Wednesday, February 8, 2012

The contraceptive implant 'controversy' is just mud flinging

In decrying a safe and effective treatment, the anti-choice lobby is again undermining sexual healthcare for young people

Young people are still deprived of good quality, accurate information about sexual health at school.' Photograph: Britstock Images/Alamy

"The strategy of the United States' anti-contraception, anti-choice lobby is to keep flinging mud until some sticks, draining healthcare professionals and advocates of time and energy by inventing battles that need to be fought and throwing up misinformation that needs to be corrected."

These were words of warning from a colleague at a meeting just yesterday. She could have been talking about Nadine Dorries MP, who within the past six months has tried to remove pregnancy choices counselling from the Department of Health-regulated Pregnancy Advice Bureaux, and tried to make schools teach young women sexual abstinence. Today, Dorries writes in the Daily Express expressing outrage about tried-and-tested health policy and practice – the provision of contraception to young women under 16. This stuff is straight out of Tea Party activism 101.

The right to information, advice and contraceptive provision for under-16s has been well established since 1985, when Victoria Gillick famously failed to stop doctors prescribing the pill to young women without parental consent. Since then, doctors have been required to assess their patients' ability to consent to treatment, and to explore with young patients the benefits of talking to their parents or carers.

This is something that the 4,000 professionals we have trained around England take very seriously. Everyone's ideal scenario is that young people and their parents have the kind of relationships in which they can discuss these issues openly and safely. For those who can't, most parents would rather their children did have the option of talking to a trained health professional than the alternative – which is no information or advice, no contraception and the risk of unintended pregnancy.

The contraceptive implant, on which the latest "controversy" is focused, is one of four long-acting reversible contraceptive methods available to women (including teenagers) in England and Wales. There has been a drive to make these methods more widely available because they are so extraordinarily effective at preventing pregnancy. There are undoubted benefits to being able to access methods that are non-user-dependent, but they are not a panacea.

There are, of course, side-effects that women need to be well-informed about before choosing a contraceptive method, and the National Institute for Health and Clinical Excellence (Nice) makes this very clear in its guidelines. Each woman will feel differently about a given contraceptive method and the procedure needed to fit it. There are no quick fixes, and good quality contraceptive counselling – which addresses a woman's needs, her lifestyle, the acceptability or otherwise of different side effects, and ways to minimise side effects – is absolutely vital.

If there is any controversy, it should be about why, 50 years after the invention of the pill, we still haven't found the pot of gold at the end of the rainbow – the perfect 100% reliable, side-effect-free contraceptive method. Or why young people are still deprived at school of good quality, accurate information and education, about sexual health and relationships. Or why parents and children in this country are so ill-equipped to discuss these things with each other.

However, I don't think the inventors of today's brouhaha really care about any of that. This is just mud-flinging plain and simple. Today's salvo is probably the first in a new campaign against young people's right to confidential advice and treatment. Tomorrow there will be another baseless scare story about the pill – which will see abortion rates spike as women abandon a trusted contraceptive method. The next day there will be a moral panic about a classroom resource which depicts two women holding hands, and the next a call to censor The Muppet Show for its sexual licentiousness ... and so our energy is diverted from our actual work with actual young people providing evidence-based education and good quality healthcare.

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