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.

Norma McCorvey (1947–2017)

Jane Roe was the pseudonym for the plaintiff in the well-known Roe v Wade case1 which liberalised abortion law in the USA in 1973. The case turned on a woman’s constitutional right to privacy which had long been held to protect intimate and personal decisions from government interference. What is often not realised is that at no point in her life did ‘Jane Roe’ ever have an abortion. She was a woman lifted by chance into a national spotlight she never sought and tried to avoid for years. The real Jane Roe, Norma McCorvey, died on 18 February 2017 aged 69.

Norma was the ninth child of a poor family living in rural Louisiana. She was neglected by her parents and exhibited disturbed behaviour in childhood. Norma was made a ward of court and institutionalised. At 16 she had left school and was working as a waitress when she met and married a sheet-metal worker, Woody McCorvey. She suffered violence at his hands, before and after she became pregnant. She left him and gave birth to a daughter, Melissa, in 1965. She began drinking heavily and came out as a lesbian. She was deceived into signing adoption papers for Melissa by her mother; her mother raised Melissa.

At the age of 18, having been working in a series of mundane jobs, Norma had a second child whom she gave up for adoption. Norma was aged 22 and pregnant for the third time when in 1969 she sought an abortion, then illegal under Texan law except when necessary to save a woman’s life. After first claiming she had been gang-raped, thinking that this might get her a legal abortion, and seeking an illegal one as well, she visited the Dallas lawyers Sarah Weddington and Linda Coffee. She was already 20 weeks’ pregnant. They wished to challenge the law which they knew would take time; McCorvey wanted an abortion urgently. She later claimed she had signed the affidavit without reading it and did not understanding what the case would entail. The case was filed against the Dallas County District Attorney, Henry Wade.

McCorvey’s baby had been born, given up for adoption and was 2½-years-old by the time the Supreme Court made its ruling. The decision, by a 7–2 majority, came on 22 January 1973. Justice Harry Blackmun’s opinion gave women the right to choose, while protecting the state’s interest in protecting the fetus in the later stages of pregnancy. Roe v Wade, and a companion ruling in a Georgia case, Doe v Bolton, nullified restrictive laws in 46 US states. The landmark decision marked a milestone in women’s reproductive rights.

Some years later, McCorvey stepped into the public eye, becoming a prominent voice for the pro-choice movement from the 1980s to the mid-1990s. Admitting in the media that her story of impregnation through gang rape was a lie (though that played no part in the case that went to court), she was pilloried by those on both the left and right. Working at a Dallas women’s clinic during a period when violence was not uncommon at abortion clinics, she was faced with verbal abuse from protesters daily.

McCorvey never managed to escape from poverty. She became increasingly embittered towards the feminist movement whose leaders were much wealthier and better educated than her. By the time her autobiography, I Am Roe, written with Andy Meisner, was published in 1994, McCorvey had become a born-again Christian. She was baptised by the head of Operation Rescue whose headquarters had moved to the same block as the clinic she worked at. She began campaigning vigorously against abortion, claiming she had been a pawn of her Roe v Wade lawyers. Later she converted to Catholicism.

Testifying before the Senate in 1998, she said “I am dedicated to spending the rest of my life undoing the law that bears my name”. She petitioned the Supreme Court to overturn the Roe v Wade decision, but it rejected her appeal. She protested when Barack Obama spoke at the Roman Catholic University of Notre Dame in 2009, and was arrested at Senate hearings while protesting against the appointment of the pro-choice Sonia Sotomayor to the Supreme Court.

Sam Rowlands, Visiting Professor, Bournemouth University, Bournemouth, UK

1 Roe v Wade 410 US 113 (1973).

BSACP 2017 Conference – Session/Lecture Suggestions Invited

31 March 2017

Dear BSACP Members

We are currently preparing the agenda for the next BSACP conference, which will be held on Wednesday 11 October 2017 at the Royal Society of Medicine in London.

We would like to invite members to contribute ideas for sessions/lectures, which will be combined with the list of suggestions made at the inaugural BSACP conference held in October 2015.

We welcome your views and suggestions, as we are keen to tailor the conference agenda to members’ requirements and interests.

Please submit your suggestions to the BSACP Administrator (admin@bsacp.org.uk) as soon as possible.

Please also remember to save the date – Wednesday 11 October 2017  – in your diary!

Welcome to the BSACP Website!

The British Society of Abortion Care Providers (BSACP) has been formed to promote best practice, education, training and research in abortion care.

The BSACP will serve its members by providing a forum for professional development and networking, as well as by raising the profile of the specialty and improving understanding amongst those responsible for abortion-related policy, guidance, commissioning, regulation and training.

BSACP Members’ Forum: DocMatter

BSACP members have access to a closed discussion group hosted by DocMatter. This is a forum for our community to share best practices in patient care, learn from one another, and collaborate.

New BSACP members will receive a welcome e-mail directly from DocMatter with a link to join, but if you have not received this, please click here to log in or sign up. Remember to use an institutional e-mail address if you are requesting access.

If have already set your password, you will be able to find the discussion group, here: https://www.docmatter.com/bsacp

If you have any questions, you can contact our Support Manager, Katherine Bruce, at: katherine@docmatter.com

Chair and Clinical Lead for the NICE Guideline Committee on Termination of Pregnancy

Applications are invited for the posts of Chair and Clinical Lead for the NICE Guideline Committee on Termination of Pregnancy. This is a chance to be involved in the guideline when the scope is under discussion and to help to review evidence-based medicine in this important field. The closing date for applications is 10.00am on Wednesday 15 February 2017.

Details of this guideline can be found here: https://www.nice.org.uk/guidance/indevelopment/gid-ng10058

 Roles

  1. CHAIR – we are looking for an experienced committee chair. For further information please see: https://www.nice.org.uk/get-involved/join-a-committee/chair-termination-of-pregnancy-gc
  2. CLINICAL LEAD – we are looking for an experienced professional in termination of pregnancy. For further information please see: https://www.nice.org.uk/get-involved/join-a-committee/clinical-lead-termination-of-pregnancy-gc

How to apply

The following documents are to be completed and sent via email to Victoria Rowlands (details below) before the deadline of 10.00am on Wednesday 15 February 2017 or alternatively apply to NGAapplications@rcog.org.uk :

  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 two referees
  4. Declaration of interests form
  5. Equality monitoring form

The forms can be downloaded from the NICE website here:

https://www.nice.org.uk/get-involved/join-a-committee/professional-member-applications#

***NB. The deadline for receipt of applications has now passed.***

Please encourage your network of contacts to apply for the important roles of Chair and Clinical Lead on the NICE Guideline Committee on Termination of Pregnancy before the deadline. 

Additionally if you would like to register as a stakeholder organisation please see https://www.nice.org.uk/guidance/indevelopment/gid-ng10058

 

Victoria Rowlands

Project Manager – National Guideline Alliance (NGA)

Royal College of Obstetricians and Gynaecologists

T: +020 7045 6747

E: vrowlands@rcog.org.uk

W: www.rcog.org.uk

 

International Women’s Day 2017: ‘Abortion Care: Our Responsibility’

Joint RCOG/FSRH Event on Friday 3 March 2017, 9.00am–3.30pm at the Royal College of Obstetricians and Gynaecologists, Regent’s Park, London, UK

24 January 2017

Each year in England and Wales around 200,000 women have an abortion, making this the most common medical or surgical procedure performed in this country. Around one-third of British women will have had an abortion by the time they reach the age of 45 years.

Fifty years after the Abortion Act 1967, the Royal College of Obstetricians and Gynaecologists (RCOG) has identified as a key priority the need to ensure today’s abortion services are sustainable into the future. Changes to the way abortion care is commissioned and delivered are having an impact on doctors’ access to training and women’s access to services, while the low prestige and stigma that can be associated with abortion care are affecting morale.

You are invited to join the RCOG and the Faculty of Sexual and Reproductive Healthcare (FSRH) to celebrate International Women’s Day 2017, where the aim is to ensure abortion is seen as a core part of women’s health services, not ‘somebody else’s business’. All healthcare professionals who provide abortion care are invited to attend this free event.

Expert speakers and advocates for abortion care will provide insights into the challenges experienced in providing training in this area, what it’s like to work in abortion care, and the wider environment in which abortion services are delivered. The programme includes presentations on:

  • The moral case for abortion
  • Training and working in abortion care – stigma, conscientious objection, and the view from clinicians
  • The effect of unintended pregnancy and abortion on mental health and wellbeing
  • Recent technical advances in abortion care
  • Commissioning abortion services in the UK
  • The RCOG Abortion Task Force

Attendees will also have the chance to take part in a panel discussion looking at current clinical controversies in abortion care, as well as an interactive workshop exploring attitudes to abortion.

Programme: https://www.rcog.org.uk/globalassets/documents/courses-exams-and-events/postgraduate-and-scientific-events/international-womens-day-2017.pdf

Further information/register at: https://www.rcog.org.uk/en/departmental-catalog/Departments/postgraduate-and-scientific-meetings/1772—7ch—international-womens-day/

 

Manual Vacuum Aspiration Training – 10 February 2017

Dear Colleagues

The Manual Vacuum Aspiration (MVA) training course is a joint RCOG/BSACP/FSRH hands-on and theoretical course that focuses on the outpatient management of miscarriage and abortion using manual vacuum aspiration.

The MVA procedure is accessible, easy to deliver, does not require a general anaesthetic and is cost-effective. With the high safety profile of this procedure and increasing potential, there is need to improve access to MVA in the UK.

In addition to providing a grounding in the MVA, this course covers the equipment, staffing, analgesia and other requirements for surgical uterine evacuation in the outpatient setting.

Learning objectives:

  • Learn how to confidently fit together and operate a MVA kit
  • Gain knowledge of appropriate pain relief
  • Safely undertake MVA of uterine contents in a model
  • Learn how to provide appropriate support for the woman and her support person
  • Gain skills to develop a business case for MVA
  • Meet others with experience of setting up similar services
  • Make contacts for sharing guidelines and pathways

View the programme and book online: View the programme and book online >>

We look forward to seeing you at the College.

Events Team

Royal College of Obstetricians and Gynaecologists

27 Sussex Place, Regent’s Park, London, NW1 4RG, UK

+44 20 7772 6245

events@rcog.org.uk

 

Scottish Abortion Care Providers Conference

Friday 27th January 2017, Royal College of Physicians, 9 Queen Street, Edinburgh, UK

The scientific programme for this conference appears below.

An application form is available and places will be allocated on a ‘first come, first served’ basis. NHS Scotland delegates can attend free of charge. Other delegates will be expected to pay a £50 attendance charge.

Further information and application forms are available from: Kate Elder, Team Leader/PA, Chalmers Centre, 2a Chalmers Street, Edinburgh EH3 9ES, UK. E-mail: kate.elder@nhslothian.scot.nhs.uk

***Closing date for applications extended to: 20th January 2017***  

FINAL PROGRAMME Friday 27 January 2017

9.15-9.45  

Registration

 

Speakers

 

Check timings

 

9.45- 9.50

 

Welcome – Dr Sharon Cameron

 

 

 

 

Session 1

 

 

Trends and Issues in Scotland

 

Chair: Dr Sharon Cameron

 

9.50-10.10

 

Termination of pregnancy statistics

 

Dr Rachael Wood, NSS

 

 

10.10-10.30

 

Options for TOP if you are a woman in Ireland

 

Dr Caitriona Henchion, Northern Ireland

 

 

10.30-10:50

 

Management of very early TOP

 

Dr Philippe Faucher, France

 

10.50 – 11.10

 

Questions

 

 
11.10 – 11.40 Morning Tea/Coffee break and poster viewing
 

Session 2

 

 

Hot Topics

 

Chair: Dr Lucy Caird

 

 

Hot topic 1

11.40-12.00 noon

 

Same day mifepristone and misprostol for EMA Dr Patricia Lohr, bpas
 

Hot topic 2

12.00-12.20

 

GPs’ role in provision of abortion care

 

Dr Jeni Harden, University of Edinburgh

 

 

Hot topic 3

12.20-12.40

 

 

WEMA study findings: women’s experiences of more than one abortion

 

Dr Lisa McDaid, MRC Social Science/University of Glasgow

 

Hot topic 4

12.40-13.00

 

What’s new in Sexual Health policy?

 

Mary Stewart, Scottish Government

 

13.00-13.30 Lunch Break and Poster viewing
 

13.30-14.00

 

“Let’s talk about abortion….”

Leanne Rockingham, NHS Lothian and Jill Wilson, Greater Glasgow and Clyde (Health Improvement Lead)

 

 

14.00-14.30

 

Safety and efficacy of medical abortion when provided by ‘Women on Web’ to women in Ireland and Northern Ireland

Professor James Trussell, Honorary Fellow, University of Edinburgh
 

14.300-15.00

Impact of legalising abortion in Poland  
 

15.00-15.30

Lara’s stories Sarah Sherman, Medical Student
15.30-15.45 Questions  
15.45-16.00 Best Poster Presentation & Closing Remarks Dr Audrey Brown