On woman's hour - woman seeking abortion should receive counselling from GP rather than BPAS

[Bumperlicioso]

Was listening to WH earlier and they were discussing this. Details from the bbc website below:

, Abortion Law, New Attempts to Tighten Rules Around Terminations

Nadine Dorries MP and Frank Field MP have put forward amendments to the Health and Social Care Bill currently passing through the Commons that would mean a tightening up of the rules around abortion. They claim that the current system means pregnant women receive advice from organisations such as British Pregnancy Advisory Service, who are ?abortion providers with a vested interest?, consequently they say, they cannot give the independent advice that women should get. So are women not receiving enough independent advice? Ann Furedi, Chief Executive of BPAS and Nadine Dorries join Jane Garvey to discuss'

Am I being naive to think this is just another hoop for women to jump through and surely no one really has a 'vested interest' in convincing woman to have abortions. Are GPs really qualified to give this advice? That is what Dorries seemed to be suggesting should happen.

Well, to be honest, I changed GPs immediately, but I still had to go private as the time lag would have been too long. I was a shocked, hormonal sitting duck. He shouted at me and was really quite abusive. But what can you do? There you are, a woman in a very vulnerable position at the mercy of someone who feels it is their right to impose their morality on you. I, at least, was fortunate enough to have both the money to go private and the emotional resources to not be intimidated into doing something I really, really didn't want to do and, having done it, have never regretted.

GPs can refuse to refer you for a termination if it's against their religion (not yours you note).

slug I think your story is exactly why there should be self-referral routes for terminations and counselling because some pro-lifers are not always able to separate their emotion from the job (and equally some pro-choice slip up from time to time).

I hate that women would ever find themselves in that position so putting steps in to avoid the situation makes sense.

I do wonder where this idea that GPs are the saviours of the NHS has come from? It seems odd to me and a disproportionate responsibility. Why can't they best left to get on with the business of delivering medical care, be involved in consultation and have someone else do the administration? No other industry expects those delivering services to also be commissioning it.

This is a horrendous idea. There are parts of the country where it is actually quite difficult to get referred by a GP, as they can abstain if it's against their religion (as slug says). BPAS are a fantastic and non-judgemental organisation, ime, and I speak as someone who has used their service and decided against a termination, so whilst they do make the process of getting a termination as painless as possible I don't agree that they do not counsel about the alternatives.
I just don't think it's in women's interests to make the process of getting a termination more difficult. Mainly because I just don't believe that it's a decision that anyone goes into lightly, but also because restriciton of access to terminations has traditionally been a method of supressing women, and still is in a lot of countries.

Apparently BPAS do offer counselling, according to their rep on the programme anyway.

'There are parts of the country where it is actually quite difficult to get referred by a GP, as they can abstain if it's against their religion '

Where?

LessNarkyPUffin, there was a report out that gave details - this is some years ago. Trying to find it.

Traditionally parts of the West Midlands, surprisingly. Also, obviously, Northern Ireland. Also, if your GP is anti then it is difficult. So, if you go to your GP and are refused referral, what's your next step? Not every area has an accessible BPAS clinic. Also, not every woman has the resources, or knows the system well enough to know that there are alternatives if the GP will not refer.

I know N.Ireland has issues. I thought the GP had to pass the patient on to another GP who would refer?

Apparently it's only 'good practice'

GMC guidance on "Good Medical Practice" is somewhat more understanding and s8 says

"8 If carrying out a particular procedure or giving advice about it conflicts with your religious or moral beliefs, and this conflict might affect the treatment or advice you provide, you must explain this to the patient and tell them they have the right to see another doctor. You must be satisfied that the patient has sufficient information to enable them to exercise that right. If it is not practical for a patient to arrange to see another doctor, you must ensure that arrangements are made for another suitably qualified colleague to take over your role"

Yes, that's how it works (at least in theory). However, if you are in an area where there are lots of GPs who refuse to refer, then your nearest alternative could be many miles away, and therefore, in practise, inaccessible, especially to women living rurally, and those in receipt of benefits, or women who don't have access to money except through their partner, for whatever reason.

I changed GP but there was a 6 week wait for an appointment. In my part of London this is quite normal as all the GP surgerys are oversubscribed. There was no way that I could have afforded to wait. What would have happened if the new GP turned out to have the same attitude as the first?

I know I was fortunate enough to be able to afford to go private. My DP paid and my best friend knew where to go. But I am well aware that not every woman is as fortunate as I was. It's a horrendous position to find yourself in.

I'm really shocked by what your GP said to you Slug. That must have been incredibly upsetting and distressing. Were you not tempted to report him to the BMC or whoever regulates GPs? I'm sure it's breach of standards for him to tell you that abortion is a sin

He was perfectly within his rights to refuse me medical treatment on the basis of his religious beliefs. He just took a bit longer to explain that than was strictly necessary.

I had only registered with him because he was the only GP in my area with space on his books (I wonder why?) He was also pretty agressive to the women who worked in the surgery.

Yes but don't they have to be up front about the services they do and don't provide at the point of registering? My GP also refuses to prescribe contraception or to refer for abortions but they told me that when I registered so I knew what I was letting myself in for! And they also told me about other family planning clinics etc nearby where I could get contraceptive advice.
You shouldn't have to find out about your GP's religious beliefs at the point that you turn up saying you need an abortion!

KatieMiddleton "I do wonder where this idea that GPs are the saviours of the NHS has come from?"

Andrew Lansley's first wife is a GP.

Nope, they don't have to tell you when you sign up. Or at least I wasn't told. The first I heard about this was the lecture when I presented with an unplanned pregnancy.

You are lucky that your GP is so upfront RamblingRosa. Personally, I think that, as the GPs are providing a service paid for by the state, they should have no right to deny women treatment based on religious beliefs rather than clinical need.

slug "I think that, as the GPs are providing a service paid for by the state, they should have no right to deny women treatment based on religious beliefs rather than clinical need."

too bloody right! This is something I may take up with my MP actually.

Are GP's qualified to counsel women about abortion?

It doesn't sound like a very good idea to me, unless they all do counselling courses. I think GP's have enoguh to do, don't they?

slug "I think that, as the GPs are providing a service paid for by the state, they should have no right to deny women treatment based on religious beliefs rather than clinical need."

I totally agree too! Really winds me up. It's my bloody right to have a perfectly legal procedure. Your right is not to go into a branch of medicine where you have to deal with it.

I wonder if there are legal implications to refusing women medical care related to reproduction? I know registrars who refuse to perform
civil partnership ceremonies citing religious reasons have been ruled to be fairly dismissed and B&B owners can't discriminate based on any of the protected characteristics in the Equality Act so why can medics discriminate against women seeking to control their fertility for contraception (bit fuzzier for abortion but mental health and maternal wellbeing might be arguments??)?

Because doctors are very powerful representatives of the patriarchy.

They have more power and status than B&B owners or registrars.

I think it just comes down to that.

I am glad that this law is being looked into. I got pregnant with a longterm boyfriend last year who completely turned on me, ended the relationship and refused to see/talk to me after we did the test. We're both 'educated' and 'successful' I am normally a strong willed and independent woman, but finding myself pregnant and traumatised in crisis, plus on the verge of eviction from my house due to a dodgy landlord, I found myself unable to think clearly about my pregnancy.

Initially I knew I wanted my baby and was happy, at 34 it was the right time for me in my life. But as my partner had left me and was scaring me sh*tless I found myself asking my GP for counselling. The only way I could access this was through an abortion clinic. I had to wait weeks forthis appointment and when I eventually went it was not counselling and within 5 minutes the 'counsellor' was asking me who would collect me after the procedure. I cried and said I hadnt gone there for a procedure but to help me make a decision. I was given NO advice on the support available to me if I was to continue with my pregnancy and in fact told that I was in a bad situation to have my baby. That was on the NHS. In retrospect this is when I should have walked away.

But I realised this was awful advice so asked to be referred to Marie Stopes who had telephone counselling available. I knew that I did not want an abortion, but was too scared and confused to accept I wanted to keep the baby. Again, no information was given on the support services available to me - and in the end I was advised to go to the clinic and 'see how I felt' on the day. This caused me great distress as I couldnt think straight at the clinic due to the high stress levels. I even called my GP and said I thought I was having a mental breakdown. My ex-partner at this stage was threatening legal action if I contacted him to discuss my pregnancy and accusing me of sleeping with other people. This was crazy.

Through lack of questioning I ended up waking up from an abortion and lost a child I loved and miss. It has destroyed my life and lives of those close to me. I can never get back my child and dont think I will ever get over this.

Counselling should most definitely be available to people outside of abortion clinics. Now I am starting to wake up from the nightmare I am horrified that I had to go to one of those clinics just to get support. I was then in the system and each time I backed out of abortion they just booked me another date to come back. This was even after numerous telephone counselling sessions where I remained ambivalent. Yet no-one asked me serious questions about what I wanted that day even though I hadnt been able to do it 3 times before and spoke about wanting to know my first child.

Lives are ruined, hearts broken... I have always been pro-choice but now I have been in that situation, as a vulnerable woman, I think women should be able to at least access counselling without having to go near an abortion clinic - be it NHS or private. Having to use a clinic for advice turned out to be the most dangerous thing I have ever done.

I needed to be told about housing options, childcare help, my rights in ensuring that the father of my child couldnt continue to abuse us. I needed to be told about the effects of Post Abortion Stress Syndrome, which many women suffer from even when they are clear about wanting an abortion. I have suffered from PASS for 5 months now and unable to sleep, work, function and my relationships are falling apart.

Something needs to be done to offer women like me who are in a crisis pregnancy, or just unsure of the best thing to do, the right support for the most important decision they will probably ever make in their lives.

i really struggled to find counselling when i was considering an abortion. there are no state funded helplines open on weekends or evenings at all.

my experience with bpas was similar to cinnabarred's. i had a doctor's appointment and the doctor tried to talk me out of even considering abortion - it was obvious that she personally (not professionally) didn't approve and i had to beg her to make my bpas appointment.

at bpas i saw a "counsellor" who explained the procedure and aftercare, but not what would happen if i didn't proceed.

i then saw their consultant, had a scan and then the consultant wanted me to sign a consent form straight away. i declined and asked to see the counsellor again. i told them i needed to think a bit more and they were very supportive. i left and didn't have an abortion.

i am absolutely pro-choice.

rather than this frankly dubious proposal, i'd like to see bpas able to offer broader services:

telephone helplines out of hours
cab advisors in their clinics (a big worry about having baby for me was that i couldn't afford to support a child)
access to psychiatric services if needed/referred

this is way too big a job for a gp, especially when they are now going to be biased by the fact they will control the purse strings. it could become very easy for them to see abortion as an expensive service that wasn't essential...