrhoea, so there are fewer and fewer people to provide contraception.”

Prof Glasier said there had been a “cultural change” in contraception use as well, fuelled by celebrities and influencers spreading the idea that hormonal contraception was bad for a person.

A spokeswoman for the Scottish Government said: “We are aware of the increased pressures faced by our sexual health services and continue to work closely with our women’s health champion and NHS boards to increase the provision of longer acting methods of contraception across Scotland.

“This includes widening access to sexually transmitted infection testing online.”

Prescriptions of IUDs and implants increased from 50 to 51.3 per 1,000 women between 2021/22 and 2022/23, but this is still lower than the 2019/20 figure of 54.3.

Despite Prof Glasier’s warnings, health boards across Scotland say their contraception services are recovering after the coronavirus pandemic, and many deny claims these clinics are being cancelled because staff are too busy dealing with abortions.

However, most health boards acknowledged there had been an increase in STIs and abortions since the pandemic, and have found “demand exceeds capacity” when it comes to contraception.

NHS Grampian said its provision of IUDs and implants was “still recovering post-pandemic”, and the health board had occasionally had to open up waiting lists because of the demand.

A spokesperson said: “Appointment cancellations are unusual, and only in the event of emergencies, such as unplanned staff absence. We have increased our staff cover for abortion services  to ensure we can meet the demand.”

However, the health board said it had seen an increase in both STIs and abortions since 2022. Other health boards have similarly seen increases in rates of STIs post-pandemic.

NHS Tayside said STIs “present an ongoing public health challenge”, but added this could be down to an “increased awareness of testing” and more people recognising the signs of gonorrhoea. 

A spokeswoman said: “Demand for [contraception] services is high, but it is met with dedicated clinics within sexual health services and local GP practices.”

NHS Greater Glasgow and Clyde has seen a rise in both abortions and is offering STI treatment within two days, but said no long-acting contraceptive appointments were being impacted.

NHS Forth Valley said there were no waiting lists for IUDs and implants, but it had seen an “increase in certain STIs such as chlamydia and gonorrhoea across Scotland”, and was working to raise awareness of the risks of STIs.

NHS Fife said offering IUDs and implants “may be challenging due to demand”, but that rates had “recovered to almost pre-pandemic levels”. The health board said the demand for abortions did not impact their contraception clinics.

NHS Shetland said it had actually seen a fall in waiting times for implants and IUDs since the coronavirus pandemic, but stressed this was coupled with an increase in gonorrhoea and abortions. However, it said abortions were provided separately to sexual health and therefore did not impact on contraception clinics.

NHS Borders similarly said abortions were done by a separate service and therefore did not impact on contraceptive clinics, and NHS Ayrshire and Arran said while STIs had increased post-pandemic, the health board had not had to cancel contraceptive clinics.

All other Scottish health boards were approached for comment.