There were more than 200,000 abortions in England and Wales last year - the highest number ever recorded.
Over the past 10 years, rates have been increasing among older women over 35 and decreasing in under 18s, figures from the Department of Health and Social Care show.
Doctors said the figures showed there was an urgent need to improve access to contraception for women of all ages.
Cuts to local public health budgets had also affected services, they said.
Rising rates in older women
In total, there were 200,608 abortions in women living in England and Wales in 2018 - a rate of 17.4 per 1,000 women aged 15-44.
This is just below the peak of 17.9 abortions per 1,000 resident women in 2007.
The actual number is higher now because there are more women in the population.
The latest figures show younger women are continuing to have fewer terminations.
Among 16-17 year olds, the abortion rate has halved from a decade ago, to 10 per 1,000 women, and just 1,267 under 16s had a termination last year.
But rates have gone up in women aged 30-34 and the over 35s - from 6.7 to 9.2 per 1,000 women between 2008 and 2018.
Prof Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said: "Women must have access to effective contraception and sexual health services to enable them to take control of their health and fertility by preventing unwanted pregnancies and sexually transmitted infections.
"This is why we are calling for an end to fractured commissioning and greater accountability to stop the under-funding and fragmentation of these services which disproportionately affects women."
Additionally, more than 4,600 abortions were carried out on non-residents in 2018, most from Ireland and Northern Ireland - a slight increase on the year before.
Prof Regan said this demonstrated the "pressing need" to legislate for safe abortion services in Northern Ireland.
She added: "We continue to call on the government and work with other organisations to ensure that women and girls - regardless of where they live - have access to safe, legal and compassionate abortion care services."
However, since 1970, the number of abortions to non-residents has generally been falling.