Doctors for Choice UK Second Annual Conference: ‘Protecting and Advancing UK Abortion Care’, London, UK, Friday 26 April 2019
25 February 2019
Inspired by the success of their first conference last year – a brilliant day of interesting talks and pro-choice solidarity – Doctors for Choice UK will be holding their second annual conference on Friday 26 April 2019.
Venue: UCL Cruciform Building, Lecture Theatre 2, Gower Street, London WC1E 6BT
Link for tickets and programme: https://dfcconference2019.eventbrite.co.uk
Tickets
Free for Doctors for Choice UK members. Join Doctors for Choice UK: www.doctorsforchoiceuk.com/join
£7 for students/unwaged (non-members) £27 for waged (non-members)
Five £50 travel bursaries are available to medical students from outside London. Students should email doctorsforchoiceuk@gmail.com with 250 words about why they want to attend the conference, by the end of March. The five successful applicants will be notified by 8 April 2019.
For more information email: doctorsforchoiceuk@gmail.com
@DrsforChoice_UK
www.doctorsforchoiceuk.com
www.facebook.com/DoctorsforChoiceUK
Please help us spread the work by sharing details of this conference with colleagues far and wide!
Hayley Webb and Jayne Kavanagh
Doctors for Choice UK Secretary and Co-Chair
Contact: Jayne Kavanagh. Email: j.kavanagh@ucl.ac.uk
RCGP to Support Decriminalisation of Abortion
Abortion Must be Safe, Legal and, Importantly, Local
22 February 2019
In the January 2019 issue of BMJ Sexual & Reproductive Health, Aiken et al.1 offer us a stark reminder of the toxic consequences wrought by the criminalisation of abortion.
The qualitative study was conducted using in-depth interviews with Northern Irish women who have experienced induced abortion. The stories told by these women are those of fear: fear of arrest, fear of being found out, fear of being denied an abortion. These stories will be familiar to anyone who has worked in a setting where abortion is criminalised, and indeed will be familiar to anyone who worked in the UK before the 1967 Abortion Act was passed.
These women remind us of the universal truth that abortion cannot be banned; only rendered unsafe. They tell us about trying to take toxic levels of vitamin C, drinking castor oil and vodka, or asking their partners to assault them to induce abortion because they do not have access to the funds to travel outside of Northern Ireland.
The study period spans a time of change in the UK when policy relaxed to allow Northern Irish women to access National Health Service (NHS)-funded abortion in Scotland, England and Wales. Despite this, the study illustrates the barriers to travel that exist in getting from Northern Ireland to Britain – needing a passport for certain air carriers, the cost of short-notice flights, having to conceal travel from partners, family members, children and employers, and so on.
The article’s findings reiterate what women and abortion care providers know, and what politicians and service commissioners need to learn, namely that abortion must be safe, legal and local.
The open access article can be read here: https://srh.bmj.com/content/45/1/3
Consider writing to your Member of Parliament (MP) to ask them to support decriminalisation in Northern Ireland by clicking on the following links: https://nowforni.uk/email/ or https://www.writetothem.com.
John Reynolds-Wright, BSACP Trainee Representative and Clinical Research Fellow, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK. Email: jjrw@doctors.org.uk. Twitter: doctorjjrw
Reference
1 Aiken ARA, Padron E, Broussard K, et al. The impact of Northern Ireland’s abortion laws on women’s abortion decision-making and experiences. BMJ Sex Reprod Health 2019;45:3-9.
New Abortion Care Resource Launched to Support Relationships and Sex Education Lessons in Schools
30 January 2019
The Faculty of Sexual and Reproductive Healthcare (FSRH) and the Royal College of Obstetricians and Gynaecologists (RCOG) have launched a free Abortion Factsheet resource to support teachers with relationships and sex education (RSE) lessons in secondary schools in the UK. FSRH RCOG Abortion Care Factsheet RSE Lessons
Endorsed by Public Health England, the Sex Education Forum and PSHE Association, it aims to dispel some of the misinformation around this topic. Despite being a common medical procedure, myths about abortion and stigma are widespread, including in the classroom.
This factsheet provides accurate, up-to-date factual information about abortion and abortion care in the UK. It counters myths that are known to be taught in schools such as abortion causing infertility and mental illness.
Find out more about the Abortion Factsheet at www.fsrh.org/abortionRSE.
Isle of Man Becomes First Part of the British Isles to Decriminalise Abortion
29 January 2019
The move towards reproductive choice in the world is often incremental – allowing abortion in some cases but not others, gradually increasing the number of abortion service providers. So it comes as a particular (but welcome) surprise to see the Isle of Man change its laws on abortion from one of the most restrictive in the British Isles, together with Northern Ireland, to the most liberal in a single step. Crucially, the Isle of Man is now the only place in the British Isles where abortion has been decriminalised.
The Isle of Man is a Crown Dependency, and whilst the Tynwald (the parliament of the Isle of Man) commonly adopts statutes from Westminster, this is not automatic. The Tynwald did not adopt the 1967 Abortion Act and abortion was instead governed by the Termination of Pregnancy (Medical Defences) Act 1995. Abortion at any stage of gestation was highly restricted, and access was further complicated by requirements in the Act that multiple consultants must agree the criteria for legal abortion. On an island with one hospital and a very limited number of consultants, the result was women faced a lengthy wait, which could take them beyond the cut-off date for terminations.
Consequently 1076 Manx women travelled from the Isle of Man to access abortion in England and Wales between 2007 and 2016, and a further 204 over 8 years requested medical abortion from Women on Web. Those who came to England or Wales had the expense of private treatment, compounded by travel costs, whilst those seeking medical abortion were performing an illegal act, which would make it difficult for them to seek either physical or psychological aftercare on the island.
The Abortion Reform Act 2018, which passed the final legislative step of receiving royal assent on 15 January 2019 after being passed by both houses of the Tynwald in late 2018, radically changes women’s access to reproductive healthcare on the island. It allows termination on request in the first 14 weeks of pregnancy, abortion up to 24 weeks if there are serious social grounds to justify it, and after 24 weeks if pregnancy would cause risk to the life of the mother, or if the baby when born would suffer serious impairment or die shortly after birth. Midwives and pharmacists as well as doctors can dispense the medication for medical abortion. The Act also makes the Isle of Man the first place in the British Isles to create statutory ‘buffer zones’, preventing protestors from gathering within a certain distance of abortion care providers. The Act was first introduced as a Private Members’ Bill in 2017 by Dr Alex Allinson, a general practitioner and member of the House of Keys, the lower house of the Tynwald. He steered the bill through the Tynwald in order to take abortion “out of the realm of the criminal justice system” and make it “strictly a health care issue”.
Abortion in England, Wales and Scotland is widely available – there were 192 900 abortions in England and Wales in 2017 – so many do not realise that abortion is still regulated by criminal law. Crucially, by decriminalising abortion this makes the Isle of Man the only place in the British Isles where abortion is regulated like any other health service. In England, Wales and Scotland, abortion service providers rely upon the 1967 Abortion Act, which provides exceptions to the crime of administering or procuring an abortion. These exceptions mean that a pregnancy can be lawfully terminated if two medical practitioners agree that the pregnancy has not exceeded its 24th week and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family. Abortion can be carried out after 24 weeks, though this accounts for a tiny percentage of abortions overall, in the event of risk of death or grave injury to the mother, or severe fetal abnormality. Any abortion which is not carried out under these exceptions is a crime under the 1861 Offences Against the Person Act, and carries a potential prison sentence.
Four key UK medical associations – the British Medical Association (BMA), Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and Royal College of Nursing (RCN) – now are explicitly calling for the decriminalisation of abortion across the UK. If abortion is to be recognised as a normal healthcare procedure, it is stigmatising for both the providers and the patients if that procedure is singled out as regulated by criminal law, rather than regulatory and professional guidelines. Professor Lesley Regan, RCOG President, is clear that “decriminalisation does not mean deregulation and abortion services should be subject to regulatory and professional standards, in line with other medical procedures”. Most importantly, the restrictions imposed by the current law indicate a lack of trust in women, and serve to place obstacles in the way of those seeking bodily autonomy.
At the start of 2019, attention is turning to abortion law reform in Northern Ireland and continuing the momentum of 2018’s changes in Ireland. The reforms in the Isle of Man provide evidence that dedicated campaigning, and a recognition that the majority of the population support abortion, can lead to a dramatic change in women’s reproductive freedoms in a single legislative act.
Charlotte Kelly, BSACP Patient and Public Involvement (PPI) Representative; charlotte.kelly@balliol.ox.ac.uk
Note on the Author
Charlotte Kelly is BSACP’s Patient and Public Involvement (PPI) Representative, and so brings a lay perspective to the BSACP Committee. She is also a member of the Women’s Voices Involvement Panel of the RCOG and has a long-term gynaecological disability. She is a DPhil (PhD) student in Socio-Legal Studies at the University of Oxford, and her research spans children and disability law.
Joint BSACP/RCOG Manual Vacuum Aspiration (MVA) Training Course, RCOG, London, Thursday 7 February 2019
Learn how to confidently assemble and operate a manual vacuum aspiration (MVA) kit at this one-day, hands-on and theoretical training course.
In addition to providing understanding in the MVA procedure, this course covers the equipment, staffing, analgesia and other requirements for surgical uterine evacuation in the outpatient setting.
Find out more at: Learning objectives: https://www.rcog.org.uk/en/departmental-catalog/Departments/training-courses/2086—manual-vacuum-aspiration/
- Safely undertake MVA of uterine contents in a model
- Gain knowledge of appropriate pain relief
- Learn to provide appropriate support in the woman
- Meet others with experience of setting up similar services
- Make contacts for sharing guidelines and pathways
- Gain skills to develop a business case for MVA
Book now at: https://www.rcog.org.uk/en/departmental-catalog/Departments/training-courses/2086—manual-vacuum-aspiration/
For any queries regarding this event, please contact:
Elouise Chadderton-Illing (RCOG)
Tel: +44 (0)20 7772 6312
Email: echadderton-Illing@rcog.org.uk
Abstract Submission Extended for RCOG World Congress
Abortion care abstracts – last chance!
The Royal College of Obstetricians & Gynaecologists (RCOG) has asked us to announce that the deadline for submitting abstracts for RCOG World Congress 2019 has been extended to Monday 28 January 2019 at 23:59GMT.
Abortion care is a featured category for which the Congress organisers are currently inviting abstracts. This is a great opportunity for abortion care providers to showcase the latest work in abortion care to a global audience.
Information about abstract submission is available here: http://bit.ly/RCOGGlobalAbstract
Anti-Abortion Protests Outside Abortion Service Providers in Ireland Highlight the Need for Buffer Zones Around Abortion Clinics in Ireland and Britain
22 January 2019
The first week of extended access to abortion services in Ireland has also brought with it scenes in Galway of picketing and campaigning outside abortion services by anti-abortion activists. In response, the Twitter hashtag #SiulLiom (“I walk with her” in Irish) has been trending, as people offer to accompany and support women seeking abortions who feel intimidated by the prospect of protests outside clinics.
Protesting outside abortion services has seen an increase over the past decade in Britain, with forms of protest ranging from confrontation of women entering the clinic and the display of graphic imagery to silent prayer vigils and the handing out of leaflets offering support for women to continue their pregnancies. Yet such activities are largely legal, as buffer zones around abortion services, which would criminalise anyone protesting within a certain distance of an abortion provider, do not exist in Britain.
The need for buffer zones
One woman interviewed by the BBC, who had experienced anti-abortion protests at the gates of the abortion service, described being “haunted” after being told that she was a murderer, while another said: “I remember just feeling so scared of [having the abortion].… I didn’t expect to be faced with a group of people standing outside, casting shame on what was a really difficult thing for me… It added a lot of pain to something that was already very painful.”
Research by Lowe and Hayes has shown that the presence of protestors, even when they described themselves as there not to protest but simply to pray silently, was still experienced as traumatic by abortion service users because of the experience of being watched and having their physical space encroached upon. The fear caused by the uncertainty of what the protestors might do was also raised as a factor by women as they entered and exited the clinics. Lowe and Hayes draw a parallel with the frequent experience of street harassment in women’s lives; the unwelcome persistent attention, often in relation to a woman’s body, which is the essence of street harassment is amplified in women’s experience of negotiating stares, physical obstruction and judgment about their reproductive choices as they enter or exit an abortion provider.
Buffer zones are necessary, in the words of Mairead Enright, senior lecturer in law at Birmingham University because “It’s about generally sending a message about access, sending a message that it’s no longer permissible to stigmatize and intimidate and mislead and obstruct women who are accessing a legal service,” she said.
Balancing freedom of expression
The countervailing argument is that to create zones where even peaceful protest is prohibited is to unnecessarily restrict freedom of expression. This argument has been made forcefully by the Society for the Protection of Unborn Children (SPUC) that such zones “criminalise prayer” and could “fatally injure the highly treasured principle of freedom of speech”. SPUC highlight instances where women intending to have abortions had their minds changed after they were offered help and support by those praying outside the clinic gates.
There must of course be a weighing between the Article 8 right to privacy under the European Convention on Human Rights and the Article 10 right to freedom of express. Yet in relation to protests about other controversial issues, criminal legal restrictions have been employed. Power exists under the Protection from Harassment Act for injunctions to create exclusion zones to protect animal research laboratories by preventing anti-animal testing protestors from demonstrating within a specific distance of certain laboratory buildings, breach of which is an arrestable offence.
There is a further dimension – this is a question of place. Abortion care is simply one part of legal National Health Service (NHS) medical care. Accessing any sort of medical care brings with it an expectation of privacy which is violated by protests both for individual women seeking care, and for the premises of the abortion service provider more generally, to which attention is continually being drawn. This seems obvious in the context of other NHS healthcare facilities: for a person to stand outside a sexual health clinic, telling all passersby that anyone entering the clinic had a sexually transmitted infection would be a clear breach of the peace. There is no limitation on those opposed to abortion protesting in other public spaces such as outside Parliament, or publicising anti-abortion literature. The buffer zone serves merely to ensure that a medical service can be provided to patients with the privacy they expect.
The current patchwork of legal protection for abortion service users and providers
In early 2018, the Home Secretary Sajid Javid undertook the Abortion Clinic Protest Review to investigate whether buffer zones should be established around all abortion providers. The outcome of the Review in September 2018 recognised that protest activities outside abortion providers caused distress both to women seeking abortion services and abortion provider staff. The Review did, however, decide against a change in the law, claiming that the scope of current protest was small, and that existing legislation existed to restrict protest activities which would cause harm. Sadly, this is not the case: applying current criminal law to these protests will at best prevent some protest activities, but the patchwork of legislation cannot provide the protection that is needed.
The Public Order Act 1986 prohibits the display of images that cause harassment, alarm or distress, which may prevent the display of graphic images of foetuses by protestors. However, the police only have powers to disperse a gathering if it “may result in serious public disorder, serious damage to property, serious disruption to the life of the community, or that the purpose by the assembly organisers is to intimidate others to compel them not to do an act that they have a right to do”. This is law designed to prevent public disorder, rather than recognise the harassment felt by women entering abortion clinics by the very presence of anti-abortion campaigners. If any crime such as assault has occurred outside the clinic, then the onus is on the woman to report this to the police, at what is likely to be an already stressful time in her life.
Another model?
In April 2018, the West London council of Ealing introduced a Public Spaces Protection Order (PSPO), imposing a 100m buffer zone around a Marie Stopes clinic which had been the subject of prolonged anti-abortion campaigning. This has been backed by the Royal College of Obstetricians and Gynaecologists (RCOG), the Faculty of Sexual & Reproductive Healthcare (FRSH) and also politicians from all parties, with reports that city councils in Manchester and Birmingham are looking into making similar orders.
The problem however, is that the PSPO as used in Ealing cannot provide a full solution to the problem of protests. The PSPO lasts only 3 years, after which there must be a full further consultation with proof provided that the buffer zone needs to continue. The initial process for a council to obtain a PSPO is onerous with regard to proving the need via public consultation and a separate PSPO must be obtained for each abortion service provider. Women seeking healthcare therefore face a ‘postcode lottery’ as to whether the council in their area has introduced a PSPO for the individual abortion service provider they are visiting.
Laws that provide for buffer zones already exist in states in Australia, Canada and the United States. It is time for Parliament in Westminster to lead the way and create a single national law to allow women to access NHS reproductive healthcare without harassment.
Charlotte Kelly, BSACP Patient and Public Involvement (PPI) Representative; DPhil Student in Socio-Legal Studies, Oxford, UK; charlotte.kelly@balliol.ox.ac.uk
Note on the Author
Charlotte Kelly is the BSACP Patient and Public Involvement (PPI) Representative, and so brings a lay perspective to the BSACP Committee. She is also a member of the Women’s Voices Involvement Panel of the RCOG and has a long-term gynaecological disability. She is a DPhil (PhD) student in Socio-Legal Studies at the University of Oxford, and her research spans children and disability law.
Abortion Decriminalised in the Isle of Man
16 January 2019
Manx abortion reforms to be introduced after new law receives Royal Assent
Women on the Isle of Man will soon be able to request an abortion within the first 14 weeks of pregnancy. Tynwald President Steve Rodan said the Abortion Reform Act had received Royal Assent, meaning that the UK’s Ministry of Justice has given its approval. The Manx government is yet to announce when the new law, proposed by Ramsey MHK Alex Allinson, will be introduced.
https://www.bbc.co.uk/news/world-europe-isle-of-man-46879046
15 January 2019
Isle of Man first place in British Isles to decriminalise abortion
The Isle of Man has become the first place in the British Isles to decriminalise abortion.
The new law will allow abortion for any reason up to 14 weeks’ gestation and in certain circumstances between 15 and 23 weeks. From 24 weeks until birth, abortion will be permitted when pregnancy would cause risk to the mother’s life or if the baby when born would suffer serious impairments or die shortly after birth.
The new law will make the Isle of Man – a self-governing region of the British Isles – the only part of the UK to have decriminalised abortion. Elsewhere it is broadly legal, but not entirely decriminalised.
Those seeking abortion up t o14 weeks will not need the approval of two doctors, as is the case currently in England, Scotland and Wales, and midwives and pharmacists will be allowed to dispense abortion pills, as well as doctors.
See also blog by Charlotte Kelly (BSACP’s PPI Representative): https://bsacp.org.uk/isle-of-man-becomes-first-part-of-the-british-isles-to-decriminalise-abortion/
In Memoriam – James Trussell
We are sorry to announce that James Trussell, a prolific researcher in the area of reproductive health, and latterly of Princeton University, and until recently a BSACP Council member, passed away on 26 December 2018 aged 69 years after a brief illness.
Kelly Cleland, one of James’ colleagues at Princeton University, writing to the International Consortium for Emergency Contraception (ICEC), said: “James made innumerable contributions to our collective understanding of contraception, including and especially emergency contraception. To this end, James authored hundreds of articles, testified before the FDA, presented all over the world, and answered hundreds of individual questions from users of the Not-2-Late website. His unwavering commitment to improving knowledge about and access to contraception for women around the world was the hallmark of his long and prolific career. We are profoundly grateful for James’s contributions.”
Below are links to a short announcement of James’ death made by the European Society of Contraception (ESC) website, and his Princeton biography.
https://www.escrh.eu/about-esc/news/memoriam-james-trussell-0