Tag Archives: women

Warning pregnant women over dangers of alcohol goes too far, experts say

Women are being unfairly alarmed by official guidelines that warn them to avoid alcohol completely during pregnancy, experts claim.

Some mothers-to-be may even be having an abortion because they are worried they have damaged their unborn child by drinking too much, it is claimed.

The British Pregnancy Advisory Service, maternal rights campaign group Birthrights and academics specialising in parenting say official advice on drinking in pregnancy is too prescriptive.

Revised guidelines that came into force in January 2016 are not based on reliable evidence, they say. The advice, endorsed by the four UK nations’ chief medical officers, deleted a longstanding reference to pregnant women potentially having one or two units of alcohol once or twice a week while expecting and instead said that they should not drink at all.

“We need to think hard about how risk is communicated to women on issues relating to pregnancy. There can be real consequences to overstating evidence or implying certainty when there isn’t any,” said Clare Murphy, director of external affairs at BPAS, the contraception and abortion charity.

“Doing so can cause women needless anxiety and alarm, sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm.”

Ellie Lee, director of Kent University’s centre for parenting culture studies, said the advice means pregnant women also shun social occasions unnecessarily.

“As proving ‘complete safety’ [of drinking in pregnancy] is entirely impossible, where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign,” Lee added.

Last year’s revised guidelines followed the first in-depth UK review of the evidence on drinking in pregnancy since 2008. It concluded that “definitive evidence, particularly on the effects of low-level consumption [on a baby’s health] remains elusive”. Despite that, it nevertheless recommended that: “If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.”

The NHS’s start 4 life website, which promotes healthy behaviour, says: “What you drink, your baby drinks too. Play safe and cut out alcohol.”

Jennie Bristow, senior lecturer in sociology at Canterbury Christ Church University, criticised the negative effects of advice to mothers to be. “Does it simply make for healthier pregnancies or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women.”

The guidelines state that: “Alcohol, like a numbr of drugs, is a teratogen, which means something that can disturb the deveopment of a fetus. Teratogens may cause a birth defect, or may halt the pregnancy.” The risks to the child also include the child being born prematurely or very small or having behavioural problems.

The Royal College of Midwives believes that any woman who is or is trying to become pregnant should shun alcohol altogether. “Our message [is]… that there is no evidence that any level of consumption is safe for the growing baby,” it said when the guidelines came out last year.

Warning pregnant women over dangers of alcohol goes too far, experts say

Women are being unfairly alarmed by official guidelines that warn them to avoid alcohol completely during pregnancy, experts claim.

Some mothers-to-be may even be having an abortion because they are worried they have damaged their unborn child by drinking too much, it is claimed.

The British Pregnancy Advisory Service, maternal rights campaign group Birthrights and academics specialising in parenting say official advice on drinking in pregnancy is too prescriptive.

Revised guidelines that came into force in January 2016 are not based on reliable evidence, they say. The advice, endorsed by the four UK nations’ chief medical officers, deleted a longstanding reference to pregnant women potentially having one or two units of alcohol once or twice a week while expecting and instead said that they should not drink at all.

“We need to think hard about how risk is communicated to women on issues relating to pregnancy. There can be real consequences to overstating evidence or implying certainty when there isn’t any,” said Clare Murphy, director of external affairs at BPAS, the contraception and abortion charity.

“Doing so can cause women needless anxiety and alarm, sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm.”

Ellie Lee, director of Kent University’s centre for parenting culture studies, said the advice means pregnant women also shun social occasions unnecessarily.

“As proving ‘complete safety’ [of drinking in pregnancy] is entirely impossible, where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign,” Lee added.

Last year’s revised guidelines followed the first in-depth UK review of the evidence on drinking in pregnancy since 2008. It concluded that “definitive evidence, particularly on the effects of low-level consumption [on a baby’s health] remains elusive”. Despite that, it nevertheless recommended that: “If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.”

The NHS’s start 4 life website, which promotes healthy behaviour, says: “What you drink, your baby drinks too. Play safe and cut out alcohol.”

Jennie Bristow, senior lecturer in sociology at Canterbury Christ Church University, criticised the negative effects of advice to mothers to be. “Does it simply make for healthier pregnancies or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women.”

The guidelines state that: “Alcohol, like a numbr of drugs, is a teratogen, which means something that can disturb the deveopment of a fetus. Teratogens may cause a birth defect, or may halt the pregnancy.” The risks to the child also include the child being born prematurely or very small or having behavioural problems.

The Royal College of Midwives believes that any woman who is or is trying to become pregnant should shun alcohol altogether. “Our message [is]… that there is no evidence that any level of consumption is safe for the growing baby,” it said when the guidelines came out last year.

Warning pregnant women over dangers of alcohol goes too far, experts say

Women are being unfairly alarmed by official guidelines that warn them to avoid alcohol completely during pregnancy, experts claim.

Some mothers-to-be may even be having an abortion because they are worried they have damaged their unborn child by drinking too much, it is claimed.

The British Pregnancy Advisory Service, maternal rights campaign group Birthrights and academics specialising in parenting say official advice on drinking in pregnancy is too prescriptive.

Revised guidelines that came into force in January 2016 are not based on reliable evidence, they say. The advice, endorsed by the four UK nations’ chief medical officers, deleted a longstanding reference to pregnant women potentially having one or two units of alcohol once or twice a week while expecting and instead said that they should not drink at all.

“We need to think hard about how risk is communicated to women on issues relating to pregnancy. There can be real consequences to overstating evidence or implying certainty when there isn’t any,” said Clare Murphy, director of external affairs at BPAS, the contraception and abortion charity.

“Doing so can cause women needless anxiety and alarm, sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm.”

Ellie Lee, director of Kent University’s centre for parenting culture studies, said the advice means pregnant women also shun social occasions unnecessarily.

“As proving ‘complete safety’ [of drinking in pregnancy] is entirely impossible, where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign,” Lee added.

Last year’s revised guidelines followed the first in-depth UK review of the evidence on drinking in pregnancy since 2008. It concluded that “definitive evidence, particularly on the effects of low-level consumption [on a baby’s health] remains elusive”. Despite that, it nevertheless recommended that: “If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.”

The NHS’s start 4 life website, which promotes healthy behaviour, says: “What you drink, your baby drinks too. Play safe and cut out alcohol.”

Jennie Bristow, senior lecturer in sociology at Canterbury Christ Church University, criticised the negative effects of advice to mothers to be. “Does it simply make for healthier pregnancies or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women.”

The guidelines state that: “Alcohol, like a numbr of drugs, is a teratogen, which means something that can disturb the deveopment of a fetus. Teratogens may cause a birth defect, or may halt the pregnancy.” The risks to the child also include the child being born prematurely or very small or having behavioural problems.

The Royal College of Midwives believes that any woman who is or is trying to become pregnant should shun alcohol altogether. “Our message [is]… that there is no evidence that any level of consumption is safe for the growing baby,” it said when the guidelines came out last year.

Warning pregnant women over dangers of alcohol goes too far, experts say

Women are being unfairly alarmed by official guidelines that warn them to avoid alcohol completely during pregnancy, experts claim.

Some mothers-to-be may even be having an abortion because they are worried they have damaged their unborn child by drinking too much, it is claimed.

The British Pregnancy Advisory Service, maternal rights campaign group Birthrights and academics specialising in parenting say official advice on drinking in pregnancy is too prescriptive.

Revised guidelines that came into force in January 2016 are not based on reliable evidence, they say. The advice, endorsed by the four UK nations’ chief medical officers, deleted a longstanding reference to pregnant women potentially having one or two units of alcohol once or twice a week while expecting and instead said that they should not drink at all.

“We need to think hard about how risk is communicated to women on issues relating to pregnancy. There can be real consequences to overstating evidence or implying certainty when there isn’t any,” said Clare Murphy, director of external affairs at BPAS, the contraception and abortion charity.

“Doing so can cause women needless anxiety and alarm, sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm.”

Ellie Lee, director of Kent University’s centre for parenting culture studies, said the advice means pregnant women also shun social occasions unnecessarily.

“As proving ‘complete safety’ [of drinking in pregnancy] is entirely impossible, where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign,” Lee added.

Last year’s revised guidelines followed the first in-depth UK review of the evidence on drinking in pregnancy since 2008. It concluded that “definitive evidence, particularly on the effects of low-level consumption [on a baby’s health] remains elusive”. Despite that, it nevertheless recommended that: “If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.”

The NHS’s start 4 life website, which promotes healthy behaviour, says: “What you drink, your baby drinks too. Play safe and cut out alcohol.”

Jennie Bristow, senior lecturer in sociology at Canterbury Christ Church University, criticised the negative effects of advice to mothers to be. “Does it simply make for healthier pregnancies or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women.”

The guidelines state that: “Alcohol, like a numbr of drugs, is a teratogen, which means something that can disturb the deveopment of a fetus. Teratogens may cause a birth defect, or may halt the pregnancy.” The risks to the child also include the child being born prematurely or very small or having behavioural problems.

The Royal College of Midwives believes that any woman who is or is trying to become pregnant should shun alcohol altogether. “Our message [is]… that there is no evidence that any level of consumption is safe for the growing baby,” it said when the guidelines came out last year.

Facebook censors group that helps women obtain abortion pills

Facebook has censored the page of an organization that helps women obtain abortion pills, citing its policy against the “promotion or encouragement of drug use”.

Women on Web, which is based in Amsterdam, helps connect women with doctors who can provide abortion pills if they live in countries where abortion access is restricted. It is a sister organization to Women on Waves, which provides abortions and other reproductive health services on a ship in international waters.

Women on Waves announced that the page had been “unpublished” on its own Facebook account, writing: “Women on Web provides life-saving information to thousands of women worldwide. Its Facebook page publishes news, scientific information and the protocols of the World Health Organization and Women on Web has answered over half a million emails with women who needed scientific, accurate information essential for their health and life.

“We expect Facebook will [undo] this action soon enough, as access to information is a human right.”

This is the second censorship row between Facebook and Women on Web. In January 2012, Facebook deleted the profile photograph of the group’s founder and director, Dr Rebecca Gomperts. The image contained instructions for inducing an abortion using Misoprostol. Gomperts was locked out of her account for two days after re-posting the image, but Facebook subsequently apologized and reinstated both the image and her account.


We expect Facebook will [undo] this action soon enough, as access to information is a human right

Facebook did not immediately respond to a request for comment.

With nearly 2bn users, the social media site plays a crucial role in disseminating news and information around the world. But Facebook has struggled to meet competing demands to allow for the free flow of information while cracking down on graphic material (such as the livestreamed murder of a baby in Thailand in April).

In 2016, the company faced international condemnation over its decision to censor the iconic Vietnam War photograph of a naked girl fleeing a Napalm attack. Facebook subsequently altered its policy to allow for editorial judgments about newsworthiness.

On 3 May, amid criticism over its handling of graphic videos, Facebook announced that it would hire 3,000 more content reviewers. Such content reviewers are tasked with applying the company’s “community standards”, often with uneven results.

Facebook’s has faced particular difficulty enforcing its rules for “regulated goods” – prescription drugs, marijuana, firearms, and ammunition. The company bars “attempts by private individuals to purchase, sell, or trade” such items, but has struggled to halt gun sales.

The company has cracked down aggressively on pages related to legal medical marijuana, however. In 2015, the site temporarily banned business publication Crain’s for promoting a cover story about medical marijuana.

New website offers US women help to perform their own abortions

Fearful that Donald Trump’s presidency poses a once-in-a-generation threat to US reproductive rights, an international advocacy group this week is unveiling what is sure to be a controversial response: a web portal dedicated to helping US women terminate their own pregnancies with abortion-inducing drugs they have obtained outside of a medical setting.

The project, launched by Women Help Women, is a nod to the fact that many US women may already be taking matters into their own hands as abortion options in this country contract.

“Women in the US have been and are using the pills without good guidance,” said Susan Yanow, the US spokeswoman for the group, Women Help Women. “If a woman is anxious and has the pills in her hand, and doesn’t know what to do … we can help her understand what to do. We can help her understand what signs to look for, and what’s going on.”

Research suggests that there is a small but significant number of US women who attempt to induce their own abortions without any medical supervision.

Several studies have shown that many of these women, particularly those living along the US-Mexico border, are using misoprostol, a miscarriage-causing drug that can be legally purchased over the counter in many Central American pharmacies. In the US, it is illegal to administer the drug outside of certain medical clinics.

Rules for taking misoprostol are easy to find online. What Women Help Women has done differently is connect US women with counselors who can provide step-by-step instructions, and answer questions, in real time.

Their counselors are trained by medical professionals to walk women through the process of using misoprostol for a DIY abortion. Counselors will also strive to connect women with abortion funds if payment is the main obstacle for getting an abortion in a clinic.

But the main goal is to support the unknown numbers of women who are performing their abortions themselves.

Part of the inspiration, Yanow said, came from an article the Guardian US published in November. The story followed a young Texas woman who, unable to afford an abortion in the US, traveled to Mexico to purchase an abortion-inducing drug over the counter.

“There’s just so many questions,” the woman told the Guardian. “I would so much rather have a health professional help me in this and kind of guide me through it versus DIY.”

Those words stuck in Yanow’s mind. And as she grappled for a way to respond to November’s election, it occurred to her that Women Help Women could tailor its services to the needs of women in the US.

The project will be titled Self-managed Abortion, Safe and Supported, or SASS, and use the website abortionpillinfo.org.

Women Help Women is already a longstanding provider of abortion pills and instructions in other countries. Every month, its staff members answer 5,000 emails from women around the globe seeking to end their own pregnancies.

The group will not provide abortion-inducing drugs to women in the US. And it has made other changes to its methods because of the United States’ uniquely hostile, anti-abortion atmosphere.

In the US, at least 18 women have been charged with a crime based on allegations that they attempted to induce their own abortion. A handful of states have made it explicitly illegal for anyone but certain medical professionals to administer abortion-inducing drugs.

Enterprising prosecutors have found other, creative ways to levy charges, through the use of laws against child endangerment, practicing medicine without a license, or drug possession.

Women Help Women counselors will inform clients of some of the legal risks that come with self-administering misoprostol, as well as some of the limitations.

But the legal implications of the project are far from certain.

“This area of the law is nothing if not complicated,” said Jill Adams, the chief strategist of the the Self-Induced Abortion Legal Team, a project associated with Berkeley Law. Her group has shared legal information about self-induced abortion with Women Help Women, but stopped short of legally vetting the information that counselors will provide to US women.

In general, the act of looking for or giving out information about self-inducing an abortion is protected by law, Adams said. And she knows of no one who has been prosecuted merely for seeking information.

Still, it could compound the risk of prosecution. Purvi Patel, the first US woman to receive a significant prison sentence for inducing her own abortion, was convicted after prosecutors obtained emails that showed her purchasing an abortion-inducing drug from a Chinese pharmacy.

With those facts in mind, Women Help Women designed its portal to delete conversations between clients and counselors after seven days.Its servers are located abroad – out of easy reach for US prosecutors, the thinking goes – as are all 23 of its counselors.

The legal risks are thought to loom larger than the medical risks.

“In general, I would say there’s kind of a growing recognition that from a safety or a medical perspective, we have few few concerns about” women using abortion drugs on their own, said Daniel Grossman, a clinical professor of obstetrics and gynecology at the University of California–San Francisco who researches self-induced abortion.

“Especially if we’re talking about women using misoprostol on their own. It’s a very safe and effective medication,” he continued. “If women have information about how to use it, then women can safely use it on their own.”

When women go to an abortion clinic, they are typically given two drugs: mifepristone, a drug that blocks hormones necessary to sustain a pregnancy administered in person, and misoprostol, which is taken many hours later and causes the uterus to contract and expel its contents. The Food and Drug administration permits women to leave the clinic and take misoprostol at home.

Researchers believe that women who self-administer abortion drugs are most likely taking misoprostol by itself, because it is easy to obtain from foreign pharmacies. Misoprostol used without mifepristone is less likely to cause an abortion but still has a high success rate.

There are certain medical risks in self-administering an abortion drug without the involvement of medical professionals. An ultrasound is often necessary to confirm a pregnancy and assess how many weeks a woman has been pregnant. Misoprostol is less effective and requires a different drug regimen later in the first trimester.

Medical professionals will also inform women about how to recognize complications, like excessive bleeding, that could occur after they leave the clinic and require medical attention. And using the drug improperly – say, at a high dose in the second trimester – can lead to serious medical complications.

Grossman argued that a project like Women Help Women’s could minimize those risks. “I think that it’s worse to just remain silent while we know women are doing this,” he said.

But abortion rights opponents cite these safety concerns as reasons to oppose any project that makes abortion drugs available outside a clinical setting.

In response to a study, first reported by the Guardian, that tests the efficacy of sending women abortion drugs by mail, a spokeswoman for Americans United for Life said, “We have grave concerns about handing out dangerous, life-ending drugs without medical supervision because women face great risks for chemical abortions.”

Carol Tobias, president of the National Right to Life Committee, asked, “Who are they supposed to call if they have a problem?”

Yanow says that’s exactly the point of Women Help Women’s new portal.

“People are not being advised to use the pills,” she said. “They’re being advised if they’ve already decided to use the pills. What drives this project is the knowledge that women have been managing this on their own.”

More than 800 women sue NHS and manufacturers over vaginal mesh implants

More than 800 women are suing the NHS and the manufacturers of vaginal mesh implants after suffering serious complications.

Some women reported that implants had cut into their vaginas, with one woman saying she was left in so much pain that she considered suicide. Others have been left unable to walk or have sex, according to the BBC.

However, the medical regulator said that the best current evidence supports the continued use of mesh implants to resolve health conditions that could themselves cause serious distress to patients.

The implants are used to treat incontinence after childbirth or pelvic organ prolapse, where the womb or bladder bulge against the walls of the vagina.

Between April 2007 and March 2015, more than 92,000 women had vaginal mesh implants in England, NHS data shows. About one in 11 women suffered complications. The issue reached prominence in Scotland last year after women with painful and debilitating complications formed a support group.

Claire Cooper began to experience pain three years after her operation. Doctors initially thought the discomfort was related to the removal of her womb, a procedure she had undergone aged 39.

When the pain continued, she said a GP told her she was imagining it. This, and the severity of the pain, resulted in suicidal thoughts, which she said she only overcame because of her children. Her constant pain has forced her husband to become her carer.

Cooper said she and her husband have not had sex for more than four years. “This stuff breaks up marriages,” she told the BBC. “I wouldn’t at all be surprised if there are mesh-injured women that have taken their own lives and didn’t know what the problem was.”

Another woman, Kate Langley, described the surgery as “barbaric”. She told the BBC that a surgeon who examined her “could see the [mesh] tape had come through my vagina – protruding through”.

Data from the Medicines and Healthcare products Regulatory Agency (MHRA) for 2012 to 2017 shows there were 703 adverse incidents relating to patients who had been given the implants to treat stress urinary incontinence, where urine leaks when the bladder is under pressure. A further 346 adverse incidents were reported for patients who had been given a mesh support to prevent pelvic organ prolapse.

The MHRA said the figures did not necessarily indicate a fault with any particular device and said evidence supported the continued use of vaginal mesh surgery for certain conditions.

A spokesman said: “What we have seen, and continue to see, is that evidence supports, and the greater proportion of the clinical community and patients support, the use of these devices in the UK for treatment of the distressing conditions of incontinence and organ prolapse in appropriate circumstances.”

A study published in the Lancet in December found that women who were given mesh implants were roughly three times more likely to suffer complications and twice as likely to need follow-up surgery compared with women who had the traditional version of the surgery, where stitches are used to provide support for the organs.

Rachael Wood, a consultant in public health medicine for NHS National Services Scotland and the lead author of the Lancet study, said: “The results were quite clear that women do suffer a higher complication rate and that it is no more effective. You can make quite a clear recommendation that it shouldn’t be the first line of treatment for prolapse.”

However, Wood said that the results on incontinence surgery were less clear, and for incontinence the study found fewer short-term complications when mesh surgery had been used compared to traditional treatment, which involves major surgery.

She said: “There’s no doubt that some women have had very poor outcomes. It is worth saying that nothing is without risk. There are also bad outcomes from traditional surgery and from doing nothing.”

The agony of ending a wanted late-term pregnancy: three women speak out

Last year, Donald Trump suggested that current abortion laws allowed doctors to “rip the baby out of the womb of the mother just prior to the birth of the baby”. His statement erroneously described abortion procedures, and also triggered an uproar among the women and men who know firsthand the devastation of ending a late-term pregnancy.

Nearly 99% of abortions occur before 21 weeks, according to the Center for Disease Control and Prevention, but when needed pass that point it is in response to harrowing circumstances.

“Abortions that occur at this stage in pregnancy are often the result of tragic diagnoses and are exactly the scenarios wherein patients need their doctors, and not obstructive politicians,” says Dr Jennifer Conti, clinical assistant professor at Stanford University. “Asking a woman to carry a fatally flawed pregnancy to term is, at the very least, heartbreaking. I’ve often heard women say that they chose to end such pregnancies because of unselfish reasons: they couldn’t bare the thought of putting their fetus through even more pain or suffering.”

Just this year, 400 abortion restrictions were introduced in 41 states, according to the Guttmacher Institute, a research organization that supports abortion rights. Among them, Republicans introduced the first ever federal “heartbeat” bill earlier this year – which would ban abortions after a heartbeat is detected. Meanwhile, Congress is considering a bill that would also ban abortion at 20 weeks nationwide – which is when ultrasounds can offer the first signs of fetus anatomy anomalies.

Here, three different women agreed to share their experiences to end misconceptions about late-term terminations, and to explain to politicians and the general public why they’re necessary in the first place.

Kate Carson, teacher, outside of Boston, Massachusetts

That warm June day, the recovery room was silent. The doctor entered carrying Laurel, a bundle of just five pounds wrapped in a pink-and blue striped cotton blanket. He gently passed her to her mother, Kate. She bent forward to smell her. She touched her skin. Her daughter was warm, but not as warm as she should have been.

“I just needed to know it happened. I needed to know that I had a baby,” Kate Carson says.

At 27, Kate had her life planned out. She and her husband were going to have four kids, and she was going to be an engineering professor. Her first pregnancy went fine, and she had a healthy baby girl. But while pursuing her PhD in engineering, she suffered three miscarriages. “It was a long road,” she says, but at by 29, she was finally expecting another girl, Laurel. She was due in the summer of 2012, and both parents were elated.

Kateholds her baby Laurel’s foot and hand prints that were made by nurses at the clinic.


Kate holds her baby Laurel’s foot and hand prints that were made by nurses at the clinic. Photograph: Kayana Szymczak for the Guardian

At 19 weeks, an ultrasound revealed a shadow of concern but the finding was reversed with full confidence at a level two ultrasound. “I’m not seeing any problems. Everything looks fine,” the specialist told the parents.

But Kate had a nagging worry. “My husband and I did not feel like everything was fine,” she says. She asked the nurse how sure the specialist was. “He would have to be so certain. They would never reverse a diagnosis without being super sure about it,” the nurse replied.

Yet her husband encouraged her to book another second level two ultrasound, a “piece of mind ultrasound”.

Expecting only reassurance, Kate knitted a pink sweater for Laurel while chatting freely with the technician who quickly grew silent. There was a big black spot on Laurel’s brain. “This baby is different,” the technician said. She left the room and returned with a maternal fetal specialist and a specialist in training.

“That’s when they started telling me,” Kate says. The fetus had Dandy-Walker malformation, a set of abnormalities of the cerebellum.

“The problems we didn’t see last time, we are seeing today,” said the specialist. She offered Kate adoption and abortion, “if it was still a legal option”. They used to send women to Kansas for abortions, she told her, but that was before Dr Tiller was shot in the face at a Sunday church service.

Kate asked if children with Dandy-Walker malformation are ever normal. “Yes,” said the specialist.

“And that, honestly, is so hard to hear because you just want something definitive”, Kate recalls. “On the one hand, of course you want your child to be normal. On the other hand, you want to know, is your kid going to be okay, is your kid going to receive a devastating diagnosis?” But the specialist had no definitive answers and recommended an MRI to determine whether Laurel would be okay or “incompatible with life”.

Kate couldn’t get the MRI for the next 48 hours. The wait was excruciating. At home, she could find no peace and substituted knitting her baby’s sweater for sleeping. She curled up on her living room sofa and cried until her husband scooped her up each night and took her to bed.

“When you’re imagining futures beyond the miracle happy ending, it’s sinking in,” she says.

The day of the MRI finally arrived. She was 35 weeks, 0 days. By the end of it, Kate and her husband had the hardest answers they’ve ever received.

Their daughter had moderate to severe Dandy-Walker malformation. But that wasn’t the only diagnosis; Laurel also had a brain condition in which fluid builds up in the ventricles, eventually developing into hydrocephalus and possibly crushing her brain. She had a congenital disorder too, in which there was complete or partial absence of the broad band of nerve fibers joining the two hemispheres of the brain.

What this meant was Laurel was expected to never walk, talk, or swallow. That was if she survived birth.

Kate asked her doctor, “What can a baby like mine do? Sleep all the time?”

“Babies like yours are not generally comfortable enough to sleep,” the neurologist said.

“That is when it became very clear what I wanted to do,” she says. “The MRI really ruled out the possibility of good health for my baby.”

A personal letter of support from Barack Obama. Kate wrote to President Obama after her abortion experience, in an effort to educate politicians about the realities of late-term abortion.


A personal letter of support from Barack Obama. Kate wrote to President Obama after her abortion experience, in an effort to educate politicians about the realities of late-term abortion. Photograph: Kayana Szymczak for the Guardian

For Kate, giving a child life and peace are the two gifts a mother can offer. “Most babies get to have life and get to have peace, but this baby, I had to choose. I could choose life, with the outside chance of peace or occasional peace, or I could choose certain peace without life. And for me, certain peace without life was the choice I wanted to make.”

On their ride home, Kate and her husband were silent as they drove in rush hour traffic across the Zakim Bridge. Unable to say it herself, Kate’s husband uttered the word abortion. “I think we should ask about it,” he said.

“I had been in this dark, awful prison of a place inside myself,” she says. Her husband’s words comforted her.

When they arrived home, Kate immediately called the doctor and left her a message. Her mother arrived to pick up their daughter and before leaving said she would have done the same. An hour later, the phone rang. Kate grabbed it. If they wanted the abortion, they had 30 minutes to call a clinic in Colorado before closing time or wait the weekend. The procedure would last four days. And they would need $ 20,000. Massachusetts doesn’t allow abortion after 24 weeks unless it’s necessary to save the life of the mother.

Kate and her husband live a modest life, certainly not one with $ 20,000 readily available. Kate’s younger brother offered his life savings of $ 5,000, but it was her parents who gave them the money from their retirement fund. “This is exactly why these abortions exists,” said her father.

Three days later, they were driving up to Dr Hern’s Boulder Abortion Clinic, where surveillance cameras and razor wired fences surrounded them. She was 36 weeks.


I felt like the only one in the entire world … but we are not entirely alone. Just hidden

Kate Carson

Inside the clinic, Kate took a blood test followed by exhaustive counseling sessions, then the consent form. Dr Hern wanted to make sure she was doing this of her own free will.

By the end of the day, Kate and her husband knew it was time. Dr Hern took Kate to a room for the injection. It would slow her baby’s heart to a stop as soon as it penetrated. Sometimes, it happens quickly. For Kate, it happened over the course of a couple of hours. Just as she and her husband were planning to grab a bite of food, Laurel kicked. “I lost it,” says Kate. She retreated to her hotel room and lay there until the moving stopped. When Laurel went still, Kate’s stomach sagged low and lifeless, she says. “It was really sad and really hard.”

“I did not ever doubt I was doing the right thing for her but that did not make it easier,” she says. Kate says Laurel got the “tightest hug”. Her body was hugging her.

Next, it was time to get dilated, which was painful for Kate because she couldn’t receive an epidural. On the last day in Colorado, on an early June day, Kate, who was in labor for two and a half hours, delivered Laurel.

In the recovery room, Dr Hern brought Laurel to her. She smelled right, she felt warm, but not as warm as a live baby.

“She was beautiful,” Kate says.

When Kate returned home, they scattered Laurel’s ashes in the ocean. It was time for closure, but Kate worried about judgment so she didn’t tell anyone what happened for months. Then the self-doubt came.

“I feel like myself got fragmented into a million different selves. And I had my angry guard dog piece and my jealous piece, had my sad piece, I had the guilt, the religious piece. All of these pieces, and I had to figure out who I was”.

For some time, Kate wondered about the human error piece in the equation and wondered if her first doctor might have mislead her on purpose. A little research later proved it was just an honest mistake. “I can live in a world where people make mistakes,” she says. “I felt like the only one in the entire world who had had such a later abortion and it is true that we are rare, but we are not entirely alone. Just hidden.”

Since Laurel, Kate gave birth to another healthy daughter.

Kate Carson speaks about her experience to doctors, lawyers, and neighbors. You can also read about her experience here

Lindsey Paradiso, wedding photographer, Virginia

Lindsey and Matt Paradiso, photographed inside their home.


Lindsey and Matt Paradiso, photographed inside their home. Photograph: Justin Ide for the Guardian

The moment Lindsey, 27, found out she was pregnant, she wrapped the positive test strip in a used gold metallic gift bag and surprised her husband, Matt, with it. Two months later, they named her Omara Rose.

This was not the easiest pregnancy for Lindsey. She suffered from sciatica nerve pain and had to undergo daily injections for her blood clotting disorder. But she was over the moon about the pregnancy.

At first, it looked like a bubble floating on the ultrasound. At the routine 18-week visit in February 2016, the doctor speculated the peculiarity could be cystic lymphangioma, a group of cysts found mostly in the neck. Or it could be nothing. They immediately booked an appointment with the University of Virginia (UVA).

After seeing the ultrasound at UVA, Lindsey noticed the growth had enveloped half of Omara’s face and spread around her neck to the back of her head. When the doctor entered, they expected the worst. Again, the term lymphangioma came up. But so did cervical teratoma. Only an MRI could determine decisively, but whether it was malignant or benign, it could be fatal to the baby.

“You could just tell the energy in the room was like you should end it, it’s not going to turn out well,” she says. The doctor told them they could terminate the pregnancy since Omara’s chances of survival were slim. Matt and Lindsey were crushed by the prospect. They wanted to fight.

Twenty days after seeing the first signs of trouble, they learned that Omara had an aggressive form of lymphangioma growing out of her neck. The diagnosis came in the form of a dense two-page MRI report. The fast-growing, inoperable tumor had grown into her brain, heart, and lungs. It had wrapped around her neck, eyes, and deep into her chest. It was so invasive, it was pushing her tongue out of her mouth.

Her chances of living to age of viability or birth were slim. Lindsey and Matt made the heartbreaking decision to follow through with an abortion at around 24 weeks. They were just a few days away from it being an illegal termination.

A shadow box of memories of their daughter, including her hand and foot prints, sits with a teddy bear.


A shadow box of memories of their daughter, including her hand and foot prints, sits with a teddy bear. Photograph: Justin Ide for the Guardian

On 26 February 2016, Omara Rose’s heart stopped beating. Shortly after, Lindsey was admitted into the hospital for labor induction but the epidural stopped working. “I felt like my insides were being ripped apart,” she says. When the doctor administered a second epidural, Lindsey became nauseous. Her ears rang. The room spun. The doctor rushed in to administer a third epidural.

She was conflicted the whole time because while she was in pain, she didn’t want it to stop because she knew by the end of it “your child is going to be dead”, she says. Matt held her hand the whole time.


To hide something because you’re ashamed of it is just going to perpetuate misunderstanding

Lindsey Paradiso

When she finally delivered Omara Rose 40 hours later, she was so small, “I barely felt her leave me but I knew she had,” she says.

Over the next few hours, Lindsey and Matt got to hold Omara Rose, dressed in a tiny dress with a hat the size of the cup of Lindsey’s hand. Then Lindsey’s and Matt’s family came, each taking turns to say their goodbyes. “I wanted her to be alive so badly but I knew it was for the best. She went without pain,” she says.

The next day, they buried their daughter in a cemetery four hours away from where they live now.

“I don’t think people understand the gravity of how sick she was. How fatal her tumor was,” says Lindsey.

But it took some time for them to be open about it, especially Matt. Lindsey found comfort in blogging while Matt focused on completing his education at Virginia Tech.

“To hide something because you’re ashamed of it is just going to continue to perpetuate misunderstanding,” says Lindsey. People automatically assumed that if she had the abortion, it was out of convenience. On the contrary, she says. “It’s something that will stick with you forever.”

For those who believe these babies are unwanted, Matt says: “You’re not going to wait until halfway through your pregnancy to finally have an abortion.”

Prompted by Donald Trump’s statements on late-term abortions, Lindsey shared more widely her experience in a Facebook post, which was shared over 100,000 times.

“Abortions are hard decisions made by real people,” she says. “Being open is a call for empathy.”

Lindsey Paradiso testifies against bills to limit access to safe and legal abortions. She’s also blogged about her experience here

Darla Barar, Austin, Texas, copyrighter

Darla Barar and her husband Peter. Darla was pregnant with twins - Catherine and Olivia - when they discovered that Catherine had a number of serious health issues.


Darla Barar and her husband Peter. Darla was pregnant with twins – Catherine and Olivia – when they discovered that Catherine had a number of serious health issues. Photograph: Courtesy of the Barar family

On 22 June, at 3.30pm, the doctor let them see Cate one last time. She danced for them and then kicked. Her mom told her it was going to be okay. And then, guided by the ultrasound, the doctor injected a medication into Cate’s heart, stopping it. When they checked for a heartbeat 30 minutes later, the silence was deafening.

Darla, then 29, and her husband Peter had tried for years to get pregnant. When treatments failed, they traveled to the Czech Republic to use donated eggs. A week after the transfer, Peter got a dinner dessert with a message: “Congratulations daddy.” They were expecting twins.

Darla and Peter had named their twins Catherine “Cate” and Olivia, and by their 20-week anatomy scan they already knew their distinct personalities. Olivia was a “diva” and Cate was shy, a “cuddle bug”. “We loved them more fiercely than I ever thought possible,” Darla says.

But during a routine anatomy scan, the technician was abnormally quiet. Cate was measuring a little behind but she was always the smaller of the two, so Darla didn’t worry much. After a long wait, the OBGYN entered the room and asked Darla to sit next to her husband. “I just knew something was wrong,” Darla says.


Finally, we just looked at each other and said it was okay. We had to do what was best for her

Darla Barar

Darla recalls hearing the doctor say he had never seen this combination of anomalies before.

Darla and Peter saw additional specialists, and all confirmed a number of issues. Cate had encephalocele, which is a neural defect that causes brain matter to leak out, slow growth, microcephaly, a very large cleft lip and possible fused digits. Her cerebellum was so underdeveloped that one doctor had trouble finding it and her brain’s midline was shifted, indicating “severe disorganization”.

To make matters worse, Olivia’s life was in danger. Cate’s amniotic sac was growing and restricting the growth of Olivia’s sac.

If she carried to full term, the restriction on Olivia’s sac would likely mean an early delivery. Darla says that every specialist they saw disclosed there was a high probability that Cate would not survive the delivery but if she did, there was no guarantee the surgeries – removing the encephalocele and placing her brain tissue back into her skull – would save her.

Darla cried and Peter prayed. “We needed a miracle and we knew as the day went on we weren’t going to get one.”

‘And then we had to grasp that we were only a family of three.’


‘And then we had to grasp that we were only a family of three.’ Photograph: Courtesy of the Barar family

Their other option was abortion, one they did not take lightly, but one that felt rushed because of Texas’ restrictive abortion laws, which bans abortions after 22 weeks. Darla and Peter had 12 days to decide. “If laws were different … we would have done more testing – one doctor mentioned an MRI, for example, to try to test the level of her brain function. But we didn’t have that, and knowing what timeline we were on, we spent a lot of sleepless nights researching, making appointments, talking to each other and our therapist, and really just spending time being the four of us,” she says.

“Finally, we just looked at each other and said it was okay. We had to do what was best for her. So we knew what we had to do to bring home one”. Darla says she was prepared to deal with it all, but “if it meant Cate was going to suffer, we just couldn’t do that to her.”

At 21 weeks and 6 days, Darla had an injection, and Cate’s heart stopped. “For us, it was completely humane,” she says.

In the case of an additional fetus that gets aborted in the womb, the tissue is usually reabsorbed back into the body, but that wasn’t the case this time.

“I kept telling Peter, I’m carrying our healthy baby and our dead baby. I can’t reconcile that in my brain. At the same time, it was a comfort to know that I didn’t have to say goodbye right then,” she says.

Thirteen weeks after the diagnosis, Darla delivered Cate and then gave birth to Olivia, a healthy five-pound baby. The family took turns holding Cate and later in the afternoon, the chaplain came to take her away.

“And then we had to grasp that we were only a family of three,” she says.

Darla says she couldn’t face people after the abortion. She called it a stillbirth. “I knew I was dealing with more than just grief and I couldn’t explain that to people,” she says. She was also dealing with guilt. But she never felt regret, she says. She knew she did the right thing.

Spurred on by Donald Trump’s comments about later abortions, Darla took to social media to share her story and the response was overwhelming, both good and bad. The meaner comments focused on abortions as a version of birth control, or a way to rid oneself of an imperfect child.

“I can tell you, knowing how much the procedure cost, nobody is doing that for birth control,” she says. “Ask us why we’re getting it. Don’t assume that you understand our lives.”

Nonetheless, “being open has allowed me to be a better mom. I’m much more free with my emotions,” she says. Knowing that she could become a voice for women and men who needed it empowered her.

“It’s always the health of the mother but the health of the baby is never taken into consideration [into laws] and in situations like ours, it could have meant two dead babies on our hands,” she says.

Darla Barar blogs about her experiences here

One in four young women in UK report mental health problems, study shows

A quarter of young women in the UK have suffered from anxiety and depression, according to a new survey released by the Office for National Statistics (ONS).

The figures were collected as part of a wide-ranging survey gauging the wellbeing of people aged between 16 and 24. They show that, despite an increase in the number of those who said their quality of life had improved since 2009, one in four young women said they had faced symptoms linked to poor mental wellbeing in 2014-15.

The report said that young women were “significantly more likely” than their male counterparts to recognise and admit being anxious or depressed, with less than one in six young men reporting similar symptoms.

The ONS report used data taken from surveys that focused on a person’s overall happiness – shown by their attitudes to issues such as relationships, work, education and finances – to create a nationwide picture.

The results show that while more than a third of young people aged between 16 and 19 who were questioned said they had a “very high” level of life satisfaction, this dropped to just a quarter among people aged between 20 and 24.

The study also reveals that in the four years from 2009-10 to 2013-14, the number of young people saying their mental health had “deteriorated” rose from 18% to 21%.

Tom Madders, campaign director at the mental health charity YoungMinds, said: “There is still a huge amount of misunderstanding about mental health conditions, making people less likely to open up to others if they are struggling to cope. This is particularly difficult for young people who face pressure, including stress at school, college or university and body image issues.”

He said that an environment of 24-hour access to social media led to some young people feeling they needed to “keep up the pretence of having a perfect life”.

Other figures from the study show that the number of young people who believe they are financially comfortable has increased since 2009-10. Seven years ago, 15% said they were struggling to get by, while by 2014-15 the number reporting financial hardship was 7% – and a significantly higher percentage (45%) said they were satisfied with their household income, up from about 30% in 2009-10.

The report added that levels of “general health satisfaction” had risen, with 56% saying they were “mostly or completely happy” in 2014-15, compared with about 52% the year before.

However, the figures also show a rise in households deemed to be living in poverty, based on families who earn less than 60% of the average UK income. One in four said they lived in a household at such a level, compared with 20% in 2008.

YoungMinds recently called on teachers, parents and carers to sign an open letter to the prime minister, Theresa May, urging her to place an increased emphasis in schools and colleges on improving young people’s mental health, and to recognise the pressures caused by exam stress, cyberbullying and fears over employment when they leave education.

Madders said: “A good quality of life includes having positive mental health and wellbeing, so it’s crucial that the problems which young people report are taken seriously and supported to prevent them escalating and going into crises.”

Can the contraceptive pill protect women from cancer?

Who is suggesting that the pill might protect women from cancer as well as from pregnancy?

The University of Aberdeen, which has been analysing results from the Oral Contraception Study set up by the UK Royal College of General Practitioners more than 40 years ago. There have always been concerns about the mass medication of healthy women, and it has more often been the risks and harms of the pill, rather than its benefits, that have been trumpeted.

So which cancers does the pill protect women from?

The pill protects women from endometrial cancer – cancer of the womb – ovarian and bowel cancer. That had been established. But this, the longest-ever study, says that protection lasts up to 35 years after women stop taking it, and that there are no other cancers connected to it in the long-term.

But doesn’t the pill increase the risk of breast cancer?

Yes, while taking it, but women on the pill are generally young and have a low risk of breast cancer, unless they have a family history. A small increase on a small risk is not much to worry about, and the increased risk disappears within five years of coming off the pill. There is also a small increased risk of cervical cancer, but that also disappears within five years of stopping.

Did the study discover anything else?

Yes. It found that women who take the pill are no more likely to get other sorts of cancers in later life than women who don’t. So, in relation to cancer, researchers say the pill is very safe in the long term.

What have other researchers found?

Researchers at Oxford University published a major review in 2008, which showed that the pill reduced the risk of ovarian cancer by 20% for every five years that a woman took it. Those on it for 15 years cut their risk in half. That’s an attractive idea, because ovarian cancer is not easily detected at an early stage, and kills two-thirds of those who get it. The Oxford scientists published in the Lancet, which ran an editorial calling for the pill to be available over the counter, as opposed to prescription-only, thereby “removing a huge and unnecessary barrier to a potentially powerful cancer-preventing agent”.

In 2015, the same team published a further review on the protection the pill provided against endometrial cancer. Protection lasted for at least 30 years, said Prof Valerie Beral. Women in their 70s were still being protected due to taking the pill earlier in life. “It is time to start saying that not only does it prevent pregnancy, which is why people take it, but you should know you are less likely to get cancer than women who don’t take the pill,” Beral said.

Why would the pill protect from cancer?

Female hormones are implicated in a number of cancers. The pill contains a low dose of the hormone oestrogen, which is linked to breast and cervical cancer, so it raises these risks, as does HRT (hormone-replacement therapy), which is given to women dealing with menopausal symptoms. But it also contains progesterone, which is known to be protective against endometrial cancer.

Aren’t there other risks involved in taking the pill?

Yes, although the NHS says they are small and that “for most women, the benefits of the pill outweigh the risks”. There is a slight increased risk of stroke because oestrogen can cause blood to clot more readily. In the leg, that can cause deep-vein thrombosis. Clots can also form in the lung or cause a stroke or heart attack. The NHS has a list of conditions that make taking the pill more risky, and says that if women have more than one of them, they should find another form of contraception. They include being over 35, being a smoker, being very overweight and having high blood pressure.

So does this mean most women should take the pill for a while in their youth?

If women want to use the pill to prevent pregnancy, the anti-cancer effect is an added bonus, and might make it a more attractive form of contraception. But no medicine is without any side effects at all, and for a small number of people, the pill is a more risky option.