Women’s health ‘placed at risk’ as spending on contraception falls by almost a fifth since 2015

Exclusive: ‘When I finally saw a doctor, the old IUS she removed was fitted incorrectly by my last practice nurse so was extremely painful to remove,’ says Kate Dempsey

Maya Oppenheim
Women’s Correspondent
Sunday 01 December 2019 16:54
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Figures show spending on contraception has fallen by almost a fifth since 2015 and around one in five councils plan to shut clinics providing contraception before the end of next year
Figures show spending on contraception has fallen by almost a fifth since 2015 and around one in five councils plan to shut clinics providing contraception before the end of next year

Women’s health is being put at risk and abortion rates are rising because clinics providing women with contraception are being forced to close due to “damaging” cuts, frontline service providers warned.

Figures show spending on contraception has fallen by almost a fifth since 2015 and around one in five councils plan to shut clinics providing contraception before the end of next year.

Data provided by the Advisory Group on Contraception shows the proportion of councils reducing the number of places providing contraceptive services has risen from just nine per cent in 2015/16 to 26 per cent in 2018/19.

Cuts are occurring at the same time as the need for local sexual and reproductive health services is surging and abortion rates in women over 30 are steadily going up.

The group of experts, made up of leading clinicians and campaign groups, is urging all political parties to pledge to protecting women’s access to comprehensive services providing contraception and overturning cuts to the public health budget that have taken place since 2015.

Anne Connolly, who sits on the advisory group, said the cuts to contraceptive services were hitting low-income women the hardest as they are less able to travel long distances to access clinics.

The GP, who works in central Bradford and spent 20 years working in a contraceptive clinic but recently left, said her local area went from having 13 clinics to five when they recommissioned the new service in 2015.

She said: “It really impacts those who have less ability to travel because of financial or social reasons, or who may have a disability, or who are young girls in school. The cuts to contraception have been dramatic and drastic. The cuts have most impacted on ethnic groups and those on lower incomes. They increase inequality. The most vulnerable have the greatest problems with the hurdles to contraception. We have seen this around the country. Access to contraception is getting harder.

“Not being able to access contraceptive care can lead to risky sexual activity and we are seeing abortion rates rise. I think there is definitely a link between cuts and this, but there are other reasons as well.

“It is a human rights issue. Women should have a right to choose when and if we become pregnant. More women are becoming pregnant at a time when they might not choose to and might not want to. This can lead to trickier pregnancies if the women already have other health risks. The cuts can put women’s health at risk. This gives the maternity system a bigger challenge.”

Dr Connolly said the cuts were “very frustrating” because they are a “false economy” – adding babies born to women who may not be at their “best place in life” does not give children their “best chance in life”.

She noted specialist contraception clinics – such as those that specially cater to young people and drug and alcohol users – had been the hardest hit by cuts.

Dr Connolly said women were struggling to access specialist services for their preferred methods of contraception so were having to get contraception from GPs that their bodies were not used to. This process could be delayed by GP appointments often being hard to get, she added.

The new figures show more than a third of councils commissioned fewer sites to provide contraceptive services in 2018/19 than they did in 2015/16.

Kate Dempsey, who took part in the study, said: “I had to wait at least three months to have my expired IUS [a long-acting form of contraception] taken out and a new one put in. I was not able to access this service at my GP because there were no appointments and had to wait and use a sexual health clinic at a hospital.

“It all took so long I had to go on the pill because my chosen contraception was no longer working. I was ready in advance to have my IUS replaced but the lack of appointments and trained staff led to this. When I finally saw a doctor, the old IUS she removed had been fitted incorrectly by my last practice nurse so was extremely painful to remove.”

Women are forced to turn to GP practices, which are already overstrained, as specialist contraceptive clinics slash the hours they are open or shut up shop altogether.

The rate of prescription for the most effective long-acting reversible contraception methods – such as the coil and implants – have plateaued, with frontline service providers saying this is linked to cuts.

Having such devices fitted is becoming an increasingly lengthy process in some areas due to there are not being enough doctors who can fit them because funding for them being taught to do so has been axed.

Rachael Clarke, of the British Pregnancy Advisory Service (BPAS), the UK’s largest abortion provider, said the cuts were troubling and were ultimately making life harder for women.

She also noted they were also making it more difficult for women to access the more effective forms of contraception, which may have fewer side effects.

“Outside London, people can be faced with real barriers to getting the care they need,” she said. “Women might have to go to a clinic 10 miles from their house, which is only open one day a week.”

Councils took over from the NHS for contraception services in 2012 but then-chancellor George Osborne slashed their public health grant back in 2015.

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