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You can find the current article at its original source at https://www.theguardian.com/commentisfree/2018/sep/14/contraception-services-cuts-councils-clinics
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| Contraception frees women. Rationing by stealth is crazy | Contraception frees women. Rationing by stealth is crazy |
| (about 1 month later) | |
| A woman who wants to control her fate must first control her fertility. It’s a statement of the bleeding obvious in lots of ways, but it’s still easily forgotten in an age when most of us take free contraception for granted. British women are so used to snapping open a blister pack, swallowing a pill and getting on with their lives; or blissfully ignoring the whole thing, bar the occasional IUD checkup. | A woman who wants to control her fate must first control her fertility. It’s a statement of the bleeding obvious in lots of ways, but it’s still easily forgotten in an age when most of us take free contraception for granted. British women are so used to snapping open a blister pack, swallowing a pill and getting on with their lives; or blissfully ignoring the whole thing, bar the occasional IUD checkup. |
| The days when our mothers and grandmothers had to buy cheap wedding rings from Woolworths and lie through their teeth just to stand a chance of getting the pill or the cap – which clinics wouldn’t prescribe to anyone but married women until 1967 – seem light years away. Now the only serious threat to reproductive rights that most of us in the UK could conceivably imagine is if some Trump-esque rightwing populist movement, implacably hostile to women’s sexuality and ambition, somehow rose to power. | The days when our mothers and grandmothers had to buy cheap wedding rings from Woolworths and lie through their teeth just to stand a chance of getting the pill or the cap – which clinics wouldn’t prescribe to anyone but married women until 1967 – seem light years away. Now the only serious threat to reproductive rights that most of us in the UK could conceivably imagine is if some Trump-esque rightwing populist movement, implacably hostile to women’s sexuality and ambition, somehow rose to power. |
| But what if the reality was more prosaic? What if the real risk to freedom of choice wasn’t ideology, but boring old money? | But what if the reality was more prosaic? What if the real risk to freedom of choice wasn’t ideology, but boring old money? |
| Sexual health care cuts will stop me helping survivors of rape and FGM | Sexual health care cuts will stop me helping survivors of rape and FGM |
| This week, the Advisory Group on Contraception released a survey, based on freedom of information requests, showing that half of local authorities have cut or plan to cut contraception services this year. Across England, specialist clinics are restricting their hours or shutting down, shunting women back into already overstretched GP surgeries – which is probably fine for those who just need a repeat prescription, but not for the very many women whose lives and needs are more complicated than that. Significantly, there’s an emerging problem for many women in getting hold of long-acting reversible contraceptives (Larcs), such as the coil and contraceptive implants. | This week, the Advisory Group on Contraception released a survey, based on freedom of information requests, showing that half of local authorities have cut or plan to cut contraception services this year. Across England, specialist clinics are restricting their hours or shutting down, shunting women back into already overstretched GP surgeries – which is probably fine for those who just need a repeat prescription, but not for the very many women whose lives and needs are more complicated than that. Significantly, there’s an emerging problem for many women in getting hold of long-acting reversible contraceptives (Larcs), such as the coil and contraceptive implants. |
| Larcs have been hailed as a huge leap forward because, unlike the pill, you can’t forget to take them and, unlike condoms, you’ll never have to persuade a man to use them. But funding for training GPs to fit them has been cut: in some areas there aren’t enough doctors who can do it, and that means a long wait for referral to someone who can. If access to the best possible contraception was threatened in this way by some politician arguing that women who want to sleep around without getting pregnant don’t deserve to have public money spent on them, we’d be marching in the streets in protest. But the councils making these cuts aren’t doing so for ideological reasons. They’re simply responding to financial pressure – after taking over responsibility from the NHS for contraception services in 2012, they had their public health grant cut by George Osborne in 2015– and most of us have barely noticed. | Larcs have been hailed as a huge leap forward because, unlike the pill, you can’t forget to take them and, unlike condoms, you’ll never have to persuade a man to use them. But funding for training GPs to fit them has been cut: in some areas there aren’t enough doctors who can do it, and that means a long wait for referral to someone who can. If access to the best possible contraception was threatened in this way by some politician arguing that women who want to sleep around without getting pregnant don’t deserve to have public money spent on them, we’d be marching in the streets in protest. But the councils making these cuts aren’t doing so for ideological reasons. They’re simply responding to financial pressure – after taking over responsibility from the NHS for contraception services in 2012, they had their public health grant cut by George Osborne in 2015– and most of us have barely noticed. |
| It would be wrong to exaggerate the impact so far of this form of stealth rationing, given conception rates are still falling except for women over 40, and abortion rates rose only slightly last year. But the warnings now bubbling up from family planning experts and GPs about what may be lurking around the corner are worth heeding all the same. | It would be wrong to exaggerate the impact so far of this form of stealth rationing, given conception rates are still falling except for women over 40, and abortion rates rose only slightly last year. But the warnings now bubbling up from family planning experts and GPs about what may be lurking around the corner are worth heeding all the same. |
| The young mother interviewed by the BBC this week as it covered the survey stressed how much she loved both her children. But Melissa’s story was disconcerting all the same. When she went to her doctor to ask for contraception after having her first baby, she says she was told she’d have to wait eight weeks. The upshot is that she now has a one-year-old and a newborn, despite being only 22 years old and suffering from what she described as mental health issues. Her friend, who had to wait two months for a coil fitting, said her terror of getting pregnant in the meantime had had a serious impact on her relationship. | The young mother interviewed by the BBC this week as it covered the survey stressed how much she loved both her children. But Melissa’s story was disconcerting all the same. When she went to her doctor to ask for contraception after having her first baby, she says she was told she’d have to wait eight weeks. The upshot is that she now has a one-year-old and a newborn, despite being only 22 years old and suffering from what she described as mental health issues. Her friend, who had to wait two months for a coil fitting, said her terror of getting pregnant in the meantime had had a serious impact on her relationship. |
| And no doubt some listeners will have been shouting at the radio, asking why these women couldn’t just cross their legs for a bit or buy some condoms. Yet it’s precisely this rush to moral judgment, in a way, that makes contraceptive services so vulnerable to cutbacks. Councils facing hard choices are naturally keen to minimise the backlash, and cutting services whose users are defensive or a bit embarrassed about using them is the easiest way of doing so. Women forced to wait months to have a coil fitted probably won’t go rushing to the papers to share their gynaecologist histories with the world. | And no doubt some listeners will have been shouting at the radio, asking why these women couldn’t just cross their legs for a bit or buy some condoms. Yet it’s precisely this rush to moral judgment, in a way, that makes contraceptive services so vulnerable to cutbacks. Councils facing hard choices are naturally keen to minimise the backlash, and cutting services whose users are defensive or a bit embarrassed about using them is the easiest way of doing so. Women forced to wait months to have a coil fitted probably won’t go rushing to the papers to share their gynaecologist histories with the world. |
| Those most likely to end up with an unplanned pregnancy if they can’t easily get hold of contraception – the young, the chaotic, women in exploitative relationships where saying no to sex isn’t an option – tend not to arouse much public sympathy either, though an unplanned baby in a family already at the end of its tether is a potential recipe for disaster. Not for nothing was the original slogan of the family planning movement “babies by choice, not chance” – a reminder that children tend to thrive when they’re born to people ready and able to raise them. | Those most likely to end up with an unplanned pregnancy if they can’t easily get hold of contraception – the young, the chaotic, women in exploitative relationships where saying no to sex isn’t an option – tend not to arouse much public sympathy either, though an unplanned baby in a family already at the end of its tether is a potential recipe for disaster. Not for nothing was the original slogan of the family planning movement “babies by choice, not chance” – a reminder that children tend to thrive when they’re born to people ready and able to raise them. |
| There’s something particularly galling that all this is happening under a government that has raised the stakes around unwanted pregnancy by restricting benefits to the first two children. It is sheer hypocrisy to lecture parents about not having kids they can’t afford, while quietly presiding over cutbacks in family planning. | There’s something particularly galling that all this is happening under a government that has raised the stakes around unwanted pregnancy by restricting benefits to the first two children. It is sheer hypocrisy to lecture parents about not having kids they can’t afford, while quietly presiding over cutbacks in family planning. |
| But there’s a broader principle at stake, for women both rich and poor, and it’s that contraception is the foundation stone on which so many female freedoms are stacked. Turn back the clock even a fraction, and there are potentially serious implications for young women’s (and young men’s) lives, hopes, education and ambition. We shouldn’t have to wait until the damage is done before acting. | But there’s a broader principle at stake, for women both rich and poor, and it’s that contraception is the foundation stone on which so many female freedoms are stacked. Turn back the clock even a fraction, and there are potentially serious implications for young women’s (and young men’s) lives, hopes, education and ambition. We shouldn’t have to wait until the damage is done before acting. |
| • This article was amended on 17 September 2018. The clinics are shutting down in England, not across the UK as an earlier version implied. | • This article was amended on 17 September 2018. The clinics are shutting down in England, not across the UK as an earlier version implied. |
| Contraception and family planning | Contraception and family planning |
| Opinion | Opinion |
| Local government | Local government |
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