Sarah Catt: when we've stopped pointing the finger let's ask ourselves how much we care

Sarah Catt faces an eight year jail sentence after taking abortion medication purchased over the internet to end her pregnancy at 39 weeks. I don’t know if she had any idea that she was putting her life and her liberty at risk when she did this. There is speculation as to both her motivation and her mental state, but the only fact of the matter is that for some reason the idea of giving birth to a living baby, which she almost certainly would have done within just a couple of weeks, was intolerable to her.

Speculation about whether she is a monster or just desperately ill and unhappy will, no doubt, be rife. Arguments will rage to and fro about whether she should have received such a long sentence. Others will ask whether the current time limit for abortion is right, whether there should be time limits at all or whether our focus should be on doing everything we can to make abortion as accessible as possible, as early as possible. Some people will say that this case demonstrates an argument for taking abortion out of the sphere of criminal law altogether, others that this proves we need legal limits on abortion provision because we simply cannot trust women not to go running around choosing late term abortions.

For me this case is so unusual that I’m not sure if it can helpfully inform debates about abortion law. They say that hard cases make bad law and this is probably a case in point.

If we can draw any lessons from this it might be about the support that we can provide to those women who consistently struggle to control their fertility, to choose and use an appropriate contraceptive method, and to manage relationships. There are many reasons why women who feel negative or at least ambivalent towards pregnancy still get pregnant repeatedly including complex personal circumstances. Easy as it is to blame individual women for making bad decisions (we rarely blame their partners) we also have to ask ourselves whether sometimes repeat unintended pregnancies do highlight a shortfall in services. Did Sarah ever seek or was she ever offered any support to think about her fertility, to clarify her own feelings about pregnancy and parenthood and to make informed choices about future relationships and contraceptive use?

Did she have the emotional and practical support she needed after she placed a child for adoption? Or did that process contribute to her belief that it was better to go through the potential pain and danger of labouring alone to have a stillbirth, than to give birth safely and retain the option of placing the baby for adoption? When she was turned down for abortion after 24 weeks did anyone offer her the opportunity to think about ‘what next?’ Did anyone offer to help her talk to her husband and think through the possible consequences (good and bad) of having this conversation in terms of her safety, their relationship and the future of their family?

When a healthy woman with a healthy pregnancy seeks abortion after the legal time limit, it is likely that her circumstances and her feelings about the pregnancy are pretty desperate. For good or ill, a woman in this situation cannot have an abortion after 23 weeks and 6 days. What do we offer these women to address the circumstances they find themselves in, in which continuing the pregnancy is intolerable? Are they made aware of the dangers both medical and legal of trying to induce an abortion themselves? Is there anything we can offer to make the next 16 weeks of pregnancy tolerable, safe and manageable for them...let alone the next 20 years of parenthood?

I don’t know what kind of support is available to the handful of desperate women who are turned away from abortion because they’re just too late. Later abortion is a divisive issue, but whatever anyone feels about it, we must all feel some duty of care towards women who want one, but can’t have one.

EFC Youth Advisors produce short film about pregnancy testing

We're very pleased to announce that the short film produced by our lovely Youth Advisory Group is now up on our You Tube channel (and you can view it below!)

The group wanted to make a film which would give other young people information about pregnancy testing and pregnancy options but which would also make the process seem a little less intimidating.

Chau: 'I have definitely learned more about sexual health and am able to tell others more precise facts'
Namratha: 'It's a great resource for young people to know of their concerns and options locally available to them'
Nataliah: '(the film allows) young people to gain information on services available to them without feeling embarrassed or intimidated to directly ask someone.'

Well done guys!

"I didn’t know there was such a thing as an implant": Sixth Formers tell us about their sex education lessons

I recently visited a school in Essex to deliver EFC’s Talk About Choice presentation to the Sixth Form there. I was lucky enough to be able to speak to a few of the students afterwards to get their thoughts on the presentation and what they’d learnt.

I was surprised when the students told me that a lot of the information on contraceptive methods had been new for them:

‘The contraception methods I didn’t know about’

‘I didn’t know there was such a thing as an implant’

 ‘I didn’t know you could get injections’

‘We know the usual stuff like pills and condoms but we didn’t know the sort of more unconventional stuff’

As years 12 and 13 I had expected them to have covered basic sexual health topics such as STIs and contraception in earlier years but it seems that had been limited and worryingly, for most of them, had taken place in R.E lessons as a purely abstract discussion of religious views:

 ‘They did talk about some types of contraception but it was more about what religions thought’

‘It was sort of like, if you were Christian what would you think about abortion’

Sex education outside of R.E lessons had only been experienced by some of the students:

 ‘A good 60 people a year group don’t have that lesson so all they have is the RE side’

‘If you did triple science you don’t do it’

These students were articulate about what was missing from their sex and relationships education. Sadly, their clear need and desire for sexual health education was not being met thanks to patchy delivery. With little knowledge of their own rights and responsibilities, or practical information about local services the students recognised that they were less able to practice safer sex. As two pupils remarked on their lack of condom education:  ‘if you don’t use it properly then you’re gonna be at a higher risk’ and ‘if you don’t know how to do it then obviously you’re gonna worry when you do it and also then you might be more embarrassed and then you don’t use it’.

The students also gave an extremely mature and thoughtful take on what abortion education should look like. They appreciated having a talk about contraception and abortion which was not attempting to push a moral agenda but rather gave factual information:

‘(you)made it less daunting, like saying, don’t be scared to talk to who you need to talk to rather than saying like, I dunno, you’ll be punished and shamed’

 ‘I think when approaching the subject of abortion...you can’t be biased, like ‘abortion is completely wrong’ or ‘abortion is fun, it’s really good’ you have to be neutral, it’s neutral territory when it comes to approaching teenagers I think’

‘It’s good when you’re not really presented with ‘a viewpoint’, because a lot of the time you already have some form of viewpoint and if you just give the statistics, ...then it’s more like making up your own mind’

They were also concerned about the effect a strongly anti-abortion speaker might have on a young audience. When I asked how they would feel if a speaker used images in their talk, one young man said:

‘Doesn’t matter as long as they’re not being biased, like if they’re using it to influence...then it’s a bit unfair. Cos if there was a girl in that room for example who was pregnant she might look at that and feel awful’

It was refreshing and heartening to hear them speak so enthusiastically and sensibly about the need for a non-biased approach to abortion education, but it’s disappointing that a school which clearly had good intentions had so clearly failed to provide the students with what they needed. I’d like to think this is a blip, but all the evidence from surveys, questionnaires and anecdotes suggests it’s pretty typical.

Brook survey shows almost half of secondary school students felt that their SRE was unsatisfactory

Contraceptive implants for 13 year olds a Four for One mythbust

As the groundwork is laid for an attack on young people’s access to contraceptive advice, we offer this myth-busting Monday special - busting four of the many myths that have been asserted following publication of this article last week.


13 year olds are all running around having contraceptive implants


In fact most younger teenagers are not having sex at all. When Dorries raised the issue of 13 year old girls being given secret implants she chose an eye catching, but relatively rare example to get press attention – it worked!


The under 16 conception rate for England is 7.5 per thousand (7,100 13-15 year olds got pregnant in 2009). Of these, the vast majority are conceptions to 15 year olds and relatively few to younger girls. This statistic has fallen over the 10 years of the teenage pregnancy strategy which means either that the strategy and its emphasis on good Sex and Relationships Education (SRE) which encourages thoughtful decision-making about sexual activity (including delaying sex) has paid off and resulted in less sex OR that young teenagers are having as much sex as the media sometimes claims, but being pretty successful in using contraception to prevent pregnancy, or maybe both. Either way the fact that this rate has fallen (not by enough, but still fallen) should not be ignored. Analysing the statistics more carefully you can see that some of the more dramatic reductions have taken place in the areas that originally had the highest teenage pregnancy rates. This is significant because these are often the areas that invested the most in SRE and tailor-made sexual health services for young people. 


Parents are always the best people to make decisions about their children’s health choices


We would love to think that parents are all able to have supportive, constructive conversations with their teenagers about all aspects of health and lifestyle, but we know that parenting and adolescence don’t always work this way. Some of the most loving, caring and competent parents struggle to communicate with their teenagers effectively, but there are also the parents who don’t attempt to communicate with, care for, or nurture their children. Then there are young people in the care system where the local authority has taken over parental responsibility because there parents simply can't or won't keep them safe.


Parents are not a homogenous group of caring, loving, competent, infallible, sexual health experts. At their best they provide love, nurture and a values framework that they hope their children will follow, but often they cannot provide objectivity or expertise, something that young people need and value when making important decisions about their health and lifestyle. 


Providing contraception encourages/increases under-age sexual activity


This assertion does not reflect sexual health practice at all. Although sexual health providers would probably prefer under-16s not to have sex at all, the fact is that many of them are choosing to. A conversation about contraception with young teenagers is an opportunity health workers use to find out more about their lifestyle, sexual behaviour and relationships; to check for coercion, pressure or abuse within their relationships; to explore sexual decision-making with them; to signpost them to services that will help address additional needs young people often present with; and to establish whether they are currently having, or imminently going to have, sex. While many people - parents and professionals - may feel conflicted about providing contraception to a young teenager, what we know is that NOT providing contraception will NOT prevent young people having sex, because the presence of one or more of adolescent sexual desire, love, adrenalin, alcohol, and culture are often irresistible even in the face of the law, and the risk of pregnancy and STIs.


The law says that 16 is the age of consent so surely giving contraception to under-16s is breaking the law. 


The law is intended to protect young people and is implemented in this spirit. It is unlikely that similarly-aged adolescents who have both consented to sex would be prosecuted even if one is underage, but a sexual relationship entailing a large age gap or a very young person would be subject to safeguarding procedures and further investigation.
Alongside the age of consent, The Fraser Guidelines which govern sexual health advice for under-16s  allow nurses and doctors to have a confidential consultation with a young person of any age and to provide them with contraception or abortion. In this situation their legal duty is:


• to decide whether there are any safeguarding issues and whether information about this young person must be shared with other professionals in order to protect him/her/other young people;
• to assess the competency (or ability) of a young person to understand the risks and benefits of any treatment they ask for; 
• to assess on balance of risk whether providing contraception will be beneficial (for example what is the likelihood of the young person becoming sexually active whether or not they are provided with contraception); 
• to encourage the young person to consider talking to a parent or carer and to help them assess the risks and benefits of doing so.

More on this:

Lisa's Comment is Free piece

Simon Blake in HuffPo

The Telegraph

Myth Busting Monday – ‘Abortion makes you infertile’

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts.

We’ve talked about this before but we think it’s worth repeating: legal abortion doesn’t cause infertility. Young people and professionals often come to us with concerns that someone who has an abortion will not be able to have children in the future. In fact, as the RCOG point out:

“There are no proven associations between induced abortion and subsequent ectopic pregnancy, placenta praevia or infertility”

In fact, “ovulation occurs within a month of first-trimester abortion in over 90% of women” which means that those wishing to prevent future pregnancies should get information about contraception following abortion. Some contraceptive methods can be fitted or initiated at the time of abortion while a woman's motivation is likely to be high.

This myth may relate to times and places where abortion is illegal and thus unsafe. However, some organisations in the UK are still making this claim about legal abortion: Care Confidential talk about ‘relative infertility’ as a risk of abortion and a centre in their network recently gave out literature stating that ‘sub-fertility or infertility’ is a longer term effect of abortion.

Myth-Busting Monday - World Contraception Day Special

Today is ‘World Contraception Day’ so we thought we’d share some common myths we hear about contraception.

A multi-national survey was released today which reported a number of barriers young people have in accessing trustworthy information about sex and contraception. Only 55% of those interviewed in Europe said they had received sex education at school and 20% said that ‘their school does not provide a comfortable environment for questions on sexuality and intimacy’. One of the most worrying findings was that 14% of young people in the UK reported that their teachers had provided information about contraception which was inaccurate or untrue. We believe school is a place where young people should feel comfortable to ask questions and confident that they will receive evidence-based answers. Teachers need access to reputable sources of information on sexual and reproductive health (like fpa and Brook) as well as training and resources to deliver the balanced and informed SRE young people need. We believe this is particularly pertinent when dealing with the topic of abortion – a subject shrouded in stigma and myth, and that’s why we offer training and resources to help them do so.

So let’s bust some common myths about contraception. You can find detailed information on all forms of contraception by visiting the fpa website.

Using two condoms when you have sex means double the protection. This one came up just the other day in new Channel 4 comedy ‘Fresh Meat’ when two characters ‘double bag’ by using a female and a male condom at once. In fact, using two condoms at once is likely to increase friction and could mean that they are more likely to tear or come off. If somebody wanted to further decrease their chances of getting pregnant they could use condoms alongside a non-barrier method of contraception (like the pill or the implant).

Women who haven’t given birth shouldn’t be fitted with the coil. This myth is common enough that we’ve heard it from some medical professionals. In fact, women of all ages (including those who are ‘nulliparous’ i.e. haven’t given birth) can be fitted with an IUD/coil. Young women should be offered the full range of contraceptive methods with a discussion of the suitability and side effects of each one.

Taking the contraceptive pill can lead to fertility problems. Some people think that taking the pill for a number of years will affect a woman’s fertility in the long-term but this is not true. In fact, some women conceive immediately after stopping taking the pill and while it doesn't cause fertility problems the pill can mask problems that were already there, such as irregular periods.

Have you heard any other myths about contraception from young people or in the media? Let us know by commenting below!

Why we're supporting the pro-choice demo 9th July

EFC is happy to promote the Pro-Choice demo happening next Saturday (9th July 2011) in London, to its friends and followers. This blog gives a bit more information on why we think this action is so relevant and important. To register your attendance visit the Facebook page and follow @ProChoice9July #prochoicedemo2011 for up to date information.


Recent months have seen a number of worrying intrusions into our reproductive rights in this country. Including:
• Nadine Dorries’ and Frank Field’s ‘Right to Know’ campaign which posits abortion providers as having a ‘vested interest’ in persuading women to end their pregnancies, and argues for ‘independent’ centres to provide pre-abortion counselling. EFC believes these amendments are based on a false premise – that women aren’t currently getting impartial, evidence-based support with their pregnancies.  Our research into crisis pregnancy centres in England also suggests that a great deal of ‘independent’ centres do not provide impartial accurate information but rather, are driven by an anti-abortion agenda. Read a thorough debunking of this campaign by Darinka from Abortion Rights here.
• Anti-abortion charity Life invited to sit on the government’s Sexual Health Forum.  LIFE is a well funded charity with a large profile and has every right to promote its anti-abortion position. However, as a lobbying group with no commitment to evidence-based clinical practice, or to promoting and providing good quality contraceptive and reproductive health care, it simply has no place on this group, which otherwise consists of sexual health experts, clinicians and service providers.
• Michael Gove commends the new SRE council of abstinence education groups. LIFE and Care (a Christian organisation which opposes abortion) join 5 other abstinence/anti-choice groups on the new SRE council which has been welcomed by the education minister. See our blog for more information on these groups and more information on why abstinence doesn’t work.
• Nadine Dorries’ abstinence education for girls. Worryingly, Tory MP Dorries’ misguided bill to teach girls abstinence passed the first stage vote in parliament. Another reason to keep on our toes and make the case for evidence-based comprehensive sex education.


EFC supports the rights of young people to accurate information and good quality, evidence-based information on abortion; and their right to impartial support with pregnancy decision-making. We believe that current developments will impact most on young people by depriving them of essential information and diverting them away from health professionals who could give them the support they need to access services quickly.


Those of us who believe women should have access to safe, legal abortion and they and their partners and families access to evidence-based information on contraception, pregnancy and abortion need to stand up for these rights before they are eroded.


Join EFC on the demo to make a stand for the pro-choice majority and for young people in this country.

Myth-Busting Monday: 'If everyone had access to birth control and all the methods were 100% effective, all pregnancies would be wanted'

This week we're borrowing another myth from the brilliant Scarleteen article How to (un)Pack for a Real Discussion About Abortion. Thanks again to Heather Corinna at Scarleteen for giving us permission to reproduce this extract entitled: 'If everyone had access to birth control and all the methods we had were 100% effective, all pregnancies would be wanted and we would have no abortions'.

While some women have very firm and consistent feelings before and during the whole of a pregnancy that a pregnancy is wanted, not everyone feels that way. Given how much pressure expectant mothers are under to express nothing but joy about a pregnancy, we can’t even accurately say how many women have mixed or mutable feelings: we just don’t live in a world yet which allows women that kind of honesty around pregnancy.

Even if every wanted pregnancy remained wanted, we can be certain that many women would still want and need abortion. Life doesn’t just stay put while we’re pregnant, so our circumstances can always change, and some of those changes can seriously alter our plans, previous wants and needs or the status of our pregnancy. In fact, I think it’s pretty strange to talk about a process which is about nothing but constant change – for a developing, as well as for a pregnant woman – as if it could be unchanging.

That said, birth control access and efficacy is a huge issue, and given that in America alone, nearly half of all pregnancies which end in abortion are unintended, we know that lack of access to methods, not knowing how to use methods properly or having a lack of cooperation around contraception in sexual partnerships and the level of effectiveness methods provide does very much contribute to more abortion than we would see otherwise. Those earnestly looking to help reduce the number of abortions drastically should absolutely be working to increase birth control access, awareness and the development of reliable methods of contraception, since this is the one thing we know would make a huge difference which does not in any way diminish or remove women's reproductive rights.

Truth behind the headlines: 11-year-olds and contraception

Earlier this week, I was disappointed but not surprised to see the Telegraph, the Daily Mail, and other media outlets report a "huge rise" (Telegraph) in 11-year-olds on "the pill", or the combined oral contraceptive pill. Their conclusion? That pre-teens on the pill were the victims of "sexualisation".

So what's the real story behind the headlines? Yes, some 11- and 12-year-olds take the pill. Does this mean they're sexually active? No. One of the benefits of the pill is that it can help regulate the menstrual cycle, decreasing cramping and heavy periods. For many women, taking the pill saves them from agony and discomfort. I could write up a storm on this, but there's no need when Dr. Petra Boynton has already written an amazing post over at her blog. She explains how the story happened, what the statistics really mean, and what we, as sexual health and reproductive rights advocates, can be doing to put a stop to media hype around these issues.

Myth-Busting Monday: If everyone used contraception, would there still be a need for abortion?

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts.

There are many methods of contraception, and most of them are reliant on the woman or her partner to use them consistently and correctly. Long Acting Reversible Contraceptive (LARC) methods can be fitted for the woman by a doctor or nurse and do not rely on perfect usage.  These methods have an extremely high success rate in preventing pregnancy. Even so, all contraceptive methods occasionally fail (LARC fails less than others; see James Trussell’s presentation on why contraception fails). In fact, if every single contraception user worldwide used their chosen contraceptive methods perfectly, there would still be hundreds of thousands of unintended pregnancies each year around the world.

Despite the existence of effective methods of contraception, some women do not always find it easy to seek contraceptive care or advice or may find it hard to reach their local family planning clinic; others may find it hard to get support from their partners to use contraception; others may have the intention of using condoms or other barrier methods each time they have sex, but find it hard to remember to do so.  Sexual assault continues to be a massive problem in the UK and internationally, and can lead to unintended pregnancy. For many reasons the existence of contraception per se does not remove the need for the safety net of abortion for those women who haven’t successfully protected themselves against unwanted pregnancy.

Good news - today's abortion statistics

I was really happy to see the abortion statistics published by the Department of Health today. They show reductions in the abortion rates for women of all ages. Since it is unlikely that women had less sex in 2009 than they did the year before, it probably means that men and women are using contraception more regularly and more effectively and getting offered a better choice of contraceptive methods – good news! For those women who did access abortion the statistics show that services for women are improving too. 94% of abortions were paid for by the NHS and a massive 91% were carried out before 13 weeks into pregnancy .

The figure that shows an increasing proportion of abortions taking place earlier in pregnancy definitely brings a smile to my face. The earlier abortions happen, the safer they are, and the easier to access. Young women are often the last to seek help because they’re scared, lack knowledge or are in denial about their pregnancy, so getting them into services earlier is a challenge we’ve been helping professionals to meet all over the country.

Just in case you wondered, I’m not complacent. Most abortions happen because the women didn’t intend to get pregnant at that point in her life. That’s a lot of people who still aren’t getting support from partners and professionals to use contraception successfully and of course there’s still that pot of gold at the end of the rainbow we are all searching for – the perfect contraceptive method...

No Sir, these figures don’t make me want to put my feet up and light a fat cigar. There’s so much more to do to make sure young people are given accurate information about pregnancy prevention, pregnancy choices and abortion. Education For Choice is one of dozens of organisations which rue the day the Government failed to give us statutory sex education. We still visit students in schools who have been given presentations by anti-choice organisations who quite deliberately misinform and distress them. Young women seeking abortion after 12 weeks, in all but a few large cities, are most likely to have to travel substantial distances to get an abortion – which is extremely difficult for those with no parental or partner support. In a nutshell , there’s still loads to do and these statistics are just showing slight improvements across all areas. Those improvements have been hard won with professional commitment and substantial investment. Let’s hope the money and commitment continue so we can celebrate again next year.