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.

Sexuality and Honour Abuse: Challenges in Reproductive Healthcare

Honour violence is a complex system of abuse that has attracted a lot of media attention over the last few years, not least because of the deeply vicious nature of murders carried out by family and close members of the victims’ community. The tragic stories of women like Shafilea Ahmed, Banaz Mahmoud and many others  are at the extreme end of a scale of abuse unique in character and quite different to domestic violence or murder, mainly because of the level of community collusion involved.

In these communities a family’s status is judged by its ability to control its women and children, and must ensure their adherence to a strict code of behaviour. Swift punishment is expected for any deviance from this. Physical violence, stalking, forced marriage, rape, incest, imprisonment, domestic/sexual exploitation and forced immigration have all been carried out in the name of ‘honour’, although these and other abuses such as genital mutilation can occur without any such ‘breach of behaviour’.

Reproductive health practitioners face a number of specific challenges in supporting victims of honour abuse, as the range of apparent offences that can provoke it mostly involve expressions of sexuality or discovery of sexual activity. There is a particularly high risk of unplanned pregnancy due to lack of contraceptive awareness or unwillingness to use contraception that may interfere with menstrual cycles.  In abusive households periods may be monitored by female members, most often the mother, to deduce readiness for marriage and to ensure that the hymen, a mistaken indicator of virginity, is kept intact. It can also safely be said that the life of most victims who present with pregnancy at a reproductive health clinic is at risk, and this should never be underestimated. Women have either become pregnant as a result of the abuse, or they have been sexually active in a ‘forbidden’ relationship i.e. with someone from the ‘wrong’ race or even the ‘wrong’ caste.

Mental health issues may also impair victims’ capacity to make important decisions about their health. As this study demonstrates, depression, self-harm and suicide can all affect South Asian women 2-3 times more than the national average, and stigma around mental illness in this community is well documented.  Where sexual abuse and incest occur, it is most often with the knowledge of other family members who are complicit in the abuse due to active participation, inaction and/or fear of reprisal. Seeking help for any kind of personal family issue is heavily frowned upon and can constitute a loss of honour in itself.

Although measures are beginning to be taken to address the problem, there continues to be a deep lack of general awareness around the issue. If you would like to find out more about honour abuse, organisations like Karma Nirvana, the Iranian & Kurdish Women’s Rights Organisation (IKWRO) and the Southall Black Sisters have a range of useful resources available. Information can also be found online at HBV Awareness and in publications such as Rana Husseini’s ‘Murder in the Name of Honour’ and Lynne Welchman/Sara Hossain’s ‘Honour: Crimes, Paradigms and Violence against Women’.

The impact of anti-abortion protestors on our clinic staff

The first thing anyone at bpas will say if asked how protestors make them feel is ‘Oh I’m OK – it’s the women I worry about.’ Our staff are passionate about their work and hate to see the impact of groups like ‘40 Days for Life’ or ‘Abort67’ when a woman is already feeling vulnerable. Helping women and their escorts deal with protestors will always be our top priority so the impact on the doctors, nurses and support staff who work in clinics is usually at the back of our minds, but it is worth taking a moment to explain what it is like for us during that time.

The general feeling among staff in the clinics affected by major protests (primarily Central London, Brighton and increasingly Milton Keynes) is that while it is unpleasant it is manageable. Support of the local police goes a long way to reassure staff that they are protected from any extreme behaviour by, increasingly entirely male, groups that stand outside clinics. The outpouring of support from our neighbours and local people has also been a comforting reminder that the protestors are a tiny minority.

Imagine every day when you get to work there is a strange man standing by the front door either glaring at you or trying to ‘befriend’ you depending on his mood. When you step outside the door during the course of the day, depending on what you look like, you may be hassled by protestors asking if you’re pregnant, face a dozen people who start praying loudly when they see you or have leaflets aggressively thrust at you. At the end of the day when the clinic is closed you lock up the building there is a large man is standing by the door, this time with no pretence about ‘helping women’ – he is just there to intimidate you as you leave alone at night.

That is an average day – manageable but unpleasant. The occasions where staff are followed on their lunch breaks, filmed coming in and out of the clinic or called ‘murderer’ while on a fire drill are thankfully infrequent.

Ultimately everyone at bpas feels this is unimportant when compared to the distress protestors cause women and their escorts, but that’s not to say the deliberation creation of a hostile environment outside clinics is meaningless to staff. Our staff should not suffer a form of daily harassment that the protestors would find reprehensible should the women in their own lives were subjected to it.

40 Days for Life, anti-abortion protests and their impact on women

At the end of another 40 Days for Life, we want to share some comments from women attending our clinics who have faced protestors. These comments reflect experiences with 40 Days for Life and the group Abort 67. We really hope that before protestors start their next “vigil” they consider the impact they have on women.

“I’ve felt harassed by one of the ladies asking me constantly if I was sure of my decision and offering me her help giving me her phone number. I found that like an intrusion in my private life and not making easier such a difficult decision like the one I had to make.”

“They kept staring at me and made me feel uncomfortable and upset.”

“I was very nervous about coming to my appointment and felt very intimidated by the 5 or 6 women standing on the street. Not knowing the area I did not know another route to avoid them and due to feeling extremely distressed by their presence, I turned around and went home.” This woman subsequently came for another appointment.

“She told me they could help; that I was going to hurt terribly emotionally after today and it wasn’t too late to walk away. I was running a few minutes late as I’d travelled quite far and she suggested I was late for a reason.”

“I was harassed and intimidated. I was told to read the leaflets they were trying to give out. Then they went up to my daughter and tried giving her the leaflets.”

 “I am extremely angry at the presence of the protestors. Me and my girlfriend are upset enough but have made our decision and I believe confronting people on their way into the building is sickening.”

“Please remove the protestors. It’s fine to offer a leaflet but chasing me down the street is not.”