The recent news that Ethiopian Jewish women had been given the injectable contraceptive Depo Provera without their knowledge or consent awakened a strong feeling of déjà vu for me.  When I came into the field of reproductive health, 35 years ago,  Depo Provera had just come onto the market. There were far fewer contraceptive methods available at the time and therefore far less choice. From one perspective, a method that a woman need only renew once every three months was a gift. One injection four times a year and no fear of unwanted pregnancy, no need to insert anything, wear condoms, remember to take a pill every day, get your partner’s agreement if he was opposed to using something. It was heralded as the solution to high levels of unwanted pregnancy. more…

Post partum haemorrhage (PPH) is one of the leading causes of maternal deaths. According to WHO estimates, in 2010 there were 287,000 maternal deaths, 25% of which were associated with PPH. The risk of PPH is greatest in anaemic women and the risk of PPH resulting in death is greatest in settings where there is a lack of timely referral processes, long distances to or a lack of transport to adequately staffed and equipped clinics, and inadequate emergency obstetric care at referral centres. more…

At the Labour conference last week, Andy Burnham accused Jeremy Hunt of failing to make any statements about important current health service issues in parliament since he became health secretary. What a pity he decided to speak up last week, because now we know just how uninformed he is. Hunt said he favoured reducing the abortion time limit to 12 weeks. Really? How much more irrelevant can it get with this government? But he wasn’t alone. Maria Miller, who became women’s minister in the recent shuffle, had already expressed her personal opinion on the abortion time limit in the Guardian. Theresa May was then pushed to take a view on the Today programme on Saturday, and (not to be left out) David Cameron also offered his two cents’ worth on the BBC. A bit like lemmings, except that they all had different views, and the government, according to Cameron, has no plans to put forward legislation anyway. Still, every news outlet in the country seems to have picked up on it. Is that what the media are for these days—to report every off-the-cuff, unthought-out opinion that comes down the road? Give me a break. This is non-news. more…

I was among the first generation of women in the 1960s to experience the miracle of the pill just at the age when I was wanting to start having sex. All I had to do was take a pill every day, I was told, and hey presto, I didn’t have to worry about getting pregnant if I didn’t want to, and it worked! But oh, if only it had all turned out to be that easy! Like one in three women in the UK today, a country where contraceptive prevalence is almost as high as it can get, I needed an abortion several years later. Again, I was lucky, the 1967 Abortion Act meant I was able to get a legal abortion. The lesson is simple—while contraception continues to be a miracle, because it helps people not to have children if and when they don’t want to, it is not enough on its own and it never has been. more…

Punch-drunk on power after his success at sticking up two fingers to the entire health profession at the passage of the Health & Social Care bill in Parliament last week, Andrew Lansley has apparently found a new mission—to harass doctors and clinics who provide abortions, both in the private sector which he otherwise seems to love so much, and in the NHS, whose death knell he has just sounded.

His first target was abortion counselling. Despite parliament’s outright rejection of an attempt by Nadine Dorries MP to change abortion counselling regulations, the Department of Health went fishing for evidence of wrongdoing by non-NHS abortion clinics. It has sought (ironically) to problematise counselling by independent service providers as being linked to profit. After a great deal of fuss and bother, and no evidence of wrongdoing emerging, a consultation on the future of abortion counselling was announced. We await the questions with bated breath, now that the next phase of what is beginning to look like a longer-term campaign against abortion providers has begun to emerge. more…

Ach, what a furore. The Daily Telegraph is in its element and having a ball printing nasty allegations about doctors doing abortions illegally on grounds of sex selection. Let’s look at the issues a bit more dispassionately. First, is it actually illegal? Yes and no. The 1967 Abortion Act does not permit abortion on grounds of sex selection per se, it is true, and the law is framed so that anything that cannot be defended as coming under one or more of the named legal grounds is technically illegal. However, the question remains whether abortion on grounds of sex selection can be defended under the existing legal ground for abortions. I believe the answer is yes. more…

So, the silicone’s hit the fan.

The use of industrial-grade silicone intended for mattresses, the possible fraud in hiding information from inspectors at production stage, and the failure in quality control in the regulatory phase, are particularly outrageous. However, the rapidly expanding private sector provision of breast implants for cosmetic reasons, by an “industry” that has been permitted to remain self-regulating in spite of evidence of its shortcomings and the risks involved, was a public health problem waiting to happen. more…

Many years ago now, when news of female sterilisation first came out, Catholic priests in Puerto Rico and other Catholic countries preached from their pulpits against women being sterilised. As a result many more women learned that sterilisation existed, and many went out from church asking where to get it. In effect, the church gave family planning free advertising space by opposing it. Recently, the Daily Mail and others who rant against emergency contraception and abortion have played a similar role. more…

Nadine Dorries MP is a very skilful politician. She decides there is a problem, for which she has absolutely no evidence. She not only manages to get her problem on to the front pages of the newspapers but also on to the agenda of the House of Commons. Having spoken to her about it, the Department of Health (DoH) agrees to take it up and resolve it without putting it before Parliament. But the DoH have no evidence of a problem either. Nadine Dorries wants to make life harder for the one in three women in this country who will have an abortion in their lifetimes. But what excuse does the DoH have? One can only presume they were trying to stop Dorries from stealing the limelight from Andrew Lansley’s NHS bill next week, which is contentious enough without her. Today, as reported by the Guardian,  Downing Street has intervened. more…