Wednesday 27 June 2012

Today's BMA motion on pregnancy options counselling

Today, at the Annual Representative Meeting of the BMA, members voted in favour of the following motion:

That this Meeting:-
i) supports the universal availability of neutral counselling for women considering abortion;
ii) believes that any counselling provided for women considering abortion should accord with NHS
iii) believes that women considering abortion should be able to access counselling that is
independent of the abortion provider;
iv) deplores picketing and intimidation around abortion services.”

As the Telegraph reports:

“The option of counselling should be available for all women, and not mandatory as some politicians have called for, the British Medical Association annual representatives meeting heard.”

We’re glad to hear that doctors are supportive of neutral counselling for pregnant women which accords with NHS standards. We’re also pleased to see that there is no attempt to make counselling mandatory - not every woman wants or needs additional counselling when making her decision about a pregnancy and forcing women to access this service could simply provide unnecessary delay.

It’s also positive that the motion does not recommend stripping abortion providers of their role in counselling, as has previously been suggested by Nadine Dorries. Should they wish, women are of course currently able to access counselling independent of the NHS. However, this counselling will not be regulated in the same way as that taking place at official Pregnancy Advice Bureaux registered with the Department of Health. Our own research has shown that a number of independent centres offering pregnancy options counselling have given biased or inaccurate information and we therefore remain cautious about any attempts to dissuade women from accessing registered, trusted services. 

What is excellent to see is that the motion condemns the picketing and intimidation that has been taking place outside abortion clinics across the country. We know that women who feel comfortable about having made their own, informed decision about a pregnancy are those who have the best outcomes following either a choice to end or continue the pregnancy. It’s heartening that the BMA members acknowledge the detrimental effect harassment of pregnant women can have on their wellbeing and autonomy and how important it is that any counselling given is impartial and non-directive.

This reflects the GMC's guidance on personal beliefs and medical practice, which advises doctors that:

 "Patients have a right to information about their condition and the options available to them. You must not withhold information about the existence of a procedure or treatment because carrying it out or giving advice about it conflicts with your religious or moral beliefs."


Monday 18 June 2012

Mythbusting abortion and breast cancer link. Again.

Another day, another article linking abortion to breast cancer.

In the Catholic Herald today Francis Phillips states her reluctance to share fundraising emails for breast cancer charities with her friends due to their refusal to mention the ‘proved link between induced abortion and breast cancer.’ She claims that ‘the sadly high rates of breast cancer would drop significantly – if there were fewer induced abortions’.

Phillips wishes that cancer charities (and presumably medical professionals) would make women aware of this so called danger:
‘I wonder how many of the millions of young, confused and frightened women who every year seek advice on their pregnancies come away unaware of the medical dangers of abortion – dangers that may come back to haunt them in later life’.

So what’s going on? Why aren’t breast cancer charities warning women to stop having abortions? Why aren’t doctors informing women of the increased risk of cancer following abortion?

Well, because the evidence (and here we mean the robust, peer-reviewed, reliable scientific evidence) does not support such a link. Here are a few UK sources:

'There is no reliable scientific evidence to suggest that there is a link between abortion and breast cancer.' Breakthrough Breast Cancer

'A study coordinated by Cancer Research UK scientists and published in The Lancet has shown that pregnancies that end in miscarriage or abortion do not increase a woman's risk of developing breast cancer later in life... Professor Valerie Beral, Director of the Cancer Research UK's Epidemiology Unit at the University of Oxford, says: "This review of the worldwide evidence has shown that pregnancies that end in an abortion do not increase a woman's chances of developing breast cancer later in life."  Cancer Research UK

'Women should be informed that induced abortion is not associated with an increase in breast cancer risk.' Royal College of Obstetricians and Gynaecologists.

So why does this myth continue to surface? We’ve seen the link being made in school presentations developed by anti-abortion groups, but also in various newspapers. Google ‘breast cancer abortion’ and you get a big confusing mess of links to various scientific studies, anti-abortion sites and pro-choice blogs.

Breakthrough Breast Cancer has produced a leaflet on pregnancy and cancer which helps explain some of the confusion:

'Over the long term, having a baby reduces the risk of developing breast cancer and women who have their first child at a younger age have a greater reduction in their risk. For example, a woman who has her first child before the age of 20 has a lower risk of breast cancer than a woman who has her first child after 30 or a woman who has not had children at all.

The risk of breast cancer also slightly decreases the more children a woman has and the earlier she has them. In the short term, research studies suggest that a woman’s risk of breast cancer increases for a short time after giving birth. However, it is important to remember that breast cancer during the childbearing years is rare.'

So. The research suggests that carrying a pregnancy to term and giving birth (especially at a young age, or more than once) has a slightly 'protective' quality with regards to breast cancer. However,  a pretty big leap is being made when people flip this to suggest that abortion causes breast cancer. You don’t need to be Ben Goldacre to see that that’s just bad science.