Abortions in England and Wales Reach Record High in 2019
11 June 2020
A record number of women in England and Wales had an abortion last year, and numbers rose particularly sharply among women aged 30 years and over. There was, however, a fall in the number of teenagers undergoing an abortion in the same period. A total of 207,384 procedures were carried out, official figures show, the highest number in a year since the historic vote in 1967 to legalise abortion in Britain through the Abortion Act.
https://www.theguardian.com/world/2020/jun/11/abortions-in-england-and-wales-reach-record-high
The Abortion (Northern Ireland) Regulations 2020
4 June 2020
A briefing on The Abortion (Northern Ireland) Regulations 2002 has been compiled by a group of professional medical bodies, service providers, and human rights organisations involved with establishing, advocating for, and providing abortion reform and services within Northern Ireland. Key signatories include the Royal College of Obstetricians and Gynaecologists (RCOG), the Faculty of Sexual & Reproductive Healthcare (FSRH), The Royal College of Midwives (RCM), British Pregnancy Advisory Service (bpas), the National Unplanned Pregnancy Advisory Service (NUPAS), Marie Stopes UK, the British Society of Abortion Care Providers (BSACP), Amnesty International, and Informing Choices in NI.
The briefing has today been sent to all Members of Parliament in advance of the regulations being debated by the Delegated Legislation Committee on Monday 8 June 2020, ahead of the regulations being voted on by both Houses (Commons and Lords) by 19 June 2020.
Briefing document in full: Joint Briefing on Northern Ireland Abortion Regs
Two New Books on Abortion Themes
3 June 2020
Assuming (perhaps erroneously?!) that in the current climate people may perhaps have more time available for leisure activities such as reading, we thought it timely to highlight two recently published books on topical abortion themes that might be of interest. The books in question have been read and reviewed by two BSACP Council members, and their reviews are included below.
The first book, entitled ‘Decriminalising Abortion in the UK: What Would It Mean?’ edited by Sally Sheldon and Kaye Wellings, comprising chapters written by leading experts in the fields of medicine, law, reproductive health and social science, offers a concise and authoritative account of the evidence regarding the likely impact of decriminalisation of abortion in the UK. The public and parliamentary debate about UK abortion law reform is often diverted away from key moral and political questions by disputes regarding basic questions of fact. And all too often, claims of scientific ‘fact’ are ideologically driven. But what effect would decriminalisation be likely to have on women’s health? What would be the impact on the incidence of abortions? Would decriminalisation equate to deregulation, sweeping away necessary restrictions on dangerous or malicious conduct?
This book is both timely and highly relevant to those working in the field of abortion care provision, and indeed it includes a chapter entitled ‘How would decriminalisation affect women’s health?’ authored by three individuals who will need no introduction, namely Patricia Lohr, Jonathan Lord and Sam Rowlands.
Book Review Decriminalising Abortion in the UK 22042020
As an added incentive to obtain a copy/read this book, the price of the paperback edition is currently being discounted by 20% (£10.30 cf. the list price of £12.99) and the publisher, Policy Press (an imprint of Bristol University Press), is additionally offering no-cost (free) access to an downloadable Open Access version of the book. To order/access this book visit the publisher’s website at: https://policy.bristoluniversitypress.co.uk/decriminalising-abortion-in-the-uk
The second book, ‘Obstacle Course: The Everyday Struggle to get an Abortion in America’, tells the story of abortion in America, capturing a disturbing reality of insurmountable barriers people face when trying to exercise their legal rights to medical services. Authors David Cohen and Carole Joffe lay bare the often arduous and unnecessarily burdensome process of terminating a pregnancy: the sabotaged decision-making, clinics in remote locations, insurance bans, harassing protesters, forced ultrasounds and dishonest medical information, arbitrary waiting periods, and unjustified procedure limitations. Based on patients’ stories as well as interviews with abortion providers and allies from every state in the country, Obstacle Course reveals the unstoppable determination required of women in the pursuit of reproductive autonomy as well as the incredible commitment of abortion providers.
Book Review Obstacle Course 28052020
Happy reading!
Janie Foote (BSACP Administrator)
New BSACP Position Statements
20 May 2020
BSACP is in the process of compiling a suite of Position Statements, the first five of which are available on the BSACP website at: https://bsacp.org.uk/resources/bsacp-position-statements/
The first five Statements cover the following topics:
- Remote Consultations
- Protests (Safe Access Zones)
- Providing Genuine Choice
- Refusal to Treat on Grounds of Conscience or Religion
- Widening the Range of Providers and Settings for Abortions
Further Position Statements are currently being prepared on topics including:
- Certification and Notification
- Decriminalisation
- No Gestational Limit
- Patient-Centred Care
- Access for Marginalised Groups
- Conscious Sedation
Counselling in the Time of COVID-19
15 May 2020
For more than 30 years I have sat with, listened to, and talked with people accessing abortion services. In that time, I have learned that no two people are the same, no matter how they may present.
People approach ending their pregnancy in a variety of ways, and it has been my role to help meet their needs and ensure that they have the best abortion possible, as many don’t feel they deserve the kind, compassionate service that I have been involved with for all this time.
Sitting with someone at a time when they may be struggling to work out what is best for them has been a privilege. To hear their dilemma and talk through what they feel is going to be the best outcome for their pregnancy can take a lot of patience and is about recognising that it is not about me, my values or ideas, but all about them, and this is where it takes experience to see the uniqueness of the situation.
Sometimes, as I sit talking with and listening to the person who didn’t want ‘counselling’ I need to be reading the person in front of me to get the clues as to how they are feeling, as they can be too afraid to express their distress out loud. This is my job’s greatest reward: allowing someone to be their own person and giving them unconditional positive regard whatever their story.
Six weeks ago, all of this changed for me and in the blink of an eye I am now doing all of this on the telephone. Remote counselling has taken off in a big way and the demand is high.
We are delivering most of our treatment to clients under 10 weeks’ gestation completely remotely and it is possible to have an abortion without seeing either a clinician or a counsellor face to face. The upside of the service we are providing is that anyone who does want to talk is able to access the opportunity very quickly and in some cases on the same day. The downside is that both the client and I do not have an opportunity for a face-to-face interaction at all – we are not using any video media that provide face-to-face interaction remotely and I think that is for the best.
This makes all my previously acquired skills of visually reading my client redundant, and I have had to adjust to using my ears as my eyes have nothing to go on. I have previously done some telephone work; however, I prefer face-to-face interactions for all the reasons mentioned above but I am now developing a new set of counselling skills and in some cases the conversations are changing too.
I have a heightened awareness of any pauses in the conversation, and am no longer able to offer the tissues to wipe an eye; I check the client has these to hand before we begin. ‘Are you alone in the room?’ is a new question in my repertoire, and I do not always get an honest answer and never really understand why.
On the telephone it seems I may not always be given the full attention I am used to – I hear a kettle boiling or an oven door shutting as dinner is being made or occasionally the flushing of a loo!
Many of the dilemmas remain the same – ambivalence about the pregnancy, being not ready, too young, too old and family complete. Now, there is a new underlying anxiety as we are all in a period of such uncertainty due to the pandemic.
Being a bad person and feeling guilty are still high on the list of reasons why making the decision to end a pregnancy can be difficult, and as much as I would like to be able to take away the stigma of abortion it still remains very much in place for a lot of people.
The opportunity to offer some counterarguments for reassurance is very important; this is now a straightforward part of my day and they are often received as revelations by my clients. An explanation that ending a pregnancy can be as much a part of being a good mother as continuing one in the right circumstances often gives people some relief.
I have noticed an increased need for support for those anxious about going through the treatment alone when either no one else knows or because no one can be there with them on account of the lockdown. I have been talking through all sorts of strategies for people to feel safe and secure during treatment; reassurance has been a large part of the reason for the call.
My work has changed; I look forward to having some face-to-face interaction again but I am certainly learning that there are many effective ways to look after people seeking termination of their pregnancy and those who are exploring the options. As long as the opportunity to talk through their feelings remains a part of the process for those who need it, I know we will adapt our services to meet those needs.
Jane Calvert, Lead Client Care Coordinator, British Pregnancy Advisory Service (BPAS); jane.calvert@bpas.org
Note on the Author
Jane Calvert is passionate about ‘well-delivered’ abortion care, and is an advocate within her organisation for the best service possible. Jane has worked for BPAS for 29 years and has recently taken on the Lead role for Client Care Coordinators and those delivering the organisation’s Counselling Services. She is proud to work for BPAS, a forward-looking reproductive health provider.
SRHM Webinar on ‘COVID-19: What Implications for Sexual and Reproductive Health and Rights?’
5 May 2020
On Friday 27 March 2020, the journal Sexual and Reproductive Health Matters (SRHM) hosted a webinar on the implications for Sexual and Reproductive Health and Rights (SRHR) in the era of Covid-19. The webinar organisers were moved by the coming together of the SRHR community during this time to discuss the situations being faced by vulnerable and key populations and the actions that are needed in this emergency response. The webinar attracted in excess of 1300 participants on Zoom and more than 3500 people logged in to watch via Facebook live.
Watch the recording here: http://www.srhm.org/news/covid-19-what-implications-for-sexual-and-reproductive-health-and-rights/
‘The Spotlight’: A New Webinar Series from MSI
5 May 2020
Marie Stopes International (MSI) have recently launched ‘The Spotlight: the webinar series shining a light on all things sexual heath, gender and rights’, the rationale being that with the evolving pandemic impacting reproductive rights and frontline healthcare the world over, and many people now working at home, they believe that it is important to remain connected.
MSI say that “Given that many of the events that would have brought our communities together this year have been cancelled, we would like to continue some of these conversations. To support this dialogue, Marie Stopes International have launched a new webinar series – ‘The Spotlight’ – inviting partners from the sector and beyond to discuss key issues facing sexual and reproductive health, gender and rights.”
The series began on 8 April 2020 with the first webinar – ‘Delivering Access to Safe Abortion in the Time of COVID-19’ – sharing the potential impact of coronavirus on Sexual and Reproductive Health and Rights (SRHR), alongside strategies for ensuring that women can continue to access safe abortion services during the crisis; through telemedicine, pharmacies and government partnerships.
The webinar can be viewed here: https://www.safeaccesshub.org/access/webinar-delivering-access-to-safe-abortion-in-the-time-of-covid-19/
Future webinars related to safe abortion and post-abortion care will be announced via SafeAccess. Subscribe at https://www.safeaccesshub.org/subscribe-to-safeaccess-newsletter/ to remain updated.
‘Self-Managed Abortions should be Universally Available’ - Article in 'The Conversation'
19 April 2020
Sam Rowlands (Visiting Professor, Health and Social Science, Bournemouth University and BSACP Secretary) has written an article entitled ‘Self-Managed Abortions Should be Universally Available’ for the online publication, The Conversation (published 24 March 2020).
https://theconversation.com/self-managed-abortions-should-be-universally-available-132398
The Conversation is an independent source of news and views, sourced from the academic and research community and delivered direct to the public. Professional editors work with university and research institute experts to unlock their knowledge for use by the wider public. By providing access to independent, high quality, authenticated, explanatory journalism, The Conversation aims to encourage better understanding of current affairs and complex issues, and ideally allow for a better quality of public discourse and conversations. The Conversation launched in Australia in March 2011 and in the UK in May 2013. The newsroom is based in London, and the reporting team is part of a global newsroom able to share content across sites and around the world.
BSACP Webinar on 'Implementing RCOG Guidance on COVID-19 and Abortion Care (2)' - Thursday 9 April 2020 - REGISTER NOW!
7 April 2020
BSACP is organising a webinar this coming Thursday at which Dr Patricia Lohr will host service leads in the NHS and Independent Sector to discuss strategies and protocols for implementing the recommendations in the RCOG’s guideline on COVID-19 and Abortion Care.
Time: Thursday 9 April 2020 6:30–7.30pm
Topic: Implementing RCOG Guidance on COVID-19 and Abortion Care (2)
Description: Second webinar to learn from services leads across the NHS and independent sector about how they are approaching the recommendations in the
RCOG’s guidance on COVID-19 and Abortion Care. Format: presentations followed by a Q&A session with panel members.
Planned speakers:
Professor Sharon Cameron, Consultant Gynaecologist and Professor (Hon) at the University of Edinburgh
Dr Caroline Scherf, Consultant in Sexual and Reproductive Healthcare at Cardiff & Vale UHB
Mr Michael Nevill, Director of Nursing at British Pregnancy Advisory Service
Host: Dr Patricia Lohr, Medical Director at British Pregnancy Advisory Service
Registration link: https://zoom.us/webinar/register/WN_TYK4Oh6bRC-6O6oYHYsDsw
REGISTER ONLINE NOW TO GUARANTEE YOUR PLACE (maximum 100 attendees per webinar)
Once your registration has been approved, you will receive a confirmatory e-mail containing information about joining the webinar.
NB. Attendance at the live webinar is restricted to current BSACP members.
BSACP membership information is available at: https://bsacp.org.uk/about-bsacp/membership/about-bsacp-membership-information/
This webinar will be recorded and made available on the BSACP website for those who cannot join the live events.
A recording of the first webinar on this topic (held on 2 April 2020) is available at: https://zoom.us/rec/share/3JN1Apb88WpIa9Lz7HvRAqNwEYPneaa803MZ86cLyE6DNAkdKgCzLD9OfZEhMPT3
Janie Foote
BSACP Administrator
Tel: +44 (0)1243 538106
E-mail: admin@bsacp.org.uk
Website: www.bsacp.org.uk
New ‘No Touch’ Protocols for EMA from the USA
7 April 2020
Details are provided here of an EMA protocol from US experts soon to be published in the journal Contraception. The protocol is in draft form; however, the authors do not expect much in the way of changes. This protocol is very similar to what is currently being implemented at BPAS.
Sample Protocol and Patient Instructions for No-Test Medication Abortion – Draft 3 April 2020
Sample Protocol and Patient Instructions for No-Test Medication Abortion – Draft 3 April 2020
Currently under review by Contraception; the journal’s editor has authorized distribution in advance of publication.
Protocol Purpose: To enable safe and effective provision of medication abortion without a mandatory pre-treatment ultrasound, pelvic examination or laboratory tests when medically appropriate, given that these tests may be significant barriers to access and, in the setting of a pandemic, may increase transmission of infection to patients and health care workers.
The Reproductive Health Access Project have also made protocols for ‘no touch’ EMA as well as miscarriage and ectopic pregnancy assessment available at the following link:
https://www.reproductiveaccess.org/covid19/
These protocols, together with other useful information relating to COVID-19, are available on the ‘open access’ ‘COVID-19 Advice’ page within the ‘Resources’ section on the BSACP website. Direct link: https://bsacp.org.uk/resources/covid-19-advice/
Dr Patricia Lohr
BPAS Medical Director/BSACP Education Officer