Wednesday, 5 October 2011

Tribute to Madeleine Simms

We are sad to report the news that stalwart pro-choice campaigner Madeleine Simms died this week. She was a member of the Abortion Law Reform Association, which campaigned successfully for the introduction of legal abortion in the UK in 1967. She remained committed to the provision of safe legal and abortion and was always very supportive of EFC's work. As a tribute to Madeleine we are publishing an interview with her taken from Abortion Law Reformers: Pioneers of Change
(with kind permission of Abortion Review and bpas)


Interview with Madeleine Simms, Author of Abortion Law Reformed (with Keith Hindell) and founding trustee of Birth Control Trust


In about 1960 I went to a Fabian Society lecture by Gerald Gardiner QC, who later became Lord Chancellor. He outlined a list of legal issues to which he thought the next Labour Government should apply itself. He just mentioned in passing that the abortion law needed to be reformed. This was the first time I became aware that abortion was illegal. In retrospect this seems rather odd, because I was already a 30-year-old married woman with a child. It shows how hidden the subject was then, that you could actually reach that stage in life and not quite understand what the position was about abortion.


I joined the Abortion Law Reform Association (ALRA). The Association didn’t seem to do very much, but I joined anyway.


We were the second wave of ALRA activists. Alice Jenkins and her friends Janet Chance and Stella Browne had founded ALRA in 1936. They did a lot of educational work and held meetings and conferences, but when the war came, the whole thing went into hibernation. When I joined 25 years later, there were a lot of elderly and rather respectable people running it, with an Indian army Colonel as the chair, which was not quite what I had expected. They were restrained and discreet. They felt you could hardly mention abortion in public, you could not write letters to the press about it, nor even to MPs unless you knew them personally. But in the 1960s we younger members started writing letters all over the place and found they were often printed. We showed that you could go into the House of Commons and not only talk to MPs about the subject, but pounce on the first few names drawn in the annual Private Members’ Ballot and ask the lucky MPs to sponsor an Abortion Bill. This was new – we probably pioneered this type of lobbying. Now of course everyone does it.


I became really active when the Thalidomide tragedy occurred. I have always been particularly concerned about the prevention of handicap, and it struck me as so appalling that there were people around who were actually prepared to compel women to have handicapped babies when this could be avoided. A friend of my parents had a brain-damaged son who grew far too big for her to handle; he was quite violent. It devastated her life. Seeing this at close quarters affected me. Until people have experienced the devastating affect on their own or a friend’s life of having a handicapped child, they do not always understand what the implications are for the mother and the whole family. There is a lot of sentimental talk about the joys of a lifetime’s caring, particularly on the part of those who do not have to do it themselves. If people choose to have a baby with Down’s Syndrome, that is their right. But the notion that you have the moral right to inflict your preferences on other people who are much less able to cope is monstrous.


So Thalidomide was my original motivation, but once you become involved in a cause, other issues come into play. I became very conscious of the social injustice involved. Middle-class women in a sense needed abortion law reform least because they could always buy abortions in Harley Street and could obtain them most easily. Working-class women often in desperate need had to go to the most appalling and often self-mutilating lengths and put themselves in great danger to obtain an abortion. Alice Jenkins, one of the founders of ALRA, wrote a book Law for the Rich, which particularly drew attention to the social injustice.


Another very important motivation was my love of children, and the horror that they might be born to women who did not want them, and who might therefore resent, neglect or abuse them. Children born in these circumstances often end up in care and in the courts. The notion that the law favoured inflicting unwanted children on hostile mothers makes no sense at all. I cannot understand why anyone should support such an idea – religion has a lot to answer for. 


Some of our political opponents in the 1960s really did believe that those who were in favour of having children by choice not chance disliked children. So they were quite surprised that between us we had so many. I remember being amused by this thought when I was correcting proofs of an article about abortion law reform while sitting in bed at University College Hospital awaiting the birth of my second child.


I continue to be shocked by the notion of having a child carelessly. It is too important and far-reaching a decision to be undertaken lightly. It is a lifetime’s commitment, and only to be entered into with deliberation. It’s not like choosing a holiday or making some other trivial decision. If parents have children only when they really want them, this maximises the chances of the children having happy and successful lives, and this is what matters most.


The Steel Bill was not the ideal Bill. It was too hedged around by bureaucracy and restrictions. But I thought it was probably the best compromise we could achieve in the circumstances. It was scandalous that Northern Ireland wasn’t included, as long as it continued to be part of the United Kingdom, but at the time we nearly lost Scotland too. It was only because David Steel was a Scottish MP that we did not. I was unhappy about the absence of a straight social clause, but we had to settle for what we could – in this case the ‘medico-social’ clause as it came to be called. We had to fight hard to save even that. David Steel was under enormous pressure to cut down his Bill. I greatly admire what he did and regard him as one of the great unsung heroes of the women’s movement, but he was desperate, as MPs are in these circumstances, to achieve an Act of Parliament. We knew we could not go through all this again in a hurry, so we had to ensure that we obtained a major reform, which we did.


Years later the Abortion Act seems inadequate and restrictive, however advanced it appeared in the 1960s. This is inevitable. Perspectives change over time. I don’t think the abortion decision should be up to doctors, it should be the decision of women. They are the only ones who can truly judge their social and emotional resources. It seems obvious now that abortion should be available on request at least in the first three months of pregnancy, and thereafter on serious grounds. It should be treated like any other operation, and not hedged round by special regulations, for two doctors to agree, and legal notification, and all the rest of it. At that time, of course, doctors did not want their authority taken away from them and handed to patients. They said in effect: ‘We know best’. The 1967 Act enshrines this attitude, which is my chief objection to it. On the whole doctors now recognise that they can’t know best in this particular context, though they generally do of course know best about the technical aspects of the operation, which is anyway becoming more simple all the time. Most doctors now recognise that it is not up to them to deny women birth control or abortion if that is what the women require. Of course, in the 1960s, Roman Catholic MPs and doctors were as opposed to contraception as they now are to abortion. People have forgotten that, and Roman Catholics do not much like to be reminded of this now. A series of national opinion surveys have shown that a majority of Catholic voters now support abortion law reform, even surprisingly in Northern Ireland, and this despite all the pressure on them from the Church and their politicians.


Despite my reservations, I do think the Abortion Act was an enormously important reform. It has enabled anyone who needs an abortion on grounds of serious handicap to obtain it, and there has been a huge increase in access for working-class women. There are still problems. But, yes, I do think reforming this law was a great thing to do. It was also an important international landmark which had tremendous influence in changing the abortion laws in Europe and America and throughout the developed world. I am enormously proud of having been a part of it. It is the most useful thing I have ever helped to do in my life and I am grateful to have had the chance to participate in such a campaign.


The group of people who came together in the 1960s was formidable. Getting to know them well was one of the marvellous side effects of being so closely involved in this cause. I suppose it was in the spirit of the age to some extent. Reform was in the air. We were getting rid of the last bits of Victorian baggage that were surplus to requirements – the 1861 Offences Against the Person Act in our case. The whole thing could not have taken off without Vera Houghton, our chair, who was a superb co-ordinator of all our individual and slightly chaotic efforts. She was the only one of us with previous high-level political and administrative experience both in her own right and with her husband, the greatly-respected Labour MP Douglas Houghton.


I remember it primarily as a parliamentary campaign. I always loathed demonstrations, of which there were many by the 1970s, and always marched rather unwillingly, doubting how effective this form of mindless activity was. But the Catholics did it so we felt we had to as well. I preferred sitting at those round tables in the lobby of the House of Commons helping MPs to write speeches. I remember the great excitement when the Bill finally went through, having stayed up all night, then going out in the morning to find a barrow selling coffee and buns off Parliament Square.


I am a bit sad that my own children are not involved in this sort of campaign, though they and my husband have been wonderfully supportive of my activities. I feel they are really missing out on something. Making common cause with people brings very close ties. It is natural in a way that young people today are a little complacent about abortion because they have grown up taking for granted that it is legal and safe. But if you look across the Atlantic you can see how threatening it can be if you do not keep up the pressure. 


The 1967 Abortion Act has helped a new generation of women plan their lives and careers in a way that very few women of my generation were able to. If you are confident that you can control your fertility you can afford to be ambitious and compete with men for the really interesting, worthwhile and powerful jobs. This is beginning to happen now and it is wonderful to witness.


I have often heard people say at meetings that the Abortion Act was the result of the women’s movement, but this isn’t so. The women’s movement did not really start until the 1970s. The 1960s campaign for abortion gave impetus to the women’s movement. It brought women together and showed that, by concentrating their efforts on a central issue, they could achieve something. I think this example encouraged women to come together on other issues too. It was a stepping stone to the whole feminist rising in the 1970s and 1980s. I hope it will continue.


Do read fascinating interviews with the other Abortion Law Reformers in this book including David Steel 

Monday, 3 October 2011

Myth Busting Monday – ‘Nearly 10% of all mental health problems are directly attributable to abortion’

A recent study claiming a causal link between abortion and mental health problems has been cited by a number of anti-abortion groups, keen to support the notion that abortion is ‘bad for women’.

The study makes some bold claims, these quotes are from The Telegraph coverage:

“Overall, the results revealed that women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems were shown to be directly attributable to abortion.”

“The study said that abortion was linked with a 34% greater chance of anxiety disorders, and 37% higher possibility of depression, a more than double risk of alcohol abuse – 110% – a three times greater risk of cannabis use – at 220% – and 155% greater risk of trying to commit suicide.”


Since its publication the study has been attacked by a number of prominent scientists. Responses to the article in the British Journal of Psychiatry draw attention to the flawed methodology and apparent bias of the authors:

“Priscilla Coleman presents her conclusions as "an unbiased, quantitative analysis of the best available evidence" concerning the adverse mental health consequences of abortion. Huge numbers of papers by respectable researchers that have not found negative mental health consequences are ignored without comment. Not surprisingly, over 50% of the "acceptable" studies she uses as her "evidence" are those done by her and her colleagues Cougle and Reardon. The work of this group has been soundly critiqued not just by us but by many others as being logically inconsistent and substantially inflated by faulty methodologies. As noted by the Royal Society of Obstetricians and Gynaecologists , the authors consistently fail to differentiate between an association and a causal relationship and repeatedly fail to control for pre-existing mental health problems...The "unbiased nature" of most of the studies Coleman has used in her analysis and the Declaration of Interest stated as being "none" must be taken with a large grain of salt. Reardon, the leader of this group, has clearly expressed his new rhetorical strategy as "we can convince many of those who do not see abortion to be a "serious moral evil" that they should support anti-abortion policies that protect women and reduce abortion rates" . He has stated that "I do argue that because abortion is evil, we can expect, and can even know, that it will harm those who participate in it. Nothing good comes from evil."

Reputable research from around the world disputes a causal relationship between abortion and significant mental health problems. Where women do feel sadness or regret following abortion, it may come from the circumstances of the pregnancy rather than the abortion itself.  Those women who are at greatest risk of regret are those who feel ambivalent about the decision, or have been coerced or forced into having an abortion against their will, or have had previous experience of psychiatric problems. For more on this see the RCOG’s ‘The Care of Women Requesting Induced Abortion’.


For further critique of Coleman's work see The Ministry of Truth blog.

Thursday, 29 September 2011

Abortion - a Marmite issue?

Recently a friend described abortion as a Marmite issue to me. She confidently asserted that people are either for or against abortion, love it or hate it. Her assertion was that it divided people as much as Marmite. I couldn’t agree with her for several reasons (only one of which is that I belong to that awkward group of people the advertisers have conveniently ignored who quite like Marmite and choose to have it occasionally).


Seriously though, I really don’t see abortion as a Marmite issue. It’s such a normal part of women’s lives that it’s really more our bread and butter than a mere condiment. 1 in 3 women in the UK will have an abortion in their lifetime and it is now considered by most people, including health professionals, as an essential element of the family planning toolkit, which confirms that it is more analogous to a staple of our diet rather than a luxury toast topping (to spread the metaphor thinly).


Even those using contraception conscientiously, consistently and correctly may experience contraceptive failure. Given our long, fertile and sexually active adult lives, it is amazing how well we all do really at preventing unwanted pregnancy. A fertile woman ovulates approximately 450 times in her life – that’s 450 potential opportunities to conceive. This means that a woman having one abortion in her lifetime has experienced a 0.22% contraceptive failure rate and even a woman having three abortions only a 0.66% contraceptive failure rate over her reproductive life time.


Another reason the Marmite analogy doesn’t really work is that while some people definitely hate abortion no one really loves it. They might love its availability, the crucial role it has played in promoting public health, the part it plays in promoting women’s reproductive – and by extension economic and cultural freedom and more, but like good quality dental care, we’re glad it’s there, but it doesn’t mean we actually enjoy having it or ‘love it’.


I’m sure that there are far more Marmite-haters than anti-abortionists in the UK. The main difference between the two is that much as they may loathe the brown, tarry, sticky, salty weirdness that is Marmite, most Marmite-haters don’t have an agenda to stop me eating it.

Monday, 26 September 2011

Myth-Busting Monday - World Contraception Day Special

Today is ‘World Contraception Day’ so we thought we’d share some common myths we hear about contraception.

A multi-national survey was released today which reported a number of barriers young people have in accessing trustworthy information about sex and contraception. Only 55% of those interviewed in Europe said they had received sex education at school and 20% said that ‘their school does not provide a comfortable environment for questions on sexuality and intimacy’. One of the most worrying findings was that 14% of young people in the UK reported that their teachers had provided information about contraception which was inaccurate or untrue. We believe school is a place where young people should feel comfortable to ask questions and confident that they will receive evidence-based answers. Teachers need access to reputable sources of information on sexual and reproductive health (like fpa and Brook) as well as training and resources to deliver the balanced and informed SRE young people need. We believe this is particularly pertinent when dealing with the topic of abortion – a subject shrouded in stigma and myth, and that’s why we offer training and resources to help them do so.

So let’s bust some common myths about contraception. You can find detailed information on all forms of contraception by visiting the fpa website.

Using two condoms when you have sex means double the protection. This one came up just the other day in new Channel 4 comedy ‘Fresh Meat’ when two characters ‘double bag’ by using a female and a male condom at once. In fact, using two condoms at once is likely to increase friction and could mean that they are more likely to tear or come off. If somebody wanted to further decrease their chances of getting pregnant they could use condoms alongside a non-barrier method of contraception (like the pill or the implant).

Women who haven’t given birth shouldn’t be fitted with the coil. This myth is common enough that we’ve heard it from some medical professionals. In fact, women of all ages (including those who are ‘nulliparous’ i.e. haven’t given birth) can be fitted with an IUD/coil. Young women should be offered the full range of contraceptive methods with a discussion of the suitability and side effects of each one.

Taking the contraceptive pill can lead to fertility problems. Some people think that taking the pill for a number of years will affect a woman’s fertility in the long-term but this is not true. In fact, some women conceive immediately after stopping taking the pill and while it doesn't cause fertility problems the pill can mask problems that were already there, such as irregular periods.

Have you heard any other myths about contraception from young people or in the media? Let us know by commenting below!

Monday, 19 September 2011

Myth-Busting Monday – ‘The morning-after abortion pill’

C’mon Michele Bachmann. Really? Even EFC, staunch defenders of The Facts, are getting sick of mythbusting this one. At a recent Tea Party debate Republican representative Bachmann talked about the ‘morning-after abortion pill’. There’s no such thing. She seems to be conflating the ‘morning after pill’ (emergency hormonal contraception) and the ‘abortion pill’ (medical abortion). In fact, the former is taken to try to prevent pregnancy, an abortion is the termination of an existing pregnancy. We’ve busted this one before, but it’s still being touted by anti-choice groups in the UK.

This isn’t the first medical issue Bachmann has slipped up on. Her claims about the HPV vaccine causing ‘mental retardation’ have led to a $11,000 reward being offered for anyone who can provide any evidence to back them up. Go science!

Monday, 12 September 2011

Myth-Busting Monday - 'Abortion is the only procedure which requires 2 doctors' signatures'

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts.Today's blog was inspired by a recent tweet from @christineburns who pointed out that abortion is not the only procedure which requires the signatures of two separate doctors.

As Christine points out, during discussions of Nadine Dorries' failed amendments to the health and social care bill last week some MPs and commentators stated that abortion is the only situation whereby somebody has to obtain the signature of two doctors for the procedure to be granted legal. Abortion rights campaigners are keen to point out that no other medical procedure requires this level of intervention, but, as Christine rightly points out, this same requirement is true of gender reassignment procedures. The 2004 Gender Recognition Act makes legal recognition of a transsexual person's true gender dependent on reports from two doctors and this GIRES document offering guidance to transmen on genital surgeries states that "two referrals supporting your clinical need for genital surgery are usually required before a surgeon will undertake it. In the UK one of these must be from a medical doctor (a gender psychiatrist) and the other can be a psychologist, endocrinologist or GP for instance."

So it's simply not true that abortion is the only procedure which requires two doctors' signatures- thanks again to Christine Burns for highlighting this. Check out her blog Just Plain Sense here. And the RCOG's comments on the requirement of two signatures for legal abortion here.

Monday, 5 September 2011

The only incentives in life are financial


The myth that underlies The Dorries/Field amendment on abortion is that abortion providers have a financial incentive to promote abortion and therefore their employees do not and cannot provide independent, non-directive support for women trying to make a decision about whether or not to continue a pregnancy.

I’m not a psychologist, but I’m sure if I had more time I could lay my hands on copious literature which finds that people are motivated and incentivised to act by a range of different factors, only one of which is money. I would take an amateurish stab at things such as shared values within your community or amongst your peers and family, strongly held philosophical or religious belief, and more. 

In my experience, for example, those working for abortion providers in any capacity are very strongly motivated by a profound and deeply held belief in a woman’s right to choose the outcome of her own pregnancy and a horror of the known consequences of witholding safe, legal, free and accessible abortion as a real option for women. 

Surely the biggest incentive people have is their own personal belief, and that’s why it’s hard to fathom that during this whole debate on ‘independent counselling’ not a single organisation that was founded on an anti-abortion principles, and staffed by people who oppose abortion, has felt the need to explain how their deeply held belief that abortion is wrong does not provide them with an incentive to dissuade or obstruct women from accessing abortion.

Even in this materialistic world we all inhabit, I still think that strongly held beliefs trump money for most people. So, once again I ask you... all of you who have a strongly held belief – whether grounded in a faith position or otherwise – that every abortion is intrinsically wrong, sinful, damaging and tragic, how can you NOT want to dissuade women from having an abortion. 

More discussion of this is here and here