Oireachtas Committee Recommends Abortion Decriminalisation and Free Access up to 12 Weeks with Overwhelming Support for Free Contraception

14 December 2017

An article in The Times newspaper today illustrates two pieces of compelling oral evidence presented to the Oireachtas Committee that were heavily influential in this decision: Abigail Aiken’s data on the number of women known to be buying abortion pills online, and Patricia Lohr’s evidence on flaws in UK legislation. Both of these issues are just as relevant and harmful to women in mainland UK, and this recommendation for Eire further emphasises the totally unacceptable position for the women of Northern Ireland. Furthermore, the reduction in access to contraception, which will especially hit the highly effective long-acting reversible contraceptive (LARC) methods, further increases the risk of unwanted pregnancy. [Sexual health services on the brink, BMJ 2017; 359; doi: https://doi.org/10.1136/bmj.j5395]

The British Society of Abortion Care Providers (BSACP) notes the groundswell of public and professional opinion, and fully supports legal and regulatory changes that increase access to evidence-based abortion care in both Eire and across the entire United Kingdom.

https://www.thetimes.co.uk/article/women-buying-illegal-pills-swayed-abortion-decision-tvp2kffst

Kate Guthrie/Joanne Fletcher (BSACP Co-Chairs)

BSACP/ARHP Joint Webinar on Simultaneous EMA: 14 December 2017

Outcomes with Simultaneous Administration of Mifepristone and Misoprostol for Early Medical Abortion

with Patricia Lohr, MD MPH, BPAS Medical Director and BSACP Treasurer

Thursday 14 December 2017 at 6:30 PM GMT / 1:30 PM EST

This joint webinar with the British Society of Abortion Care Providers (BSACP) and Association of Reproductive Health Professionals (ARHP) is the first of a new series of members-only educational opportunities. We will provide several of these webinars throughout the year at no cost to BSACP/ARHP members, so although this inaugural webinar is open to non-members, we encourage you to join BSACP or renew your membership for 2018 to participate in future activities.

[NB. BSACP will shortly be contacting current members individually about membership renewal arrangements for 2018.]

In this webinar, Dr Patricia Lohr, Medical Director of British Pregnancy Advisory Service, will discuss reduced-interval medical abortion regimens including outcomes from a large cohort study comparing simultaneous dosing with a 24–48 hour interval. As legislative restrictions continue to affect the provision of medically-induced abortion, reduced interval regimens offer an opportunity to protect patients’ access to care but at the expense of greater effectiveness.

By the end of this activity, participants will be able to:
1. Identify the primary impact of legislative restrictions on medical abortion care
2. Explain the rationale for reduced interval medical abortion regimens
3. Describe the effectiveness and acceptability of reduced-interval medical abortion regimens
4. Compare outcomes using simultaneous administration of mifepristone and misoprostol to those using a regimen with a 24- to 48-hour interval between medications.

Register NOW by clicking: https://register.gotowebinar.com/register/5452575305632583171

We hope you will consider joining us for this FREE webinar and future ARHP/BSACP activities.

Kate Guthrie/Joanne Fletcher  (BSACP Co-Chairs)

Health Canada Further Increases Access to Early Medical Abortion

8 November 2017

Abortion was decriminalised in Canada. Health professional scope of practice regulation is now in the jurisdiction of the respective health professional regulatory colleges. In Ontario, nurse practitioners can prescribe and dispense mifepristone if they have undertaken the prescribed training programme. Health Canada has now removed all restrictions on distribution, prescription and dispensing of mifepristone in Canada, giving it federal regulations similar to other prescription drugs. This means women can collect both mifepristone and misoprostol from the pharmacy and take both at home, unsupervised.

More information is available at this Health Canada link: http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2017/65030a-eng.php

Kate Guthrie (BSACP Co-Chair)

Joint RSM/BSACP Conference on ‘Excellence in Abortion Care’ at the Royal Society of Medicine, London, UK on 11 October 2017

On Wednesday 11 October 2017, I attended the joint conference organised by the British Society of Abortion Care Providers (BSACP) and the Royal Society of Medicine (RSM) with the theme ‘Excellence in Abortion Care’. I was particularly excited to attend, as I am currently the President of the Society of Medical Students for Choice in QUB, as well as a volunteer with Alliance for Choice, an activist group based in Belfast, and I have a keen interest in abortion care and women’s health.

The day was packed with informative sessions, split into six main sessions: Update on Abortion Statistics; Clinical Update in Abortion Care; Using Telemedicine to Increase Access and Satisfaction of Abortion Care; Inspection and Regulation; Access and Management of Abortion After the First Trimester; and Nurses and Midwives in Abortion Care. With such a varied and mixed day, I believe that the conference was accessible and interesting for people involved in many different areas of abortion care.

The abortion statistics session contained many interesting points about the implications of Northern Irish and Irish pregnant women and people travelling to Britain for abortion access. The point was made that the numbers of women and people travelling from Northern Ireland and Ireland to undergo abortions in Britain are always underestimates, on account of stigma and fear leading to people not providing accurate addresses and postcodes.

The session around clinical updates in abortion care was very interesting with regard to the woman-centred aspects of abortion care, and demonstrated how the patient experience is useful in improving clinical practice. This session focused on early medical abortion (EMA) and pain management during manual vacuum aspiration. I found the EMA session particularly informative about the benefits versus the negatives of EMA in terms of patient satisfaction and reducing the stress of unexpected pregnancies and the risks of EMA, including missed ectopic pregnancies.

Telemedicine is an area of medicine that is often underutilised; however, it has an important role to play in abortion provision, facilitating the care of patients living in remote areas or those who cannot attend clinics for a variety of reasons. It was stressed in this session how important the decriminalization of abortion care is in facilitating the provision of better access to abortion services to those patients who cannot access care within a clinic or hospital setting. This is an example of the Inverse Care Law being seen in action, namely those who are most in need of care being unable to access it, including those in controlling relationships or those with childcare or work responsibilities that they cannot abandon in order to attend a clinic or hospital for a day. Despite the National Health Service (NHS) being set up to reduce health inequalities, travelling for abortion care can result in many inequalities for those who are unable to travel for the reasons given above. This is also important to remember in respect of pregnant women and people in Northern Ireland and Ireland – free abortion services and funding in Britain is not a long-term solution for many women, and abortion services must be accessible within local care facilities or even at home. Unfortunately, however, legislation often stands in the way of providing high-quality, patient-centred care.

This focus on legislation continued into the afternoon, with the session on Nurses and Midwives in Abortion Care commenting on the limits of the 1967 Abortion Act, which we are celebrating 50 years of in Britain. This Act, which was extremely welcome in 1967, as women were dying or left with lifelong disabilities after unsafe and illegal abortions, is out of date for 2017. With developments such as ‘Women on Web’ and ‘Women on Waves’, that provide abortion pills to people who cannot access healthcare facilities, access to abortion can be as close as a mouse-click away. Similarly, legal limitations on who can provide abortions restricts abortion care provision to doctors and excludes nurses and midwives, despite them being highly trained members of the healthcare team, when their involvement in abortion care provision might sometimes be preferable in terms of resource allocation.

The day ended with a documentary film showcase led by Dr Jayne Kavanagh, a clinical teaching fellow at University College London. This film was incredibly powerful and emotional, and featured interviews with doctors who worked both before and after the 1967 Abortion Act; activists and politicians who were instrumental in bringing about changes in abortion legislation; and, of course, women who accessed abortion services before the Act was introduced. I personally found the film particularly moving because this year not only represents 50 years since the 1967 Abortion Act was introduced in Britain, but also because it represents 50 years of denial of abortion care to pregnant women and people in Northern Ireland.

However, to end on an optimistic note, I do believe that continuing activism and advocacy from leading healthcare organisations, including the British Medical Association, Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and, of course, the BSACP, are helping to bring about a change of opinion and ensuring access to essential abortion care services to all pregnant women and people, regardless of their address or postcode. Similarly, the hard work and success of the British Pregnancy Advisory Service’s #WeTrustWomen campaign and Alliance for Choice’s #TrustWomen campaign are bringing abortion to the forefront for politicians to discuss, and are raising public awareness about this important healthcare and human rights issue.

Jill McManus, Third-year Medical Student, Queen’s University Belfast, Belfast, Northern Ireland; jmcmanus27@qub.ac.uk

Note on the Author

Jill McManus is president of the QUB chapter of Medical Students for Choice, and is an activist with Alliance for Choice, a pro-choice activist and advocacy group based in Northern Ireland. She also has a blog, where she writes about current events and information on abortion.

Scotland is the First UK Country to Allow Women to Take Abortion Pills at Home

26 October 2017

Professor Alan Templeton announced from the podium at the wonderful The Abortion Act 1967 Conference held at the Royal College of Obstetricians and Gynaecologists (RCOG) earlier this week that women in Scotland will soon be able to take the misoprostol component of early medical abortion at home. The date has yet to be announced but the decision has been made. We can but hope that this woman-centred, safe and compassionate change is also sanctioned in England and Wales. One would think it difficult to argue otherwise.

Link to BuzzFeed article: https://www.buzzfeed.com/laurasilver/scotland-first-uk-country-to-allow-women-abortion-pill-home?utm_term=.epnRNxpk8

BuzzFeed App available at: https://bzfd.it/bfmobileapps

Kate Guthrie  (BSACP Co-Chair)

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

[NB. The deadline for submission of applications has now passed.]

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.

[NB. Reports on this conference will appear on the website shortly.]