‘Abortion: The Facts’ – A film by young people, for young people

Last week saw the final meeting of the first EFC Youth Advisory Group. Sob. Thanks so much to Kiki, Ruth, Rosa, Rachael, Sam and Zalika for being involved and making it such a success. As well as attending events and focus groups on behalf of EFC the group worked hard to produce this short film to give other young people the facts about abortion. Please watch 'Abortion: The Facts' (below and also on our YouTube page) and let us know what you think – and do pass it on to any young people/educators who might be interested! Some closing comments from the YAG follow...



Kiki: We went to an exhibition concerning sexual health at City Hall where we got freebies, leaflets and met sexual health organisations. We also created a film of some of the facts about abortion to dispel the myths around the topic. The production was good fun as we collaborated ideas and did audio snippets.

Rachael: During my time at EFC I was introduced to the different views as well as facts of abortion. Personally I feel that I have learnt valuable information not only for myself but also family and friends. By contributing to the creation of our video: ‘The Facts About Abortion’ I have learnt how important it is to encourage young people to think about the subject.

Ruth: The film project came about after us noticing the lack of decent information about abortion online – particularly in video form. YouTube is populated with sometimes misleading anti-abortion videos. Young people deserve to have the facts to make an informed choice and they need to know their rights. What I found particularly interesting when making the video was the common theme of the lack of sex education in schools which addresses abortion. Perhaps our video can help to fill this gap and even prompt a discussion about how limited sex education is in UK schools. I’d like to share the film with anyone and everyone!

Rosa: From my time at EFC, I have learnt a lot. I was one of the many without a knowledge surrounding abortion that I should have got from school. I found that a lot of things I took as truths were not at all, and I have felt better within myself and feel that my autonomy has grown as a result. The making of the film was largely good fun, at times difficult, but with a strong group around us we could always find a way to laugh whilst we worked. I’m proud of the film but I can’t help but feel sad it’s all over. This is a fantastic organisation and I have loved being involved.

Myth Busting Monday: 'Abstinence education is a really good idea'

So, a topical myth-bust today in light of Nadine Dorries' recent proposal that young women be taught abstinence education in schools. Lisa has already blogged on that issue here; so today is all about debunking the myth that abstinence education actually works, i.e. empowers young people to delay sex, and reduces levels of STIs and unplanned pregnancies.

The Sex Education Forum gives a very sensible, straight-forward account of abstinence education here. In answer to the question 'Does abstinence education work?' it states:

'There is no evidence that ‘abstinence – only’ education either reduces teenage pregnancy or improves sexual health (Kirby 2001 & Swann et al 2003). There is also no evidence to support the claims that the teaching of contraception leads to increased sexual activity (Swann et al 2003).'

Worryingly, the research suggests that such programmes which withhold information about sexual health can place young people at higher risk of STIs and unwanted pregnancy. Not a huge shock to anyone with some common sense.

In terms of abortion education, we hear similar arguments from the 'abstinence-brigade' against giving young people information about pregnancy options. There is a sense that if you tell young women what abortion is and where you can access information and services they'll all want to run out and have one. In fact, our own student evaluations tell us that having the space to think about pregnancy decision making actually motivates the young people we speak to to use contraception and consider the choices they make. The University of Southampton's report on second trimester abortions shows that some women's lack of information on what abortion involved, or where to access it, meant that they delayed the procedure, with possible increased risks to health.

All of this is why we side with those, like the Sex Education Forum who believe in educating young people about sex and pregnancy in a balanced way, helping them to think about not just how to prevent unwanted pregnancies but examining their motivation to do.

decisions decisions...

My relationship with TV researchers is one of false hope followed by inevitable disappointment. Each time researchers have been putting together a new series of the Sex Education Show they have called me up. Like a fool my heart beats a little faster and my brain starts whirring and I believe, I really believe, that this time they actually want to get it right.

The first time abortion was mentioned on the Sex Education Show (an episode first aired in 2010) it was a description of an abortion method, accompanied by the presenter making eeuch faces and yeuch noises. I tweeted like a lunatic - Why the focus on the abortion procedure? Why the pulling of faces? Another missed opportunity to represent abortion and abortion education constructively.

This time when they rang asking for something I couldn't and wouldn't provide them with (probably a young woman who would talk about her abortion to the nation), I grabbed the bull by the horns. 'I'm afraid we can't help you with a real life case study, but what we can do is spend a bit of time helping you to consider useful ways in which to represent abortion and ways to address it within the Sex Education Show.' Silence at the other end of the phone.

'For example', I blathered on, 'I could send you the resources we use in schools. If you like you could come and observe one of our workshops to see what it is that young people really want to know about abortion and how you can usefully address the subject. I can send you a list of the questions they commonly ask and an explanation of how to answer them. Anything you'd like to know about this we'd be happy to explain, or to demonstrate '...SILENCE.

'It's just (I don't give up easily) it would be so much better if we could help the young people think about why abortion happens and how people come to that decision, rather than looking solely at the abortion process as you did last time. After all the abortion process is quick as a few minutes, and labour a few hours, but the decision to have a baby may be life changing.'

'Ok, well we'll get back to you, thanks' came the chirpy TV researcher voice on the other end of the phone.

So, did she get back to me?...No!
So, did the show focus on decision-making and avoid obsessing about the procedure itself?...No!
So, was I surprised?...No!

The show got some things right – abortion is a 'real' issue that YP aren’t given many opportunities to learn about. As one of the girl’s commented, the only stuff about abortion she knows comes from East Enders, hardly a reliable source of accurate information on the subject.  40,000 young women under 18 become pregnant in England and Wales each year many of whom face a real dilemma about what to do. As the show rightly stated, 18,000 abortions carried out for young women under the age of 18 every year in England and Wales, so it's a real shame so little good quality work is done around this topic within SRE. The young people interviewed were - as we find they always are - hungry for discussion of abortion.


Once again the opportunity to demonstrate good work was lost. Once again the abortion procedure took centre stage. As the presenter said 'we want to show teenagers the cold hard facts about abortion'.

At 40 minutes in to Episode 3 you can watch as a group of young people are led into the procedure room of a Marie Stopes abortion clinic. I've met the nurse who talked them through the procedure. She might even have participated in some of our training, and she was great - calm, clear and reassuring. But the constant camera fixation with the stirrups on the bed, and the cutting in of a photo of surgical instruments (which would only be used in a small proportion of the 9% of abortions that take place after 13 weeks) couldn't but make the whole procedure seem scary. One of the young women who had her hand over her mouth to denote 'I'm going to be sick' mode, before she even entered the room, became another point of repeated focus for the camera and editor.

Although both surgical and medical methods of abortion where mentioned, the information given was muddy and unclear, it implied that all abortions after 9 weeks are surgical which is not true - in fact the RCOG recommend medical procedures be used at all stages of gestation.

On the positive side it was instructive to see the small size of the cannula (a straw sized tube) which is inserted through the cervix and into the uterus to perform a 'surgical' or vacuum aspiration abortion. Many young people we talk to assume that it will be done using something the size of a hoover or, worse, that they have to actually cut you open. One of the young men in the programme said he had always assumed that this was how they performed abortion and it's not surprising since it's a common piece of misinformation deliberately disseminated by some anti-abortion organisations speaking to students in schools.)

As part of a comprehensive discussion of abortion it is natural that young people will ask about different abortion methods, but it really is only one part of the discussion and not, IMHO, the most important.

In Education For Choice workshops we explore the reasons women get pregnant when they don't intend to. That means looking at different contraceptive methods, different circumstances, positive and negative situations. We then get everyone to consider what that must feel like. What would the dilemma be like for the young woman and how would her partner be feeling. How easy would it be for them to talk to each other, what would they have to take into account in making a decision about pregnancy, who else could they talk to and would they get family support for whichever option they chose. We always ask them to consider adoption as well as parenthood and abortion and allow them to consider the pros and cons of all of these. We ask them to identify local services that can help with contraception, pregnancy testing and impartial pregnancy decision-making support. These lessons generate thoughtfulness and empathy as well as a lot of forthright views and interesting questions. Most young people leave the classroom with a much better understanding of what abortion is and why it is the right option for some people, but most importantly they are more motivated to avoid conception and to use contraception.

We always answer questions about abortion method clearly and simply, but just as I would if I had a pregnant young woman in front of me, we try to get them to prioritise thinking about the decision itself. However squeamish we are or fearful of pain and discomfort, the decision to bring a baby into the world and the lifelong commitment to caring for it must take priority over worrying about the relatively short abortion procedure or even the potentially long and painful labour.


I'm sad that I couldn't get this message through and that once again Channel 4 has prioritised 'shock and awe' over quality information giving. I wonder whether the next time the Sex Education Show ring me up to ask for help will I rebutt them?


Somehow I doubt it. Once again, my heart will beat faster, my brain will start to whirr and I will try again. Maybe I'm stupid, but this is just too important to get wrong.

Download our Best Practice Toolkit: Abortion Education FREE

ARC regrets DH loss of appeal over abortion statistics

Last week the Department of Health lost it's legal right to limit publication of specific data on later abortion that it believes could jeopardise the confidentiality of women and the privacy of doctors. The Department had changed the way in which they published figures for rare later abortions following the Joanna Jepson case, in order to prevent the media or anti-abortion activists identifying individual doctors who had agreed to perform late term abortions for pregnant women following a diagnosis of fetal anomaly.

While the rest of the world has an interesting theoretical debate about the merits or otherwise of transparency, some of those working on the front line are concerned about the impact of this ruling on real women and their doctors. Antenatal Results and Choices (ARC) is the only national charity which provides non-directive support and information to expectant and bereaved parents throughout and after the antenatal screening and testing process.

This statement from ARC Director, may give us all pause for thought.

We regret that the Department of Health has lost its appeal to limit the detail of annual post 24 week abortion data, which they feel is necessary in order to protect the confidentiality of those involved.

ARC is the only UK charity providing non-directive information and support to parents through antenatal testing. We offer specialised support to parents after the prenatal diagnosis of a life-threatening or severely disabling condition in their baby. We speak daily to women and their partners dealing with the shock and grief of the diagnosis and agonising over whether to continue or end a wanted pregnancy.

On our helpline we hear from desperate women and partners who have been given a late diagnosis and face the trauma of having a termination of pregnancy after twenty-four weeks. These situations are rare, but extremely distressing. Women are ending their pregnancy at a stage when they have often prepared practically and emotionally for the birth of their baby. They enter this decision knowing it is life-changing and need to feel entirely confident that their privacy and confidentiality is protected. In our experience clinicians take their legal responsibility very seriously in what are challenging circumstances for them too. They need to be able to provide sensitive care to parents without fear of retribution on a personal level from anti-abortionists.

All involved in late terminations deserve our compassion, trust and support rather than the misguided suspicion that they are engaged in some nefarious ‘pursuit of perfection’.

Jane Fisher

Director

Ante-Natal Results and Choices (ARC)

Abstain from abstinence please Dorries

MP Nadine Dorries has proposed a ten minute rule motion:

Ten minute Rule Motion SEX EDUCATION (REQUIRED CONTENT)

That leave be given to bring in a Bill to require schools to provide certain additional sex education to girls aged between 13 and 16; to provide that such education must include information and advice on the benefits of abstinence from sexual activity; and for connected purposes.

The evidence against using an abstinence-only approach to sex and relationships education has stacked up over the years and I don't plan to review it here. To be fair Dorries doesn’t use the term abstinence-ONLY, so I’ll give her the benefit of the doubt and assume that she would like discussion of abstinence to be part of a wider sex and relationships education curriculum.

So what’s the problem with this motion?

Firstly, it seems bizarre to call for more sex education for girls specifically. For all those women (quite a large majority) who sometimes, often or always have sex with men, it would be quite useful if the men knew a thing or two too about positively choosing whether or not to have sex, what real consent looks like and how sex fits into a relationship. If we are (which I’m not) trying to promote abstinence, we really do have to talk to the boys too. After all it really takes two to abstain just as it takes two to tangle.

Secondly, as with so many of Dorries' bills, amendments and random proclamations – just scratch the surface and there is a dodgy premise in there. The dodgy premise is that SRE currently does not get young people to think about positively choosing not to have sex. In my experience sex educators are always talking about: a) the fact that not having sex is the best way to guarantee you won’t get pregnant b)the importance of feeling ready for sex, c) how unacceptable it is to pressure someone into sex d) how eminently sensible and reasonable it can be to choose not to have sex...etc

Thirdly, comprehensive Sex and Relationships Education – and I note her Bill does not include the word ‘relationship’ TUT TUT – is all about empowering young people to make informed decisions and one of the many they will be faced with is: do I have sex now, in this place, with this person, with/without this form of contraception? This kind of approach which eschews the obsession with virginity, purity, and a sense of once it’s gone it’s gone, is much more useful than typical abstinence education. Instead of proposing that sex in and of itself is wrong/terrifying/horrendously risky and should be avoided for as long as possible, it gives students a framework against which to consider whether each sexual opportunity should be embraced or avoided: How will it make me feel right now/later/tomorrow? How will it make him/her feel? How will it impact on our relationship? What will I gain or lose from the decision to have sex now? What are the pitfalls of sex here, now, with this person? How well protected are we against pregnancy and STIs etc...This approach allows someone to have sex once and then choose not to for months or years. Just because you’ve had sex once all is not lost. Every opportunity you have to say yes becomes an opportunity to say no, or not now, or not like that, or not here, or not without a condom.

Fourthly, ‘abstinence’ is not a fantastically useful term. It holds within it a powerful sense of deprivation - e.g. I’m going to abstain from eating chocolate until I’ve lost a stone - which surely makes chocolate seem more desirable. Abstinence is often associated with virginity – causing many young people to bypass vaginal penetrative sex for the more 'abstinence-friendly' activities such as oral and anal sex (which are sometimes considered not to count – when you’re saving yourself for marriage).

Finally, I’m baffled as to how we could make one aspect of sex education compulsory and leave the rest to the whim and whimsy of schools to deliver as and when they see fit. As it stands, Dorries' motion is strong on implication, poor on understanding of contemporary practice, and weak on practical help for young people. If Dorries truly wants to empower young people and improve their health she should join the chorus of voices crying out for delivery of comprehensive SRE to all our students in all our schools and all our communities, because only by providing that will we give our young people the power to say NO as well as YES and NOT NOW or MAYBE ANOTHER TIME.

Myth-Busting Monday: 'If everyone had access to birth control and all the methods were 100% effective, all pregnancies would be wanted'

This week we're borrowing another myth from the brilliant Scarleteen article How to (un)Pack for a Real Discussion About Abortion. Thanks again to Heather Corinna at Scarleteen for giving us permission to reproduce this extract entitled: 'If everyone had access to birth control and all the methods we had were 100% effective, all pregnancies would be wanted and we would have no abortions'.

While some women have very firm and consistent feelings before and during the whole of a pregnancy that a pregnancy is wanted, not everyone feels that way. Given how much pressure expectant mothers are under to express nothing but joy about a pregnancy, we can’t even accurately say how many women have mixed or mutable feelings: we just don’t live in a world yet which allows women that kind of honesty around pregnancy.

Even if every wanted pregnancy remained wanted, we can be certain that many women would still want and need abortion. Life doesn’t just stay put while we’re pregnant, so our circumstances can always change, and some of those changes can seriously alter our plans, previous wants and needs or the status of our pregnancy. In fact, I think it’s pretty strange to talk about a process which is about nothing but constant change – for a developing, as well as for a pregnant woman – as if it could be unchanging.

That said, birth control access and efficacy is a huge issue, and given that in America alone, nearly half of all pregnancies which end in abortion are unintended, we know that lack of access to methods, not knowing how to use methods properly or having a lack of cooperation around contraception in sexual partnerships and the level of effectiveness methods provide does very much contribute to more abortion than we would see otherwise. Those earnestly looking to help reduce the number of abortions drastically should absolutely be working to increase birth control access, awareness and the development of reliable methods of contraception, since this is the one thing we know would make a huge difference which does not in any way diminish or remove women's reproductive rights.

Myth-Busting Monday: All independent pregnancy advice centres offer women impartial, balanced pregnancy decision-making support

Since Lisa wrote a blog about Nadine Dorries and Frank Field’s ‘Right to Know’ campaign and their proposed amendments to the Health and Social Care Bill we’ve seen the issue discussed by a number of journalists and bloggers. In light of that, today’s Myth Busting Monday focuses on one particular aspect of this campaign which we believe could pose a real threat to women’s access to impartial support with pregnancy decision-making, and that is the presence of unregulated pregnancy advice centres.

The Right to Know site claims that:
An amendment to the Health and Social Care Bill would guarantee that all women considering abortion have access to independent advice and counselling - provided by someone with no vested financial interest in the outcome of their decision.

Our question is – just who would be providing this service? What is the alternative for a woman who doesn’t speak to her doctor or a counsellor at an abortion provider?

Crisis Pregnancy Centres (CPCs)
There are already a number of independent pregnancy advice centres across the country. Some are upfront about operating with a specifically anti-abortion agenda, some aren’t. Some are transparent about religious affiliations or funding organisations, some aren’t. Some may be providing evidence-based information and impartial support to women facing an unplanned pregnancy but we know of many more which aren’t. Our own research, coupled with the insight of the many professionals we speak to across the UK suggests that a good number of these centres are not offering women a balanced discussion of their pregnancy options but rather serving misinformation, health myths, overblown statistics and, in some cases showing women anti-abortion videos. This Channel 5 news report gives an idea of the kind of misleading information which may be given by a CPC.

Our concern is that suggestions that women need to look for independent pregnancy advice could open up the capacity of centres which offer biased information, driven by an agenda. Perhaps not the ‘financial incentive’ Dorries accuses abortion providers of, but an agenda nevertheless.