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Marie Stopes International (MSI) warns up to 9.5 million women and girls risk losing access to its contraception and safe abortion services in 2020 due to the COVID-19 pandemic.
The consequences would be devastating. MSI estimates that across the 37 countries where it works, the loss of its services due to COVID-19 could lead to an additional:
Simon Cooke, Marie Stopes International’s Chief Executive, said:
“Women and girls will pay the price if governments do not act now to safeguard access to essential healthcare, including safe abortion and contraception.
“Abortion is an essential and time-sensitive procedure, and delays caused by social distancing, healthcare shutdowns and travel restrictions will have a profound impact. But if governments are willing to work with providers there are simple, effective and proven steps that could save thousands of lives.”
Contraception and abortion are essential healthcare
We are seeing the effects first-hand in countries like Nepal, where the government has ordered a national lockdown. Due to mobility restrictions, neither providers nor clients were able to reach Marie Stopes Nepal’s centres, forcing them to close. However, women’s need for sexual and reproductive healthcare has not stopped. Marie Stopes Nepal's contact centre has seen an increase in calls from women seeking abortion services since the start of the lockdown.
Sarita Ojha, a Counsellor at Marie Stopes Nepal’s Contact Centre, shared:
“This woman was crying on the phone. ‘When will your services restart? I cannot afford to have another child. Please help me!’ It really broke my heart not to have an affirmative answer for her.”
Fortunately, by working in partnership with local government, Marie Stopes Nepal has been able to re-open seven clinics, with more in the pipeline, meaning women can still access care.
Women’s health and lives at risk if services stop
During the 2013-2016 Ebola outbreak in West Africa, women in Sierra Leone were not only at risk due to Ebola: their access to essential and lifesaving reproductive care was also disrupted, resulting in as many, if not more, pregnancy-related deaths than from Ebola itself.2
Learning from the Ebola crisis, governments must define contraception and safe abortion services as essential, meaning life-saving care can be delivered, with the appropriate precautions and protective equipment.
Felix Ikenna, a doctor and quality assurance director for MSI in Sierra Leone, said:
“People will always need services, irrespective of an epidemic. During Ebola, the number of women we saw went up as word spread that we were still open.
“The crisis led to a spike in the number of teenage pregnancies. People were too afraid to go to hospital or government facilities. If we had stopped providing contraception and post-abortion care, it would have been much worse. … Marie Stopes Sierra Leone was one of the only organizations that continued providing services.
“I remember one woman came to us following a miscarriage. She had a fever and probably had Ebola, but we were able to follow MSI infection prevention guidelines which stopped any cross infection. It’s the same now with COVID, if people come in with a cough it could be coronavirus or because the rains are coming. Whatever happens you need to protect yourself.”
Health care at a breaking point
In countries, like Uganda, already hit by the funding cuts caused by the US imposition of the Global Gag Rule , the impact of COVID could be even more dire.
Marie Stopes Uganda Country Director, Dr Carole Sekimpi said:
“The Global Gag Rule only serves to put women at even greater risk when a crisis like COVID-19 hits.
“Over the past three years, the Gag Rule has cut off access to contraception for Uganda’s most vulnerable women and adolescent girls. I have seen first-hand the consequences of this shameful policy: women’s lives, health and futures put at risk when they can't get the contraception they need.
“Women and girls in Uganda have already lost access to contraception and health care due to the Gag Rule. They will be further stretched to prevent an unintended pregnancy or get basic reproductive healthcare when COVID hits their communities.”
In many of the 37 countries where MSI provides services, health systems are struggling to provide safe abortion and contraception under the strain of COVID-19. But there are concrete actions governments can take to ensure access and save women’s lives: from allowing women to access safe abortion and contraception services remotely via telemedicine, allowing pharmacies to provide services and removing unnecessary waiting times and the need for multiple doctor sign offs.
Above all, anti-choice lawmakers must not exploit the COVID-19 pandemic as an excuse to try to deny women access to abortion and contraception.
Now more than ever, to save lives, governments worldwide must include the reproductive healthcare women need in the list of essential services.
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Notes to Editors
For interviews and further information please contact:
Tel: (+1) 202 864 2522/ (+44) 07769 166 516
MSI is a global organisation providing contraception and safe abortion services to women and girls in 37 countries. We believe that every woman and girl must determine her own future, and the high-quality services we provide give a woman the power to pursue her dreams for herself and her family.
If you are covering the government’s decision to allow women to access early abortion care at home, you may find the following statement from Marie Stopes UK helpful.
Jonathan Lord, Medical Director for Marie Stopes UK said:
“The government’s decision to allow women in England to take both sets of early medical abortion pills at home during the COVID-19 crisis, shows that they value both women’s health and that of hardworking abortion care staff, who have continued to deliver essential healthcare, despite a global health pandemic. We now stand in full solidarity with women and girls in Northern Ireland seeking the same protection.
“This would not have happened without such a mobilised and quick campaign from health experts, campaigners and journalists alike, that made it impossible for the government to deny the medical and moral force of the case for early abortion care at home.
“By listening to expert clinical advice, the government has ensured that the next round of #ClapforCarers will be from the 200,000 women who need to access safe abortion services each year.”
As Coronavirus (COVID-19) spreads around the world, Marie Stopes International’s priority is continuing to deliver care to the women and girls who need us, while protecting the health and safety of our team members.
We recognise that many of our programmes may be affected and have detailed business continuity plans in place as well as sensible protocols to protect both team members and clients, focused on continuing our work with minimum disruption and maximum safety.
We are delighted to announce that Glenda Burkhart is joining Marie Stopes International as Chair of our Board of Trustees.
Glenda is a skilled professional in the area of large-scale organisational change and brings a wealth of experience from the not-for-profit and commercial sectors. She brings substantial board experience as the co-chair of the International Rescue Committee Overseers, where she served on the board for 12 years; co-chair emerita of the Women’s Refugee Commission, and US co-chair and board member of Tusk USA, which supports innovation in conservation in Africa. She also chaired the Board of Directors for the Northwest Connecticut Centre for Family Service and Mental Health.
‘As a lifelong advocate for women’s health and reproductive rights I am excited about joining Marie Stopes International at this critical time. Never has it been more important to expand access to quality safe abortion and contraception services across the world, and to advocate for a woman’s right to choose.’
Glenda has worked in corporate executive roles for several large companies, including Millipore, and Reader’s Digest and the Andrew W. Mellon Foundation, which seeks to strengthen and defend the humanities and arts as central to the well-being of diverse, fair and democratic societies.
Glenda’s consulting experience includes the restructuring of British Airways North America Sales and Marketing; the restructuring of the Human Capital organisation at the NY City Department of Education; and the roll-out of and related advocacy of research regarding race-sensitive admissions policies in colleges and universities.
We warmly welcome Glenda into the MSI and SRHR community.
The leading sexual health charity’s on-going campaign - #SmashAbortionStigma - aims to break the harmful wall of silence around abortion
9 in 10 (90%)[ix] UK adults now believe women should be able to access abortion services in the UK, leading global sexual and reproductive healthcare charity, Marie Stopes International, has revealed.
The new figures, commissioned by Marie Stopes International and calculated by leading pollsters, YouGov, are significantly higher than a previous estimate of attitudes to abortion in the UK, ran by NatCen in 2017, which put public support at 70%[x] if a woman wanted to end a pregnancy.
Interestingly, men and women’s attitudes towards abortion are similar, with 88%[xi] of men believing women should be able to access abortion care compared to 91%[xii] of women.
The study also shows adults becoming progressively more pro-choice as they age, with 82%[xiii] of 18-24 year olds believing UK women should have access to abortion care compared with 90%[xiv] of 25-49 year olds and 92%[xv] of over 65s.
The research confirms across-the-board support for pro-choice legislation in the UK where a continuous shift in public attitudes follows several high-profile reproductive rights battles including the Irish abortion referendum, abortion law reform in Northern Ireland and on-going abortion rights challenges in the U.S.
The charity believes that undue weight given to the anti-choice movement perpetuates the shame, stigma and silence associated with abortion.
This is despite the fact that more than three quarters (79%)[xvi] of women want to talk more about abortion to help women feel more supported (76%)[xvii] and to increase understanding around abortion (75%)[xviii].
Katriana Ciccotto, 25 from London, had an abortion:
“Finding out I was pregnant was a huge shock and really unexpected as I was using contraception. At the sexual health clinic, the nurse I saw had a crucifix round her neck and made no eye contact with me at all. She made me feel extremely guilty, like I was a bad person.
“I knew I wanted an abortion but interestingly, although I am pro-choice, I had a subconscious negative view of women who access abortion services.
“I was googling stories about abortion, looking on YouTube, but there was nothing I could relate to. I know if I had been able to find stories about other women, I would have felt less alone.
“The lady I eventually spoke to at the Marie Stopes Clinic was so patient and gave me time to speak. It felt like she understood me, and I felt like a person rather than a number. I felt like I had options.
“My sexual partner at the time was supportive at first but the closer I got to the date of the procedure, the less supportive he got – that was a really hard pill to swallow and made the experience more difficult. I felt let down and thought maybe he thought badly of me.”
Following previous research from the leading NGO around women’s views on abortion, the study also took a deeper look at male attitudes, finding men to be overwhelmingly supportive of their sexual partners decisions.
91%[xix] of men think it’s important to provide emotional support if their sexual partner was considering an abortion, 82%[xx] of men think it’s important to accompany a sexual partner to appointments or sessions and 81%[xxi] of men think it’s important to seek information or advice about abortion for their partner.
But, while 41%[xxii] of men are happy with the current level of information about abortion available to them, just over a third of men (34%)[xxiii] feel uninformed about the topic of abortion in general and more than 4 in 10 (42%)[xxiv] of men would like more information about abortion to be made available.
Steffan, 25, was Katriana’s sexual partner:
“When I found out Katriana was pregnant, I was scared. Firstly, I was shocked as she was using contraception, then I was worried about how she was mentally and physically.
“We both felt like an abortion was the right thing to do, but although I’ve always been pro-choice, looking back I didn’t really know anything about abortion. It wasn’t something I’d talked about and I didn’t know of anyone who had been through one. I didn’t want to tell my friends or my parents, so I only told my brother.
“We talked on the phone and met up before the appointment happened, but after she’d had the abortion, I felt like I’d fulfilled my role. I don’t think I had a real awareness of the situation because I didn’t attend the appointments, and if you aren’t there, you feel removed from the situation.
“I know Katriana felt like I didn’t support her fully during the abortion, and in hindsight I would have been there for her more, before and after.”
The campaign aims to amplify across-the-board support that exists for women and choice both in the UK and worldwide, reduce stigma around abortion and increase access to information and support in the face of an increasing anti-choice presence and the beginning of the 40 Days for Life campaign. It also hopes to encourage male support in the pro-choice movement.
Marie Stopes International has updated its online resources for partners, family and friends to help them feel equipped and confident whilst supporting someone through an abortion experience.
Jonathan Lord, Medical Director for Marie Stopes UK said:
“The UK is overwhelmingly pro-choice, yet in public debate, anti-choice views are often given equal weighting. This leaves women feeling judged and stigmatised and both men and women shamed into silence about their opinions, experiences and understanding of abortion.
“We hear from women who attend appointments alone because they are too frightened to tell their sexual partner, and men who need more knowledge and tools to support their sexual partner fully.
“Our research shows that open and honest conversations about abortion help both women and men feel informed, educated and supported when it comes to making or supporting choices around pregnancy and by breaking down the harmful wall of silence, we can continue to smash abortion stigma and champion the right of women to access abortion care.”
Join the movement to #SmashAbortionStigma on social media or read more about the campaign here: #SmashAbortionStigma
Notes to Editors
For interviews and further information please contact:
Tel: +44 (0)20 7034 2377/ +44(0)20 3219 8245 or +44(0)7769 166 516 (out of hours)
[i] All figures unless otherwise stated are from YouGov Plc. Total sample size was 5098 UK adults (18+). Fieldwork was undertaken between 6th-9th January 2020. The survey was carried out online. Respondents were asked: In general, do you think women should or should not be able to access abortion services in the UK?
[ii] NatCen. 2017. British Attitudes to Abortion. NatCen. Viewed 4th February 2020. < http://www.natcen.ac.uk/blog/british-attitudes-to-abortion>
[iii] YouGov Plc. (2020) Total sample size was 5098 UK adults (18+). Respondents were asked: In general, do you think women should or should not be able to access abortion services in the UK?
[vii] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: How informed, if at all, do you feel on the topic of abortion in general?
[viii] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: Thinking about the topic of abortion in general, would you like more or less information to be made available, or is the current level about right?
[x] NatCen. 2017. British Attitudes to Abortion. NatCen. Viewed 4th February 2020. <http://www.natcen.ac.uk/blog/british-attitudes-to-abortion>
[xi] YouGov Plc. (2020). Total sample size was 5098 UK adults (18+). Respondents were asked: In general, do you think women should or should not be able to access abortion services in the UK?
[xvi] YouGov Plc. (2019) Total sample size was 2,684 women (18+). Respondents were asked: Thinking about the topic of abortions in general, do you think it should or should not be talked about more openly?
[xvii] YouGov Plc. (2019) Total sample size was 2,684 women (18+). Respondents were asked: You said abortions should be talked about more openly, why do you think this? (Please tick all that apply)
[xix] All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1956 UK Men (18+). Fieldwork was undertaken between 6th -9th January 2020. The survey was carried out online. Respondents were asked: Thinking about a scenario where a sexual partner was considering getting an abortion, how important, if at all, is it for men to provide emotional support
[xx] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: Thinking about a scenario where a sexual partner was considering getting an abortion, how important, if at all, is it for men to accompany a sexual partner to appointments or sessions
[xxi] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: Thinking about a scenario where a sexual partner was considering getting an abortion, how important, if at all, is it for men to seek information or advice about abortion for their sexual partner
[xxii] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: Thinking about the topic of abortion in general, would you like more or less information to be made available, or is the current level about right?
[xxiii] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: How informed, if at all, do you feel on the topic of abortion in general?
[xxiv] YouGov Plc. (2020). Total sample size was 1956 UK Men (18+). Respondents were asked: Thinking about the topic of abortion in general, would you like more or less information to be made available, or is the current level about right?
Marie Stopes International – a leading global sexual and reproductive healthcare charity – is today launching a campaign to #SmashAbortionStigma as it reveals that just one in three women (33%) in the UK would tell their family if they were considering getting an abortion.
The new research, commissioned by the charity and conducted by YouGov, also reveals that only one in three women (34%)[viii] would speak to their friends about their choice and just 62%[ix] of women would tell their sexual partner.
Sadly, 6%[x] of women disclosed that they would not to talk to anyone, aside from a medical professional, if they were considering getting an abortion.
The study shines a spotlight on women’s attitudes to abortion in the UK, where despite more than nine in ten women (92%)[xi] identifying as pro-choice, on-going abortion stigma means there is still a wall of silence around the topic.
Emily, had an abortion while at university:
“I’d taken emergency contraception, but it wasn’t effective, so when I found out I was pregnant it was a complete shock.
“I knew straight away that I was not in the right circumstances emotionally or financially to continue with a pregnancy, and although I have a good relationship with my family, having an abortion wasn’t something I felt I could speak to them about.
“I eventually told my mum six months later. I didn’t regret my decision, but my body had been through a lot of changes and not being able to talk about my experience was scary and isolating.”
“The first thing she said was “I hope you haven’t told anyone”. This reaction affirmed why I didn’t want to tell her, I didn’t feel supported at all and it was very painful experience.”
79%[xii] of women, however, think abortion should be talked about more openly. Top reasons include: to help women feel more supported (76%)[xiii] to increase understanding around abortion (75%)[xiv] and to reduce stigma around abortion (67%)[xv].
Through the launch of its new campaign - #SmashAbortionStigma - Marie Stopes International is addressing this need for open conversation by calling on people to break the silence around abortion. The charity is encouraging people to get involved by sharing their stories on social media using the hashtag or by recording a short video explaining why they are pro-choice.
The campaign aims to counteract negative attitudes towards women seeking abortion care, to amplify the support that already exists for women and choice both in the UK and worldwide, and to bring abortion to the forefront of everyday conversations – it is supported by a number of high-profile figures including Heidi Allen MP, novelist Marian Keyes and Derry Girls actress, Siobhan McSweeney.
#SmashAbortionStigma also aims to bust abortion myths, something nearly half (49%)[xvi] of women feel talking about abortion more openly would do.
Dr Caroline Gazet, Clinical Director for Marie Stopes UK, said:
“In the UK, one in three women will have an abortion in her lifetime, yet we know that abortion stigma can make women feel judged, shamed and silenced.
“Women want to talk, and our research shows that open and honest conversations about abortion help women and girls feel informed, educated and supported when it comes to making their own choices about their own bodies.
“The UK is a pro-choice nation, but with a small minority of anti-choice voices threatening abortion rights worldwide, it is more important than ever that we smash abortion stigma and champion the right of women to access abortion care.”
Join the movement on social media or at www.mariestopes.org/smashabortionstigma.
For interviews and further information please contact:
Tel: 020 7034 2377 / 020 3219 8245 or 07769 166 516 (out of hours)
i. All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,684 UK women (18+). Fieldwork was undertaken between 22nd – 25th September 2019. The survey was carried out online. Respondents were asked: Imagine you were in a scenario where you were considering getting an abortion. Of the following, who do you think you would talk to about it?
v. YouGov Plc. (2019) Respondents were asked: In general, do you think women should or should not be able to access abortion services in the UK?
vi. YouGov Plc. (2019) Respondents were asked: Thinking about the topic of abortions in general, do you think it should or should not be talked about more openly?
vii. YouGov Plc. (2019) Respondents were asked: Imagine you were in a scenario where you were considering getting an abortion. Of the following, who do you think you would talk to about it?
xi. YouGov Plc. (2019) Respondents were asked: In general, do you think women should or should not be able to access abortion services in the UK?
xii. YouGov Plc. (2019) Respondents were asked: Thinking about the topic of abortions in general, do you think it should or should not be talked about more openly?
xiii. YouGov Plc. (2019) Respondents were asked: You said abortions should be talked about more openly, why do you think this? (Please tick all that apply)
The UK Department for International Development (DFID) has announced a major funding commitment for sexual and reproductive health and rights projects between 2020 and 2025.
The £600 million investment will give more than 20 million women and girls access to family planning per year over the next five years.
Responding to the news, Simon Cooke, CEO at Marie Stopes International, said:
“With the US Government and others now reversing at speed from their previous commitments on sexual and reproductive health and rights, it’s heartening to see the UK holding the line to ensure that more women and girls can access essential family planning services.
“Expanding access to sexual and reproductive healthcare, including safe abortion services, is one of the smartest investments countries can make for their future. Giving women and girls reproductive choice creates healthier and more prosperous societies, allows women to contribute more fully to their communities, and supports stability and security.
“We applaud DFID’s leadership in this area. Their commitment will not only save thousands of women’s lives but create the opportunities that drive countries’ economic and social development.”
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For more information please contact the media team on +44 (0) 7769 166 516, or email firstname.lastname@example.org.
The UK Government has voted overwhelmingly in favour of extending abortion rights to Northern Ireland.
Franki Appleton Advocacy and Public Affairs Advisor for Marie Stopes UK said:
“This is a historic day for women’s rights. As an organisation that has supported the push for abortion access in Northern Ireland, we are delighted that MPs have taken this opportunity to demand law reform and give every woman in the UK access to safe, legal abortion.
“For too long, women in Northern Ireland have been treated as second-class citizens, and today’s momentous vote in Westminster is the first step to righting this grievous wrong. We join all those who have campaigned tirelessly for change in celebrating this much longed for and very necessary progress."
For more information please contact the Marie Stopes International media team on +44 (0) 7769 166 516, or email email@example.com.
A new study finds the Global Gag Rule increased abortions by 40% in sub-Saharan Africa, providing crucial evidence about the devastating impact of the policy on vulnerable women and girls.
The study, published today in The Lancet, spans two decades from 1995-2014 and found that when the Gag Rule was in effect, abortion rates in sub-Saharan Africa increased by 40% in countries more reliant on US aid. Many of these abortions are likely unsafe.
“This important study proves that attempts to stop abortion through restrictive laws or punitive policies like the Global Gag Rule do not work because they do not eliminate women’s need for safe abortion care,” said Marjorie Newman-Williams, President of MSI United States. “This study adds rigorous evidence to what our providers see every day: The Global Gag Rule only serves to deny women access to contraception and safe abortion, stripping them of their ability to make choices about their own bodies, lives and futures.”
The study also found that the Global Gag Rule reduces contraceptive use and increases unintended pregnancies: reinforcing that organizations like Marie Stopes International that provide or counsel on safe abortion care are also key to providing access to contraception.
In fact, under the latest version of the Global Gag Rule - which President Trump reinstated on his first day in office in January 2017 – 1.4 million women and adolescent girls globally will lose access to MSI services by 2020. The loss of Marie Stopes International services alone will result in:
However, there is hope: The study found that the impacts of the policy reversed between 2009 and 2014, when the Global Gag Rule was not in effect under the Obama Administration.
Newman-Williams said: “Women and girls pay the price for cruel policies like the Global Gag Rule: from the adolescent girl who could have prevented an unplanned pregnancy, so she could finish school, to the mother of five who could have avoided an unsafe, backstreet abortion.
This study adds new urgency to efforts that would permanently repeal the Global Gag Rule. We owe it to women and girls around the world who have lost access to contraception and safe abortion, and control over their bodies, lives and futures. They deserve better than the Global Gag Rule.”
The BBC has said it won’t stop labelling attempts to ban abortion after six weeks as “heartbeat bills” - despite conceding the phrase is biased and medically inaccurate.
A coalition of four leading reproductive healthcare organisations – the Federation of Gynecologists and Obstetricians (FIGO), International Planned Parenthood Federation (IPPF), Marie Stopes International (MSI) and Planned Parenthood Federation of America (PPFA) wrote to the BBC, demanding it stop using the phrase in its coverage of attempts in some US states to introduce six-week abortion bans.
In its letter, the coalition pointed out:
This description is biased, coined by opponents of safe and legal abortion in an attempt to frame the debate in their own emotional and empathetic terms.
In her reply, Fran Unsworth, BBC Director of News and Current Affairs said:
“I quite understand the point you make about the use of the phrase “heartbeat bill” and we would not aim to adopt it as our own description of the legislation.”
But she went on to say the term was “now in common usage” and the BBC would not stop using it.
Dr Alvaro Bermejo, Director General, International Planned Parenthood Federation, “The BBC can’t concede “heartbeat bill” is a biased and medically inaccurate description and then say it’s going to use it anyway.
Saying it is “in common usage” is no excuse, especially when the BBC – which boasted only last week that it has a global weekly audience of 426 million people – shares the blame for spreading it.
Language around legal abortion has been weaponised by those who want to deny women access to it and journalists – especially those who work for a news organisation which claims to be impartial and trusted – must wake-up and see they are being played.
This phrase was chosen very carefully by people who want to end access to legal abortion and who are exploiting the mainstream media to insert biased language into the common vernacular. It’s designed to hide the devastating impact on women of their plans and skew coverage. The right thing to do is to stop using it. We call on the BBC to think again.”
Simon Cooke, Chief Executive Officer, Marie Stopes International, commented: “We are frustrated and disappointed by the BBC’s decision to continue to amplify a phrase which is not only medically inaccurate and overtly emotive, but which can put women’s health and lives at very real risk by increasing stigma.
To fall back on ‘common usage’ as a defence legitimises and normalises anti-abortion rhetoric and further extends the chilling effect of restrictive anti-choice policies and views, especially when used by a globally respected and trusted media organisation such as the BBC. It’s sad to see antiabortionists so easily able to manipulate the mainstream media for their own ends.”
Dr Leana Wen, President and CEO, Planned Parenthood Federation of America said: “As a physician, I know just how critical it is for people to have the most accurate information about their health care. At this moment when our rights and freedoms are under unprecedented assault, now more than ever, we must stand up to dangerous misinformation. As scientists and public health leaders, we have a responsibility to stand up and reject misleading rhetoric and we call on the BBC to adopt medically accurate and unbiased language.”
Marie Stopes International (MSI) welcomes a landmark study released today that finds certain contraceptive methods do not increase a woman’s risk of HIV.
The ECHO study is a rigorous international study that examined rates of new HIV infection among women using three different contraceptive methods: a hormonal injectable called DMPA, a hormonal implant called Jadelle and the non-hormonal copper IUD. The study took place in Eastern and Southern Africa, where women are hard-hit both by HIV and deaths related to pregnancy, childbirth and unsafe abortion.
The ECHO study found similar HIV incidence rates among all three methods – meaning that, when compared to each other, none of the methods significantly increases a woman’s risk of HIV. The study also found that all three contraceptive methods are safe and highly effective at preventing unintended pregnancies: reinforcing that women everywhere need access to all contraceptive methods, complemented by all available HIV prevention options.
“We welcome the release of the ECHO study, which provides crucial answers for women so they can make the best choices for their lives,” said Dr Kathryn Church, Director of Global Evidence at MSI. “Every woman, everywhere, deserves to know all the potential benefits and risks when choosing her contraception. We can now reassure them that these contraceptive methods are safe, effective and do not put them at an increased risk of HIV.”
More than 150 million women worldwide use various hormonal contraceptives to prevent an unintended pregnancy. In sub-Saharan Africa, injectable contraceptives with the hormone progestogen, like DMPA, are the most commonly used methods. Many women choose injectable contraceptives because they are often the most discreet methods available.
Given the widespread use of DMPA in areas with high HIV incidence, largely in Eastern and Southern Africa, the question of whether DMPA increases women’s risk of HIV has been a critical issue for individual women, their families and communities, and public health.
Now that ECHO has provided clear evidence that these contraceptive methods do not increase a woman’s HIV risk, MSI will continue to provide as many contraceptive options as possible for women around the world. We will also provide our clients with the information and counseling they need, reassuring them that these methods are safe and effective choices to prevent an unintended pregnancy.
“We remain committed to providing women with as many safe and effective contraceptive options as possible,” Church said. “Ultimately, the ECHO study reinforces that we must continue to prioritise the individual needs of each and every woman who comes to us for contraception. We strive to understand her personal lifestyle and needs, giving her information and counselling so she can make the choice that’s best for her.”
The ECHO study also emphasizes the urgent need for high-quality healthcare for women, including a wide choice of contraceptive methods and all available HIV prevention options. Women and adolescent girls unquestionably deserve healthily and happy lives, and they want protection from both HIV and unintended pregnancies.
“Women in Uganda, and around the world, need more choice and control over their health and lives. We can - and must - expand women’s options to prevent unintended pregnancies and HIV” said Dr. Carole Sekimpi, Country Program Director for MSI in Uganda.
“Women and girls need protection against both HIV and unintended pregnancies: they do not separate their healthcare decisions into different, distinct categories. We owe it to these women and girls – vulnerable to unintended pregnancies, unsafe abortions and HIV - to provide them with respectful, holistic and personalised healthcare that focuses on their unique lives and needs.”
Sekimpi added: “In Uganda and globally, every woman and adolescent girl needs more safe and effective contraceptive options, HIV prevention methods and healthcare that prioritises her needs and desires, as well as the knowledge to help her make informed decisions.
“Women and girls everywhere deserve the opportunity to make their own choices and determine their own futures.”
A cross-partner coalition, led by Marie Stopes International (MSI), Ipas, International Planned Parenthood Federation (IPPF), Population Services International (PSI) and the Safe Abortion Action Fund (SAAF), have launched SafeAccess, the first digital platform of its kind, working to eliminate unsafe abortion by putting evidence-based guidance in the hands of frontline practitioners and policy makers.
According to the Guttmacher Institute, almost half of all abortions that will occur this year, an estimated 25 million, will be unsafe. It’s predicted that 7 million women and girls will suffer devastating injuries and over 22,000 will die. The World Health Organization states that almost every single one of these deaths could be prevented. Through sexuality education, contraception, and the provision of safe, legal abortion and post-abortion care, no woman or girl should die for the right to determine her own future. Yet, from the southern states of America to sub-Saharan Africa, we see every day that people are having their right to access reproductive healthcare denied.
With the recent expansion of the Mexico City Policy (also known as the Global Gag Rule) and in the face of an emboldened opposition, five of the world’s largest sexual and reproductive health organisations are standing together in support of a woman’s right to safe abortion. Recognising the challenge ahead, MSI, Ipas, IPPF, PSI and SAAF are launching SafeAccess: an online platform sharing briefs, infographics, videos, toolkits and more, on what quality safe abortion and post-abortion care programming looks like worldwide.
As a coalition of the largest sexual and reproductive health organisations worldwide, the SafeAccess hub will host valuable resources alongside previously unpublished lessons on what works, to support frontline practitioners and policy makers to remove barriers and expand access to life-saving services.
In a joint statement launching SafeAccess, the CEOs of MSI, IPPF, Ipas, PSI and SAAF said:
“As part of our commitment to both sharing our knowledge and to a more collective approach, Marie Stopes International, International Planned Parenthood Federation, Ipas, Population Services International and the Safe Abortion Action Fund are delighted to launch the SafeAccess Hub. As implementing organisations, we share our own learnings on what works, with the hope that those on the frontline can use these lessons to expand access to life-saving services.
“With growing opposition to reproductive rights, it is more important than ever that our community comes together in support of a woman’s right to safe abortion. It is time to remove barriers to access, to put women at the centre of reproductive health programmes and to finally eliminate unsafe abortion, together.”
SafeAccess is being launched at the Women Deliver conference in Vancouver on Wednesday 5th June. Women Deliver is the world’s largest conference on gender equality.