Women’s equality in the UK – A health check

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12.51 12.52 12.53 12.54 aimed at improving patient care and reducing delays to treatment. 119 Recommendation: Reform the Abortion Act 1967 to remove the two doctors’ signature requirement, allow suitably trained nurses and midwives to carry out early medical and surgical abortions and allow women to take the second stage of early medical abortion medication at home Budgetary constraints placed on the NHS and Local Authorities by the present government, combined with reorganisation of services currently underway, are likely to have a significant impact on health service provision in the coming years. As yet, the impact on timely access to abortion care is unclear. However, problems with the delivery of contraception and sexual health services are already apparent, 120 as are fears that progress in reducing rates of unplanned pregnancy amongst teenagers will be reversed if current financial restrictions continue. 121 We are also concerned about the biased provision of services to women surrounding abortion and reproductive health by some ‘crisis pregnancy centres’ run by Christian and anti-choice organisations around the UK which give inaccurate and misleading information. 122 This needs to be considered by commissioners to ensure that inappropriate services are not provided to women. 123 Maternity services Women’s reproductive role can put their physical and mental health at risk including (but not restricted to) maternal mortality, anaemia, preeclampsia and depression in and after pregnancy. 124 One in ten women reported significant depressive symptoms during pregnancy and a further 15% of mothers experience postnatal depression. 125 We have not seen an extension in maternity choice through the development of new provider networks for women during pregnancy and childbirth as the Government claim in their 7th Periodic Report. 126 In fact the changes to the NHS will have a significant impact on women who rely on these services most, for example the cuts in maternity and care services. 127 119. Science and Technology Committee (2007) Scientific Developments relating to the Abortion Act 1967. No. 66 of Session 2006-07, 31 October 2007, http://www.parliament.uk/business/committees/committees-archive/science-technology/science-and-technologycommittee/scitech311007a/ 120. All Party Parliamentary Group on Sexual and Reproductive Health in the UK (2012) Healthy women, health lives? The cost of curbing access to contraception services http://www.fpa.org.uk/media/uploads/campaignsandadvocacy/advocacy-and-lobbying/healthy-womenhealthy-lives-full-report-july-2012.pdf 121. Williams, R. (2012) ‘Sexual health services hit by cuts’, The Guardian, 23rd April 2012 http://www.guardian.co.uk/society/2012/apr/23/ sexual-health-services-cuts 122. Quinn, B. (2011) ‘Abortion: Pregnancy counselling centres found wanting’, The Guardian, 2nd August 2011 http://www.guardian.co.uk/ lifeandstyle/2011/aug/02/abortion-pregnancy-counselling-found-wanting 123. Education for Choice (2011) Shapshot of Crisis Pregnancy Centres operating in England http://www.efc.org.uk/PDFs/CPC%20report%20 executive%20summary%20EFC%202011.pdf 124. World Health Organization (2009) Women and Health: Today’s evidence, tomorrow’s agenda. WHO: Geneva http://whqlibdoc.who.int/ publications/2009/9789241563857_eng.pdf 125. Nonacs, R. (2007) ‘Depression during pregnancy is often not treated’, MGH Centre for Women’s Mental Health website, 10th February 2007 http://www.womensmentalhealth.org/posts/depression-during-pregnancy-is-often-not-treated/ 126. Government Equalities Office (2011) CEDAW (Convention on the Elimination of all forms of Discrimination against Women) report. United Kingdom’s Seventh Periodic Report. GEO: London http://www.homeoffice.gov.uk/publications/equalities/international-equality/7thcedaw-report?view=Binary Para 176 127. Bragg, R. (2012) ‘How cuts to maternity services are threatening health and care’ False Economy, 20th July 2012 http://falseeconomy.org. uk/blog/how-cuts-to-maternity-services-are-threatening-care 124 Women’s equality in the UK: CEDAW shadow report 2013
12.55 12.56 12.57 Case studies: 128 The innovative Enhanced Midwifery Service run by Liverpool Women’s Hospital offers vulnerable mothers-to-be in deprived areas advice about health issues such as smoking and diet in pregnancy and breastfeeding. Yet its future is in doubt after Liverpool City Council said it would withdraw its 75% funding for the scheme and three maternity support workers did not have their contracts renewed. The postnatal counselling group in Islington, north London, for mothers with postnatal depression ended in March 2011 when funding was withdrawn. Similarly, Andover birth centre in Hampshire is ‘temporarily suspended’, 129 Eastbourne maternity ward is being threatened with closure and the maternity unit at the King George Hospital in Romford, Essex, is also under review. Pregnant women, including refused asylum seekers, trafficked women, women whose immigration status is dependent on their husband and undocumented migrants, are not entitled to free NHS maternity care, putting not only their own health at risk but also that of their unborn child. 130 (See Article 9) Migrant women who are charged for health care are not only deterred from seeking help, but their needs are rendered invisible as women who are chargeable are less likely to appear in data collected from health services. Charging regimes often lead to increased costs overall. 131 Case study: 132 “One of the biggest problems we see relates to undocumented migrants who have given birth, they are most often on their own and destitute, and once they return home with their new born baby the hospital starts hounding them for tens of thousands of pounds for medical bills. This is often the case with anaesthetist bills if she has had an epidural or caesarean birth. Praxis was contacted by an undocumented woman who had given birth to triplets and received a bill of over £200,000. The triplets were premature and needed aftercare but this was an enormous sum for a woman with no legal income. She came to Praxis very distraught and the NGO had to negotiate with the hospital until they eventually agreed she could pay it back at £5 per week.” The difficulties some women face in accessing maternity care also means that they lack screening for HIV which would usually take place during their pregnancy. This may result in them failing to access the treatment services for HIV that they need, and to prevent the mother to child transmission of HIV. This has a profound impact on the potential for health of the unborn child. The UK Government has failed to take steps for the provision of services that decrease the infant mortality rate and prevent maternal mortality, by introducing practices that have effectively denied pregnant women, including women with HIV, access to maternal healthcare. 133 (See Appendix: 24) Despite overall increases in midwife numbers over the last ten years, the rising birth rate 128. Stephenson, M. (2011) TUC Women and the Cuts Toolkit: How to carry out a human rights and equality impact assessment of the spending cuts on women. TUC: London http://www.tuc.org.uk/equality/tuc-20286-f0.cfm 129. Campbell, D. And McNicoll, A. (2011) ‘NHS cuts: the first casualties’, The Guardian, 11th April 2011 http://www.guardian.co.uk/society/2011/ apr/11/nhs-cuts-first-areas 130. The People’s Health Movement UK (2009) Shadow Submission on the Right to the Highest Attainable Standard of Health in the United Kingdom for the International Committee on Economic, Social and Cultural Rights, 42nd Session, 4th – 22nd May 2009. In association with Medact and Doctors for Human Rights http://www.phmovement.org/en/node/2002 131. Maternity Action (2012) Guidance for Commissioning Health Services for Vulnerable Migrant Women. WHEC: London http://www. maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/guidancecommissioninghealthservvulnmigrantwomen2012.pdf 132. From Bethan Lant of Praxis http://www.praxis.org.uk/ Accessed: 13/04/13 133. The People’s Health Movement UK (2009) Shadow Submission on the Right to the Highest Attainable Standard of Health in the United Kingdom for the International Committee on Economic, Social and Cultural Rights, 42nd Session, 4th – 22nd May 2009. In association with Medact and Doctors for Human Rights http://www.phmovement.org/en/node/2002 Women’s equality in the UK: CEDAW shadow report 2013 125
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Women’s equality in the UK - A he
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Women’s equality in the UK - A he
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Appendices (online only) Appendix 1
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• the continued discrimination ag
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• Develop a common model of analy
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Article 9 - Nationality: One third
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investment in social infrastructure
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and increase the marginalisation of
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have been no prosecutions in Englan
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1 2 3 4 5 Introduction This is a Un
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10 11 12 13 housing crisis, a ‘lo
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1.1 1.2 1.3 Article 1 - Overarching
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1.7 1.8 1.9 1.10 1.11 1.12 Women’
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1.17 1.18 1.19 Young women We are a
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2.4 2.5 2.6 2.7 consult to “remov
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2.12 2.13 discrimination”. Howeve
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2.17 2.18 2.19 2.20 2.21 worsen gen
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2.26 2.27 2.28 2.29 CEDAW and the l
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3.7 3.8 3.9 3.10 would “increase
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3.15 3.16 3.17 and accountable EHRC
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3.22 3.23 3.24 report is was partic
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classes, migrants, and Gypsy, Trave
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the institutional discrimination an
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5.5 5.6 5.7 Case study: 8 Sandra li
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5.12 5.13 5.14 issue. A more approp
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6.1 6.2 6.3 6.4 Article 6 - Exploit
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6.9 6.10 6.11 to the protection and
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6.15 6.16 6.17 6.18 Office’s own
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6.24 6.25 6.26 women and increase t
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6.31 6.32 6.33 6.34 infrequent lap
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7.1 7.2 Article 7 - Political and p
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7.7 7.8 7.9 7.10 The House of Lords
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7.13 7.14 7.15 7.16 7.17 Recommenda
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7.21 7.22 7.23 Political representa
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9.1 9.2 9.3 9.4 9.5 9.6 9.7 Article
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9.9 9.10 Mainstreaming gender in th
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Page 107 and 108: 11.37 11.38 Case study: 83 Jasmine
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Page 111 and 112: 12.3 12.4 12.5 12.6 of women and en
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19.22 19.23 19.24 19.25 VAWG is a c
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19.30 19.31 19.32 19.33 DV is still
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19.38 19.39 19.40 perpetrators thro
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19.43 19.44 19.45 Support for victi
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19.49 19.50 19.51 19.52 Recommendat
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19.57 19.58 19.59 19.60 BMER VAWG p
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19.62 19.63 19.64 19.65 VAWG in hea
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19.70 19.71 19.72 Invisibility of s
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19.77 19.78 19.79 A number of repor
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19.85 19.86 means more provision. T
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Annex 1: The Devolved Administratio
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to 41.8% of rural men. 16 Rural are
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Annex 2: The UK’s relationship wi
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Annex 3: UK reservations and declar
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ESA - Employment and Support Allowa
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Annex 5: Acknowledgements Many than
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Women’s Resource Centre is suppor
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