For every bit of good British news, it appears some grim, disappointing information must follow.
Despite Scotland becoming the first country in the world to offer free sanitary products last year, and despite the BSI releasing new period and menopause standards for workplaces today, leading gynaecologist Prof Lesley Regan recently told The Guardian that “Women are finding it harder to access contraception than they did a decade ago.”
The Faculty of Sexual and Reproductive Healthcare (FSRH) state that “45% of pregnancies and one third of births in England are unplanned or associated with feelings of ambivalence”.
So what’s going on here?
According to Regan, the issue stems from ”‘destructive’ changes made to the NHS commissioning system in England in 2012, which siloed GP surgeries from hospitals.”
“If you’re not commissioned to deal with the problem, there’s no incentive to do a job properly … Contraception has got to be everybody’s business and up until this moment it’s been nobody’s responsibility and no one’s been accountable for it,” she adds.
And the British Medical Journal (BMJ) says that COVID-19 has had an effect on women’s access to contraception, too.
They found that “women were nine times more likely to report difficulty accessing contraception after lockdown”, and stated that among their 9,784-person-strong subjects, “the proportion of unplanned pregnancies has almost doubled.”
Access (or lack thereof) is not evenly distributed
Of course, not all contraception troubles are created equal.
“In a study among homeless women in Central London, some participants reported experiencing unwelcoming healthcare settings and this discouraged them from opening up about their challenges, and some asylum seekers reported not being registered with a GP,” say Biomed Central.
And Gov.uk says that “women from certain demographic groups experience far worse outcomes in early pregnancy, infertility, maternity and gynaecological conditions.”
For example, rates of miscarriage “were almost four times higher for women from Black ethnic backgrounds and almost two times higher for women from Asian ethnic backgrounds, compared to White women.“
They add that “Living in the most disadvantaged parts of the country is also associated with higher admissions for conditions such as pelvic inflammatory disease and ectopic pregnancy, higher rates of teenage pregnancy, and higher abortion rates, potentially indicating difficulties in accessing contraception in these areas.“
Sexuality plays a role, too – “Among lesbian and bisexual women, teenage pregnancy is higher than the national rate and cervical screening rates are also lower,” Gov.uk says.
Ahhhhhh! So what’s being done?
A Department of Health and Social Care spokesperson told the Guardian that they had “recently announced £25m for women’s health hubs – enabling women across the country to benefit from better access to care for essential services including contraception.”
However, gynaecologist Lesley Regan says that this is “a drop in the ocean” and that “finding ways to train more GPs in contraception and dissolving the barrier between general practice, clinics and hospitals was also crucial.“
What a time to have a vagina...