Wednesday 20 July 2011

Conscientious objection and the ‘looming crisis’ in abortion care

A recent survey of medical students in the UK has shown that a number of those questioned would object to providing abortion care in certain circumstances. The survey’s author Sophie Strickland believes these findings have worrying implications for the future of abortion care, with fewer future doctors willing to perform terminations. Indeed the dwindling numbers of doctors opting to train in abortion services has been labelled a ‘crisis’ in terms of women’s access as this article attests.

Dr Patricia Lohr, medical director of BPAS, takes a less pessimistic view of the survey findings:

“Importantly, this study suggests that many students surveyed would perform an abortion in a variety of scenarios. For example, just under 16% stated they would not perform a termination for fetal anomaly under 24 weeks gestation, implying that the majority would perform the procedure if necessary. Similarly, less than one quarter stated they would not perform an abortion before 24 weeks for a contraceptive failure suggesting that three-quarters of those questioned would. More research on the medical student attitudes and knowledge about abortion are clearly needed.”

She notes the importance of education and training in this area:

“It’s extremely important that abortion is included in the medical school curriculum. Medical students may not currently engage much with the reasons why a woman may find herself with an unwanted pregnancy and the decision making process women undertake when determining whether to continue or terminate a pregnancy. Abortion is the most commonly performed gynaecological procedure in the country. Regardless of whether a doctor specialises in this area or not, they will during their career come across many women facing an unintended pregnancy and considering abortion.”

The issue is not just with having fewer doctors willing to perform the procedure but also a lack of wider professional support for women’s right to choose abortion. Similar surveys of GPs have shown that almost a quarter refuse to refer women for abortions. (This form of conscientious objection is protected by the General Medical Council guidelines which state that a doctor has a right to refuse referral but is obliged to pass the patient on to a supportive colleague.)

Some doctors have religious or moral objections to abortion, others simply wish to specialise in areas of medicine with more prestige or social support but clearly there is an issue with the numbers willing to refer for or provide abortion versus the number of women requiring terminations. If we look to the States, where abortion doctors have been harassed and even killed for providing medical services we can see a resistant pro-choice medical movement which refuses to take the stigma and abuse lying down. Groups like Medical Students For Choice have been set up to encourage medical students to engage with the importance of reproductive health care and the potential erosion of vital services. Activist groups like Abortion Gang and I Am Dr Tiller write passionate blogs affirming the essential work abortion providers do. At a time of rising anti-choice sentiment in the UK perhaps it’s time we too started to see this work as not only essential but also laudable.

Monday 18 July 2011

Myth Busting Monday: Sex educators don’t tell young people about saying ‘no’ to sex

When Nadine Dorries proposed the motion to teach girls aged 13-16 ‘the benefits of abstinence’ she claimed that young people are ‘taught to have safe sex, but not how to say no’. Is this really the case?

The argument put forward by those who back abstinence-based sex and relationships education is often based on the misconception that SRE in schools is focused purely on teaching young people how to have sex, with no reference whatsoever to delaying or refraining from sexual activity. One member of the new abstinence-heavy SRE Council, Challenge Team UK claims:
‘By giving information about condoms and showing teens how to use them, adults who are the authority figures in teens' lives may be giving them, unintentionally, permission to have sex’.

In fact, good SRE is NOT about encouraging young people to have sex as soon as possible. Good SRE will always acknowledge the importance of having sex only when the time is right for you (and your partner/s). Good SRE will make clear that ‘sex’ isn’t necessarily just about male/female penetration and that there are many other ways (sexual and non-sexual) of showing someone affection and feeling pleasure. Good SRE will note that the legal age of consent for young people is 16, but that the age at which people feel ready for sex, or start to have sexual relationships can be different for everyone. Good SRE will of course stress the importance of only having the kind of sex you want to have at a time which feels right for you. And yes, good SRE will encourage the use of condoms (alongside other contraceptive methods) should this situation arise, as a way to reduce the risk of unplanned pregnancy and STI transmission. Good SRE will cover communication and relationships alongside consent – how to say yes, no, and ‘not now’!

Sex Educators aren’t telling young people about safer sex because they want them all to be having sex as early as possible. But because they live in the real world, where yes, some young people may already be having sex and need to know where they can access accurate information and advice. And because, well, the vast majority of young people they speak to in a school or youth centre will, at some point in their lives have sex. Just as with other aspects of education, we teach young people life skills which may not be relevant to them at this very moment but will almost certainly be relevant for their futures.

Wednesday 13 July 2011

‘Men have wombs too'

There were some great banners at the pro-choice demo on Saturday: see our photos of them here on Flickr. But one which stood out was a simple sign proclaiming that ‘men have wombs too’. Today’s blog attempts to unpick this slogan and look deeper at the intersections between pregnancy, sex and gender.

When most people talk about pregnancy they tend to focus on a female-born, female identified ‘woman’, generally assuming that this pregnancy has occurred because of penetrative sex between a ‘cis man’ and a ‘cis woman’ (see Scarleteen and Bish for a full explanation of ‘gender’ terms). These two people are also often assumed to be straight (see previous LGB blog for more on pregnancy and sexuality). Whilst this may indeed be the case the majority of the time, at EFC we think it’s really important to acknowledge the fact that some ‘men have wombs too’. But what exactly does this mean?

When delivering our Talk About Choice sessions in schools, more than once I have had young people ask me ‘if men can get pregnant’. There’s generally a titter, and somebody will reference a TV show in which they’ve seen a ‘pregnant man’ to back up their point. What these young people are generally referring to are trans men who have conceived and given birth. That is, someone who was born into a body typically read as ‘female’ but whose gender identity is male. Not all those who feel this discrepancy between their assigned sex and their lived gender will undergo full surgery (commonly known as ‘a sex change’ in the media) but some may choose to take hormones to affect secondary gender characteristics such as facial hair and a deeper voice, or may have a mastectomy and/or hysterectomy.

Some trans men retain their female reproductive organs and are able to conceive and carry a pregnancy to term, although they may have an outwardly masculine appearance. Thomas Beattie is an example of a trans man who has ‘gone public’ with his pregnancies although of course many more trans men become pregnant without such media attention. Trans men of course may choose to terminate a pregnancy, hence the banner which called out for the right to choose for all those who can become pregnant, male or female.

We believe it’s important for young people to acknowledge and understand the implications of sex, gender and sexuality with respect to pregnancy and are keen to address the diversity of those who are affected by pregnancy, abortion and childbirth.

Monday 11 July 2011

Myth-Busting Monday: 'Abortion is available "on demand" in the UK

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts. This week we're repeating a Myth Bust from last year: 'Abortion is available “on demand” in the UK'.
The term “abortion on demand” describes an abortion law that allows women to choose abortion without interference from legal or medical authorities, usually within a given time limit.  In the UK, most GPs will refer a woman who asks for an abortion (and those who don’t should make provision for the patient to access another doctor who will refer, in line with General Medical Council guidance).  Additionally, family planning clinics can also refer for abortion, and in some areas, central booking lines are available for patients to book their own abortions.  Nevertheless, abortion is not technically available “on demand” in England, Scotland and Wales (abortion is illegal in Northern Ireland). Two doctors must still authorise the abortion and there is a specific list of criteria that women must meet to access an abortion. The 1967 Abortion Act gives doctors the right to perform abortions legally under certain conditions. It does not provide women with the right to demand an abortion under any circumstances.  That said, any woman who wants an abortion within the legal time limit should be able to access one according to general medical guidance.

For more information on abortion in Ireland and Northern Ireland check out Abortion Support Network.

Wednesday 6 July 2011

Advertising Standards Authority rule against anti-abortion group

Advertising Standards Authority rules against anti-abortion advice centre

Just as the Government is considering changing regulations on abortion counselling and diverting women to alternative, ‘independent’ abortion advice centres, the Advertising Standards Authority (ASA) today upheld a complaint about an anti-abortion counselling centre. 

Education For Choice (EFC) made the complaint about an advert placed by the Albany Women’s Centre, an anti-abortion counselling organisation, on EFC objected that the ad was misleading, because it did not make clear that Albany Women's Centre was an anti-abortion group who would not offer impartial advice on abortions.

EFC made the complaint after their own enquiries found that women who attend this organisation for counselling about unwanted pregnancy may be given misinformation and subjected to biased views on abortion.

EFC Director, Lisa Hallgarten, said:

‘We are extremely pleased that the Advertising Standards Authority ruled against the advert. It is totally unacceptable that women seeking impartial support and evidence-based information to support them to make a difficult decision about pregnancy should be subjected to misinformation and bias. We are especially concerned about the effect of these services on young people’s ability to make decisions and access services quickly. 

We hope this ruling will draw attention to the fact that there are organisations on our high streets, which advertise pregnancy support and advice but which oppose contraception and abortion and whose intention is to obstruct or dissuade women from accessing these services. 

The Government is currently considering new regulations that will divert women seeking abortion away from the highly regulated abortion providers and towards ‘independent’ counselling organisations. We hope this timely ruling will encourage the Government to think carefully about who is providing these alternative services, what their motivation is for doing so, how transparent they are about what they really offer, and what quality of service women might expect from them.’

Sunday 3 July 2011

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.