Late abortions

The University of Southampton has just published a study on the reasons behind late abortion. It seems that there are a number of different reasons, but one that is noticeable is that many did not realise they were pregnant for quite a while.

The reasons given for this were:

• Irregular periods

• Using contraception

• Continued having periods

So, if there are any other delays, such as being unable to make an appointment with her own doctor; waiting for a consultation; the wait between appointment and abortion, these, added to the delay in realisation of pregnancy, may well turn a straightforward early abortion into a late one.

Coupled with this is the problem of finding doctors who are willing and able to perform abortions, which has been widely reported as I mentioned in an earlier post. It was also covered well by the NHS Blog Doctor in NHS Blog Doctor: Libby Purves joins the abortion debate from a doctor's point of view. This can only lead to still further delays and if the law is tightened there could be repercussions for many women.

If things continue as they are, we may yet need the services of the Dutch abortion ship as discussed on the f-word and The Times. This ship became headline news when it was blocked from entering Portuguese waters to collect women for abortions. There is some speculation that this led to the relaxing of Portuguese abortion laws. The ship effectively had its licence removed by the right-wing Dutch government in 2004 by banning it from sailing beyond a 15 mile radius of a Dutch hospital, but the government has now been replaced and the licence has been given back . It can perform abortions up to only 7 weeks of pregnancy but they are hoping to have this extended to 12 weeks.

The only EU country which no longer allows abortion is Malta, with Ireland and Poland having very strict conditions.

Abortion crisis in the UK

The Royal College of Obstetricians and Gynaecologists today issued a statement to say that the number of doctors prepared to carry out abortions is gradually falling and will lead to a crisis in the service. They recognise any doctor's right to refuse to carry out abortions but equally are aware that it is an essential service. They go on to say that family planning and gynaecological services should have adequate funding to ensure that abortions are kept to a minimum.

There is an extensive and what seems to be a well-balanced report in the Independent. By the time the BBC reported the story, the situation was threatening the National Health Service.

The report I find interesting though, is also in the Independent, "Issue that goes to the heart of our differences with America". I've said in the past on other blogs that there just doesn't seem to be nearly as much emotion on this side of the Atlantic, but faced with the discussions that seem to abound, sometimes I have wondered if I was missing something here. A case of selective awareness perhaps, and only noticing opinions that would reinforce my own point of view. Well if that is the case, the Independent article is another reinforcement. I particularly like the final sentence.

Embryos to be destroyed

There has been a great deal of coverage here in the UK for the plight of a woman whose ex-partner insists that the embryos they had frozen when they were together should be destroyed.

They had undergone IVF treatment when it was discovered that she had pre-cancerous cells in her ovaries. The embryos were frozen for later implantation and her ovaries were removed. In the meantime she and her partner split up and he refuses to let her use the embryos, insisting that they are destroyed. His reason is that he doesn't feel ready for the emotional or financial burden of fatherhood.

This has been taken all the way to the European court of Human Rights and the final appeal has been rejected, meaning the embryos will be destroyed very soon. Apparently the law is very clear on the matter.

I find that a really distressing verdict, even if it does obey the letter of the law. Is it really justice? It's almost like forcing the woman to have an abortion, and it is particularly cruel when the ex-partner knows full well that she cannot have a child any other way. There surely must be some way of drawing up an agreement of what to do if the couple split up, so that a situation like this never arises again. And it should be compulsory to have such an agreement so that the subject has to be adressed from the outset, so that the question doesn't cause anyone to feel their commitment is being challenged.

Contraceptive Awareness Week

It's contraceptive awareness week in the UK. How many people know that? I happened upon it by following up an article in the Guardian somewhat by accident. You’d think they’d try a bit harder at the awareness.

Two surveys have been published to coincide with this event.

Schering Health Care surveyed 1020 women. Some of the figures are fairly staggering - 12% of women aged 26-34 have had an abortion; 20% of these had not been using contraception and 27% had forgotten to take their contraceptive pill. 30% have gone through with an unplanned pregnancy whilst in a long term relationship; 41% of these were not using any form of contraception at the time, and a further 29% had forgotten to take their pill. Well all right, in a long term relationship they possibly weren’t as concerned as they would have been otherwise, but it’s still bad.

Although nowhere like as bad as the Glasgow study which found that approximately 50% of women were using no contraception, the conclusion was similar: that there is a need for better contraceptive education. Schering, who produce long-acting reversible contraceptives, of course are not unbiased.

At the same time, the FPA published a survey to highlight other sex education issues. They surveryed 495 people over 18. Did this include 70 year olds? And what was the weighting “applied to the data to bring it into line with national profiles”?

I have to say I took the quiz and found a couple of the questions tricky so I’m not surprised that some of the results were poor. Again though, the results do highlight the need for better education. That 29% could think that jumping up and down, douching or urinating could prevent pregnancy is unbelievable (with the proviso that I don’t think the question was well phrased).

Teenage pregnancy

I spent what felt like years, but was probably only two plus several bits, studying part-time for a further degree in health psychology. It was very relevant to the job I was doing at the time and it's a subject that fascinates me.

One particular aspect which interests me is reproductive health so when I spotted two blogs, first The Well-Timed Period: Who Doesn't Use Birth Control and then figleaf (note: adult content with some very thought provoking posts), had picked up on a BBC report “Teenage pregnancy myth dismissed” - I delved a bit further. So far in fact that I ended up emailing the authors and they very kindly sent me a copy of the original paper.

The main finding is that “older women” are as irresponsible as teenagers about contraception, with around 50% not having used contraceptives at all. I’m not disputing their findings an any way – far from it. It’s just that I would have liked more information. I think there probably is quite a lot more to be tweaked out of the data.

I have difficulty in understanding why the researchers made a division of the population into teenagers and not-teenagers. What happens when they are 20? Are they expected to change their attitudes suddenly? I don’t know why they did that, and especially when you see that the mean age of the so-called older women was 28. There must have been a much greater number in their twenties than in their thirties or forties (the range was 20 – 46). It would have been interesting to see those age groups separately, if not the raw data. It might show more in the way of trends.

Given that teenagers were expected to be more irresponsible, and that there have been a number of government initiatives since 1999 trying to combat teenage pregnancies, it could be the sex education has worked to some extent. Teenagers are now no worse than other age groups.

The results are dire however. I have to say in the case of this research and where it was carried out, social problems will have had a very large influence. It is an area of high unemployment, overcrowded housing, and so on.