FPA oral evidence Cross-Party Inquiry into Unwanted Pregnancy

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1 Tuesday 12 September 2012 FPA oral evidence Cross-Party Inquiry into Unwanted Pregnancy Introduction Welcome the Inquiry, thank you for inviting us to give oral evidence and we will also be submitting written evidence. FPA (formerly the Family Planning Association) is one of the UK s leading sexual health charities with over 80 years experience of providing the UK public with accurate sexual health information, education and advice services. Through our Enquiry service we answer thousands of telephone, web and text enquires every year. In 2011 we answered nearly 25,000 calls to our helpline from women, men and professionals. The majority of calls from women were about contraceptive methods and accessing contraception services (approx 66 per cent). Approximately 9 per cent of calls from women were about abortion. Over the past year we have been hearing about increasing restrictions that women are facing in accessing contraception, particularly women over 20/25 years old. FPA and Brook will be launching the XES We Can t Go Backwards campaign next week which aims to raise awareness of people s sexual health rights, gather people s stories and influence local and national policy makers and commissioners. 1. What is your view on the issue of unwanted pregnancy in the UK? FPA believes that women have the right to control their fertility and choose if and when they have a family. Unplanned pregnancies can have a huge impact on women s lives, their partners and their families and we want to ensure that women are able to plan their families as much as possible. Talk about why we say unplanned rather than unwanted. Unplanned can be wanted. Reproductive health and fertility control are not episodic health issues they remain throughout women s reproductive years (15-44 years old). And about healthy people accessing preventative medicine. Contraception choice and use are vital. Two most popular methods of contraception are the pill and the condom (42% and 25% respectively). We know that when women are happy and confident with their method of contraception they are more likely to 1

2 use it effectively. Therefore a choice of contraceptive methods with accurate information about them is vital. FPA Contraceptive Awareness Week in 2009 Finding the perfect partner research Estimated that there were nearly 2million women in the UK not happy with the current contraceptive method Found that almost one in three UK women aged typically spends up to just five minutes selecting a suitable contraceptive method to use Found that almost half of these women (47%) have had a pregnancy scare (thinking they were or could be pregnant when they didn't want to be). Remember that no contraceptive method is 100 per cent effective so there will always be unplanned pregnancies and a need for access to safe abortion services if needed. 2. Should the Government be concerned about recent trends in unwanted pregnancy such as rising abortion rates in some age groups, rising repeat abortions and high teenage pregnancy rates? Impact of unplanned pregnancy The Government should be concerned about the impact of unplanned or unwanted pregnancies on women s, their partners and their family s lives. The Academy of Medical Royal Colleges and National Collaborating Centre for Mental Health s systematic review of the mental health outcomes of induced abortion (Dec 2011) concluded that the rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth Gov should also be concerned about the economic impact of unplanned pregnancy. Unplanned pregnancies cost the NHS money. Investing a 1 in contraception saves In 2005 NICE calculated that fully implementing its guidance on access to long-acting reversible methods of contraception would save the NHS in England more than 100 million a year. Northern Ireland Government should also be concerned about UK citizens that don t have access to safe and legal abortion services which women in Northern Ireland do not. They are forced to access and pay for abortion services abroad and means that they do not have the same reproductive rights as women in the rest of the UK. This situation needs addressing urgently. Trends On the trends we warmly welcome the fact that 2010 saw the lowest TP rates since They do remain high though and the Gov should indeed be concerned about that and continue to invest in TP work and making SRE statutory. The abortion rate has been same for last 3 years though there are different patterns in the rates. We cannot prove causality or know what the reasons are for the slight increase in the repeat abortion rate or the rise in abortion rates among older women. We do 2

3 know that women over the age of 25 years old are finding it harder to access contraception services and that could be a reason for the rate rising in older women. Must remember that a repeat abortion could be a woman having one at 20 years old and one at 35 years old so isn t necessarily consecutive but sometimes at different points in their reproductive life. FPA CAW in 2010 was called conceivable? and focused on unplanned pregnancies in women over 35 years old. 3. Do you feel that there are any underlying reasons that explain these and other trends in unwanted pregnancies? Access to a choice of contraception for all people. Particularly for older women (APPG report found that women over 25 were experiencing restrictions in access to contraception) Patchy provision of high quality relationships and sex education Lack of sustained national campaigns on contraception, relationships and pregnancy choices Two most popular methods of contraception are the pill and the condom (42% and 25% respectively) both of which are user dependent. It is about everyone having the information and understanding to be able to choose the best contraception for them. 4. What lessons can be learnt from previous attempts to tackle unwanted pregnancies? Teenage pregnancy rate reduced because: Dedicated national strategy National accountability (Independent Advisory Group) Improved provision of sex and relationships education Investment in contraception and information services Local services working together We are not saying that exact method has to be followed but investment coupled with incentives and national accountability would go far in improving rates of unplanned pregnancy. 5. Are there any measures the Government should be implementing to reduce unwanted pregnancies? Local authorities will currently be mandated to provide appropriate access to sexual health services from April 2013 we believe this mandate should be much clearer about what appropriate means We would like to see more moves towards guidance and support for commissioning high quality sexual health services from DH and Public Health England Need clear accountability for local authorities that fail to commission or deliver high quality services for all 3

4 Relationships and sex education should be made a statutory part of the primary and secondary curriculum Publish the sexual health policy document. In the public health white paper, the Government committed to publishing a sexual health policy document in March In September 2012 the document has still not been published. The delay in publishing the sexual health policy document has had negative impact on the development of local sexual health priorities and NICE guidelines. Research into new contraceptive technologies 6. Line on our funding situation Our contract with DH entitled sexual health direct, which included specialist information to the public and health professionals, public awareness campaigns and a helpline service ceased in March of this year. The contract was worth 1,345,000 per annum. We received six month transition funding to continue the helpline until a new contract was awarded. The contract was awarded to SERCO and FPA funding for our specialist SH helpline ceased this month We have recently won a new DH contract to deliver specialist sexual health information but not a helpline or public awareness campaigns. This contract is 1,129,653 over three years (year 1 = 367,210: year 2= 390,713 year 3 = 371,730) We have lost our core funding from the DH of 70,000 per annum We have also lost funding for our community projects, for example Speakeasy in England was funded by DfE but that funding of 262,414 per annum ceased in March Overall project funding in England, Scotland and Wales dropped from 713,034 in 2011 to 280,179 in We have a partnership programme with Brook and Durex for three years, in which Durex are committing one million over the course of the three years. Our collaboration with Brook has also enabled us to deliver more for the people we work with but also deliver efficiency savings through sharing office space and posts Possible other questions Do you believe in unrestricted access to abortion services? We believe that abortion is part of reproductive healthcare and women should be able to access services when they choose. How many abortions should women be able to have? There is no right number of abortions and any concerns around women accessing services can be addressed by qualified health professionals who can work with individuals. 4

5 Shouldn t parents be able to consent for a young person to have an abortion? Young people under 16 have the right to access confidential services. Health professionals will always encourage them to talk to their parents or a trusted adult. Impact of health reforms on unplanned pregnancy? Concerns around indicators focusing on young people, budgets, fragmented commissioning, open access and accountability. Cultural issue around trends? Get some information if there is a cultural issue and get back to you. 5