NICE Termination of Pregnancy Guideline – Call for Committee Members

NICE is seeking additional committee members for its Termination of Pregnancy Guideline – see request below. Please feel free to forward this request to relevant colleagues. Applicants should contact Eleanor Howat directly for an application form as this is no longer available on the web.

BSACP Administrator

 

Dear Colleague

I am writing to invite you and your network of contacts to consider applying for the role of committee member for the NICE guideline committee on Termination of pregnancy. Please submit your application by 10am Monday 16th October 2017. A copy of the application form and supporting documents should be requested from Eleanor Howat at ehowat@rcog.org.uk.

Committee role

We are looking for committee members as follows

1 x psychologist or counsellor with experience in termination of pregnancy services

1 x anaesthetist/sedation provider

Details on the guideline can be found on the NICE web site using the link below:

https://www.nice.org.uk/guidance/indevelopment/gid-ng10058

 How to apply for professional roles

Please send a short CV and cover letter before the deadline of 10am Monday 16th October to NGAapplications@rcog.org.uk for my attention.  The following documents should be included:

  1. A cover letter, explaining how you meet the criteria in the person specification and your motivation for applying for the post
  2. A short CV
  3. Applicant information form – with details of 2 referees
  4. Declaration of interests form
  5. Equality monitoring form

Please request a copy of the application form and supporting documents from Eleanor Howat  at ehowat@rcog.org.uk.

Spread the word

Please encourage your network of contacts to apply to be part of this committee.

Thank you for your help in finding committee members for this NICE guideline.

Eleanor Howat (Project Manager)

National Guideline Alliance (NGA)

Royal College of Obstetricians and Gynaecologists

T: +020 7772 6452

E: ehowat@rcog.org.uk

W: www.rcog.org.uk

13th FIAPAC Conference, September 2018

13th FIAPAC Conference on ‘Liberating Women – Removing Barriers and Increasing Access to Abortion Care’, Nantes, France, 14–15 September 2018

A little more than 40 years after the adoption of the Veil law, the care provision of abortion and contraception is being continually modified by input from new organisations, as well as the evolution of techniques and thoughts. This topic will be re-explored and discussed at this FIAPAC conference, which is supported by the National Association of Abortion and Contraception Centers ANCIC, and the National College of Gynecologists and Obstetrics (CNOGF) and the Réseau Sécurité Naissance.

http://www.fiapac.org/en/program/22/Nantes-intro/

BSACP Welcomes RCOG Council’s Vote in Support of Decriminalisation of Abortion in Britain

22 September 2017

The British Society of Abortion Care Providers (BSACP) welcomes today’s news that the Council of the Royal College of Obstetricians and Gynaecologists (RCOG) voted to support the decriminalisation of abortion in Britain and called for its regulation in line with other medical procedures.

Dr Kate Guthrie, BSACP Co-Chair, said: “BSACP has long been a supporter of the effort to remove abortion from the criminal code in Britain. Abortion is an integral part of women’s healthcare but the current legal framework stigmatises women who need abortion care as well as those who provide it, and hampers medical progress in service delivery. The mounting support of professional organisations such as BSACP, RCOG, Royal College of Midwives and the British Medical Association should compel the British Government to move forward with the decriminalisation of abortion for the well-being of the women who need this service and the clinicians committed to providing it.”

Kate Guthrie (BSACP Co-Chair)

https://www.rcog.org.uk/en/news/rcog-backs-decriminalisation-of-abortion/

New Research Finds Access Barriers to Abortion in Great Britain

20 September 2017

A paper published in the journal Contraception gives voice to women who have experienced such difficulty in accessing abortion care in Great Britain that they have resorted to online care on the Internet.

The study examined the demographics and circumstances of all women requesting early medication abortion through the online telemedicine initiative Women on Web (WoW) over a 4-month period which shows that some of the most vulnerable and marginalised groups of women are prepared to break the law to surmount barriers in accessing abortion care. Closing the healthcare gap would require legal and regulation change.

Aiken Abigail R.A., Guthrie Katherine A., Schellekens Marlies, Trussell James, Gomperts Rebecca. Barriers to accessing abortion services and perspectives on using mifepristone and misoprostol at home in Great Britain. Contraception 2017; doi: 10.1016/j.contraception.2017.09.003

http://www.contraceptionjournal.org/article/S0010-7824(17)30435-3/pdf

BSACP/RSM Joint Conference on ‘Excellence in Abortion Care’, Wednesday 11 October 2017

The British Society of Abortion Care Providers (BSACP) and the RSM’s Sexuality & Sexual Health Section are jointly organising a one-day conference on ‘Excellence in Abortion Care’ to be held at the Royal Society of Medicine (RSM) in London, UK on Wednesday 11 October 2017.

New developments in abortion care and commissioning processes impact on the way that abortion and sexual health services are being delivered. It is important that health care professionals working in abortion, sexual health services and general practice are aware of and understand how these developments can impact on patient care and patient outcomes. This conference will bring together a wide range of experts and health care professionals from all areas of the UK to provide a comprehensive overview of current and future concepts in abortion care.

See the full conference programme and register at: https://www.rsm.ac.uk/events/sek01

BSACP members are entitled to a preferential (discounted) registration fee of £80.00.

***Advance online registration closed on Wednesday 4 October 2017. A limited number of delegate places will be available on a ‘first come, first served’ basis at the conference from 8.30am onwards .***

***BSACP members are encouraged to attend the BSACP AGM to be held during the lunch break from 1.30-2.00pm.***.

 

‘Doctors, Conscience and Abortion Law and Practice’ Workshop, University of Kent, Canterbury, UK, 29 June 2017

On Thursday 29th June I attended a conference at the University of Kent entitled ‘Doctors, Conscience and Abortion Law and Practice’ organised by Dr Ellie Lee and Professor Sally Sheldon as a collaboration between the Centre for the Interdisciplinary Study of Reproduction (CISoR), the Centre for Parenting Culture Studies (CPCS) and the British Pregnancy Advisory Service (bpas). This conference was part of a series of events for the 50th Anniversary of the 1967 Abortion Act and aimed to promote critical reflection on this legislation. There were four main sections to the day: ‘Doctors and the Abortion Act 1967,’ ‘Abortion Providers: Doctors Who Do’, ‘Conscientious Objection: Doctors Who Don’t’ and finally closing remarks from Ann Furedi (bpas Chief Executive).

Overall this conference was extremely interesting with scholars from around the world giving fascinating talks on the issue of conscience. One of the most memorable comments of the day was made by Professor Malcolm Potts (University of California at Berkeley) who said the abortion procedure is the only one in America where “the surgeon is more likely to die than the patient”. This comment was striking for me as it really drew attention to the fantastic, yet dangerous jobs medical professionals across the globe do in providing safe abortions to women. A further interesting point raised at this conference was regarding the conscientious objection clause and the current debate surrounding the position of abortion in medicine. There were many different opinions on the conscientious objection clause of the 1967 Abortion Act at the conference. Some people attending the conference believed that abortion should be considered a routine aspect of obstetrics and gynaecology, and if any doctor conscientiously objects to abortion then they should specialise in a different field of medicine. This is widely linked to debates on the position of abortion within medicine in Britain and is definitely a discussion that needs to continue.

Finally, I would like to highlight the ‘My Abortion Experience’ project led by Dr Lesley Hoggart. During the conference we were shown several films of young women describing their experience of abortion. The stories these young women told were inspirational and showed the importance of the work that medical professionals who are involved in the provision of abortion do on a daily basis. There is an upcoming 2-day conference in London as part of this series on 24–25 October 2017 entitled ‘The Abortion Act 1967: A Promise Fulfilled?’, which aims to address a range of important socio-legal, historical, political and clinical practice-based questions, focusing on the hopes and strategies of the broad coalition (made up of disparate constituencies) in favour of liberalising change and the extent to which they have been realised.

Hannah Pereira

ESRC PhD Candidate in Social Policy, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK; hp273@kent.ac.uk

 

Statement from the Isle of Man Government Department of Health and Social Care

Termination of Pregnancy (Medical Defences) Act 1995: Feasibility of an Amendment Bill during the 2017/18 legislative session

This statement from the Isle of Man Government Department of Health and Social Care (equivalent to the Department of Health in England) summarises: the current position and that of other jurisdictions in the British Isles and Gibraltar; the evidence for clinical impact of termination of pregnancy on physical and mental health; the position of groups with a particular interest in abortion on the Isle of Man; the current review of the legal position in Ireland and the legal challenge to that in Northern Ireland; and indicators of demand for termination of pregnancy from Isle of Man women.

https://www.gov.im/media/1354907/termination-of-pregnancy-medical-defences-act-1995-feasibility-of-an-amendment-bill-during-the-2017-18-legislative-session.pdf

 

Scottish Abortion Care Providers Meeting – The Highlights!

Overview

The 7th Annual Scottish Abortion Care Providers meeting was held in Edinburgh on 27 January 2017.

Over 100 delegates attended from all over Europe, representing many different disciplines. It was a fantastic opportunity to meet enthusiastic colleagues and share new information and visions, helping to improve abortion care in Scotland, through talks, discussions and poster presentations. A wide range of thought-provoking topics were presented within the main meeting themes, including current care within Scotland, and the challenges and new initiatives associated with improving a women’s journey through abortion.

Scottish Abortion Care

Dr Rachael Wood from National Services Scotland opened the proceedings by providing some background to the current abortion statistics for Scotland. We learnt that there has been an increase of 2.6% in the number of abortions performed in Scotland from 2014 to 2015. This is not thought to be due to non-Scottish residents or women travelling for abortion. The increase has been seen mainly in women living in areas of deprivation, particularly women aged 35–39 years. Almost 80% undergo a medical abortion, with approximately 60% in 2015 occurring by 8 weeks (compared with 33% in 2006).

Difficulties in Abortion Care

Dr Caitriona Henchion from the Irish fpa (@IrishFPA) highlighted the difficulties faced by women and healthcare professionals in both the North and South of Ireland.

We then learned of Portugal’s journey following the legalisation of abortion from Dr Teresa Bombas.

Dr Lisa McDaid (@mcd_li) from the University of Glasgow provided an interesting insight into women’s experience of more than one abortion.1 She explained that there are often complex and overlapping issues, which demonstrate a range of potential vulnerabilities among women seeking more than one abortion. Terms such as ‘late’ and ‘repeat’ abortion are stigmatising in themselves for women. She suggested rather than a policy focus on trying to reduce ‘repeat’ and ‘late’ abortions, instead we should shift the focus towards preventing unintended conceptions and supporting those women who need subsequent abortions.

Latest Initiatives

Dr Philippe Faucher (@PhilFaucher) gave a stimulating talk on the management of early medical abortion (i.e. pregnancy of unknown location). He presented research to highlight that this is an option for many women and something that is now offered in his service in France. Provided risk factors for ectopic pregnancy are excluded, mifepristone can be administered, following a serum human chorionic gonadotrophin (hCG) result on that day. Women should be followed up within 7 days where an 80% decrease in serum hCG level would be expected (50% at Day 4).

Dr Faucher provided evidence to suggest that mifepristone was not dangerous for an ectopic pregnancy, which could well be missed on an early pregnancy scan. In fact, he proposed that managing abortion in this way would lead to earlier detection of ectopic pregnancies.

This is not yet routine practice in the UK. Currently high-sensitivity urine pregnancy tests are used rather than successive serum hCG levels to confirm complete abortion. However, this research suggests another option for women not wishing to delay their pregnancy management.

Dr Patricia Lohr (@lohrpa) shared bpas’ experiences when altering the timing between mifepristone and misoprostol from 24–48 hours to same-day administration. Both options were found to be acceptable to women. While there may be a slightly reduced efficacy with same-day administration, this was often the preferred option for women due to their own personal circumstances.

 Professor James Trussell presented reassuring work on the experiences of women seeking at-home medical abortion through ‘Women on Web’ from both Eire and Northern Ireland.2 Over a 5-year period (January 2010–December 2015) 5650 women requested at-home medical abortion. Just over 1000 women were surveyed, with 97% feeling they had made the right decision and 98% recommending the method to others. The feelings women most commonly reported after completing TOP were ‘relieved’ (70%) and ‘satisfied’ (36%).

We then heard about Scottish initiatives to improve women’s journey through abortion. Leanne Rockingham (@learock76) and Jill Wilson from NHS Lothian and Greater Glasgow and Clyde presented a recently developed animated film entitled ‘Let’s Talk About Abortion’ (https://youtu.be/KksPuM5cokc). This work led on from research carried out by the Centre for Research on Families and Relationships on young people’s views and knowledge about abortion. This short film addresses the gaps highlighted by the research findings and provides the information that young people themselves have asked for, in a format with which they will engage.

The meeting provided lots of food for thought, and prompted discussions and networking between groups to take some of these ideas forward. I’m looking forward to next year’s meeting already!

Janine Simpson, Specialty Registrar Community Sexual and Reproductive Health, Sandyford, Glasgow, UK; janine.simpson2@nhs.net

References

  1. Purcell C, Cameron S, Caird L, et al. Access to and experience of later abortion: accounts from women in Scotland. Perspect Sex Reprod Health 2014; 46: 101–108. DOI: 10.1363/46e1214.
  2. Aiken ARA, Gomperts R, Trussell J. Experiences and characteristics of women seeking and completing at-home medical termination of pregnancy through online telemedicine in Ireland and Northern Ireland: a population-based analysis. BJOG 2016; DOI: 10.1111/1471-0528.14401.