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Open Letter to the Royal Society of Medicine on Abortion Stigma

Open Letter to the Royal Society of Medicine on Abortion Stigma

Franki Appleton, Abortion Talk Coordinator

31 October 2022, 12:00:00

Dear Royal Society of Medicine President, Senior Managers and Academic Board Members,


We are contacting you as representatives for Abortion Talk, Doctors for Choice UK and My Body My Life. We are a charity, a campaign group, and an academic research project, respectively, and are allied in our aims to destigmatise abortions for those who access care and those who provide it. We reject all forms of abortion stigma.


At the start of this month, we were invited to attend and exhibit at the British Society of Abortion Providers’ (BSACP) annual conference, Abortion Care: Focusing on the Future, hosted at the Royal Society of Medicine (RSM) building in London. Our exhibition consisted of an excerpt of the My Body My Life installation, an Open University research output, sharing the stories of people who have had abortions. Our display also included a Doctors for Choice UK banner and other promotional items, along with Abortion Talk information leaflets and promotional items.


RSM staff asked us to set up our exhibition in a seminar room in the basement instead of in the refreshments area next to the conference lecture theatre, where we set up a similar exhibition at the 2019 BSACP conference. When we challenged this, RSM staff cited “sensitivities” as the reason for wanting us to be in the basement. They emphasised that if we set up in the refreshments area, we would be next to the Children’s Trust’s paediatric brain injury conference, Breaking Down Barriers: Creating a fair playing field for children with acquired brain injury, implying that the attendees of this conference would be offended by our stand. This implication is stigmatising to abortion care specialists, paediatric specialists and anyone who has accessed abortion care – including attendees at the Children’s Trust conference.


The Sexuality and Abortion Stigma (SASS) Study research paper on what role health professionals can play in normalising abortions (Maxwell et.al, 2020) explains that everyday discourse surrounding abortion is frequently negative, presupposing shame and distress. This is despite abortions being a commonly carried out gynaecological procedure.


We refused to set up in the basement, away from the BSACP conference. Our refusal was a challenge to the stigma that is implicit in suggesting that an academic exhibition, referencing abortion care in a compassionate way, could cause distress to others in the RSM building and should be out of sight. The compromise that had to be reached in order for us to remain near the BSACP conference was that any public-facing display had to have the word “abortion” covered from view. On balance, and to de-escalate the situation, we accepted this compromise and were supplied with post-it notes to cover the words. We highlighted on the post-it notes that the word was being censored, to make it clear that this was structural stigma in action.


Our volunteers who were supervising our exhibition experienced hostile and intimidating behaviour towards them from the RSM staff. They were frequently surrounded in order to block the view of them from the rest of the refreshments area, including by security guards. They were accused of sharing confrontational posts about the incident on social media (that were posted by other conference attendees) and threatened with legal action.


The SASS research (Maxwell et.al, 2020) shows that this hostility is by no means an uncommon experience for those who work in abortion care. In the study, health professionals working in abortion describe encountering resistance or hostility from sexual and reproductive health (SRH) or gynaecology colleagues, and other healthcare professionals. They also indicated awareness of broader negative sociocultural narratives which they had to resist or reject when interacting with others outside healthcare systems.


RSM’s response to concerned social media posts on this incident was that you are proud to have organised, promoted and hosted the conference, and are investigating the claims of censorship.

We have waited for three weeks to be contacted by RSM about this incident and your investigation. We have not yet been contacted.


The behaviours exhibited by RSM staff members that day are known to perpetuate stigma through inducing shame and silencing abortion conversations. Health professionals and RSM staff can play a key role in normalising abortions, through the ways in which they frame their work and present abortion to patients and others more widely. The SASS study analysis suggests a way to achieve this is to present abortion as part of normal, routine healthcare, but that appropriate support and structural change are essential for normalisation to become embedded.


The outcome that we wish to see is a public apology from RSM for this stigmatising incident. We would also like to see a public statement acknowledging the impact that abortion stigma has on those who seek and provide care, and a commitment to normalising abortions in order to destigmatise this vital and common reproductive healthcare provision.


We invite RSM to arrange for our skilled facilitators to deliver a workshop to your teams on what abortion stigma is, how it manifests, and how to counter-act it.


It is essential that support to destigmatise abortions is implemented so that health professionals and all at RSM can contribute to lasting change and normalisation.


Sincerely,


Franki Appleton, Coordinator Abortion Talk


Dr Jayne Kavanagh, Co-Chair Doctors for Choice UK


Professor Lesley Hoggart, Academic Lead My Body, My Life Exhibition



References:

Maxwell, K. J., Hoggart, L., Bloomer, F., Rowlands, S. and Purcell, C. (2020) Normalising abortion: what role can health professionals play? BMJ Sexual and Reproductive Health, (doi: 10.1136/bmjsrh-2019-200480). Available at: https://www.sassproject.org.uk/normalising-abortion-what-role-can-health-professionals-play/