Tuesday 26 April 2011

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
Ante-Natal Results and Choices (ARC)

Tuesday 19 April 2011

Abstain from abstinence please Dorries

MP Nadine Dorries has proposed a ten minute rule motion:
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.

Monday 11 April 2011

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.

Monday 4 April 2011

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.