Wednesday, 19 February 2014

Spain is heading for a self-made mess with their new abortion law.

Spain's controversial, and highly restrictive, new abortion law is now before Parliament, with approval looming.

If passed this would mean that abortions will be permitted in only two circumstances: rape, and risk of "lasting harm" to the mother's health. The move would effectively reverse the abortion law of 2010, which permitted abortion on request in the first 14 weeks of pregnancy, and up to 22 weeks where there was serious risk of fetal anomaly.

All photos via My Belly Is Mine
The widespread opposition, both within Spain and elsewhere in Europe, indicates that the Popular Party's interest in the abortion law is not underwritten by a wider public and political desire to restrict abortion access. Throughout most countries in the developed world, with notable exceptions such as the Republic of Ireland, women's need for abortion is recognized by law and provided for through services, which are often publicly funded.

But the Spanish situation provides a shocking reminder of how quickly things can change in a country -- and the extreme consequences this can have for women.

Back in 2004, a British newspaper wrongly accused bpas of referring women to Spain, when they were "too late" to have an abortion in Britain.

The reality was that doctors in Spain were, at that time, legally able to provide abortions at later gestations than the 24-week "time limit" permitted by British law. In the extremely rare cases where women were desperate to access abortion late in pregnancy, they would sometimes find that only a Spanish clinic was able to help them.

The Spanish law of 2010 restricted abortions in later gestations, but did establish abortion on request earlier in pregnancy. Yet barely five years on, Spanish women find themselves effectively deprived of any ability to access abortion at any gestation.

Will this mean that their need for abortion goes away? Of course not. What it means is that Spanish women, like Irish women, will be forced to travel for care to Britain and other European countries.

The Irish experience shows with heartbreaking clarity that when a nation makes abortion illegal, it does not prevent women's need for abortion, or their determination to access safe procedures. Outlawing abortion simply sends the issue overseas, increasing the financial and emotional cost to women and, of course, the gestation at which they are able to access a termination.

Politicians in the 21st century must accept that abortion is a necessary back-up to contraception, and that it should be a woman's private and personal decision that she is able to make according to what she thinks is best for her and her family. It is a travesty that abortion is included in the criminal statute in so many countries -- including Britain.

As a moral matter it should be for a woman to decide in line with her values; she should be allowed to take responsibility for life and choose what she thinks is best. As a medical matter, if should be regulated like any other medical procedure.

This point was put very nicely by the Times in December 2013, in a leading article challenging the new Spanish law.

"To bring the criminal law into an issue of women's health and conscientious reflection is an abuse of government power," argued this establishment newspaper. "A constitutional society does not intrude into areas of personal judgment that most citizens consider fall within the authority of the family. Social engineering is the practice of autocratic governments."

Spain is heading towards a self-made mess. We know from the situation in the Republic of Ireland, and Northern Ireland, what the consequences of its new law are likely to be. The lesson for other governments is that they should stay out of women's personal decisions. "Nosotras Decidimos," proclaim the Spanish women's organizations protesting against their inhumane new law -- "We Decide."

Throughout Europe, organizations such as BPAS will be standing behind them, and providing the services that these women need. But how much better it would be if they could access this care at home - as, until so recently, they could.

My Belly Is Mine campaigns to keep abortion legal and safe in Spain. The group is based in Britain and you can follow them on Twitter here.  
This article was written by our Chief Executive, Ann Furedi, and was orginally published by CNN.

Monday, 17 February 2014

From the bpas archive: The Abortion Law pioneers

Nearly half a century after the Abortion Act, the battle for women’s autonomy over their own bodies continues.

Over the last few years, there have been numerous attempts at restricting women’s access to abortion care. From legislation in the House of Commons to placards outside our clinics, we have seen a significant upsurge in anti-choice attempts to erode women’s hard fought for rights.

This is why we felt it was important that we open up the bpas archive, and look again at the work of campaigners so vital to the foundation of abortion rights in this country. These campaigners from the 1960s are of course inspirational, and we can also learn from the ways the debates around abortion and women’s reproductive choices has shifted – and in some ways stayed painfully static – over the last 46 years.

Our first post from the bpas archive is by Diane Munday, an abortion rights activist and former general secretary and vice-chair of the Abortion Law Reform Association, who very kindly donated material to bpas and The Wellcome Trust which enabled this archive project to take place. Diane wrote this piece 40 years after the Act was passed, reflecting on why she became involved in the movement, along with extracts from a 1967 ALRA leaflet:

I once knew a woman who had a backstreet abortion and died: a married woman, already the mother of three young children, who just could not afford another child. I was absolutely shocked. It was the first time I had come across abortion. I was in my early twenties, working at St Bartholomew’s Hospital doing research, and I mentioned it to a group of doctors one lunch time. They looked at me in amazement, and said words to the effect: ‘Well, where have you been all your life? Stay behind on Friday.’ I discovered that Bart’s and all the other London hospitals put wards aside every Friday and Saturday night for women who were brought in as a result of backstreet abortions – Friday being pay day. Bleeding, septic, sometimes dying. This was accepted everywhere.

I put it to the back of my mind. Then, during my third pregnancy, I was very uncomfortable and not sleeping well – I am a diabetic and I had very large babies. My doctor gave me a prescription for Thalidomide (a drug found to cause disability), which I never took, and I was so thankful that my son was born perfectly alright. I was aware of a number of people in the area who had badly handicapped children. I saw a letter in the Observer, talking about the Abortion Law Reform Association (ALRA). I wrote and joined because, having thought about it deeply probably for the first time, I came to the view that if I had taken that drug, and had developed a handicapped fetus, I would have wanted an abortion.

Initially I was a fairly inactive member of ALRA – and then I became pregnant again for the fourth time in four years. I just knew that there was no way I could cope with a fourth child at that time. I was married, we had a reasonable income, but it was an instinctive drive telling me our family was complete. Nothing, nobody could have made me have that child. For the first time, I recognised the feeling, the strength of the drive that forced women, like the one who had died previously, to damage themselves, to take the risks they took to end a pregnancy. We all have our limits. For some it can be after one child, for others it can be before they have any children, and for some it can be after 10 children. It is an individual drive and so must be an individual choice.

I was fortunate. After a lot of asking around, a lot of heartache, I bought my abortion in Harley Street. The first NHS consultant I asked about an abortion treated me like dirt: ‘My wife’s got four children and she manages perfectly well, what’s the matter with you?’ Then a wet-behind-the-ears trainee psychiatrist informed me that my problem was in my relationship, that my whole life was a mess, and I should have this child and go up to London for psychiatric treatment three times a week. As far as I could see the only major problem in my life was that fourth pregnancy and to suggest I should travel 60 miles a time, three days a week with four underschool-age children just showed he didn’t know what real life was about.

A woman I had met on holiday gave me the number of a Harley Street doctor who her neighbour had been to. I was utterly terrified when I went in to see him. He said, ‘You look terrible, would you like a drink?’ and got out a bottle of gin. Everything I had ever read about backstreet abortionists flooded back to me! However, he was an extremely highly qualified man. Years later, when I persuaded him to give some money to ALRA, I asked him how he had got into doing abortions. He told me that, when he was a young doctor, a woman had asked him for an abortion and he had sent her away, told her to have the baby and that she would grow to love it. She hanged herself that same night, and he said he felt he had killed her as surely as if he had put a gun to her head.

He sent me to see a psychiatrist, for 10 guineas to get a certificate – this was 1961 – to show that I was so mentally disturbed I could not cope with another child. The gynaecologist then told me that he had booked me into a nursing home the next week and it would be £150. We could not raise £150 – that was the equivalent of over £1000 today. So in my naiveté I asked him, ‘Could I take sandwiches in and I don’t mind sharing rooms?’ He came back and asked if £90 would be alright. It absolutely broke us. But I had my abortion. I was alive and well and without the pregnancy that I could not contemplate, and I knew other women in similar situations were dying.

When I came round from the anaesthetic, I could not thank God because I don’t believe in God, so I made a very muddled vow to myself. I woke up thinking of the woman who died and others who would die and that it was because I had a cheque book to wave in Harley Street that I was alive. At that point I thought, ‘I am going to get involved in this, I am going to do what I can for women who don’t have cheque books so that they too can have what I saw then and still see as the privilege of a safe abortion’

That provided the spark for 30 years of campaigning. I went to the next ALRA annual general meeting, and that was when I met Madeleine Simms. Before I knew where I was. I was on the ALRA committee, never having sat on a committee for anything in my life. But I became determined to go out and talk about it. I went to public speaking classes and took all my medals. I think I was probably the first person that said in public, on television and the radio, that I had an abortion. It was a word that you could not say, it was never mentioned. It is impossible to imagine those days.

We will be sharing more pieces from the bpas archive - for regular updates, search #bpasarchive 

Thursday, 6 February 2014

Let's put the "deadly" risk of the pill in to perspective.

This weekend, we saw splashes across newspapers warning the women of Britain about the dangers of their contraceptive pills. Their DEADLY contraceptive pills no less.

Naturally some of the coverage was, at best, highly charged. Contraception is one of those “women’s choices” that the press just loves to scrutinise – “Is your decision to do x going to make you unlovable / infertile /a terrible mother?” etc. Add in some scientific studies with the words “death” scattered in the text and well you’ve got yourself a pretty good front page. 

These recent media stories have somewhat overblown the risks of the contraceptive pill. That is not to say there are no risks – it’s a medicine. All medicines have risks. The key is to balance these risks against the benefits of the medicines - with the pill, it’s that it is a highly reliable way for women to avoid becoming pregnant. And it is also crucial that, in order to enable people to make informed choices, these risks are conveyed in a responsible way, using the best evidence available (I’m looking at you, Mail on Sunday).

So, the controversy stems from a review looking at the available evidence of increased risks of blood clots among women using combined hormonal contraceptives, primarily the pill, but also patches and rings. The review doesn’t reveal anything new - the risks of blood clots have always been known, and they have always been known to be very low. This European-wide review confirmed that, and that the benefits of combined hormonal contraceptives continue to outweigh the risks.

The best medical evidence we have is that the risk of blood clots among non-pregnant women not using combined hormonal contraceptives is 2 women per 10,000 in a year. The risk for non-pregnant women using them is 5-12 women per 10,000. It is that low. And in comparison, the overall risk of blood clots in pregnancy and post birth is estimated at 10-20 per 10,000.

And as for the risk of dying from taking modern contraceptives, the excess risk is 1 in 100,000 women -  much lower than the risk of everyday activities like cycling. 

Women should be told about any risks as part of their decision making process when choosing a method of contraception - we all expect this when we start a new medication – and there will be women for whom combined hormonal contraceptives are not suitable. But the risks overall are incredibly small, the benefits are incredibly large – and the media should stop cherry-picking from scientific research in order to scare women.

Monday, 3 February 2014

Lack of childcare is preventing women returning to work, survey finds. No one is surprised.

On Thursday, the Department of Education released the results of their annual childcare survey. This report, aimed at monitoring the progress of policy initiatives, is based on series of interviews with parents in England and Wales about their experience and use of childcare.

The survey is extensive, and if the little snapshot below is of interest I would thoroughly recommend having a look through the full document (or at least the chapter summaries), and perhaps also the Mumsnet and Resolution Foundation research in to mother’s experiences of childcare. Both provide evidence of real problems with the current system, which will be of no surprise to the vast majority of parents, and will perhaps add voices to the calls for Britain to be more like Scandinavia. Better childcare provision AND our own The Bridge. I think that’s a sort of utopia. 

Here is our summary of the key points / the figures we found interesting:
  • Just over half (58%) of parents thought the quality of their local childcare was fairly or very good, but almost a third (30%) said they didn’t think there were enough places.  
  • Thirty-nine per cent of parents said they had too little information about childcare in their local area. 

  • On perceptions of cost opinions were divided: 32% rated the affordability of local childcare as very or fairly good, with 29% unsure and 39% it was very or fairly poor.
  • However, almost half of parents (49%) said it was easy or very easy to meet their childcare costs with a substantial minority (27%) of families finding it difficult or very difficult to pay.
  • Worryingly, the proportion of non-working lone parents finding it difficult to pay for childcare has significantly increased from 35 per cent in 2011 to 48 per cent in 2012.
  •  But for parents not using childcare, cost wasn’t the main issue – 71% said it was because they preferred to look after their children themselves, compared to 13% who said the cost was preventative. 

Childcare and maternal employment
  • Half of mothers said that having reliable childcare was the most helpful arrangement which would help them to go out to work.
  • The majority of non-working mothers (54%) said they wanted to go out to work but a lack of good quality childcare was preventing them from doing so.  
  • 29% were working atypical hours, defined as before 8am, after 6pm or at the weekend, perhaps as a way to combine work with childcare arrangements or because these were the only hours they could find childcare for.
  • The survey also looked at the reasons why mothers had returned to work. The most common reason cited (28%) was that they found a job they could combine with childcare. But 1 in 10 mothers mentioned a desire to get out of their house, wanting financial independence, or, of course, their family’s financial situation.

The survey took in to account the different experiences of mothers who were partnered or lone, as this can often have a significant impact on their ability to afford childcare and return to work in general. 
  • Partnered women were more likely to be in employment – 67% compared with 55% of lone mothers. And for those working atypical hours, it was more likely to cause problems for lone mothers than those with a partner.

The vast majority of families (78%) with children aged 0-14 use childcare, formal (63%) or informal (39%), so it is hardly surprising that good provision remains somewhat of a holy grail for all political parties. There remain significant problems with cost, and it should be of real concern that childcare provision is a common barrier to women, particularly those who are lone parents, returning to work. The government certainly does have work to do to achieve that “dynamic” childcare market they are aiming for.