High Court ruling against free access to abortion for Northern Irish women

Today, a High Court judgement ruled that women from Northern Ireland are not entitled to access abortion free of charge through the NHS in England. 

Abortion is severely restricted in Northern Ireland and is only available where the pregnant woman’s life is in danger or where there is a risk of permanent and serious damage to her physical or mental health. This means that the vast majority of those seeking abortion in Northern Ireland will need to travel to access a safe, legal procedure. Currently, these women are required to pay for the procedure, which can range from approximately £400 to over £1000 for those at a later stage of pregnancy. The test case brought to the High Court by two women was rejected, meaning that the need for Northern Irish women to pay for abortion procedures carried out in England remains.

Northern Ireland is not covered by the current 1967 Abortion Act which applies in England, Scotland and Wales. The key legislation governing abortion in Northern Ireland comes from the Offences against the Person Act 1861. This means that women’s access to reproductive health care is managed according to a law which is over 150 years old and precedes the invention of the telephone and the light bulb.

The restrictive law in Northern Ireland does not prevent Northern Irish women having abortions, but it does make it more difficult. Those who can afford the private clinic fee and travel costs to England will be able to access a safe, legal abortion, but might have to significantly rearrange work and childcare to do so. Others may face delays in their attempts to raise a large sum of money in a short period of time. Overall, abortion is safe, but is safest the earlier in pregnancy it is performed, so delayed access means higher prices and also an increased chance of complications.

Those without access to such funds will be forced to continue an unwanted pregnancy (which again, is likely to have severe financial implications for someone who cannot afford an abortion), or they will resort to an illegal and potentially unsafe method of ending the pregnancy. Abortion Support Network is an organisation which helps women in Ireland and Northern Ireland to afford the cost of an abortion abroad. Mara Clarke, who runs the organisation, details some of the desperate measures people have taken to try to end their pregnancies:

“We have mothers calling us, telling us that their 18-year-old daughter drank a bottle of floor cleaner after she was raped at her own birthday party. We hear about women taking whole packets of birth control and washing it down with vodka.”

Others unable to travel will buy abortion medication online through sites such as Women on Web – however, if they do, they risk life imprisonment for ‘procuring (their) own miscarriage’.

The latest statistics from England and Wales show that in 2012 905 women travelled from Northern Ireland to access abortion. Many more will have travelled elsewhere or bought illegal abortion medication to end their pregnancies. Clearly, strict abortion laws do not stop abortions from happening, but can make them less safe by causing delay and restricting access. Abortion for Northern Irish women is largely a matter of economic resource. As Mara Clarke puts it, “women with money have options, women without money have babies”.

As a young people’s project we're particularly concerned about young women’s access to reproductive healthcare. In 2012, 43% of abortions in England and Wales for Northern Irish residents were for those under 25. Young women are less likely to have the resources necessary to travel and pay for a private abortion. A pregnant teenager seeking an abortion in Northern Ireland may suffer from stigma and lack of support, as well as financial limitations. 

The young woman who presented a test case to the High Court was just 15 when she became pregnant and travelled to Manchester for an abortion. Her mother paid £600 for the procedure, some of which was covered by the Abortion Support Network, and described the process of raising the funds as ‘harrowing’. Not all young women will have the support of their families. We believe that the abortion law in Northern Ireland should be brought into line with the rest of the UK, so that all women, especially young women, are able to access the full range of reproductive healthcare they need, which includes abortion.

Conscientious objection obstructs women’s health … it’s not brain surgery

Blogpost by Lisa Hallgarten

It doesn't take a brain surgeon to work out that you can’t be a brain surgeon if you don’t believe in brain surgery. Nor does it take a rocket scientist or even a person of average intelligence to work out that a doctor who is not willing to prescribe the full range of contraceptive methods should not have a qualification that implies that they are able and willing to do so. The Faculty of Sexual and Reproductive Healthcare (FSRH) which provides a diploma in sexual and reproductive health, has recently updated its guidelines to confirm that doctors and nurses who have a ‘conscientious objection’ to prescribing hormonal contraception - including emergency contraception – and fitting women with IUDs and IUSs will not be able to complete the whole syllabus that is required in order to receive its diploma.

This seems uncontroversial. No woman should go to a certified doctor with a specialist qualification to discuss contraception, only to discover that her doctor will not prescribe or fit some of the available methods for reasons of personal conscience. It would be worse still for a woman seeking emergency contraception, because those who seek the right to conscientiously object do not support any method of emergency contraception. In this situation time is of the essence: if a woman wants to take Levonelle it is most effective in the first 24 hours following unprotected sex, EllaOne must be taken within five days and an IUD fitted within the same time-frame. No woman should have to scrabble about trying to find an alternative doctor who will provide her with this last ditch chance to prevent an unwanted pregnancy. Nor should any woman be preached at about why the only moral thing to do in this situation is to cross her fingers and hope for the best. You would think that even those who support a doctor’s right to conscientiously object must agree with this, but apparently not. The Christian Medical Fellowship (CMF) objects to the updated guidance because, ‘it bars pro-life doctors from specialising in sexual and reproductive health and also makes it much more difficult for non specialists to get jobs in family planning or reproductive health’.

The CMF seems to be asking for something over and above the right to conscientiously object. It seems to be asking for the right for anti-choice doctors to be certified so that they can advertise their specialism in family planning and attract women seeking contraception, with the full intention of refusing access to the full range of family planning methods.  This is not about passively opting out, this is obstruction. Likewise, the case of the two Scottish midwives who insist that they can use conscientious objection to opt out of even supervisory and management duties in relation to staff carrying out abortions.  Their appeal against an original judgement which refused them this right, on the basis that it would jeopardise abortion provision in their hospital, was funded by anti-choice organisation SPUC. This kind of extension by stealth of the right to conscientiously object is addressed in a new paper, ‘Dishonourable disobedience – Why refusal to treat in reproductive healthcare is not conscientious objection’. The authors, Canadian abortion rights advocate, Joyce Arthur, and Austrian obstetrician Christian Fiala question the moral basis for conscientious objection and challenge its interpretation and implementation by anti-choice doctors and anti-choice institutions. It is the latest salvo in a pro-choice fightback against the once uncontested concept of conscientious objection, and crucial reading for anyone who still believes that it is a benign practice which is simply about the quiet expression of personal belief.

Other useful articles on conscientious objection personal, and institutional:

• Conscientious commitment, Bernard Dickens in The Lancet
• Termination of pregnancy as emergency obstetric care: the interpretation of Catholic health policy and the consequences for pregnant women. An analysis of the death of Savita Halappanavar in Ireland and similar cases, Marge Berer for RHM Journal

It's time to slay the 'killer abortion' story

Today’s guest blogpost is from Lucy V Hay, a novelist, script editor and blogger who has just written a novel exploring one young woman’s pregnancy decision making process. She shares her insight on fictional accounts of abortion.

I’m grateful to live somewhere that allows for a woman’s right to choose, but abortion is frequently depicted in a negative light by movies and television. This Slate article sheds some light on the offenders, but does not, in my opinion, give a viable reason as to why this is so often the case.
 
As well as being the author of a pro-choice novel, The Decision: Lizzie's Story, I'm a script editor for movies, so hopefully I can offer an explanation – and though it may surprise some progressives, it’s not that the people creating those movies or television shows necessarily disagree with abortion!

When learning how to create fiction, the first thing any wannabe writer is taught is that, “drama is conflict”. In other words, a writer needs to create the worst problems for his/her characters that s/he can; it is overcoming those problems that make an audience relate to that character and invest in the character’s journey. So, if a story about abortion is to have the “most” conflict it can, obviously it will include death.

Simple, eh? But this is also where it gets complicated …

… 1 in 3 women in the UK will have an abortion at some point in their lives. What’s more, the likelihood of dying from having a legal abortion is extremely low. In fact, the risk of death from childbirth is 14 times higher than for abortion. So for starters, a story has potentially up to a third of its female audience going, “Eh? That just wouldn't happen!” Not. Good.

Secondly, though an individual movie or TV show may feature a death from an unsafe abortion (for example, if it was set in a time or place where abortion was illegal or inaccessible, like in the film Vera Drake), the sheer lack of variety in the representation of abortion in the media becomes problematic. It’s worth remembering, lots of people get their information from fiction … That’s why soap operas carry the famous: “If you have been affected by any of the storylines …” bit at the end of the show, alongside helpline numbers.

So if writers and producers shrug their shoulders and say, “It’s just a story!”, they are right. In isolation, their “killer abortion” story is just a story.

But all those “killer abortion” stories put together? A statement.

Working with writers, I am always at pains to point out we must be varied in our depictions of characters and situations and the “killer abortion” is no different. We are extremely lucky that safe abortion is a reality in Great Britain and that our friends, daughters, sisters and mothers have the right to bodily autonomy. But it’s also a sad reality that very few stories reflect this: instead, whether the writers and producers believe in the pro-choice message or not, they go for the lazy and stereotypical notion that “abortion kills” or is ‘dangerous’ in other ways (such as leading to infertility). It’s time to slay the “killer abortion” story and seek out representations that empower female characters – and the audience watching them.

Report released today – ‘Crisis Pregnancy Centres’ in the UK

EFC is pleased to be able to release the first in-depth investigation of ‘Crisis Pregnancy Centres’ (CPCs) in the UK. Following on from today's reports of two pregnancy counselling centres in London providing biased and inaccurate information we are able to provide further information.

CPCs are organisations independent of the NHS which provide pregnancy counselling – over half also provide sex and relationships education in schools. They are often run by charities which are outwardly anti-abortion or which have ties to anti-abortion organisations. The tactics of CPCs in the U.S have been documented by groups like NARAL, but this is the first full-scale investigation of CPCs operating in the UK.

EFC has identified 135 CPCs in the UK. Just under a quarter of these centres (33) were visited by volunteer mystery shoppers and background research into the remaining CPCs and their affiliations was also carried out.

Unfortunately the majority of CPCs visited were found to be giving misinformation about abortion and/or biased, unethical and unprofessional counselling methods. We are particularly concerned that many of these centres specifically market their services to young women. To give you an example, here are some quotes from the centres visited:

“The only other thing that has been reported with quite strong evidence is the increase in the possibility of breast cancer following termination of pregnancy” Oxford Care Centre (LIFE)

“There’s more risk of infertility from termination that there is from giving birth...some reports will say as low as 1% chance of infertility from termination and some will say as high as 25%” Central London Women’s Centre (Good Counsel Network)

“I do believe that God gives the gift of a baby” Reading Lifeline (Care Confidential)

“The other thing with abortion is the psychological effect of post abortion trauma.. of... the grieving that you lost, ‘cause you know at the moment for some girls it seems like a very quick option, you know and it’s a half day you go in, you’re out but you are left with the emotional turmoil of what you’ve done” Stillwaters Pregnancy Crisis Centre (Care Confidential)

Regular readers of our blog will know that abortion does not increase the risk of breast cancer, infertility or mental health problems. These ‘risks’ have all been discounted by medical professionals and to propose them as serious factors to consider in the decision making process inhibits someone’s ability to make an informed choice about their pregnancy. It is part of the anti-abortion agenda that seeks to limit choice under the guise of offering women support. 

Centres run by Care Confidential and Life do so under the name of the British Association for Counselling and Psychotherapy (BACP) which has a strict code of ethical guidelines for counsellors to follow. The directive, biased counselling offered in some CPCs cannot be considered good practice. Prominent psychotherapist Phillip Hodson states:

"Counselling is the opposite of conversion.  According to the ethical frameworks of our profession, no counsellor behaves properly by trying to sell to a client their personal religious or political outlook. Such an offence should trigger a formal complaint and - if this is proved - the offenders should be struck off by the regulating body. It goes without saying that supplying misleading medical information would be grounds for further sanction. It is my understanding that the regulator in such cases has always welcomed properly-founded complaints and their website explains how concerned individuals may proceed. I would hope for a swift response before it is suggested that counselling is not competent or motivated to regulate itself". 

EFC has sent an official complaint to the BACP and is awaiting a response.

More worrying still, Care Confidential is the primary service linked to on the front page of the NHS choices website about abortion. The organisation also claims to provide pregnancy counselling in five women's prisons. When the support Care Confidential offer is as sporadic and unreliable as our investigation has found it to be, it is far from acceptable for the NHS to offer their services to people looking for support.

Have a read of the report and watch this space for further developments.

Talking about abortion - share your story

This week, the New York Magazine published the personal accounts of 26 women who have had abortions. The article points out that abortion is "part of our everyday experience" even though it might not always be discussed openly... 

"Abortion is something we tend to be more comfortable discussing as an abstraction; the feelings it provokes are too complicated to face in all their particularities. Which is perhaps why, even in doggedly liberal parts of the country, very few people talk openly about the experience, leaving the reality of abortion, and the emotions that accompany it, a silent witness in our political discourse."

Here in the UK, a third of women have an abortion. Half of young women who become pregnant will choose to have an abortion, yet the stigma around abortion can mean that the subject is not discussed. As a result, many young people will receive no education about abortion, from parents or from their school, and misinformation and stigma are able to flourish in this absence of real people's experiences and informed discussion. 

We're therefore excited to announce our own small project dedicated to improving conversations about abortion! We've received a small grant from the Abortion Conversation Project in the U.S that will allow our Youth Advisors to create blog-posts sharing personal stories about pregnancy decision making and abortion. And here's where you come in. We'd like people of all ages and genders to send us their stories relating to reproductive choice. Our Youth Advisors have created a short survey form which allows people to share their story anonymously, or not, depending on what they feel comfortable with. These stories (which might be just simple statements, or longer narratives) will be made into visual, engaging blog-posts to be shared with other young people via the Youth For Choice tumblr.

Please help us talk about abortion, in an honest and open way. Share your story here.

For more on the impact of misinformation and stigma on young women seeking abortion see this report on young people and repeat abortion in London.

'Pro-choice' - what’s in a name?

Lisa shares her thoughts on the use of the term 'pro-choice' to describe organisations which campaign for reproductive rights.

Planned Parenthood this week decided to stop using the term ‘pro-choice’ to describe its position on abortion. I’ve read some excellent pieces on this and agree with many of the points made in favour of this change. Maybe it’s only a sentimental attachment to the term, but personally I don’t think I can ever stop being ‘pro-choice’.

Many people are arguing that the idea of choice is a misnomer because for some people there is no choice. For me this is like arguing that being pro-equal pay is a misnomer because currently there is no equal pay. Planned Parenthood has also argued that abortion should be de-politicised, and framed as a personal health decision that an individual should be able to make. Of course it is an entirely personal decision, but until certain conditions are met, de-politicising abortion seems to me like wishful thinking. The closest example I can see to this is the way in which Canada has taken abortion out of the criminal law altogether. However, even in Canada the political attacks on abortion as a legal procedure keep on coming. And importantly, as Tracy Weitz writes, shifting abortion from the public into the personal sphere does nothing to address or eradicate stigma or help to tackle obstacles to access: 'to say abortion is an individual woman's business absolves us of our obligation to create a more just world.'

It feels a lot like this change of terminology is an admission of failure: it acknowledges, implicitly, that the movement never managed to convey to the world what pro-choice should really mean (which of course includes the fact that abortion is a personal, medical decision). Also that the movement never adequately acknowledged, or fought to address the lived realities of all those in the community who wanted a real choice over their reproductive lives and parenting, and have been denied one, whether because of their age, class, race, gender, sexuality, disability, religion or other factor.

The reproductive justice movement was formed partly in response to the fact that poor women of colour in the US are damned if they do and damned if they don’t when it comes to parenting. Condemned for being disproportionately represented in the abortion statistics – though simultaneously represented as passive victims of a racist abortion ‘industry’ with no moral agency of their own; or condemned for having children when they are perceived as not having the means to support them.In fact, reproductive justice is about more than parenting choices. Reproductive justice activism embraces the whole conversation about how people define themselves, how they choose to live, and how they choose to have or not have sexual relationships, recognising the cultural, economic and social limits imposed on those choices.

For me the reproductive justice movement represents a lot about what being pro-choice should be about and what it means to me. Being pro-choice is not just about saying abortion is morally acceptable or should be legally available. Like any word, or phrase that is designed to be a shortcut to a philosophy, ethos or political position, 'pro-choice' may well not be up to the task, but I’m not convinced that inadequacy equates to inappropriateness and that we should ditch it just yet.

Until we have achieved the utopia in which real choice exists, we have to accept that it is an aspirational term, a goal to be fought and campaigned for. For me it’s about saying that complete sexual and reproductive choice – the fundamental right of a person to bodily autonomy, to have sex or not, to decide who to have sex with and how to have it, to have sex without having children; and of course the right of people who can get pregnant to decide the number, timing, and spacing of their children - is what we are aiming for. It necessitates recognising that some people’s choices are influenced by more than their desires in relation to parenting, but are constrained and directed by the culture in which they live, their economic circumstances, the social and political support or lack of support for certain pregnancy choices and much more.

Real choice can only exist in the context of:

• A society which values and provides equality, respect and security to people of all sexes, sexualities and gender identities and all people regardless of race, class, disability or religion

• Comprehensive and universal sexual health education and access to comprehensive sexual health services including safe and legal abortion and fertility services

• The destigmatisation of all pregnancy options, not just abortion and adoption but all sorts of parenthood including teenage parenthood, single parenthood, older parenthood, disabled parenthood, same-sex parenthood, transgender parenthood

• Rights to parental leave and flexible working conditions for parents

• Real economic and social support for parents caring for children including a living wage policy, accessible affordable childcare, affordable housing, VAW services and more

• Good free quality healthcare for all

In short: a society in which we can be optimistic that our children will thrive, wherever they are born and whoever they are born to...

Maybe the US context is so different that it would be laughable to aspire to any of the above conditions (free universal healthcare, adequate welfare etc), but in the UK we once achieved a few of these or were close to achieving them, and we’re fighting hard to achieve more and to stop the gains we have made slipping through our fingers.  If being pro-choice is an aspirational rather than a descriptive term I’m happy to aspire.

Happy birthday to us!

Dust off the party poppers, EFC is 20 years old this year!

We were founded back in 1992 as a result of a lack of good quality educational resources on pregnancy and abortion. Teachers were finding that despite the topic of abortion being on many syllabi, there was very little support in terms of teaching it in a sensible and balanced way. Sure, the old anti-choice stalwarts SPUC and Life had been around for a good 20 years, but their offerings tended to be (and still are) partially inaccurate, biased and often insensitive to young people's experiences of pregnancy. A group of sexual health professionals therefore got together to form 'Education For Choice' and ensure that young people could learn the facts about abortion.

Over the past 20 years we're stayed true to our mission - to provide young people with reliable information about pregnancy options. We've done this directly, by providing workshops in schools, colleges and youth centres, but also by producing resources and training up professionals who work with young people. We reckon we’ve reached around 1.8 million young people through this work. Not bad for a tiny project with limited resources eh?

Our 20 years of experience means that we are experts on young people and abortion and are often contacted by the press to provide information and comment. Recent years have seen us work to expose rogue crisis pregnancy centres offering inaccurate information, and highlight the problem of anti-choice speakers giving misinformation to young people in schools. No one else in the UK is doing this vital and unique work.

We’re proud of what we’ve achieved, but while sex education remains a patchy subject and anti-abortion groups continue to mislead young people about their health and wellbeing we think it’s important that EFC continues to shout loud for young people’s right to good education.

We’re asking you to support our work by giving us £20 for our 20 years. Or a monthly donation – even a small amount will make a real difference. To spice things up we’ll be posting some classic tunes from 1992 to now, culminating in our birthday extravaganza in London on 22nd November. We’d love to see you there.

If you believe young people deserve to be give the facts about pregnancy and abortion, then please give what you can to support EFC’s work.

Why we're supporting the pro-choice demo 9th July

EFC is happy to promote the Pro-Choice demo happening next Saturday (9th July 2011) in London, to its friends and followers. This blog gives a bit more information on why we think this action is so relevant and important. To register your attendance visit the Facebook page and follow @ProChoice9July #prochoicedemo2011 for up to date information.


Recent months have seen a number of worrying intrusions into our reproductive rights in this country. Including:
• Nadine Dorries’ and Frank Field’s ‘Right to Know’ campaign which posits abortion providers as having a ‘vested interest’ in persuading women to end their pregnancies, and argues for ‘independent’ centres to provide pre-abortion counselling. EFC believes these amendments are based on a false premise – that women aren’t currently getting impartial, evidence-based support with their pregnancies.  Our research into crisis pregnancy centres in England also suggests that a great deal of ‘independent’ centres do not provide impartial accurate information but rather, are driven by an anti-abortion agenda. Read a thorough debunking of this campaign by Darinka from Abortion Rights here.
• Anti-abortion charity Life invited to sit on the government’s Sexual Health Forum.  LIFE is a well funded charity with a large profile and has every right to promote its anti-abortion position. However, as a lobbying group with no commitment to evidence-based clinical practice, or to promoting and providing good quality contraceptive and reproductive health care, it simply has no place on this group, which otherwise consists of sexual health experts, clinicians and service providers.
• Michael Gove commends the new SRE council of abstinence education groups. LIFE and Care (a Christian organisation which opposes abortion) join 5 other abstinence/anti-choice groups on the new SRE council which has been welcomed by the education minister. See our blog for more information on these groups and more information on why abstinence doesn’t work.
• Nadine Dorries’ abstinence education for girls. Worryingly, Tory MP Dorries’ misguided bill to teach girls abstinence passed the first stage vote in parliament. Another reason to keep on our toes and make the case for evidence-based comprehensive sex education.


EFC supports the rights of young people to accurate information and good quality, evidence-based information on abortion; and their right to impartial support with pregnancy decision-making. We believe that current developments will impact most on young people by depriving them of essential information and diverting them away from health professionals who could give them the support they need to access services quickly.


Those of us who believe women should have access to safe, legal abortion and they and their partners and families access to evidence-based information on contraception, pregnancy and abortion need to stand up for these rights before they are eroded.


Join EFC on the demo to make a stand for the pro-choice majority and for young people in this country.