Abortions rise blamed on birth control clinic cuts

Ros Wynne-Jones on a blow to women's health

A few weeks ago, Emma Chalmers, a 26-year-old from east London, went to her local family planning clinic to get a repeat prescription for the Pill. "I tend to work long hours across the other side of London, and the clinic used to have a late session on Thursdays," she said. That week there was only a note on the door saying that from now on the clinic would only be open on Wednesday lunchtimes.

"I tried to get an appointment with my GP, but there weren't any for 10 days and then only in the day," she said. "In the end I had to wait for an 8.30am appointment two weeks later and by that time my cycle was messed up. I ended up having unprotected sex because my boyfriend and I hate condoms. I didn't get pregnant, but I find it ironic that in the Sixties my mother would have had no problem finding an open clinic, whereas for my generation it's harder and harder to find one open when you need one."

In 1921, Marie Stopes established the first birth control clinic. In 1967, after almost half a century of campaigning by women's groups, the NHS (Family Planning) Act finally enabled health authorities to provide free birth control advice.

Thirty years on, campaigners say those hard-won services are now in such serious decline that there is a link between the diminishing availability of clinic sessions and the 8.3 per cent rise in abortions last year.

According to the Family Planning Association, one third of Britain's health authorities will make cuts to family planning this year. Many health authorities are also considering restricting services to under 25s, under 21s and, in some cases, under 18s.

"There is a nationwide trend towards the reduction of family planning services," said Joan Walsh, health policy research officer at the FPA. "This is not because of any national strategy, but because these services are on the front line when health authorities are forced to make cuts. We believe this may be a cause of the rise in abortions."

Figures released by the Government last week show the first increase in the number of abortions carried out in England and Wales for five years, with the total rising by 13,587 to 177,225 between 1995 and 1996.

"There was the 1995 Pill alert [when many women stopped taking the Pill because of a panic over the risk of thrombosis]," Ms Walsh explains, "there is increased access to abortion because GP fundholders are now able to directly purchase terminations, and there has been wider discussion of abortion in the media, which has had the effect of publicising abortion as an option. But if there are an increasing number of women unable to access family planning this must also be a key factor."

Angeline Burke, of the Association of Community Health Councils, said: "GPs do not always provide the same wide range of services and some people are reluctant to go to them. People must have the right to choose the sort of family planning services they want to use."

One area facing family planning cuts is East Surrey, which this year will lose five out of 13 sessions per week. Dr Tina Peers, a consultant in family planning and reproductive healthcare at Dorking Hospital, said she is worried about the impact on the local community. Services performed by her clinic include birth control, emergency contraception, safer sex and HIV and Aids work, breast checks, cervical smears, rubella screening, sterilisation and infertility advice, sexual and relationship counselling and pregnancy testing.

Dr Peers points out that if family planning clinics are phased out, not only is there a risk of the abortion rate increasing still further, but there may also be a future increase in cervical and breast cancer. "What we need is for the Government to take stock of the national picture, rather than this piecemeal reduction of services," she said. "If the abortion rate is increasing then surely we need more family planning services, not less."

Part of the problem, according to campaigners, is the Government's Health of the Nation strategy, which has prioritised health services for young people. "Under Health of the Nation, young people are supposed to be an indicator of overall improvement in family planning," said Ms Walsh. "In fact, in order to achieve the strategy's objectives, some health authorities are now only targeting young people."

A Department of Health spokesman said: "The Government is keen to ensure fair access to local family planning services. This is within the context of health authorities taking account of the needs of local people, evidence of effectiveness and available resources."

Joan Smith, page 21