Friday 27 December 2013

Tim Montgomerie - 'moderate' on abortion? Really?

Yes, we're still officially on holiday, but we just couldn't resist commenting on the recent 'OpEd' from Tim Montgomerie in the Times. It's behind a paywall here, but we've included quotes from some of the parts which are particularly problematic.

Montgomerie positions himself as being a 'moderate' voice on abortion, arguing that the debate only allows for 'hot and cold'. For starters, this seems to be a dishonest presentation of where he actually stands. Montgomerie is a patron of SPUC Evangelicals. SPUC (Society for the Protection of Unborn Children) is against abortion in ALL circumstances, and even believes that certain forms of contraception cause abortion. Members of SPUC Evangelicals believe that "the widespread abuse and destruction of unborn children [therefore] constitutes a flagrant offence against almighty God." So, although Montgomerie talks about lowering the time limit, or changing the law around termination on grounds of fetal abnormality it would seem his greater desire would in fact be to ban abortion completely (or he should have a re-read of the SPUC manifesto he endorses).

So let's look at some of the arguments he puts forward for 'tighter laws'. First, Montgomerie claims that 2013 "was the year when the reality of foetal “gendercide” within Britain surfaced — the deliberate, discriminatory termination of unborn baby girls". We've written about this before, but the 'reality' of 'gendercide' within Britain did not in fact surface. What surfaced was a 'sting' set up by the Telegraph where no abortions were actually performed. The Department of Health has reported a normal sex ratio for births in the UK.

Then, Montgomerie drags out an old Christopher Hitchens quote (also used by Mehdi Hasan in his anti-abortion piece last year, yawn) to argue that the public is becoming more 'concerned' about abortion:

“In order to terminate a pregnancy,” he said in 1989, “you have to still a heartbeat, switch off a developing brain, and, whatever the method, break some bones and rupture some organs.”

Well, not quite Hitcho. As we know, the majority of abortions in this country are carried out early on in pregnancy, when this simply isn't the case. We liked Edinburgh Eye's take on this:

Yes, that’s sometimes true. Of course, the earlier an abortion takes place, the less likely that it will be: the heart may not have developed, the brain may not yet exist, the bones and organs may still be so undeveloped that there is nothing there to break or rupture. But yes: terminating a pregnancy kills the foetus. 

But it’s also true that anywhere girls and women are denied the right to choose abortion, that denial of termination ensures that heartbeats are stilled, a brain is switched off, organs are ruptured: women die. As a woman I know wrote wistfully once, “Do you suppose if we pointed out that we have dear little faces and actual fingernails on our hands, that they’d care that we die?”

With regards to UK law, Montgomerie appears to support a reduction in the legal time limit for abortion:

"Others want a still earlier limit because of research that shows that even if the foetus is not viable outside the womb it can still feel pain."

In fact, the current time limit remains at 24 weeks because experts concluded that this is the limit of viability and that the best medical evidence does not support lowering this limit. The BBC reports on the Royal College of Obstetricians and Gynaecologist's findings that there is no fetal pain before 24 weeks gestation here.

Montgomerie tweeted "I don't think abortion should ever be 'easy'". In the article he suggests introducing 'fully informed consent' by showing women scans or images of fetuses: 

'A Michigan law based on this principle requires pregnant mothers to inspect “depictions, illustrations or photographs of foetal development”. Women are still in charge but are helped to fully understand what they’re choosing'.

Thanks Tim! Women (sorry, 'pregnant mothers' ) should be given picture books to fully understand what abortion is. Because, you see, they don't understand what they're choosing, but Tim does. Tim thinks some women should be allowed to have abortions (someone tell SPUC!) but only if it was made as difficult as possible for them, and it wasn't after 12 weeks, and the decision wasn't made due to a diagnosis of fetal abnormality.

He claims that the 'exception' in the UK law which allows for abortion after 24 weeks due to fetal abnormality "has produced an alliance between anti-abortion and disability rights campaigners". Perhaps we're reading the wrong blogs but we haven't seen evidence of this. In fact, many disability rights campaigners have stated their disgust with groups like SPUC co-opting disability rights campaigns to argue against a woman's right to access abortion. 

Either Tim Montgomerie should be more honest about his desire to make abortion completely illegal, or we would suggest that his reconsider his allegiance to SPUC, a group which aims to do just that.

Monday 2 December 2013

Double your donation to EFC!

We're excited to be part of the Big Give Christmas Challenge this year. If you want to support our work with young people please read on for information on how donations you make this week can be doubled!

You can read more about the Christmas Challenge here but basically, if you make a donation to EFC on the 5th, 6th or 7th of December it has a chance of being doubled, thanks to matched funding from a generous individual donor and our 'Charity Champion' the Cabinet Office.

These matched funds are released at 10am on Thursday, Friday and Saturday this week. In order to access these funds it's important to try and make a donation as close to 10am on these mornings as possible. So please set a reminder to yourself to visit the Big Give donation page at this time to make a donation!

As always, your donations will go directly towards our work advocating for young people's right to evidence-based information about pregnancy options. If you have any questions about making a donation please email or call 0207 284 6056.

Thanks for your support!

Wednesday 13 November 2013

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.

Thursday 5 September 2013

Sex-selective abortion in the news

Health Secretary Jeremy Hunt is upset that the two doctors involved in the Telegraph’s 2012 sex-selective abortion ‘sting’ have not been prosecuted, and is seeking ‘urgent clarification’ on the case. The Crown Prosecution Service (CPS) has stated that it is not in the public interest to prosecute the doctors and has referred the case on to the General Medical Council (GMC). As far as we know the doctors have already had conditions put on their registration to prevent them from work involving abortion.

Over in the Telegraph’s ‘Wonder Women’ section, journalist Cathy Newman claims that “wherever you stand on abortion, it's extremely hard to understand why the Crown Prosecution Service has decided not to press criminal charges against doctors who agreed to arrange terminations because of the sex of the unborn baby.” Both Newman and Hunt forcefully assert that "sex-selection abortion is banned in the UK under the terms of the 1967 Abortion Act" and is "against the law". Newman goes on to claim that “there's growing evidence (sex selective abortion is) also carried out illegally in communities in this country.” 

So, what is the law around sex selective abortion? And is it happening in the UK? Why haven’t these doctors been thrown in jail?

First of all, it’s important to note that these cases were not of women actually requesting sex-selective abortions. This was an artificial situation set up by the Telegraph, where undercover journalists underwent consultations and filmed the results, something the CPS seem to have taken into account: “in these cases no abortions took place or would have taken place.”

Secondly, the law around abortion and sex-selection is a lot more complicated than these articles imply. As our blog from last year points out, the 1967 Abortion Act does not specifically prohibit abortion for this reason. However, abortion is a criminal act unless certain grounds are met. The majority of abortions in the UK are performed under Ground C: ‘the continuation of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.’ This ground could cover a number of individual circumstances and it is left to doctors to decide which of these satisfy the legal criteria for abortion. As legal abortion is statistically safer than childbirth, some doctors may consider this ground legitimate for women who do not provide further ‘reasons’ for their abortion, other than a desire to end the pregnancy. There is more information about the law in this article by Professor of Law Sally Sheldon.

Thirdly, it is not clear what ‘evidence’ there is of sex-selective abortion happening in the UK. Certainly two journalists requesting abortions they don’t intend to have is not evidence that women in the UK are actually having abortions due to sex selection. The Government’s investigation into the issue showed that the UK’s "gender ratio" is "well within the normal boundaries for populations".

In an older article for the Wonder Women section of the Telegraph Emma Barnett explores this very difficult issue and concludes that, "abortion laws don't need to change: attitudes towards girls do... it’s so important that abortion remains legal, above board and crucially transparent...Pushing abortion into the backstreets would help no one." We need to remain aware of the nuance in this debate and avoid sliding into anti-choice rhetoric which in reality does not support women to make the decision to have an abortion in any circumstance.

For more information, read the EFC blog on this issue from last year, when the allegations first arose.

'Women with money have options, women without money have babies'

This is a guest blog from Mara Clarke, founder and director of the Abortion Support Network.

What would you do if the condom broke? If your pill hadn't worked? If you had been raped? If you were faced with an unplanned, unwanted pregnancy? What would you do?

If you lived in England, Scotland or Wales, you could go to your GP or your local sexual health clinic, and get a referral for an abortion. You could do this regardless of your race, class, financial situation, or age. You could make this decision on your own, or with the support of your parents, or friends.

But what if you lived in a country where abortion was illegal? And you couldn't tell your parents? And your boyfriend threatened to paint “murderer” on your house, if you had a boyfriend? And you had no money? And no credit card, passport or photo ID?

Abortion is virtually against the law in Ireland and Northern Ireland. This is the case whether you are pregnant as a result of rape, whether the foetus has catastrophic abnormalities, if the woman involved is 14, or if, like most women having abortions, it simply isn't the right time to have a baby. But of course as we all know, making abortion against the law doesn't stop abortion from happening. It just means that, when faced with an unplanned, unwanted pregnancy, women with money have options and women without money have babies – or do dangerous and desperate things.

This is even more true for young women living in Ireland and Northern Ireland who need abortions. Because of the stigma, many of these young women aren't able to tell friends or family members. And yet somehow they need to raise the £400 to £2000 it can cost to travel and pay privately for an abortion.

Abortion Support Network is a charity that provides financial assistance, accommodation and confidential, practical information to women from Ireland and Northern Ireland forced to travel to access a safe, legal abortion. Since launching in October of 2009, we have heard from almost 1,000 women. More than 250 of those calls have been from women and girls under the age of 25. At least 30 of those were aged 16 or under.

Here’s an example of what these young women have told us:
“I can’t have this baby, I've been trying to get money together and I told the father and he left me. I'm in college and have no money. I depended on my parents and they will disown me if they knew I was pregnant. I'm getting really worried and I don’t know what to do. Anything will help. I know my time is nearly up so I'm beginning to really worry, I know I shouldn't have left it this long but this is my last option and I can’t have this baby.”
“If my parents find out I've had sex, they’ll kill me. I'm not kidding.”
A young teenager whose mother called us in desperation. The pregnancy was a result of rape and her daughter was severely self-harming.
“I'm 19 and a student and I'm approximately 18 weeks pregnant. I can’t financially and emotionally support a child so I'm planning on having an abortion. The problem is my partner and I have both been saving and scraping money together but we’re still short. I was enquiring as to whether we could get any assistance, be it monetary or just providing us with somewhere to stay when we get there.”
A young teenager with medical complications that could have been compromised by continuing her pregnancy. She and her boyfriend both sold their electronics in order to raise £100.
“I'm a college student and I'm pregnant. I can’t tell a soul and I'm devastated. My parents work so hard to put me through college that I can’t drop out to have a child. Never mind afford to support a child, nor necessarily want one at this stage in my life. Is there any assistance I could have or even an ear?”
A young teenager with an abusive ex-boyfriend. He was threatening her, to try and make her continue with the pregnancy. Her family were not in a position to provide support, emotionally or financially, a family friend put herself in debt to help with the costs but was still unable to provide the full cost.
“I'm growing more desperate by the week. I'm 6 weeks pregnant with an unwanted baby that I cannot have for financial and personal reasons. My boyfriend is unwilling to help with the costs of the abortion, as are my parents and his family. I have to cover this entire cost by myself and I am an unemployed student who will probably be homeless before long. Please let me know if there is anything you can do to help.”
These young women came from all parts of Ireland and Northern Ireland. Some had support and others didn't. Many had to delay their abortions as they tried to raise the necessary funds, causing even more expense as the price of abortion rises with gestation.

But what did these women have in common?

They were pregnant.
They didn't want to be pregnant.
They were poor.
And not a single one of them thought they would ever be in a position where they would have to call a total stranger in another country to ask for money for an abortion.

Mara Clarke is the founder of Abortion Support Network, an almost entirely volunteer run charity that helps women travelling from Ireland and Northern Ireland to access a safe and legal abortion. To find out how you can help or to sign up for their monthly eNewsletter visit or follow @AbortionSupport on Twitter.

Friday 23 August 2013

Feminism, Catholicism and Abortion

This post is a response to the interview with Caroline Farrow, a ‘pro-life feminist’ on the Faith in Feminism blog.

We are always interested to hear from people of faith on the ways in which their religion or spirituality plays into their thoughts on abortion and reproductive rights in general. In the pro-choice movement, people are often too quick to assume that all Christians, or all Muslims would automatically be against abortion. In fact, religious teachings vary, with many allowing for abortion in certain circumstances (and nearly always with regards to protecting the pregnant person’s health).

The Catholic Church however does prohibit abortion in all circumstances. Abortion, along with contraception and masturbation is forbidden by the church. However, this doesn't mean that Catholics do not masturbate, access abortion or use contraception to control their reproduction.

A 2011 report by Catholics For Choice showed that 98% of Catholic women in the U.S have used a form of contraception banned by the Vatican. Catholic women have abortions at the same rate as non-Catholics, and 86% of those surveyed disagreed with the church’s teaching on abortion.

These figures show us that individuals use their own personal conscience to make decisions which affect their lives, and their families. Farrow makes a convincing case for ‘Natural Family Planning’ (NFP) (which is indeed extremely effective if practised properly) and this may well be a favourable option for those who wish to avoid pregnancy without using condoms or hormonal methods of birth control. However, clearly, for many Catholic women other forms of contraception have proven to be a better fit for their lifestyles.  A pro-choice point of view would acknowledge the importance of allowing these women to make the choice which is right for them. If they wish to follow the church’s teachings and practice NFP, great, let’s make sure they have the support and information they need to do so. If they want to try other methods, or use condoms to help protect against STIs, then this should also be accessible for them.

Unfortunately a pro-life perspective tends to mean that this choice (which many make already, regardless of what their religion teaches) is disregarded and taken away. A ‘pro-life’ point of view holds that doctors were right to deny Savita an abortion because “it is not ethical to induce delivery of an unborn child if there is no prospect of the child surviving outside the womb”. An individual might decide that they would never have an abortion in any circumstance, but as soon as this decision is projected and extended to others it limits human rights. It limits women’s rights.

Farrow herself is extremely supportive of the 40 Days for Life ‘vigils’, which aim to shut down abortion clinics and therefore restrict women's access to abortion. Standing outside abortion clinics praying for women who have made a decision, which may or may not have been difficult for them, smacks of a desire to project one’s own position onto others, believing them unfit to decide for themselves. 

Wednesday 7 August 2013

"How to get rid of a pregnancy"

Having seen people tweeting about the weird and wonderful ways readers reach their blogs, we decided to delve into our own statistics to see what people have been typing into Google to end up at this blog. 

Although of course plenty reached the EFC blog through links on other sites, or searches like 'abortion education in schools', one of the most common searches was the phrase 'how to get rid of a pregnancy'. Other popular searches included variations on 'pills to get rid of pregnancy'. Further investigation showed that quite a few people reached the EFC blog through a link on which lead to this Mythbusting Monday post about medical abortion, explaining why the phrase 'abortion pill' can be misleading (Early Medical Abortion is actually a process involving two lots of medication, and two to three visits to a clinic, rather than just 'taking a pill').

It was sobering to realise that many people visiting this blog are not just looking for general information related to work or study but are likely themselves facing an unwanted pregnancy and unable to access the medical support they need to have an abortion. Sobering, but not all that surprising when you know that a decent proportion of visitors to this blog are from the USA and Ireland.

As you may know, although abortion is legal in the United States, access is severely restricted in some areas, meaning that those seeking abortion (especially poorer women) may look for 'cheaper' methods of ending a pregnancy, such as buying medication online. This graphic shows the varying levels of abortion access in the U.S - with mandatory waiting periods or insurance restrictions being enforced in many States, access to safe, legal abortion can be difficult.

Ireland, in turn, has one of the world's most restrictive abortion laws. Abortion is only available to save a pregnant person's life. Last year, almost 4000 women travelled from Ireland to England and Wales to have an abortion. Again, these women will have needed the financial means to pay for the procedure itself as well as transport and associated costs. Although the Abortion Support Network has been set up to help these women pay for the procedure, it can't support everyone. A recent article in Vice argued that more and more Irish women are turning to the internet to purchase abortion medication to administer themselves. The article points out that women taking this route are not recorded in the official statistics, although with hundreds of packages of such medication being seized every year, the number is clearly significant. 

Of course, ordering and using this medication is illegal in Ireland. But it seems that some are desperate enough to try to end a pregnancy even via methods which could put them in prison. And this is not just true of women in Ireland, or the U.S, but anywhere where abortion is illegal or restricted. And as the Guttmacher Institute makes clear, this method can be safer than traditional 'backstreet abortions' performed in unsanitary conditions: "In settings where abortion is illegal or highly restricted, it (abortion medication) has provided many women for the first time with a safe and discreet means for early termination of unwanted pregnancy." Safe Abortion Hotlines in places such as Chile, Poland and Kenya show that  where abortion is illegal or very severely restricted, there will still be women who find ways to end their pregnancies.

Unfortunately we were not surprised to see that some of these women had found their way to our site through searches for information on unwanted pregnancies which they cannot end in registered medical establishments, either due to legal, practical or economic constraints.

Wednesday 17 July 2013

The ‘Parliamentary Inquiry’ on Abortion and Disability

Today, anti-choice MP Fiona Bruce launched a report entitled ‘Parliamentary Inquiry into Abortion on the Grounds of Disability’. This is an unofficial inquiry, not sanctioned by Parliament, but rather the outcome of a special interest group of anti-choice MPs getting together to discuss abortion on the grounds of fetal abnormality. Although evidence was accepted from a range of individuals and organisations (including Brook and fpa) that which is presented in the report, and the final recommendations, are heavily weighted towards those who would like to see the legal right to terminate a pregnancy due to serious fetal abnormality removed completely.

A quick glance at the list of written submissions tells you a great deal about the inherent bias in this inquiry. The majority are from ‘pro-life’ organisations which believe that abortion should be illegal in every circumstance - SPUC, Life, ProLife Alliance, No Less Human (which is actually SPUC, but hey, have two submissions guys!), Image and Pregnancy Helpline, Christian Medical Fellowship, and the list goes on. Throughout the report, submissions from individuals with no professional background, and from anti-abortion lobby groups are given greater emphasis than medical experts and respected bodies such as the British Medical Association, the Royal College of Nurses and the Royal College of Obstetricians and Gynaecologists. The report uses this biased presentation of evidence to argue that “allowing abortion up to birth on the grounds of disability is discriminatory” and recommends that Parliament considers reducing the time limit for abortion on the grounds of disability or repealing this ground completely.

There is a suggestion that the current law, which allows for abortion after 24 weeks where there is a substantial risk that if the child were born it would have serious physical or mental abnormalities, is "contrary to the Equality Act 2010". This is nonsense. The law does not consider a fetus to be a legal person until birth, so the Equality Act does not apply. The further ‘evidence’ is mostly a mixture of:

•    Dodgy statistics - anti-abortion campaigner Patricia Casey is quoted as saying that "at the time of abortion 40% of women will be experiencing mental health symptoms" and links abortion for fetal abnormality to depression and post traumatic stress disorder with no reference given for this claim.

•    Emotive, inappropriate language – phrases like “not allowing doctors to deliberately kill any baby after viability” pepper the report and are a sign that the focus is not on professional medical analysis of the complex facets of abortion law and practice.

•    Anti-abortion bias – this is not surprising in a report formed by groups and individuals opposed to abortion in every circumstance. Life’s written evidence that abortion for fetal abnormality "overlooks the fact that the unborn child is as much the doctor’s patient as is the mother" is included alongside personal testimonies from parents who claim they were pressurised into having an abortion, and received little support from medical professionals with their decision to continue the pregnancy.  The fact that one of these parents, Lynn Murray, has been a member of SPUC for over 18 years, is not declared. Many of the members of the Commission have a history of anti-abortion campaigning – one example is Lord McColl, a patron of the Centre for Bioethics and Public Policy which runs Abort67 in the UK, who you might know as the group which holds up gory posters of supposed aborted fetuses outside abortion clinics. Hmm.

So we’ve established that this is essentially the position of a minority group of anti-choice MPs and campaigning bodies, which does very little to present the views of the experts who work in this field with the necessary authority that they deserve. However, it’s already being reported as if it were a neutral cross-party inquiry with the backing of the BMA. It’s important that:

•    This is not regarded as an official parliamentary inquiry, which accurately reflects the views of a range of bodies involved in reproductive care, disability campaigning and fetal medicine.

•    It is not used as evidence that the right to abortion on the grounds of fetal abnormality is ‘discriminatory’ or causes discriminatory attitudes towards people with disabilities. There are some excellent blogs on this subject which you might want to have a look at for more discussion of this (Frances Ryan in The Guardian, and Nicky Clark’s blog are good places to start).

•    The real people making decisions about often much wanted pregnancies are not forgotten in this. Abortions performed after 24 weeks are extremely rare (they made up less than 0.1% of all abortions last year) and are a result of considered choices regarding health, quality of life, existing children and many other factors. One parent in the report says: “Please understand that finding out that your unborn baby has a serious disability is one of the hardest things that a parent can hear. Please don’t make it any harder by taking away our right to choose”.

•    Those who do choose abortion, and the doctors who support them are not demonised. Underlying this report is an implication that doctors are pressurising women into choosing abortion where there is a diagnosis of abnormality. We believe it is important to trust women making these tough decisions, and to trust doctors to give the information and support they require to make an informed choice. The wonderful Antenatal Results and Choices exists to provide further support to those individuals and couples faced with making such decisions.

For further information on this inquiry and the backgrounds of those involved, have a look at this blog from the Ministry of Truth.

Thursday 11 July 2013

2012 Abortion Statistics

The latest statistics on abortions carried out in England and Wales were released today. The main findings are summarised below but you can view full information (including data tables) here. This year, the Department of Health also carried out a consultation on changes to the publication of abortion statistics, the results of which can be found here.

•    The 2012 abortion rate for all ages is 16.5 per 1,000 women – the lowest rate since 1997 and 6% lower than in 2011. The abortion rate was highest for women aged 21 (31 per 1000 women).

•    The under 16 and under 18 abortion rates were slightly lower than in 2011 (3 per 1000 and 12.8 per 1000 respectively).

•    The number of abortions taking place under 13 weeks gestation remains at 91%, and 97% of abortions were funded by the NHS. The percentage of medical abortions also remains consistent, at 48% (47% in 2011).

•    In 2012, 52% of women undergoing abortions had one or more previous pregnancies that resulted in a live or stillbirth.

A significant difference from 2011’s data is the number of non-resident women accessing abortion in England and Wales:

•    In 2012, there were 5,850 abortions for non-residents versus 6151 in 2011. The 2012 total is the lowest in any year since 1969.

The majority of non-residents accessing abortion in England and Wales are from the Republic of Ireland and Northern Ireland (making up 83.6% of the total number of non-residents in 2012). It’s unclear as to why this figure is lower than it has ever been but it’s possible that more women in Ireland are accessing medical abortion online; rising awareness of services like Women on Web through public campaigns may mean that more Irish women are using illegal methods to end their pregnancies rather than face the cost and difficulty of travelling abroad to do so.

Another interesting statistic which deserves to be unpicked is the over-representation of certain ethnic groups in the abortion statistics, particularly with regards to those women who have more than one abortion.

As you can see from the table, women who are of Black or Mixed ethnicity are more likely to have had one or more previous abortions than women of other ethnic backgrounds. The statistics do not tell us why this is, but we might question if the information provided to particular communities on contraception and abortion is relevant and accessible. We know that there are links between ethnicity and deprivation, and between deprivation and unintended pregnancy so this too might be a factor. More research is clearly needed  into the intersections between ethnicity, unintended pregnancy and abortion, but in the meantime, it is crucial to note that women from all backgrounds can and do experience unintended pregnancy and abortion and we should not shy away from providing culturally appropriate, evidence-based information in every setting.

As a result of the consultation on the publication of abortion statistics a few changes have been made, the most significant of which being local level statistics being presented by CCG (clinical commissioning groups) rather than PCT (primary care trust) data due to the changes to the health system.

One interesting aspect of the consultation was to see the number of anti-abortion groups which had responded, a number of whom requested information on fetal sex to be represented in the abortion data. This is presumably a response to recent scaremongering suggesting that 'sex selective abortions’ were taking place in the UK (despite the Department of Health’s own 2013 report finding that the UK’s ‘gender ratio’ is "well within the normal boundaries for populations").

The response to the consultation gives a firm response to this request:
"Information about the sex of the foetus and NHS number are not currently collected on  the HSA4 form. To collect such information would require changes to the  legislation, in  particular the Abortion Regulations 1991, as well as to clinical practice. This is not in the scope of this consultation. The majority of abortions take place before 10 weeks gestation and it is not currently possible to identify a foetus’s gender at that stage. Identifying the gender of aborted foetuses over 10 weeks’ gestation raises ethical and clinical issues. The Government has no plans to introduce such a practice."

Friday 5 July 2013

What the SPUC?

We regularly get requests from teachers across the country who are looking for a ‘pro-choice’ speaker to come in and balance out a talk on abortion from a ‘pro-life’ group. We’ve written before about EFC’s general concerns with this approach. Namely that a ‘debate’ around abortion can be confusing and stigmatising for young people, and rarely provides them with the factual information they need for living their lives (especially when we know that a third of women have an abortion).  This blog gives specific examples of the issues involved when inviting the most well-known anti-abortion group, SPUC, to a school. The teachers I speak to are rarely aware that SPUC runs an outspoken campaign against same-sex marriage and that the information they use regarding contraception and abortion is very often at odds with the medical establishment. So here is the lowdown:

•    Misinformation about abortion
SPUC’s educational materials make claims about abortion which are not supported by medical experts. For example, they link termination of pregnancy to ‘post-abortion trauma’, which is an invented medical condition, and claim in their student pack that 'the risk of ectopic pregnancy may increase up to 30% after a first abortion and 160% after two or more'. The Royal College of Obstetricians and Gynaecologists (who tend to know about such things) state that there is no evidence for a link between abortion and subsequent ectopic pregnancy. A SPUC speaker also made misleading links between abortion and breast cancer at a Cambridgeshire school last year.

•    Misinformation about contraception
SPUC’s booklet ‘Birth control methods which can cause abortion’ suggests that all forms of hormonal contraception can act as abortifacients. This is based on the belief that pregnancy begins at fertilisation, rather than implantation, which is unsupported by the law and established medical practice.

•    Stigmatisation of abortion and use of distressing images
The SPUC speaker in Cambridge told students that 'rape is the ultimate unplanned pregnancy...for some people who’ve been raped and had the baby, even if they don’t keep it, something positive comes out of that whole rape experience'. SPUC's student pack claims that 'pregnancy as a result of rape is extremely rare...the extreme physical and psychological trauma of being raped makes it difficult for fertilisation or implantation to occur.' This is untrue and may be upsetting for those who have experienced rape. SPUC has a history of presenting information to young people in a way which can be distressing. As far as we know, SPUC continues to use graphic images in its school workshops, and images of aborted fetuses remain on the ‘education’ section of the website, likely to be used by young people for school projects.

•    Stigmatisation of same-sex relationships and family units

SPUC currently runs a campaign against the legalisation of same-sex marriage, which it claims would increase numbers of abortions. John Smeaton, the director of SPUC, states the following on his blog:
“The fundamental argument against gay marriage is that homosexuality is disordered, as it is radically at variance with the truth and meaning of human sexuality ... Catholics must proclaim loud and clear that it is impossible for any homosexual relationship to be a marriage because genuine personal, sexual and spiritual union between persons of the same-sex is impossible.” SPUC has also made statements against same-sex couples adopting, claiming that ‘lesbian parentage is not in the best interests of children’.

•    Opposition to sex education
SPUC fronts the ‘Safe at School’ campaign which lobbies against so called ‘explicit’ sex education in schools. A recent blog claims that sex education lessons tackling pornography are ‘about dangling porn in front of young school pupils and encouraging them to embrace it in their lives.’ The group has expressed concern about sex education materials which ‘include explicit images of male and female sex organs, lessons on menstruation in mixed classes (boys and girls)’ and has labelled masturbation‘intrinsically unethical’.

SPUC are extremely well funded and do not charge for their schools work. They regularly contact schools with the offer of a free speaker on this tricky subject and it’s understandable that many teachers decide to run this lesson using an external organisation. However, we would advise all teachers to think carefully about how such an organisation might fit with their school’s SRE and equality and diversity policies, as well as their commitment to the well-being of their students, some of whom may already have experience of abortion, and many of whom will definitely go on to.

If SPUC has visited your school, we’d be interested in hearing what you thought about the lesson.
SPUC leaflet opposing same-sex marriage

Wednesday 3 July 2013

Being an EFC Youth Advisor

Holly, one of EFC's new Youth Advisors, reports back on the training she attended and what she hopes to get out of her time volunteering with us...

EFC Youth Advisors at the recent training day
A great evening of sweets, chocolate, fruit and lively conversation. For many this was the first time everyone had met the group of people they were going to be spending quality time with once a month.

It was great hearing such a range of opinions and seeing lively debate spark off in regards to some topics that many people find controversial. Knowing that everyone could speak openly about their opinions without fear of being told they were wrong and the general supportive atmosphere meant there was ample opportunity to get your voice heard.

New facts I learned from the training: Canada has no time limit on abortion. In America the nearest clinic can be up to 50 miles away which means it is not easily accessible for many women with unplanned pregnancies. The criteria for a doctor to carry out an abortion in the UK can seem incredibly severe but there is liberal room for interpretation. I feel incredibly lucky to live in a country where the clinics and doctors are easily accessible, though I’m aware that there’s a lot of work to be done about misinformation and the myths that surround abortion.

I look forward to the next meeting for more interesting conversation and to get to know what makes everyone else tick in the group when it comes to abortion.

Tuesday 11 June 2013

Become a pro-choice pal and support EFC

We all know someone who has had an abortion. A third of women in the UK will access the procedure at some point in their lives, yet it remains a subject too ‘controversial’ or ‘sensitive’ to be spoken about in many homes, schools and communities. Unfortunately this stigma and silence provides fertile ground for myths and misinformation to grow. The internet is awash with false information and distressing images of abortion, and anti-abortion organisations run ‘crisis pregnancy centres’ which mislead and frighten women in an attempt to persuade them not to end their pregnancies.

Many people are shocked to discover that these same groups are also invited to speak in schools across the country. Unfortunately the anti-choice movement in the UK continues to use misinformation to promote its point of view. Young people are being told that abortion may increase their risk of getting cancer or of becoming infertile. They are told that contraception ‘is wrong and threatens health’. These groups have substantial funds to deliver such work - SPUC has an annual turnover of over £1.7 million and Life recently received £300,000 of Big Lottery Funding.

We’re here to speak out against this misinformation and stigmatisation of a choice that half of pregnant teenagers will make. We advocate for young people’s right to evidence-based, impartial information on their pregnancy options, and provide training and resources to enable professionals to help young people making tough decisions about pregnancy. We know we have support from a wide range of parents, teachers and health professionals. But we need donations to ensure that this work can be carried out; so that EFC can continue to be the small project which, according to our charity patron Polly Toynbee, ‘packs a big punch’.

Help us continue our work with the media, professionals and policy-makers to ensure that young people’s right to reliable information on pregnancy and abortion remains on the agenda:

•    Become a pro-choice pal and make a small regular donation
•    Volunteer, and raise awareness of EFC’s work and resources as a Champion For Choice
•    Spread the word and ask your friends and contacts to support our work

 Our donors say:
“Without Education for Choice too many young women wouldn't know where to turn when faced with a crisis pregnancy.  Keep up the excellent work!”
“A small regular donation because you shout loudly when often I just don't seem to have the time or energy to add my voice - thank you.”
"Keep doing what you do. Young people need evidence based education about sex & pregnancy."

Thursday 30 May 2013

Henry Morgentaler and abortion in Canada

This week, Dr Henry Morgentaler died at the age of 90. Not many people here in the UK have heard his name but he is an extremely important figure in the abortion rights movement.

Born in Poland, Morgentaler’s Jewish family were sent to Auschwitz in 1944 – his mother and sister died there. Morgentaler survived both Auschwitz and Dachau and eventually settled in Canada where he graduated from the University of Montreal as a medical practitioner. When contraception was legalised in 1969 he began to specialise in ‘family planning’ and was one of the first Canadian doctors to provide IUDs and contraceptive pills to the unmarried.

On behalf of the Canadian Humanist group to which he belonged, Morgentaler spoke at a House of Commons meeting in 1967, stating his belief in the importance of safe, legal abortion for women. This appearance led to him being inundated with requests to perform abortions (at the time the procedure was illegal, except to save the woman’s life) which at first he refused, through fear of prosecution. However, through his medical practice he encountered a number of women who had suffered from botched illegal abortions and saw, first hand, the effect this lack of access had on their health and lives. In 1968 Morgentaler performed his first abortion at his private clinic, for the 18 year old daughter of a friend. He said:
 “I decided to break the law to provide a necessary medical service because women were dying at the hands of butchers and incompetent quacks, and there was no one there to help them...The law was barbarous, cruel and unjust. I had been in a concentration camp, and I knew what suffering was. If I can ease suffering, I feel perfectly justified in doing so.”
In 1969, the law changed to allow abortion, but only in hospitals, and where a woman’s request had been approved by a committee. However, the majority of hospitals did not have such a committee, and many did not meet, so women in these areas were still suffering from a lack of legal access to abortion. Morgentaler’s abortions remained illegal under this law, and he risked life imprisonment as well as physical attacks and death threats in order to challenge the law and provide safe, legal abortions to the women he saw in his clinics.

When Morgentaler was put on trial in the 1970s his lawyer argued the ‘defence of necessity’ – that as a doctor, Morgentaler’s responsibility was to safeguard the health and life of his patient, overriding legal restrictions which might conflict with this. Despite being acquitted by a jury, he was sentenced to 18 months in prison and underwent a number of trials and appeals to challenge the existing law. Eventually it was the public support for legal abortion, and for Morgentaler’s campaigning and actions which led to abortion becoming legal in 1988. Public juries repeatedly acquitted Morgentaler and polls found that a vast majority of Canadians believed abortion should be a decision made by a woman and her doctor. The Supreme Court ruling in 1988 essentially removed all criminal restrictions on abortion, leaving it to be governed by Canada's laws concerning medical practice (as with other medical procedures).

The Chief Justice in this case said at the time:
"Forcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of her security of the person."
Canada remains one of the few places in the world where there are no legal restrictions on abortion. Many worry that a lack of such restrictions will lead to an increase in abortions, but this is evidently not the case:
In Canada, the teenage birth and abortion rate is 27 per 1000 women between the ages of 15-19 versus 61.2 per 1000 women in the United States.

The abortion rate among all women of reproductive age (15-44) in Canada is 14.1 per 1000 versus 20 per 1000 in the United States. (Stats from Dr Jen Gunter).

Friday 24 May 2013

What are the factors most strongly associated with teenage pregnancy?

The Centre for Analysis of Youth Transitions released a report this week which links teenage conception data to the education records of all girls attending state schools in England. It looks at associations between pregnancy and individual and social factors such as absenteeism and deprivation. As it’s a 53 page document we’ve put together a brief summary of the findings here.

This Department for Education funded report compares information on teenage pregnancy (number of conceptions, conceptions leading to maternity or abortion) to data from English schools (pupils who are eligible for free school meals, who are frequently absent, who have special educational needs etc). For those of us working in this area, the key findings are not all that surprising:
“Teenage conception and maternity rates are higher in deprived areas”
“Girls who attend higher performing schools are less likely to conceive, and more likely to have an abortion if they do conceive”
We know already that teenage pregnancy relates to particular social factors, and that young women in deprived areas are more likely to get pregnant, and when pregnant more likely to continue the pregnancy and become young parents. A 2004 study looking at national variation in teenage abortion and motherhood found that “abortion proportions and social deprivation are strongly correlated”, and that young women’s socio-economic backgrounds are a strong influence on their decision to continue or end a pregnancy. The researchers interviewed young people who had had abortions/given birth and their responses give a fascinating insight into the inevitability of particular pregnancy choices for young women:
“There was no question of me keeping it because I knew I was going to go to university...I didn’t want a baby...I’d had a good education and I had a career path to go down, it was all laid out for me.”
This latest piece of research found that eligibility for free school meals and being persistently absent from school were the factors most strongly associated with teenage pregnancy and the decision to continue with a pregnancy. Those who are eligible for free school meals are more than twice as likely to conceive as those who are not. This is important information for anyone working in sexual and reproductive health and education services, and clearly there is a need to think about making these services truly accessible to young people outside of school, through outreach and non-educational settings.

Although we know there are important individual and social factors to consider when planning work which aims to prevent unwanted pregnancies, one finding from the study bears highlighting:
“Teenage conceptions occur in all social groups, areas and types of school. Similarly, teenage conceptions occur in rich and poor areas and in schools with high and low levels of attainment: no characteristic provides complete “protection” from teenage conception”
In other words, there are no young people who don’t need (and deserve) evidence-based and accessible information and support with pregnancy and pregnancy decision-making. In an ideal world, this information would be available to young people in and out of school, regardless of their ethnic and social background.

Wednesday 22 May 2013

Bipolar and pregnant

Thank you to guest blogger Zoe for allowing us to share her thoughts on the recently reported case of a woman who was granted legal access to abortion following a challenge to her ability to consent. This is cross-posted on Zoe's own blog 'The Fementalists'.

Today a woman, identified only as “SB”, won her High Court battle to be allowed to have an abortion. This fact may seem strange to many readers as since the Abortion Act was passed in 1967 legal abortion has been mostly accessible to women in England, Scotland, and Wales . However, the woman at the centre of this case has bipolar disorder and it was argued by doctors and her family that she lacked mental capacity to consent to the procedure. Lawyers representing the health authority told the judge “she is believed to lack the capacity to make a decision regarding the termination of her pregnancy due to her mental disorder.'' Fortunately, the judge disagreed with this assessment, stating that it would be "a total affront" to her autonomy to decide that she was unable to have an abortion.

I have been following this case closely as I also have bipolar disorder and as a young woman with a male partner I worry a lot about the possibility of an unplanned pregnancy, to say nothing of worrying about what my future holds in terms of planned pregnancy. It was stated in the Court that the woman in this case had stopped taking her medication and thus relapsed, culminating with her being detained under the Mental Health Act. However, many medications for bipolar are not suitable to take when pregnant as they can cause birth defects such as neural tube defects, heart defects, and developmental delay or neurobehavioural problems. Thus many people have to stop taking their medication if they wish to continue with their pregnancies. This is believed to be what happened in the “SB” case. While this may seem like a relatively minor thing, the consequences of this can be devastating. Rates of relapse into bipolar mania and psychosis are estimated at 50% to 75% respectively and WebMD states that Pregnant women or new mothers with bipolar disorder have seven times the risk of hospital admissions than pregnant women who do not have bipolar disorder.” So clearly the risk of being detained under the Mental Health Act also greatly increases during pregnancy because of the additional problems caused by stopping medication.

For me, this represents the nightmare scenario. Finding myself pregnant with a wanted foetus only to stop my medication, relapse and be detained under the Mental Health Act, and to then decide that for my own health I would like a termination and be denied it because it is argued that I lacked capacity. It is truly a terrifying prospect to find yourself unable to control your own body because you have a mental illness. Much more needs to be done to provide perinatal care for women with severe and enduring mental illness to ensure that a situation like this never arises again. Fortunately in this case the judge has made the right decision and SB is expected to have an abortion in the following days. Arguably, this situation should never have arisen in the first place.

Friday 17 May 2013

The effect of homophobia and transphobia on universal access to reproductive health

Today is IDAHO, otherwise known as ‘The International Day Against Homophobia and Transphobia’. We decided to blog about the relevance of reproductive rights to people of all (or no) genders and sexualities, and some of the problems those who identify as LGBT* can face in accessing sexual and reproductive health services and relevant information.

Why are reproductive rights important for people of all genders and sexualities?

When I tell people I work on a project which educates young people on pregnancy options they’ve asked if we only visit girls’ schools, and have expressed skepticism at the usefulness of covering this topic at a workshop for LGBT* youth. At EFC we believe everyone has a stake in understanding how reproduction works, and how people can be supported to make decisions about sex, contraception and pregnancy that are right for them. Here are some thoughts on why this is a subject which breaks though cisgendered/heterosexual ‘norms’:

-    Most people with a womb have at least the capability to get pregnant at some point in their lives. Even those who don’t choose to have vaginal intercourse can become pregnant, for example through sperm accidentally coming into contact with the vagina through non-penetrative intercourse, or as a result of rape.
-    Research has shown that young people who identify as gay, lesbian and bisexual may in fact be at a higher risk of unplanned pregnancy than their heterosexual peers. Stigma surrounding sexuality can lead some young people to ‘prove’ heterosexuality through sexual contact with a partner of the ‘opposite’ sex.
-    As Thomas Beatie has shown with his high-profile pregnancies, trans men and transmasculine people can and do become pregnant and may require specific information on this process.
-    Those who are unable to conceive in what is often seen as the ‘natural’ or ‘traditional’ way, may decide to access services which allow them to become pregnant (e.g. IVF) or to become parents through other means (adoption, fostering and surrogacy).
-    People who cannot themselves become pregnant may have close contact with those who do, whether it be a partner, family member or friend.
-    Many of the individuals and groups which seek to restrict abortion access also argue against LGBT* rights – for example, anti-choice group SPUC is currently running a campaign against equal marriage and has claimed that ‘making homosexual couples the legal parents of children is not in the best interests of children’.

What are some of the barriers for people who are LGBT* in accessing reproductive health services?

Outright stigma, and homo/trans/biphobia is a clear barrier for equal access to services. The stories gathered by #transdocfail showed systematically poor treatment of trans* people in health services, likely to be reflected in consultations relating to sexual and reproductive health. Media outrage and sensationalised headlines relating to LGBT* parenting are unlikely to make those who identify as such eager to access support and services. And as well as stigma, there may be legal restrictions to reproductive rights – the Swedish government has only just vowed to remove a statute which requires all transgender people to be sterilised in order to have their gender recognised legally.

Beyond direct objection to equal reproductive rights, there is also often a lack of tailored resources and information for those who are lesbian, gay, bisexual and/or transgender. In our own work we are trying to address this by using language that is inclusive, and thinking of ways to address gaps in resource provision, making links between the reproductive rights and LGBT* rights movements where possible. Thankfully, some progress is being made – we’ve listed some useful resources below but please do add your own comments and suggestions.

Useful resources

Wednesday 1 May 2013

What might the ‘Protection of Life During Pregnancy Bill’ mean for Irish women seeking abortion?

The Irish government has produced a bill which if passed, will, according to Prime Minister Enda Kenny, ‘clarify the circumstances’ in which medical practitioners can intervene to save a woman’s life by providing abortion. Kenny has stated that the new bill “would continue within the law to assert the restrictions on abortion that have applied in Ireland and which will apply in future”. In other words, it does not seek to change Irish law on abortion, which states that abortion is restricted only to cases where the pregnant woman’s life is in danger. Following the recent death of Savita Halappanavar in Galway there has been a demand for clarification on the circumstances in which doctors can legally provide life-saving treatment. Kenny claims that if the bill goes through it will “at last bring certainty to pregnant women and legal clarity to medical personnel who work within the system”.

So what does the bill actually say?

The bill is carefully worded so as not to present decision making around abortion as privileging the rights of the woman over the rights of the developing pregnancy. Suggested provisions are purely about saving a woman’s life in emergency situations and all efforts must be made to protect the ‘unborn child’ (as the pregnancy is referred to) wherever possible:

“Essentially the decision to be reached is not so much a balancing of the competing rights rather, it is a clinical assessment as to whether the mother's life, as opposed to her health, is threatened by a real and substantial risk that can only be averted by a termination of pregnancy.”

Some provision is made for those women who claim to be suicidal in the face of having to continue an unwanted pregnancy. It is proposed that in such cases, three doctors are to examine the woman and must reach a unanimous decision on the threat to her life. If the three doctors do not agree, the woman may appeal to another three consultants, meaning that her case could potentially be reviewed by six separate medical professionals.

What are people saying about the bill?

Members of the government claim that the bill would provide much needed clarity to enable doctors to work within the very restrictive Irish abortion law. However, there have been criticisms from both pro-choice and anti-abortion campaigners.

Some anti-abortion campaigners have evidenced concerns about the law being ‘relaxed’ with access to abortion expanded. Former Irish Prime Minister John Bruton said the idea that “a simple threat of suicide would make right something that would otherwise be wrong is a really dangerous principle”. And in a recent televised debate, a Fine Gael politician was asked if potentially fatal health risks are an 'acceptable risk' in pregnancy, or whether they are grounds for abortion in some cases. He responded: "But sure we’re all going to end up dead anyway." This begs the question of why he’s against abortion, and indeed whether he thinks medical care is redundant for all people whose lives may be in danger or just pregnant women.

Many pro-choice campaigners have taken issue with the ‘suicide clause’ in the bill. A spokesperson from the Centre for Reproductive Rights calls it ‘outrageous and paternalistic’ and goes on to criticise Irish abortion law more generally as being an “absolute violation of international human rights norms on women's right to health and dignity. It's totally off track with the rest of Europe."

In summation, the bill is not yet passed, and if it does go through both houses of Irish parliament, it will not make any changes to the law itself. Even with these amendments the thousands of Irish women who travel to the UK (and elsewhere) to access abortion would still need to do so. Arguably it might make provision for rare cases in which the woman's life is threatened but this will still sit within a legal framework which threatens to prosecute doctors whose actions are seen as being outside of these restrictions.

To follow the debate we suggest checking out the Irish ‘Doctors For Choice’ campaign which will provide regular updates.

The Protection of Life During Pregnancy Bill can be viewed in full here.