bpas event: Abortion, motherhood and the medical profession

Wednesday 12 June 2013 9:00am - 5:00pm

Tickets are now on sale for this conference, organised jointly by British Pregnancy Advisory Service and the Royal Society of Medicine’s Sexuality and Sexual Health Section.

This one-day conference will explore topical issues in the management of pregnancy and women’s reproductive decision-making. Speakers will address the impact of new developments in pregnancy testing for abortion care, miscarriage, fertility treatment and ectopic pregnancy; the role of fetal imaging in discussions about abortion and the regulation of pregnancy; the impact of policy debates about information, counselling and the abortion law; and the generational experiences of doctors working within the abortion service.

To purchase tickets, visit the RSM website here.

Sessions include:

Fetal imaging, and imagining the fetus
- Stuart Derbyshire, Reader in Psychology, University of Birmingham
- Carol Sanger, Barbara Aronstein Black Professor of Law, Columbia Law School
- Zoe Williams, columnist, The Guardian; author, What Not To Expect When You’re Expecting

Information, counselling and the law
- Jane Fisher, Director, Antenatal Results and Choices
- Patricia Lohr, Medical Director, British Pregnancy Advisory Service
- Sally Sheldon, Professor of Medical Law and Ethics, Kent Law School

Testing positive, negative and in between: How the semi-quantitative pregnancy test could transform the management of abortion, miscarriage, fertility treatment and ectopic pregnancy.
- Paul Blumenthal, Professor of Obstetrics and Gynaecology, Stanford University
- Roy Farquharson, consultant gynaecologist, Liverpool Women’s Hospital
- Joanne Fletcher, consultant nurse, gynaecology, Sheffield Teaching Hospitals NHS Trust

Discussion: A new generation of abortion doctors - challenges and opportunities
- Katharine Elliot, medical student, University of Newcastle
- Richard Lyus, doctor, British Pregnancy Advisory Service
- Mr John Parsons, consultant gynaecologist

To view the full programme and to purchase tickets, visit the RSM website.

For further information, contact Jennie Bristow at bpas: jennie.bristow@bpas.org or 07976 414751

Diane Abbott – Britain’s Crisis of Masculinity

The article below is a summary of the Demos lecture delivered by Diane Abbott MP today.

Diane Abbott MP believes that we are facing a crisis of masculinity within our society, a crisis that has for too long been ignored. We have witnessed seismic shifts within the labour market and societal and familial structures, all of which have had impacted on men and the very notion of masculinity. The male breadwinner, providing for his family by labouring during the day whilst his wife stays in their home and looks after their children, is an image that once rang true but now is a historical relic. Whilst this is in many ways a positive thing – women are now able to play a role within society that would have been unimaginable 50 years ago, the consequence for some men has not been as favourable. With the traditional markers of masculinity lost, what does this mean for men and boys understanding of just what it means to be a man? 

Economic instability

The current economic crisis has left men inhabiting a fragile space. But the change began decades ago, with the loss of light industry and manufacturing eroding job security and prospects for men with few formal qualifications. And even for the current generation of recent graduates, unemployment and crippling student debts has trapped many in a state of extended adolescence- living with their parents and unable to financially support themselves. As Abbott put it- men are growing up too soon but becoming an adult too late.

Family values replaced by hyper-consumption and marketisation.

The attributes that define masculinity have switched - earning and providing replaced by taking and consuming. In today’s society, the ability to flaunt consumption has become a defining feature of masculinity. A crude individualism dressed up as modern manhood is now an essential aspect of being a man. 

Masculinity, Abbott argues, is shaped more by marketing than by family values. Our culture has become increasingly pornified, setting out a very restrictive set of qualities for what is acceptable for a man to posses – strength, hyper-sexuality, and power. 

Education

For Abbott, Sex and Relationships Education has an important role to play in challenging this marketed vision of manhood. Through SRE, we can challenge these gender stereotypes, enable young boys to have a safe space where they can discuss perceptions of masculinity and femininity, and are able to learn about sex without relying on the distorted representations found in porn. 

Abbott is seeking to challenge a sense of fatalism around men – that this is just how they are, that boys don’t achieve well at school because, well, that’s just what boys do. In accepting this as a reality, we are failing vast swathes of our population – and not just men. Cultural notions of masculinity have huge implications for women. This is not a men vs. women debate and those of us concerned with women's role in society and the family must also be concerned with men's role within those spaces.

Given the last two days of coverage on this speech, masculinity is clearly an issue that is worthy of headlines. Let’s hope that these discussions filter down from the newspapers and in to general discourse. To challenge this model of hyper-masculinity, hyper-sexualisation and hyper-consumption, we need to start talking about it.  

In case you missed it - articles that caught our eye this week

Miscarriage - breaking the taboo

On the Grazia website, writer Jude Rogers explained why she felt she had to write about her recent experience of miscarriage:

"I want all women to feel like they can talk about things that have happened to them, without feeling they're doing something bold, edgy or dangerous. If my piece had any driving purpose behind it, I suppose, it was this: I want it to be normal to talk about normal things... I was also driven by something else. I found it odd that some friends didn't broach what had happened to me when they saw me, and I wanted them to... So if you know someone who has gone through what I have, do ask them how they are."

Rogers says that she has had an "overwhelming" response to the article, including from women who wanted to share their own experience. The Miscarriage Association is currently running a campaign to get more people talking about miscarriage. You can find out more information here.

Sexual health of prisoners

The first Commission into Sex in Prisons has found that denial over sexual relationships between inmates has lead to shocking neglect of their sexual health needs. The Commission has found that:

• Managers at one prison claimed providing barrier protection was unnecessary as "none of its prisoners were homosexual."
• At a different jail, an HIV-positive inmate was refused condoms despite the fact that he was having unprotected sex with another prisoner.

The Chair of the Commission said: “We know very little about sex in prison. No one knows how many people are sexually assaulted in prison every year, or whether some prisoners are having underage sex, perhaps putting their health or their partner’s health at risk.”

Abortion in Ireland

Pro-choice campaigners in Ireland could face jail for distributing information about how to access abortion services in the UK. In the face of new legislation which could result in 14 years in jail for women who have an illegal abortion and for those who help to procure it, campaigners have stepped up their activity to ensure that women in Ireland are aware of services abroad.

The "misogyny behind the states controls on women's reproductive rights" is examined in this article, with focus on the language used in the debates and the mistrust of women and their decisions:

"Why is Ireland so determined to deny women full rights over their reproductive health? The simple answer is fear. Like it or not there is a widespread belief that unless the powerful ability to become pregnant and have a child is controlled by the State, Pandora’s jar will open, unleashing all kinds of pestilences and chaos."

GPs conscientious objection

A Christian-run NHS GP surgery has been heavily criticised after warning female patients that some of the doctors refuse to prescribe the morning-after pill to patients on the grounds of conscientious objection. One woman who has left the practice as a result and told the Independent “I know the law allows doctors to do this but I don’t think it should.”

Pro-choice campaigners react to Irish abortion bill

Pro-choice campaigners expressed their anger and disappointment this week after the publication of the Irish government’s proposals for abortion legislation - the Protection of Life During Pregnancy Bill.

Of deep concern was the exclusion of cases concerning rape, incest or fatal foetal abnormalities.

The campaign Termination for Medical Reasons Available in Ireland, TFMRIRE, said in their incredibly moving statement :

"We are heartbroken and angry at the government’s refusal to take this opportunity to legislate for the option of termination in cases of fatal foetal diagnosis. The government cannot claim ignorance of this issue, as we have forsaken our privacy and shared our deepest losses and trauma with them. We had hoped in doing this that they would they would listen, respond with compassion and act to end this injustice... We will not stop fighting for change. This unnecessary added cruelty of forcing women out of their country to seek treatment at a time when they are already experiencing the greatest loss of their lives must end."

Some of the most heartbreaking cases bpas sees are Irish women in this situation who, instead of receiving compassion and care at home, are forced to travel to England end a pregnancy that was very much wanted.

The inclusion of a 14 years prison sentence for women who obtain an illegal abortion was described by Doctors for Choice Ireland as "particularly offensive."  The Abortion Rights Campaign in Ireland echoed this sentiment arguing:

“To threaten women facing this difficult decision with imprisonment is not only wrong in and of itself, but it may prevent women from disclosing information about previous abortion to their doctors, or seeking medical care in the event of complications from illegal abortion.”

The proposals for suicidal women to be assessed by a minimum of three and up to six separate doctors also caused outrage. The Health Minister was also forced to admit that pregnant women who were rejected an abortion on the grounds of suicidal intent could be held within a psychiatric unit for the duration of their pregnancy.

Whilst the bill will be positive for the small numbers of women who are deemed able to access abortion care under the legislation, both Catholics for Choice and Abortion Support Network highlighted that the bill will do nothing for the thousands of Irish women who will still be forced to travel to access abortion services. CfC called the bill "an insult to Irish women" and Mara Clarke of the ASN stated that it will perpetuate the current situation whereby "women with money have options and women without money have babies."

In 2012 bpas saw over 700 women giving an Irish address. We suspect this does not represent the true number of Irish women coming to our clinics. We will continue to provide care for these women whilst their government turns a blind eye to the great hardship their laws are inflicting.

What’s in a name? Reproductive justice or reproductive choice

Earlier this year there was a flurry of interest into research conducted by Planned Parenthood regarding the declining popularity of the term "pro-choice" in the US. This polling had a big impact - Planned Parenthood announced that they would be moving away from the language of "choice." The American group Physicians for Reproductive Choice and Health followed suit by changing its name to Physicians for Reproductive Health.

There is clearly a growing sense in (what we have traditionally called) the pro-choice movement that its very label is hindering progress. A key problem with the term “pro-choice”, some argue, is that it does not encapsulate the myriad of factors – economic, social or political - that affect access to reproductive healthcare. For many “reproductive justice” is a more useful term:

“The conversation about dropping “pro-choice” language is largely missing a discussion about the real limitations surrounding the word choice. A reproductive justice framework addresses how “choice” doesn’t resonate for people because many people’s “choices” are dictated by societal factors... A woman who cannot afford time off work to travel for hours or even days does not have a real “choice”, for instance.”

They also argue that the term “reproductive justice” better communicates the full range of issues the movement is concerned with – not just abortion, but access to contraception, ending stigma and ensuring proper provision of sex and relationship education.

But this shift is not universally supported.

Jon O’Brien, from Catholics for Choice, does not support the idea that reproductive justice could be a substitute for choice. O’Brien argues that believing in choice compels us to advocate for true freedom and to pursue policies that enable women to make decisions for themselves, rather than have these outcomes determined by societal factors:

“By grounding itself in the idea that each person has a right to bodily autonomy, to determining the course of his of her reproductive life regardless of circumstance, choice respects individual conscience. We believe in choice because it is robust. What matters in the choice framework is whether or not the decision to become or stay pregnant rests with a woman and her conscience.”

Our Chief Executive, Ann Furedi, also wrote a piece defending the term pro-choice. Furedi states that using the term “pro-choice” is essential as it affirms our commitment to personal autonomy and our capacity for moral self-governance. Supporting choice does not mean ignoring the real issues women face accessing care and services but to claim “that choice ‘does not matter’, or is irrelevant, to a group of women because, for example, they are economically or culturally excluded, is both patronising and degrading. It implies they have no interest in making these moral choices for themselves, and perhaps no capacity to do so.”

Whilst this debate is currently predominately America-based, it will undoubtedly over time migrate across the pond. We should not shy away from these discussions. It is right to reassess the strengths and weaknesses of the movement. But it is essential that we are able to work through these divisions whilst still joining together to fight for our common cause, still united by our shared goals and values.

bpas response to Irish abortion bill proposal

The Irish PM says this law will provide "certainty" for pregnant women and doctors. It provides certainty that the Irish government has no respect or compassion for women and their decisions.

Forcing a suicidal women to make her case to end her pregnancy before a panel of three doctors is not a practice bpas believes has a place in a modern, democratic society.

bpas will continue to provide support and treatment for Irish women with pregnancies they feel they cannot carry to term so that they do not need to navigate an inquisition before being able to access the care they need. Irish women deserve nothing less.