Articles that caught our eye this week

The government's response to the review of PSHE was released on Friday and the response from the sexual community was luke-warm at best. The Chief Executive of Brook, Simon Blake, called the review a "not very funny joke":

Clearly the Department for Education has not been looking at the same evidence as the rest of us or listening to the views of children and young people themselves. 20 months after the review was announced, this vital topic is clearly consigned to the very bottom of the DFE pile marked ‘non urgent’. This stubborn refusal of the Department of Education to improve PSHE and SRE fails children and young people yet again.

The Labour MP Diane Abbott also criticised the review and said that it demonstrated that ‘the government has run out of ideas on sexual health.’

How we talk to children and young people about reproductive issues is one that many parents struggle with. In the context of the renewed focus on PSHE and the role of schools, we found this post  from the perspective of a parent who decided to talk to her young children about abortion particularly interesting.

Be Fertility Aware looks here at the contraceptive options for new mums and provides clear, evidence based information about using breastfeeding as a form of contraception and the rules women need to follow for it to be effective.

There is an interesting juxtaposition emerging in American right-wing politics- the growing acceptance of gay marriage and increase in attacks on abortion provision. This article in the Telegraph looked at the current trends in social conservatism:

Oddly for something that has only just became a major political issue in America, gay marriage could soon cease to be one: opponents are fighting a demographic tidal wave. Yet on abortion they are getting more traction than ever. Gay marriage’s time in America may have come but, 40 years in, the abortion war may just be warming up.

Despite the alarmist headline, “Are older parents putting our future at risk?”, this was actually a very interesting article on older parenthood. It examined global and historic trends, the challenges that older parenthood can present and, refreshingly, looked at this as not just a female issue:

Though it is often portrayed as one, this isn’t just a female problem. Most men aren’t ready to settle down until somewhere around their mid-thirties. In an “information economy” like ours, people tend to stay in education longer to maximise their chances of getting a decent job. This is one of the major factors behind Britain’s declining birth rate: both men and women are more likely to go to university, which means they start work later, and take longer to feel established enough, financially and professionally, to start a family.

As always, please do share any articles that are of interest on Twitter or by email.

Birds, Bees… Abortion? Talking to Kids About Complicated Issues - See more at: http://rhrealitycheck.org/article/2013/02/01/birds-bees-abortion-how-do-we-bring-up-complicated-reproductive-issues-with-our/#sthash.wP5v7387.dpuf

Birds, Bees… Abortion? Talking to Kids About Complicated Issues - See more at: http://rhrealitycheck.org/article/2013/02/01/birds-bees-abortion-how-do-we-bring-up-complicated-reproductive-issues-with-our/#sthash.wP5v7387.dpuf

“We don't choose to miscarry. We should at least get a choice about how it is handled."

On 25 February the Miscarriage Association launched their campaign to get people talking about miscarriage. At bpas, we often see women who are experiencing a miscarriage or at risk of miscarrying and wanted to highlight the difficulties many women face when trying to access medical management.

NICE have recently published a new guideline on the care of women who miscarry in the early stages of pregnancy. The aim of the guideline is to ensure all women are able to access the best possible information, care and support they need, wherever they live, at whatever time they need it. The recommendations include setting up a seven-day service for women with complications in early pregnancy, and ensuring that all women are fully informed at every stage and given the time to discuss any concerns or questions that she might have.

These moves are of course welcomed. However, many were disappointed to see NICE also recommend that women’s choice about medical treatment should be restricted. For the first 7-14 days, NICE recommends that the first line strategy for women with a confirmed diagnosis of miscarriage should be“expectant management.” This means no medical or surgical management, just “letting nature take its course.”

The Miscarriage Association, who support people who have been affected by miscarriage and work to promote good practice in medical care, have criticised this restriction of women’s choice, stressing that most women have a definite preference for one management method or another, and this enforced waiting can be extremely distressing.

On Mumsnet, which is running a Better Miscarriage Care campaign, women have been expressing their anger over this recommendation:

 
“Waiting 14 days is barbaric. That's is why I went privately the day after my miscarriage at 11 weeks was confirmed, I could not wait the 14 days the NHS had offered me.”

“Carrying a baby you know to be dead is awful. I have never felt any kind of healing could begin to take place until the miscarriage is over and you stop being pregnant. I felt like my body had become a grave the one time I waited ten days to miscarriage naturally. Time just stopped.”

“The recommendation re: 7-14 days waiting for expectant management are particularly cruel: how can you function for that long, particularly in a working environment, waiting for "nature to take it's course".... I could not face the wait & was worried about having a natural miscarriage while trying to look after a toddler.”

1 in 5 pregnancies will end in a miscarriage. For many women and their partners this can be frightening and lonely time. To remove a choice, to force women to wait for a treatment that they know they want and prolong any kind of distress, seems like a cruel way of raising standards in an area of care that so many women will one day need. 

The reality of anti-choice activism in America - and what it means for the UK

Laura Blum is an American student currently interning for bpas.

Growing up in a largely conservative, Republican county of Maryland, anti-choice activism is something I’ve become quite accustomed to. One of my best school friends belonged to an evangelical church that displayed hundreds of small white crosses on their lawn every year, each cross supposedly representing an abortion. Other churches in my hometown hung full-colour banners with slogans such as “I’m a Child, Not a Choice,” complete with close-up photos of unborn foetuses. There are no abortion clinics or Planned Parenthood branches for 20 miles in any direction. But we are home to Birthright, an organization that claims to offer “caring support” for pregnant women, but in truth relies on misinformation and shaming tactics to prevent women from making an informed choice about their pregnancy.

None of this is new, of course. Anti-choice activists have been bombing clinics and threatening doctors since Roe v. Wade, but it wasn’t until the early nineties that they began to murder their targets. I was lucky enough to be born in 1992, just as the US anti-choice movement was becoming lethal.  In March 1993, abortion doctor David Gunn was shot and killed during a pro-life protest. In 1994, four more people were killed by extreme pro-life activists. And the violence has hardly abated since then. According to the National Abortion Federation, between 1977 and 2009 there were over 6,000 reported  incidents of violence (including 8 murders, 41 bombings, 175 arsons, and 4 kidnappings) and over 150,000 reported  incidents of disruption (including harassment and bomb threats) against abortion providers in the US.

Terrifying, isn’t it? And yet so commonplace that when I recently visited a Planned Parenthood in Delaware, I wasn’t surprised to find a heavy, bomb-proof door installed at the clinic entrance. Nor am I surprised when I read about yet another legislative attack on reproductive choice. These things trouble me, of course--but they don’t shock me.

I imagine it must be hard for people who haven’t grown up in such an environment to understand just how normal it seems. When I try to view the current climate of US reproductive rights from an outsider’s perspective, it seems appalling, backwards, and disturbing--which, of course, it is. Whilst I would love it to change, I have to accept it as the current reality.

In the meantime, I must do my best to thrive in a country full of people who want to punish me and shame me simply for having a uterus and being able to reproduce. People who would rather see me die than get an abortion. People who think that if I accidentally get pregnant, it’s my fault anyway for making such bad decisions, and I ought to just live with the consequences. People who think that even if I’ve been impregnated by rape, I should be forced to carry out the pregnancy because it would make the best of a bad situation. Sure, they’re a minority, but they’re an extremely vocal one--and they have many powerful allies in national and state government.

During my time with bpas, I’ve heard a lot about the “Americanisation” of anti-choice activism. Whilst this term does need to be put in the context of anti-abortion violence worldwide, it is certainly apt. Many people working in the women’s sector have noticed how anti-choice groups in the UK have been adopting tactics used by some of the more extreme anti-choice organizations in the US. And some of the most vocal anti-choice groups in Britain today, such as Abort67 and 40 Days for Life, are direct offshoots of US organizations.

When I look at the history of anti-choice violence in my home country, I see an unmistakable trend. Harassment leads to death threats, death threats lead to bombings and arson, and before long, abortion providers are being murdered. I’m not one to be alarmist, but the evidence is too strong for me to ignore. And I can’t help but worry about what might happen if the burgeoning anti-choice movement in the UK is left to its own devices. They may seem relatively tame now, but unchecked extremism has a way of escalating.

The UK already has a lot going for it in terms of reproductive rights and pro-choice fervour. But we mustn’t take these things for granted. I don’t want girls in Britain to grow up like I did, surrounded by hateful messages, not being offered a true choice and not being trusted to make decisions for their own lives. I don’t want to see British abortion clinics close down under threats of violence. We can prevent this from becoming a reality, but we must remain vigilant, and we must work together to defend our rights. And above all, we must not be silent. If pro-choice activists in Britain make our voices louder than the hateful anti-choice zealots, we can beat back the tide of extremism, and keep the country safe for patients and providers alike.

Breastfeeding and contraception – the support new mums need

Breastfeeding has been back in the spotlight over the last month, with calls for larger labels on formula packets explaining that "breast is best", the inevitable backlash, Maternity Action's campaign for the right of women to breastfeed on return to work, and a controversial new study of the benefits of breastfeeding.

Figures released a few months ago by the NHS also indicated that more new mums are attempting breastfeeding and are breastfeeding for longer. However, at bpas we are concerned to see women who have not been given the right information about safe contraception whilst breastfeeding, and as a result are experiencing the turmoil of an unplanned pregnancy within months of giving birth.

We recently conducted a survey with Mumsnet to find out what advice new mums are getting from medical professionals. The survey found that whilst many women were happy with the level of advice, for some women, and particularly those who are breastfeeding, this is unfortunately not the case.

There are a range of contraceptives that are safe to use while breastfeeding – including progestogen-based methods such as the coil and mini-pill. But the survey found that one third of women who were breastfeeding or planning to breastfeed said that safe contraception when breastfeeding was not discussed or raised at all by healthcare professionals.

Exclusive breastfeeding can act as an effective method of contraception if strict criteria are met. However, whilst more women are choosing exclusive breastfeeding at birth, the majority are supplementing breast feeding with formula by the time their baby was one week old and as a result they would not be protected from unplanned pregnancy. Worryingly, the majority of women we surveyed who planned to use breastfeeding as a method of contraception said that no healthcare professional discussed with them what form of contraception they would use when they stopped or reduced feeds.

There’s never going to be a one-size-fits-all answer to contraceptive advice for new mums – and many women understandably find it laughable that they would want to discuss methods hours after giving birth. Some women may want to fall pregnant again very rapidly, so healthcare professionals always have to tailor their care to the needs of the individual.

But inconsistent and unclear advice is the last thing a new mum needs, and it is worrying to hear that this is the case for some. One woman responding to the survey summed up many others' experience when she said that she “found information on what hormonal contraception is suitable whilst breastfeeding very muddled.” And others spoke of how they had received “contradictory” advice from different medical professionals about whether or not breastfeeding would provide them with contraceptive cover.

Given the growing numbers of women breastfeeding and the encouragement of women to do so, it is more important than ever that women are given consistent and accurate advice about contraception whilst breastfeeding.