The study, by the Family Planning Association and the Health Education Authority, found that two-thirds of GP practices did not offer pregnancy tests because of financial constraints.
It also found little specialist family planning provision for teenagers, confusion on advice to under-16s and poor understanding and provision of emergency, post-coital contraception.
Karen Pappenheim, head of publicity at the FPA, said: 'Pregnancy testing is rapidly disappearing as a free facility and for young people the price of an over-the-counter test is prohibitive.'
Traditionally the tests were available free via a GP. Some high street pharmacies offer a test for pounds 5 or pounds 6, otherwise women have to buy an over-the-counter kit costing pounds 7 to pounds 11.
The report, Sexual Health and Family Planning, partly funded by the Department of Health, says that only 22 out of the 60 practices offered a test. 'Patients may not be able to obtain a free pregnancy test, or referral for one, from most GPs because local hospitals have stopped providing this service, to save money. Few practices carried out pregnancy testing on site and usually sent samples to a laboratory, the pharmacy or hospital. Staff at some practices said that they would carry out a pregnancy test at the practice if it was an 'emergency'.'
Dr Sam Rowlands, a GP and committee member of the Faculty of Family Planning and Reproductive Health Care at the Royal College of Obstetricians and Gynaecologists, said: 'There is clearly an issue here over pregnancy testing. Only a minority of GPs are prepared to fork out from their own pockets to provide the service.'
Pregnancy testing did not attract a payment for GPs and the family health service authorities did not make special provision for it, he said.
Dawn Primarolo, Labour health spokeswoman, said: 'Virginia Bottomley, Secretary of State for Health, must give an immediate guarantee that all women have access to a free pregnancy test on demand as an absolute right.'