Wednesday 28 May 2014

Teaching about periods - Guest post from Chella Quint

Chella Quint is a performer, writer, and education researcher who uses her unique brand of comedy to engage the public in positive and enlightening conversations about menstruation. You can watch her TEDx Talk hereFor Menstrual Hygiene Day we've asked her to write a guest post and share top tips from her newly launched #PeriodPositive project which is all about challenging stigma connected to menstruation.

There are many sensitive topics within reproductive health and sex and relationships education.  Sometimes teachers and other educators are afraid to tackle these topics in case they ‘get it wrong’, and that’s understandable: making a mistake can be scary or embarrassing, or could even feel shameful. Challenging shame is one of the goals of Menstrual Hygiene Day, and it’s an issue I tackle frequently when challenging the messages in feminine hygiene product advertising.

There’s nothing to be ashamed of when talking about menstruation. It is a reproductive right for young people to understand their own fertility, and anyone can become a confident menstrual educator. 

Menstruation education should be:

  • Free, unbranded, objective, and inclusive of re-usables like menstrual cups and cloth pads
  • Consistent, accurate, up-to-date and peer-reviewed 
  • Supported more comprehensively by the National Curriculum, particularly in Science and PSHE
  • Aimed at different age groups, starting before puberty, and revisited regularly
  • Inclusive of different genders, cultures, abilities and sexualities

I've really enjoyed researching and developing this work both formally and informally, with schools, universities and through science engagement, and I'm continuing to create resources and test out lesson ideas. 

I always start by asking participants to plot their menstruation comfort zone on a spectrum line and on a bulls-eye chart: 

Here are some of the top tips from my research so far:
The full set of tips can be viewed here.

 Follow @Periodpositive for updates, and check back at for more free resources soon.

Thursday 8 May 2014

High Court ruling against free access to abortion for Northern Irish women

Today, a High Court judgement ruled that women from Northern Ireland are not entitled to access abortion free of charge through the NHS in England. 

Abortion is severely restricted in Northern Ireland and is only available where the pregnant woman’s life is in danger or where there is a risk of permanent and serious damage to her physical or mental health. This means that the vast majority of those seeking abortion in Northern Ireland will need to travel to access a safe, legal procedure. Currently, these women are required to pay for the procedure, which can range from approximately £400 to over £1000 for those at a later stage of pregnancy. The test case brought to the High Court by two women was rejected, meaning that the need for Northern Irish women to pay for abortion procedures carried out in England remains.

Northern Ireland is not covered by the current 1967 Abortion Act which applies in England, Scotland and Wales. The key legislation governing abortion in Northern Ireland comes from the Offences against the Person Act 1861. This means that women’s access to reproductive health care is managed according to a law which is over 150 years old and precedes the invention of the telephone and the light bulb.

The restrictive law in Northern Ireland does not prevent Northern Irish women having abortions, but it does make it more difficult. Those who can afford the private clinic fee and travel costs to England will be able to access a safe, legal abortion, but might have to significantly rearrange work and childcare to do so. Others may face delays in their attempts to raise a large sum of money in a short period of time. Overall, abortion is safe, but is safest the earlier in pregnancy it is performed, so delayed access means higher prices and also an increased chance of complications.

Those without access to such funds will be forced to continue an unwanted pregnancy (which again, is likely to have severe financial implications for someone who cannot afford an abortion), or they will resort to an illegal and potentially unsafe method of ending the pregnancy. Abortion Support Network is an organisation which helps women in Ireland and Northern Ireland to afford the cost of an abortion abroad. Mara Clarke, who runs the organisation, details some of the desperate measures people have taken to try to end their pregnancies:

“We have mothers calling us, telling us that their 18-year-old daughter drank a bottle of floor cleaner after she was raped at her own birthday party. We hear about women taking whole packets of birth control and washing it down with vodka.”

Others unable to travel will buy abortion medication online through sites such as Women on Web – however, if they do, they risk life imprisonment for ‘procuring (their) own miscarriage’.

The latest statistics from England and Wales show that in 2012 905 women travelled from Northern Ireland to access abortion. Many more will have travelled elsewhere or bought illegal abortion medication to end their pregnancies. Clearly, strict abortion laws do not stop abortions from happening, but can make them less safe by causing delay and restricting access. Abortion for Northern Irish women is largely a matter of economic resource. As Mara Clarke puts it, “women with money have options, women without money have babies”.

As a young people’s project we're particularly concerned about young women’s access to reproductive healthcare. In 2012, 43% of abortions in England and Wales for Northern Irish residents were for those under 25. Young women are less likely to have the resources necessary to travel and pay for a private abortion. A pregnant teenager seeking an abortion in Northern Ireland may suffer from stigma and lack of support, as well as financial limitations. 

The young woman who presented a test case to the High Court was just 15 when she became pregnant and travelled to Manchester for an abortion. Her mother paid £600 for the procedure, some of which was covered by the Abortion Support Network, and described the process of raising the funds as ‘harrowing’. Not all young women will have the support of their families. We believe that the abortion law in Northern Ireland should be brought into line with the rest of the UK, so that all women, especially young women, are able to access the full range of reproductive healthcare they need, which includes abortion.

Friday 2 May 2014

Conscientious objection obstructs women’s health … it’s not brain surgery

Blogpost by Lisa Hallgarten

It doesn't take a brain surgeon to work out that you can’t be a brain surgeon if you don’t believe in brain surgery. Nor does it take a rocket scientist or even a person of average intelligence to work out that a doctor who is not willing to prescribe the full range of contraceptive methods should not have a qualification that implies that they are able and willing to do so. The Faculty of Sexual and Reproductive Healthcare (FSRH) which provides a diploma in sexual and reproductive health, has recently updated its guidelines to confirm that doctors and nurses who have a ‘conscientious objection’ to prescribing hormonal contraception - including emergency contraception – and fitting women with IUDs and IUSs will not be able to complete the whole syllabus that is required in order to receive its diploma.

This seems uncontroversial. No woman should go to a certified doctor with a specialist qualification to discuss contraception, only to discover that her doctor will not prescribe or fit some of the available methods for reasons of personal conscience. It would be worse still for a woman seeking emergency contraception, because those who seek the right to conscientiously object do not support any method of emergency contraception. In this situation time is of the essence: if a woman wants to take Levonelle it is most effective in the first 24 hours following unprotected sex, EllaOne must be taken within five days and an IUD fitted within the same time-frame. No woman should have to scrabble about trying to find an alternative doctor who will provide her with this last ditch chance to prevent an unwanted pregnancy. Nor should any woman be preached at about why the only moral thing to do in this situation is to cross her fingers and hope for the best. You would think that even those who support a doctor’s right to conscientiously object must agree with this, but apparently not. The Christian Medical Fellowship (CMF) objects to the updated guidance because, ‘it bars pro-life doctors from specialising in sexual and reproductive health and also makes it much more difficult for non specialists to get jobs in family planning or reproductive health’.

The CMF seems to be asking for something over and above the right to conscientiously object. It seems to be asking for the right for anti-choice doctors to be certified so that they can advertise their specialism in family planning and attract women seeking contraception, with the full intention of refusing access to the full range of family planning methods.  This is not about passively opting out, this is obstruction. Likewise, the case of the two Scottish midwives who insist that they can use conscientious objection to opt out of even supervisory and management duties in relation to staff carrying out abortions.  Their appeal against an original judgement which refused them this right, on the basis that it would jeopardise abortion provision in their hospital, was funded by anti-choice organisation SPUC. This kind of extension by stealth of the right to conscientiously object is addressed in a new paper, ‘Dishonourable disobedience – Why refusal to treat in reproductive healthcare is not conscientious objection’. The authors, Canadian abortion rights advocate, Joyce Arthur, and Austrian obstetrician Christian Fiala question the moral basis for conscientious objection and challenge its interpretation and implementation by anti-choice doctors and anti-choice institutions. It is the latest salvo in a pro-choice fightback against the once uncontested concept of conscientious objection, and crucial reading for anyone who still believes that it is a benign practice which is simply about the quiet expression of personal belief.

Other useful articles on conscientious objection personal, and institutional: