FUTURE of ABORTION by gwz21419

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									                                 FUTURE of ABORTION
                                             Controversies & Care
                                 25-26 June 2008 • QEII Conference Centre, London

                                                          Conference Update

                                                     www.futureofabortion.org

This ground breaking two-day conference marked the 40th anniversary        Presentations were made by leading international and UK experts in
of bpas, Britain’s leading abortion provider and a participant in policy   abortion and sexual health services with the intention of stimulating
developments and media debates.                                            debate and presenting best practice in service delivery.
The event took place in the midst of a major Parliamentary debate          Many issues were discussed but four main themes emerged.
about amending British abortion law, and brought together doctors,         A summary of these key themes is contained in this
nurses, NHS commissioners, politicians, philosophers, journalists,         Conference Update.
campaigners and abortion providers from across Europe and the USA.



in this issue: abortion is a fact of life... p2 n a joined-up sexual health service... p3 n abortion law... p3 n the future of abortion... p4
“Abortion is a                                   n   Noted that abortion is an accepted part
                                                     of life - illustrated by the presence of a
                                                                                                  The presentation by Professor James Trussell
                                                                                                  of Princeton University, USA:

 fact of life”
                                                     large banner outside the conference centre
                                                                                                  n   Noted that half of all pregnancies in the
                                                     proclaiming ‘The Future of Abortion’, and
                                                                                                      USA are unintended, and that 48% of
                                                     the absence of any protestors.
Opening the conference, Rt Hon Dawn                                                                   unintended pregnancies resulted from
Primarolo MP, Minister of State for Public                                                            contraceptive failure;
Health:                                                                                           n   Highlighted the superior reliability of Long
                                                                                                      Acting Reversible Contraceptives (LARCs)
n   Recognised the role played by bpas in                                                             – ‘fit and forget’ methods that women do
    informing Parliament ahead of the vote                                                            not have to think about taking every day.
    on the Abortion Act and the forthcoming                                                           This generated front page media cover
    Parliamentary debate, ‘clearly putting                                                            age, with headlines such as ‘The Pill “has
    across the challenges and issues faced by                                                         had its day as an effective contraceptive”’
    women’.                                                                                           (The Times).
n   Acknowledged providers concern but
    reasserted the government’s view that the                                                     Addressing the question ‘What use is
    Abortion Act is working as intended.                                                          emergency contraception?’, Kate Guthrie,
n   Announced new funding of £6 million          Discussing the issue of ‘repeat abortion’,       clinical director of Hull and East Riding Sexual
    towards sexual health provision in further   Dr Sam Rowlands of Warwick Medical School:       and Reproductive Healthcare Partnership:
    education locations over three years.
                                                 n   Demonstrated that the proportion of          n   Examined research showing that increased
Ann Furedi, Chief Executive of bpas:                 repeat abortions is a predictable                access to EC does not reduce pregnancy
                                                     consequence of women having access to            and abortion rates;
n   Argued that we should not be concerned           legal abortion over the course of their      n   Argued that the public health impact of
    that the number of abortions has increased       whole reproductive life;                         EC should not be over-sold, but that the
    as access to services has improved.          n   Argued that there is no basis for viewing        benefit to individuals should be stressed,
n   Stressed the need for abortion as a              the population of women who have repeat          as ‘everyone deserves a second chance to
    back-up to contraception, evidenced by           abortions as any different to those who          prevent an unintended pregnancy’.
    the extent of contraceptive failure.             have one abortion.




“Through providing abortion, we understand it”
Ann Furedi Chief Executive of bpas,
commenting on the conference:
                                                 “We are proud to be                              we do not ignore ethical concerns about the
                                                                                                  value of life and importance of conscience,
                                                  able to host an event                           but consider and address them. It was a space
                                                  of this significance at an                      to discuss new developments in clinical
                                                                                                  practice and a platform to argue for the legal
                                                  important time for                              and regulatory frameworks that we believe
                                                  abortion legislation.”                          would best serve women and those who
                                                                                                  provide the services they need.
                                                 Ann Furedi, chief executive of bpas

                                                 “For us this was an opportunity to
                                                 demonstrate that through providing abortion,
                                                 we understand it. It was a chance to show that



2
“A good abortion service puts the woman at the centre
 and is part of a ‘joined up’ sexual health service.”
Chris Plummer of bpas:
                                                   n   Commissioning abortion services as part of    The emphasis on providing a woman-centred
n   Discussed the shift in British abortion
                                                       a robust sexual health strategy.              service was endorsed from a clinical
    provision from being seen as care bought
                                                   n   Providing a real choice of provider.          perspective by FIAPAC’s Dr Christian Fiala,
    by individuals using private clinics to
                                                   n   Clear and easy referral pathways.             Obstetrician and Gynaecologist, Austria.
    contracting services using public money via
                                                   n   Client participation in service design.
    the NHS.
                                                                                                     Discussing possible improvements in the
n   Argued that the future of abortion care
                                                   She drew attention to bpas’ innovations such      provision of EMA, Mitchell D. Creinin, MD,
    is client-focused: offering women as much
                                                   as offering Chlamydia testing and treatment       professor of obstetrics, gynaecology and
    choice as possible within resource
                                                   online, which show how willingness to             reproductive sciences at the University of
    constraints.
                                                   challenge the status quo can result in a          Pittsburgh:
n   Acknowledged that many women will not
                                                   better service.
    have a real choice in some aspects of their                                                      n   Drew attention to the safety and
    abortion provision. This may not matter ‘if                                                          acceptability of women’s home use of
                                                   Reviewing the National Sexual Health Strategy,
    compromises are considered and can be                                                                misoprostol – which is permitted in
                                                   Baroness Gould of Potternewton, chair of
    explained, and if customer focus, care and                                                           several countries, but not in Britain.
                                                   the Independent Advisory Group on Sexual
    kindness are at the heart of everything that                                                     n   Examined research on shortening the
                                                   Health & HIV:
    we do’.                                                                                              interval between mifepristone and
                                                   n   Situated abortion care firmly within a            misoprostol administration, which may
Donagh Stenson of bpas drew upon the                   broad approach to contraception provision         increase acceptability for women.
organisation’s 40 years of experience to suggest       and the treatment of STIs, emphasising the
‘what makes a good contract’, including:               need to provide a seamless service.



“Abortion law should reflect developments in science
 and international clinical practice.”
Dr Ellie Lee of the University of Kent:                                                              n   Mary Fjerstad of Planned Parenthood
                                                                                                         reported that provision of EMA by nurses
n   Drew upon her research into why women
                                                                                                         in the USA has greatly enhanced access to
    have abortions in the second trimester to
                                                                                                         abortion in rural areas;
    show why Britain’s 24-week ‘time limit’
                                                                                                     n   Sexual health advisor Kathy French argued
    continues to be necessary;
                                                                                                         that the UK should follow international
n   Noted that women’s failure to realise they
                                                                                                         practice by allowing nurses with the
    were pregnant (often due to contraceptive
                                                                                                         appropriate training to provide early
    failure), and the time spent deciding
                                                                                                         surgical abortions, and to prescribe the
    whether to have an abortion, are two of
                                                                                                         abortion medication used in EMA;
    many reasons why women present for
                                                                                                     n   Marge Berer, editor of Reproductive Health
    abortion at later gestations;
                                                   Other aspects of the UK law were discussed            Matters, noted that international research
n   Argued that affording women the time to
                                                   in relation to following international practice       and experience show that is it safe and
    make this decision is preferable to pushing
                                                   by permitting home use of misoprostol, and            beneficial for trained mid-level providers
    them to decide on an earlier abortion.
                                                   permitting nurses to carry out early medical          that are not doctors to play a greater role
                                                   and surgical abortions.                               in abortion provision.




                                                                                                                                                   3
“ The future of abortion should be determined by
  an honest, ongoing and rigorous debate.”
Engaging with the question of how abortion       that abortion is an ‘intrinsically illicit’ choice,
participants set their personal limits on        and doubted the possibility of the pro-choice
‘How late is too late?’, Lisa H. Harris of the   and anti-abortion movements finding
University of Michigan argued for ‘a new kind    common ground.
of abortion discourse’ that is open about the    n The journalist Dominic Lawson thanked

procedures used in second-trimester and the         bpas for providing a much-needed
emotive nature of it.                               dialogue and wondered how one balances
                                                    the rights of a woman and those of an
Speaking at a lively evening debate asking          ‘unborn child’.
‘What’s so bad about abortion?’:                 n Ann Furedi, chief executive of bpas,

                                                    argued she accords the embryo/foetus
n   Jon O’Brien of Catholics for Choice argued      some value – abortion is not like a
    that Catholics have a duty to follow their                                                         If you would like to see any of the
                                                    tonsillectomy and bpas’ clients know this
    own consciences, and should not be                                                                 presentations in full please visit the
                                                    too. But abortion ‘doesn’t take place in the
    forced to follow the teachings of the                                                              ‘The Future of Abortion’ website:
                                                    abstract’, and ‘I don’t accord that a life that
    Catholic Church.                                                                                   www.futureofabortion.org or contact
                                                    is not yet aware it is alive has the same
n   Josephine Quintavalle, (Catholic) of                                                               development@bpas.org
                                                    value as a woman’s life’.
    Comment on Reproductive Ethics argued




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                                     Chris Plummer, Director of Service
                                                                                                         Stratford Upon Avon
                                     Development Strategy of bpas
                                                                                                         CV37 9BF
                                                                                                         telephone: 0845 3655050
                                     “We were happy to see results from the conference
                                                                                                         email: development@bpas.org
                                     feedback included 99% of respondents were
                                     satisfied or very satisfied with the overall                        web: www.bpas.org
                                     programme and 98% stated the content was directly
                                     relevant to their work. This reflects the innovative
                                     approach we took to addressing these important
                                     issues and the quality of the speakers presenting.”
                                     Abortion Review will go into greater detail over the
                                     coming months.
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                                                                                                                                      PRI-CON-185 July 08

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