The Royal College of Obstetricians and Gynaecologists (RCOG) has, this week, published its revised guidelines on the care of women requesting induced abortion. The recommendations cover commissioning and organising services, possible side effects and complications, pre-abortion management, abortion procedures and follow up care.  A summary of new and improved recommendations and link to Q&A’s are in the RCOG press release.

Medical Students for Choice (MSFC) – based in the US, is a non-profit organisation recognising the need to create abortion providers for tomorrow:  www.medicalstudentsforchoice.org. They aim to try and correct the drastically falling numbers of providers in the US and Canada – 57% of current providers are over 50. This along with targeted violence, restrictive legislation and medical schools not addressing the issue means doctors are qualifying with little knowledge of abortion.

RCOG Honorary Fellowship

Toni Belfield

Our friend and colleague, Toni Belfield, has, today, been awarded an RCOG honorary fellowship in recognition of her long service in the field of contraception and sexual health and passionate dedication to providing accessible, evidence-based information for men and women. Included in the citation Professor Janice Rymer noted responses from colleagues who said Toni is “One of the most knowledgeable people in women’s health” and “Her contribution is always very sound”.  Her many friends in the field know, love and respect her as an ardent advocate for service users (never patients or clients!) and as someone who always keeps us on our toes when it comes to accurate use of terminology – we always fit IUDs never coils! Congratulations Toni.

Take Action! Respond to the PSHE Review – Deadline 30th November

The Department for Education is running a Review of PSHE including Sex & Relationships Education with a view to improving its delivery in state funded schools. You can read the review and respond online by following the link. The British Humanist Association has succintly summarised the situation and the fears of many in its statement to accompany its own response.

As Halloween and Trick or Treat approach we face an even greater horror, as Monday 31st October 2011 is the day the world’s population is forecast to crash the 7 billion barrier only 12 years after it passed 6 billion.

Despite overall rates of fertility falling and the basic right of all women to manage their own fertility having been officially recognised at the Cairo Conference in 1994, 215 million women in ‘high fertility’ countries still don’t have access to voluntary contraception. In addition “millions of adolescent girls and boys have little access to sex education and information on how to prevent pregnancies or protect themselves from HIV.” UNFPA report – The State of World Population 2011

As the number of commentators that report and respond to this prediction increases will politicians and others in power finally listen to what ‘family planners’ have been saying for years and concentrate budgets where they can do some good. Or are we in danger of ignoring this situation until it is too late. This, of course, echoes the post of 4 weeks ago that reported Mary Robinson ‘s warning to the UN on the same issue on the 20 year anniversary of the Rio summit and declaration .

UK’s Breast Screening Programme to be Reviewed

The UK’s National Cancer Director, Professor Sir Mike Richards, has ordered an independent review as questions were raised by the Nordic Cochrane Centre’s systematic review over whether screening may do more harm than good. As this controversy could undermine the excellent effects that are achieved by screening it is important to investigate and resolve any uncertainties. As Sara Hiom of Cancer Research UK (who will jointly lead the Review) said “We mustn’t lose sight of the fact that the fundamental principle underpinning screening – that earlier diagnosis helps improve outcomes – is right and that screening does help save lives”.

MHRA warns against purchasing HIV and non-compliant tests over the internet

We also hear that non-CE marked tests which claim to diagnose HIV and other STIs, available from a UK-hosted website, could give inaccurate results according to a press release from the MHRA . This is aside from the fact that it is illegal to market HIV tests to the public. The HPA has also been involved in contacting all those known to have purchased the tests but warn others considering using the internet as a way of accessing anonymous testing to check that any product is compliant with regulations.

Good News: another new study confirms what we already knew that The Pill and pregnancy have the biggest impact on reducing ovarian cancer risk -  published in the British Journal of Cancer and part-funded by Cancer Research UK. The greatest protection was afforded by taking the pill for more than 10 years followed by ever users then getting pregnant and having more than one child.

The latest edition of the American Journal of Obstetrics and Gynecology includes a supplement entitled: A Hormonal Contraception Update: A Decade of Innovation & Transformation.

In addition AJOG published (online 11th July 2011) a study on the impact of long-acting reversible contraception on return for repeat abortion by Rose S B and Lawton B A. The objective of the study was to determine the rate of return for repeat abortion in relation to postabortion contraceptive method choice 24 months onward from an intervention study.  Its conclusion states: “This study provides strong support for the promotion of immediate postabortion access to LARC methods (particularly intrauterine devices) to prevent repeat abortion.”

September saw the European Society of Contraception (ESC) hold its 11^th Seminar in Kaunas, Lithuania. One of the most notable features was the number of participants for a regional symposium  – 533, with the majority being from Poland and Latvia. A number of our colleagues from the UK were involved in either presentations or workshops: Dr Sarah Randall, Dr Anne Webb and Dr Simone Reuter. In addition there was a Board of Directors’ meeting which involved the 2 UK representatives, Dr Meera Kishen and Shelley Mehigan.

Kaunas itself was fascinating for its combination of old and new: elements left over from its communist-dominated past with many crumbling, abandoned buildings and its, especially young, people who are trying to adapt to a new world with western influences. This was particularly evident in the apparent twin obsessions of pizza and eating outside – as well as this may work if the pizzas are made in the Italian way and the cafes are in the Mediterranean it suffers a little in translation to a chilly Baltic state with locally made fare.  This was partly corrected by an apparent benefit to the local blanket industry!

The next full Congress will be in Athens in June 2012.

Meanwhile at home:

Have you completed elements of the new DFSRH: e-SRH; Course of 5; Clinical Exerience and Assessment; e-Portfolio or the LoC SDI or IUT? The Faculty would like to hear from you. They have commissioned an independent review by Professor Ed Piele of the University of Warwick. Visit the Faculty website to give your feedback on your experiences.

UK Agony Aunts bed-in to make sexual health a priority -

What would be the correct, collective noun for a group of agony aunts?

Well in this case it could be a ‘bedful’ or maybe a ‘boudoir’ as 8 of the UKs finest gather to add their support to a group of sexual health charities – Brook, FPA (Family Planning Association), Terrence Higgins Trust, and MedFASH – calling on the government to protect sexual health services as many have seen reduced funding lead to cuts in vital services. This at a time when:
i) a survey by Brook confirms that only 6% of children learn the facts of life from their parents – the internet, TV and friends being the usual source of information (sometimes misinformation) and
ii) the House of Lords HIV and Aids Select Committee report last month found efforts to control the spread of HIV are woefully inadequate as £2.9m is spent on prevention compared with £762m on treatment.

Fiction Book Reviews

Have you enjoyed reading the fiction book reviews in the Journal? Did you agree with the reviews this time of The Room by Emma Donaghue and The Hand That First Held Mine by Maggie O’Farrell? The book for January 2012 will be Pain of Death by Adam Creed (Faber & Faber).