February 8th, 2007
According to data released by Marie Stopes International 5992 terminations were carried out in January 2007 indicating a 13% rise in terminations in the past two years.
They claim this is the most terminations carried out in one month than at any time in their 32-year history.
The charity and subsequent press coverage have blamed Christmas parties and high level alcohol consumption on people taking more risks and getting pregnancy. Marie Stopes International are arguing for a government campaign in the run up to Christmas to alert people to using contraception to prevent pregnancy and sexually transmitted infections. Which is interesting since either Marie Stopes missed that such a campaign did launch just before Christmas last year, or maybe that campaign (which focused more on STIs) missed its mark. The charity claim they gave out ‘party purses’ that included condoms and the morning after pill in the run up to Christmas but it seems to have made absolutely no impact if their data released today are to be believed.
A spokesperson for the charity said: “We may be seeing the consequences of the festive season, when partying excess and alcohol consumption combine to increase libido and lower inhibition, with the inevitable consequences of unprotected sex resulting in unplanned pregnancies.”
All the extensive media coverage of this story has run with this idea blaming booze, irresponsible ladies and parties for unplanned pregnancy. But there are a number of questions that should have been asked about this data that don’t seem to have been addressed:
Were the figures for 5992 terminations based on actual terminations (medical or surgical) or women seeking information about having a TOP (termination of pregnancy)?
Were the 5992 terminations all referred and performed within January 2007?
Was the reason for pregnancy noted? Can it be proven that of the 5992 terminations the majority were caused by people having unprotected sex due to alcohol consumption over the Christmas period?
What were the ages of those seeking TOPs noted? How many of them were of an age where they would be attending Christmas parties and also having alcohol-induced risky sex?
This data implies women had sex over Christmas and noticed they were pregnant in January, immediately consulted for a TOP and were swiftly treated within a one-month period.
What we know about women and early pregnancy is that not everyone has a regular period so you may not notice a missed period immediately. Frequently women wait one month to see if their period will arrive so will miss at least one month (or more) before consulting a doctor. Many will hope they aren’t pregnant and so will not address the problem immediately, and often women may not be weighing up whether they want a TOP. When you go to seek a TOP in the UK most women will consult with their GP – which means waiting days or weeks for an appointment.
Some women may refer straight to a clinic for TOP but even then often women are encouraged to ‘think it over’ before deciding and two doctors have to agree a woman needs a TOP. Research evidence has consistently shown women often know what they want by the time they decide on a TOP and don’t need more time to think about it, yet delays are in place within the NHS as well as TOP services meaning TOPs don’t happen all that quickly.
We know those who live in rural areas, in busy urban areas where there are more time pressures on practitioners, those who don’t speak English as a first language, teenagers and people from particularly close knit or conservative communities find it much more difficult to access TOP services. We also know that whilst the morning after pill is available not everyone knows where to get it from and it’s not always accessible in the recommended 72-hour time frame. The concern over costs of emergency contraception also put people off (even though you can get the morning after pill for free in many places).
At a time when general practitioners are overstretched, as are family planning and genito urinary clinics many women are going to be delayed in getting a referral for TOP. We also need to be aware that many services would be closed or overbooked in the run-up to Christmas so rather than women getting pregnant over the Christmas period it could be they were pregnant before then but it took until January to get their TOP.
All of this means that the majority of women who got pregnant over Christmas probably wouldn’t be referred to and have had a TOP by the end of January.
The Marie Stopes data may be referring to women having mostly private TOPs (where they refer themselves and pay for their TOPs). In that case these women may be seen and treated within a month but that doesn’t prove that the majority of these women weren’t pregnant before the party season or got pregnant because they were drunk.
Evidence on TOP services indicates that young women (particularly vulnerable or excluded teenagers) are more likely to have a termination than to use contraception, but in general more women are using contraception than in the past. This doesn’t appear to have been considered in the latest Marie Stopes data.
Whilst any rise in TOPs need to be taken seriously I don’t feel this story is quite as accurate as we’ve been led to believe. It is predictably leading to women-blaming media coverage where women go to parties, get drunk and get pregnant. If this truly is the case then why isn’t coverage looking at the multiple societal factors that may lead to increased risk taking and alcohol use, or even praising women who, having found themselves pregnant are still able to manage their situation and refer themselves for a TOP.
I can’t quite see what Marie Stopes International hoped to gain by this. They are committed to providing TOPs to women but they also know that there’s increased pressure in the UK to restrict the availability of TOPs. Surely in sharing this data rather than suggesting they need to be giving more help to women it plays into the hands of those who want to blame women and restrict services further? I’m sure they released these figures in good faith and for good reason, but it isn’t quite clear to me exactly what motivated this course of action at this time.
News coverage has all implied that the women this data’s referring to are all having surgical abortions, which is unlikely if they were in such early stages of pregnancy as the report suggests. Most will be having early medical abortions that are far less invasive (although can still be unpleasant). To find out more about different types of termination available in the UK click here.
We do need to tackle issues of managing fertility and STIs. That includes improving our sex education, increasing funding and availability of sexual health services and contraception, and also challenging how we commercialise sex without offering people the life skills to negotiate this pressure. Tackling issues around communication and power in relationships is also important so people are able to negotiate and use contraception.
We have yet to see whether the data from the Marie Stopes report match an equally high level of STIs. It would be profoundly depressing if the STI rates were found to be equally high – but that data won’t be available for some time yet.
In the meantime we’re left with lots of hysterical coverage in the press today that probably has got overexcited about a story that may not be quite so accurate as it seems.Tweet