Isle of Man Legislative Council Approves Abortion Reform Bill

26 June 2018

The Abortion Reform Bill has been approved fully by the Legislative Council. This morning, Members of the Legislative Council (MLCs) dealt with all of its clauses – including 71 proposed amendments – and then suspended rules so that they could take the third and final reading at the same sitting. At that point, the historic vote to approve wide-reaching change was 8-1 in favour, with only Bishop Peter Eagles voting against. The bill will still need to go back to the House of Keys for final approval, however, which will be in the autumn on account of the upcoming summer recess.

http://www.iomtoday.co.im/article.cfm?id=41453&headline=LegCo%20approves%20Abortion%20Reform%20Bill&sectionIs=NEWS&searchyear=2018

FIAPAC Survey on Very Early Medical Abortion (VEMA)

Dear Colleagues

More and more women come early for a medical abortion, sometimes even before the location of the pregnancy can be determined. Colleagues handle these situations differently, some wait for 1–2 weeks, some start treatment immediately. And so far there is no recognised standard or best practice. Therefore FIAPAC (International Federation of Professional Abortion and Contraception Associates) is conducting an anonymous online survey to collect data on current practice and experience with Very Early Medical Abortion (VEMA).

The results will be published at the FIAPAC Conference (Nantes, France 14–15 September 2018) and website (https://www.fiapac.org) and will help to improve guidelines for medical abortion. Your help is needed and therefore we kindly ask you to complete a very short online survey available at the hyperlink below, which will take less than 5 minutes. Please also invite your colleagues working in the field to complete this survey.

https://www.fiapac.org/questionnaire/vema/

This survey will be accessible online until 31 July 2018 [NB. Survey now closed for submissions.]

Thank you in advance and best regards. Christian Fiala (FIAPAC Treasurer)

BSACP Comment on the Republic of Ireland Referendum

26 May 2018

The British Society of Abortion Care Providers (BSACP) welcomes wholeheartedly the ‘Yes’ vote in yesterday’s referendum.

The Eighth Amendment has been repealed. This means that the Irish Constitution can no longer block the development of an Abortion Bill that can be brought before the Lower House (Dáil) and that would, if voted for, allow a meaningful abortion law to be put into place for the women of Ireland.

In turn this would mean that the law in Ireland would no longer bring shame on its womenfolk by forcing them to travel for legitimate health care (or to deny them care altogether if they do not have money to travel and pay the bill) but could offer this care close to their homes.

A Citizens’ Assembly of 99 members plus the chair, Judge Mary Laffoy, has already deliberated and sent a report to Parliament (Oireachtas). A joint Committee of both Houses chaired by Senator Catherine Noone took further evidence and reported in December 2017 that they had voted 12:5 in favour of legalising abortion up to 12 weeks’ gestation without restriction as to reason. We understand that politicians are ready with detailed wording of an Abortion Bill and that this could be passed by the end of 2018.

BSACP sincerely hopes that this Abortion Bill will be brought forward as soon as possible so that women in Ireland can be granted reproductive autonomy and the dignity to be able to request the care they need from the health professionals they trust.

Members of BSACP are ready to continue care for those (far fewer than at present) women whose individual circumstances will fall outside the wording of the new law.

Sam Rowlands, BSACP Secretary, on behalf of BSACP Council

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Joint ARHP/BSACP Webinar on 'Barriers to Abortion Access as Reported by British Women: An Ongoing Report' on Thursday 7 June 2018

The Association of Reproductive Health Professionals (ARHP) and the British Society of Abortion Care Providers (BSACP) are jointly producing a series of webinars that focus on issues facing abortion care providers in the UK and the USA.

The fourth webinar in the series is entitled ‘Barriers to Abortion Access as Reported by British Women: An Ongoing Report’ by Dr Kate Guthrie, FRCOG, FFSRH.

Dr Kate Guthrie will report on barriers British women face when attempting to access abortion care. By the end of this activity, participants will be able to:
1. List the four primary reasons women from England, Scotland and Wales contact Women on Web.
2. Describe women who would benefit most from a change in regulation to permit misoprostol at home.
3. Discuss changes you will make in your practice to improve women’s access to in-clinic care.

Dr Kate Guthrie, now retired, was formerly Consultant Community Gynaecologist and Clinical Director for Sexual Health Services in Hull and East Riding, England. Her interests lay in service design and development, and specialist education. Amongst other commitments, she is currently a Trustee of the Faculty of Sexual & Reproductive Healthcare (FSRH), Co-chair of the British Society of Abortion Care Providers (BSACP) and supports Women on Web through the British Helpdesk.

 

This webinar is free to attend for BSACP members.

Webinar release date: Thursday 7 June 2018, 6.30pm GMT / 2.30pm EDT

Registration link:  https://attendee.gotowebinar.com/register/1577046407790286083

 

Abortion in the 21st Century: Home Administration of Misoprostol in Early Medical Abortion

29 April 2018

What is early medical abortion?

Early medical abortion (EMA) is the most common type of abortion procedure in England and Wales. It is carried out up to 9 weeks’ gestation and involves taking two medications: mifepristone and misoprostol. Mifepristone ends the pregnancy by blocking the hormone progesterone, and misoprostol induces contractions in order to expel the pregnancy. Although these two medications can be administered simultaneously, they are more effective, and the side effects are reduced, if misoprostol is administered 24–72 hours after mifepristone. This means that women often need to attend a clinic twice for their EMA treatment.

Following the administration of misoprostol, women are usually given the option of either staying in the clinic until they have passed the pregnancy, or travelling home. The majority of women choose to leave, so that they can pass the pregnancy in the comfort and privacy of their own homes. Before leaving, they are given a supply of pain relief, prophylactic antibiotics, detailed information about what to expect, and the number of a 24/7 telephone line which they can call with any questions or concerns.

The current legal framework surrounding the administration of abortion drugs

The circumstances under which abortion drugs can be administered in England and Wales are governed by the Abortion Act 1967, which provides that:

“…any treatment for the termination of pregnancy must be carried out in a hospital…or in a place approved for the purposes of this section by the Secretary of State [for Health]”.                                                                                                                              Section 1(3), Abortion Act 1967

When the Abortion Act was initially passed in 1967, the treatment that Parliament had in mind was purely surgical. Given the risks inherent in any surgical operation, it was perfectly reasonable to require that the procedure should be carried out in a hospital or clinic. However, over the next few decades a non-invasive method of termination, known as ‘medical abortion’, was developed.

In 1990, anticipating the introduction of this safer method of abortion, Parliament decided to insert a new clause into the Abortion Act 1967. Section 1(3A) gives the Secretary of State the power “to approve a class of places” for “the use of such medicines as may be specified”. When proposing the insertion of this clause to the House of Commons, Kenneth Clarke, the Health Secretary at the time, explained that:

“As the law stands, if no power such as that contained in the amendment is provided, it will continue to be necessary for the patient to have the drug administered in a hospital or other approved place. There is no medical reason for that.”                              HC Deb 21 June 1990, Vol. 174, Col. 1201

Why should women be allowed to self-administer misoprostol at home for EMA?

The cramps and bleeding triggered by misoprostol usually start about 1–2 hours after administration, however they may start sooner. This means that some women begin to expel the pregnancy, or completely expel the pregnancy, whilst travelling home. This is undoubtedly a distressing experience, and one that does not need to occur given the proven safety of administering misoprostol at home. It is also logistically difficult for many women to attend a clinic on two separate occasions. This particularly applies to women who live in rural locations, those with work and childcare commitments, and those in controlling family environments.

Home administration of misoprostol for EMA is standard practice in countries around the world, such as France, Sweden and the USA. Many studies have been conducted to assess the safety, efficacy and acceptability of this regimen, and the evidence in this area has been so conclusive that the World Health Organization states in its guidance:

“Allowing home use of misoprostol following provision of mifepristone at the health-care facility can further improve the privacy, convenience and acceptability of services, without compromising on safety.”               Safe Abortion: Technical and Policy Guidance for Health Systems (2012), p.44

Although British researchers have largely been hindered from carrying out work in this area by the legal restrictions placed on them, guidelines have been updated in accordance with the findings of studies carried out abroad. The Royal College of Obstetricians & Gynaecologists states in their guidance that:

“…published data do not suggest any clinical reason why women should remain in hospital during their abortion, and demonstrate that it is safe for women to administer misoprostol at home.”                                        The Care of Women Requesting Induced Abortion (2011), p.72

Crucially, the accepted safety of home administration of misoprostol is demonstrated by the fact that it is legal in England and Wales for women who are diagnosed with an incomplete miscarriage to self-administer misoprostol at home. The treatment for incomplete miscarriage and EMA is the same; however, it has to be delivered in a completely different manner due to Section 1(3) of the Abortion Act 1967. This double standard makes the process unnecessarily more distressing for women undergoing EMA.

Support for changing the law

In 2011, the British Pregnancy Advisory Service (BPAS) brought a legal challenge against the Department of Health in an attempt to change the law to allow for home administration of misoprostol in EMA. Unfortunately, they were unsuccessful; however, the High Court judgment reiterated that Section 1(3A) of the Abortion Act 1967 gives the Secretary of State:

“the power to approve a wider range of place [for the administration of abortion medications], including potentially the home”.                                                                                                    British Pregnancy Advisory Service v Secretary of State for Health [2011] EWHC 235 (Admin) [32]

Last year, the Scottish Parliament (to whom power over abortion law was devolved in 2016), took the decision to allow home administration of misoprostol in EMA. The Public Health Minister, Aileen Campbell, said that:

“Scotland is now the only part of the UK to offer women the opportunity to take misoprostol at home when this is clinically appropriate, a decision that allows women to be in control of their treatment and as comfortable as possible during this procedure”.

As part of its current campaign to decriminalise abortion – We Trust Women – BPAS continues to work towards changing the law in England and Wales to allow for home administration of misoprostol in EMA. BPAS is supported by the Women’s Equality Party, which published an open letter on 29 March 2018 to the Secretaries of State for Health in England and Wales, calling for a change in the law. The letter was written by a woman called Claudia, who underwent EMA and endured a distressing taxi journey home from the clinic following the administration of misoprostol.

Progress finally seems to be on the horizon in Wales, where Vaughan Gething, the Secretary of State for Health, confirmed on 17 April 2018 that his officials are looking into how the law can be amended to allow for home administration of misoprostol in EMA. At the time of publication, Jeremy Hunt, the Secretary of State for Health in England, remains notably silent on this issue.

Andrea Adams, MA, Registered Nurse, and Non-practising Solicitor; andrea.adams7@gmail.com

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  • Targeting cookies. These cookies record your visit to our website, the pages you have visited and the links you have followed. We will use this information to make our website and the advertising displayed on it more relevant to your interests. We may also share this information with third parties for this purpose.

Please note that third parties (including, for example, advertising networks and providers of external services like web traffic analysis services) may also use cookies, over which we have no control. These cookies are likely to be analytical/performance cookies or targeting cookies.

You block cookies by activating the setting on your browser that allows you to refuse the setting of all or some cookies. However, if you use your browser settings to block all cookies (including essential cookies) you may not be able to access all or parts of our site.

Except for essential cookies, all cookies will expire after 30 days.

RCN Survey 'Signals Support' for Decriminalisation of Abortion

2 May 2018

Members of the Royal College of Nursing (RCN) have “signalled support” for removing criminal sanctions from termination of pregnancy legislation, said the body in the wake of a consultation.

It revealed today that the results of a UK-wide poll of RCN members showed 73.7% of respondents had voted in favour of removing criminal sanctions from legislation relating to abortion.

The move was sparked by the debate taking place across the country, in parliament and in health organisations about removing criminal sanctions from termination of pregnancy legislation.

https://www.nursingtimes.net/news/policies-and-guidance/rcn-survey-signals-support-for-decriminalisation-of-abortion/7024312.article

 

Accessibility Information

The owners of this website care that our website is accessible to everyone, regardless of your ability or disability, your race, religion or gender.

This website was originally designed by Access by Design. They have worked in website accessibility since 2006 and have made every effort to ensure that our website is accessible as possible. However, if you find any problems with using the website, please accept our apologies and contact us so we can let them know.

This statement is to give you more information on what they have done to make your experience as accessible as possible. 

Using this website

  • The main areas of each web page are defined by Landmarks
  • There is a structured use of Headings
  • Jump menus are provided to allow you to navigate directly to the main content of the page, the Site Map and this Accessibility Statement. These can be reached by using the Tab key after the page has loaded.
  • The Site Map on this website contains links to all the pages on this website in a clean structured list, which may be easier to use.
  • Access by Design have developed a set of accessibility tools that do not rely on 3rd party plugins or overlays, as these make websites less accessible.  We believe that the only way to truly make our websites accessible for all of our visitors, is to include such tools within our code. 
  • If you wish to change the text sizes or the screen contrast, please use the options provided under our Accessibility Tools icon. You can reach these with a mouse or using the tab key on your keyboard.
    • ‘Standard text’ will provide a 12px equivalent version on most browsers
    • ‘Large text’ will provide a 16px equivalent version on most browsers
    • ‘Extra Large text’ will provide a 20px equivalent version on most browsers
    • There will be different colour contrast options, such as ‘Blue on Yellow”, “Yellow on Blue”, “White on Black” and “Black on Orange”. These can be particularly helpful for neurodivergent people or those who perceive colours in different ways. All three text sizes may still be selected when any of these options are also chosen.
    • ‘Text Only’ will strip off all our styles and provide a plain text, linear version
    • The Text Only version can also be displayed in the 4 Colour Contrast Options. 
  • To resize the text without using the toolbar:
    • In Google Chrome: Customise (3 dots top right) > Zoom > – or +
    • In Edge: Settings and More (3 dots top right) > Zoom > – or +
    • In Firefox: View > Text size > Increase or Decrease
    • In Safari: View > Zoom In or Zoom Out 
    • You can also scroll with the wheel of your mouse whilst holding down the control key (Windows) or Apple key (Mac).
  • To use the keyboard instead of the mouse;
    • Use the Tab key to move and browse amongst the menus and links.
    • Pressing ‘Enter’ is the same as clicking a mouse
    • Use the arrow keys on your keyboard to move up or down the page or from left to right.
  • There is also a specific Print Style. Should you wish to print off any of the web pages, you will see they will be formatted to ensure they stay one page wide.,
  • All images contain an ALT tag unless decorative, where they are marked as empty.
  • Links make sense out of context. Wherever possible, title tags have also been used to expand on their meaning.
  • Drop-down menu bars to allow you to access child pages from the navigation menu. Each one is marked with an arrow and can be opened with the Enter key. You will then be able to clearly navigate through these by just using the Tab key and the Enter key to make a selection. Each page will light up in turn, just as if a mouse had been used. This is called The Tab Test. If you prefer, please use the site map link for quick and easy browsing.
  • Most of our site has ‘breadcrumbs’ on the top of each page which allow you to retrace your steps and go back to where you started. However, older sites may not have this facility so you may need to use the ‘Back’ button on your browser. Back buttons are usually on the top left hand corner of your browser. By simply clicking on this button you can retrace your steps through the pages you have already viewed on our website. Some keyboards also have a Back Button as part of their options.

General Accessibility

  • This website conforms to the WCAG 2.2 four principles of accessibility and so is: perceivable, operable, understandable, and robust
  • Access by Design considered the full range of techniques, including the advisory techniques, as well as to seeking relevant advice about current best practice to ensure that this web content is accessible, as far as possible, to all communities.
  • This website has been thoroughly tested on multiple browsers, platforms and devices
  • This website has been tested using multiple automated accessibility testing software

Web Standards

  • All CSS and XHTML created by Access by Design validate to the document type.
  • Validation does not equal accessibility.
  • If a page on this website does not validate it is almost always because a third-party ‘plug-in’ has needed to be employed. Although try to use only accessible third-parties and we alert designers to accessibility issues, rectifying them is beyond our control.
  • We reserve the right to use the web standards CSS and XHML buttons on this website as all elements within our control validate correctly.

Further Help

Your computer or smartphone may have an integrated feature that will read the content on the screen to you, out loud. These include ChromeVox on Chrome OS, VoiceOver on Mac and Narrator on Windows.

If you use Windows, the two most widely-used screen readers are:

NVDA, a free screen reader.

JAWS, a commercial screen reader that comes with a time-limited demonstration mode.

Web Content Accessibility Guidelines (WCAG) 2.2

This website was compliant with WCAG 2.2 Priority A and AA Standards when it was launched. However, content updates may have introduced unintentional accessibility errors. These may be related to missing Alt Text, Link Text, Use of Language and Link Behaviour.

There may also be colour contrast issues with the standard view of this website, particularly if the branding is not accessible. Logos themselves are exempt from the WCAG Colour Contrast Guidelines, however the different colour contrast options available in the accessibility toolbar should resolve any contrast issues.

This website also complies with WCAG 2.2 AAA Standards, with the following exception relating to video content. All video content is hosted on YouTube and Vimeo.

  • Sign language interpretation is provided for all prerecorded audio content in synchronized media.
    (Fails under WCAG 2.1 AAA 1.2.6 )

Both video platforms provide automated captioning and transcripts may be downloaded. We look forward to the day that they can also provide signing facilities.

  • This site does not use meta access keys (sometimes called ‘hot keys’). Our research suggests that these are actually detrimental to most keyboard users as they already have their own keys set up which are then overwritten or confused by websites (that do not use a consistent approach). We will review this decision periodically and if research proves otherwise (or technology improves) we will resume these techniques.
  • This site may fail validation on third-party technologies. This is because we have little or no ability to recode these to meet our high accessibility standards. However, we always aim to use plug-ins that are either accessible, increase the accessibility or have simple accessible alternatives. If forced to choose between accessibility features and validation, we have taken the difficult decision to always choose accessibility.

This accessibility statement was originally produced on 31 May 2023 by Clive Loseby.

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