The Burden of Poor Reproductive Health in England: Results From a Cross‐Sectional Survey

ABSTRACT

Objective

To quantify the burden of poor reproductive health in England by age, ethnicity, and financial security.

Design

Cross-sectional survey.

Setting

England.

Sample

59 332 women and people assigned female at birth aged 16–55 years.

Methods

The Reproductive Health Survey for England 2023 (RHSE2023) used an online convenience sampling strategy and a self-completion questionnaire.

Main Outcome Measures

13 indicators of reproductive health organised into three domains: reproductive morbidities (including endometriosis, fibroids); menstrual health (severely painful and/or heavy periods; menopausal symptoms); and pregnancy-related adverse experiences (pregnancy loss, infertility, unplanned pregnancy) in the last year.

Results

Compared to the general population, our sample over-represented those with higher education levels and under-represented minority ethnic groups. 28.0% of participants reported at least one reproductive morbidity; 61.9% reported menstrual-related issue(s); and 5.5% reported pregnancy-related adverse experience(s) in the last year, with considerable variation by age. Compiling the three domains, 73.7% reported at least one indicator of poor reproductive health. Inequalities were observed: Black British, Caribbean, and African women had increased odds of reporting reproductive morbidity (aOR: 1.69); heavy and/or severely painful periods (aOR: 1.28); and pregnancy-related adverse experience (aOR: 1.50). Financial insecurity was also associated with poor reproductive health.

Conclusions

As the first study to simultaneously examine this broad range of indicators of reproductive health within a single sample, we highlight the substantial burden of poor reproductive health in England, with evident ethnic and financial inequalities.