Tag Archives: health

Mothers and babies will die

OFFERED: Fabulous boutique room, freshly painted, king size bed, 24-hour staff, pool.
REQUIRED: vaginal delivery of a perfect baby.

Of course, you’ll be lucky to make it through the doors of this little piece of heaven within the NHS. If you have any hint of a complication you’ll be sent packing to your standard local obstetric-led maternity suite. Oh, but hold on – there’s no room at the inn: all of the obstetric-led units have been shut!

Don’t get me wrong, I am all for natural childbirth. Women should be supported to give birth at home or in a midwife-led unit as advised in new guidelines from NICE (National Institute for Health and Care Excellence); let’s make sure every baby’s first moments are skin-to-skin, suckling at the breast. But the harsh reality is that the sweet, sweet words from NICE are nothing more than a whispered lullaby to lull women into thinking that they have a heart and that they’ve listened to mums and midwives. With a shortage of nearly 5,000 midwives nationally and a maternity service in tatters thanks to countless hospitals being downgraded, there is no way that a move to a midwife-led model of maternity care is a serious proposition.

So, let’s get serious. Women need an individual service tailored to their needs. Home birth requires two midwives to be present but is otherwise cheap as chips and has very good outcomes for mums and babies (within reason). Birth Centre delivery requires one midwife, with very little intervention, is slightly more expensive and also has good, reliable outcomes for mums and babies (within reason). Acute Obstetric care is on a graded scale of expense with increasing intervention and has good outcomes for mums and babies (within reason).

Reason, skill and medical training decide where it is most appropriate for a woman to give birth. In a service where the mother is at the centre of care, this should be a fairly straightforward decision – but in a service where profit and a confusing web of tariffs, CQUINS (and I’m not talking disco here) and penalties take centre stage, then the woman and her ever-expanding waistline are left to the mercy of a lottery of the market.

NICE can say what they like but the Department of Health are no longer accountable for our care and, with the advent of the CCG, they have no control of a national maternity strategy. When asked in a recent government report the Department of Health were not able to name a national policy for maternity. It’s still Maternity Matters, by the way, Jeremy.

The Health and Social Care Act untethered the Department of Health from the NHS. It claimed to hand over power to the Clinical Commissioning Groups, but in reality they are at best confused and at worst rife with corruption. All of this while introducing an open market that is spiraling out of control. The result for women is that maternity services are floundering. In that government report it was found that the Department of Health is no longer responsible even for such basic and fundamental aspects of care such as how many midwives are employed by the NHS. So, who is? No one.

With Public Health banished to the savaged hinterland of the Local Authority there is no longer a powerful body integrated into either the NHS or the CCGs to ensure that local commissioning of maternity services is in line with Department of Health Policy. Even if they knew what that is. By breaking up the NHS, the Department of Health has made it perfectly clear that it is not remotely interested in having a public health policy at all. They prefer to focus on forcing hospitals into becoming Foundation Trusts as quickly as possible.

Jeremy Hunt and his cronies may not care about boring epidemiological studies and evidence-based care, but for us mums the fragmentation of services is a catastrophic blow to choice, continuity of care and equal access to healthcare. With the desperate shortfall of 4,800 midwives (The Royal College of Midwives ‘State of Maternity Services’ Report 2013) and almost half (47 per cent) of UK hospitals lacking enough consultant obstetricians, along with a steady baby boom in England over the past decade, there is increasing strain on maternity services. Midwives and obstetricians look after women with much more complex needs.

The Coalition, UKIP and other misguided souls push an identity parade of people to blame: Immigrants (the Polish get a hard time despite working legally, paying taxes, and therefore being no different from Mr and Mrs Smith born and bred in Tunbridge Wells); The Poor (to listen to George Osborne and Iain Duncan Smith, one could be forgiven for thinking that eugenics may well be on the cards for the next election manifesto); The Needy (we might as well kick the disabled while they’re reeling from ATOS); and finally, The Labour Party (they gave those pesky women far too much with their tax credits, Child Benefit, Children’s Centres and Maternity Matters).

Amid the frenzied dismemberment of the NHS we are hurtling towards an insurance-based system for our maternity care, which embraces intervention rather than holistic, aromatherapy and massage amongst caring midwives handy with a birth stool. We need to ask ourselves, do we seriously want to live in a society in which only the super-rich can afford to have babies while the rest of us lucky enough to have health insurance count the pennies to calculate whether we can afford for the stork to pay us a call?

Never forget that pre-NHS women died in their droves in cavernous lying-in wards, or for want of an experienced midwife. The idea that all women are going to have the opportunity to lie-in in a luxurious birth centre would be a joke if it weren’t so utterly terrifying that the back-up intensive obstetric care is being closed down. We mothers need to fight and fight hard for our hard-won maternity services. We need to join together and fight those seeking dismantle the NHS and fight them we shall: we shall fight them on the labour wards, we shall fight in the midwife-led units and we shall fight in the birthing pools; we shall never surrender. We shall go on to the end.

Jessica Ormerod is the parents’ representative on the Lewisham Maternity Committee and a candidate for the National Health Action Party in tomorrow’s European election.

Photo: Wikimedia

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Anorexia: an “anti-feminist” battle with my own body?

This week, to coincide with the national Mental Health Awareness Week, we’re publishing a series of articles looking at feminism and mental health. Some readers may find this content distressing.

Being force-fed will always be one of the most traumatic, violating experiences of my life. To have a tube rammed into you, painfully, without your consent, and to witness your body change into one that repulses you is deeply humiliating. Eating is personal, as is safeguarding the boundaries of one’s own flesh. When I yanked out the tube, it was pushed back in. When I stopped resisting, I learned to be ashamed. For months afterwards I couldn’t raise my voice above a whisper. For years afterwards I couldn’t eat in public and simply wanted to disappear.

Anorexia is a complicated illness. Without force-feeding, I might have died. I know this and hence, since I want to be alive, I feel the need to come to terms with the feeding. Nonetheless, I’m wary of admitting to this. I don’t want it to sound as though I condone the force-feeding of other anorexia sufferers. I don’t feel I have the right to do that. A person’s body is his or her own and freedom of choice is integral to maintaining a sense of self. And yet, while force-feeding might have made me a lesser person – a more damaged person – without it I might not be a person at all. It’s a circle I’ve never quite managed to square.

As a feminist, I believe that one of the greatest sources of inequality lies in the belief that women don’t own their bodies. Viewed as sexual objects, incubators or foils against which masculinity defines itself, they are seen as less than human, as things to be used, shaped and sliced. In this context my battle with my own body could be seen as anti-feminist. I am ashamed at my failure to feel at one with myself; I have let the side down. And yet if feminism values choice and the right to self-definition, perhaps I shouldn’t feel this way. Women’s choices under patriarchy are rarely pure and our responses, like the feeding tube, may never be wholly good or bad. Even so, this doesn’t excuse us from having to make decisions, both about our own lives and the lives of others.

In recent years the focus of mainstream feminism has shifted somewhat from structural critique to an emphasis on respect and self-validation, something Rosalind Gill and Ngaire Donaghue call “the turn to agency”. There is obviously some value in this; it questions the notion that women are cultural dupes, following patriarchy’s rules without any degree of investment or engagement. It tells women that they are not victims and creates a sense that they can influence their own surroundings.

However, there is a downside. If any critique of meaningful responses to oppression is understood as a critique of individuals – a denial of agency – then what tools do we use to judge the choices women make? Are we permitted to judge at all and, if not, is there any form of acceptable intervention when women do harm to themselves?

I think, within a patriarchal culture in which women’s bodies are exploited, objectified and ridiculed daily, an eating disorder is not an irrational choice. The beliefs and rituals that maintain an ED are irrational (since that is how the mind responds to starvation) but to want to control the boundaries of one’s body and take up as little space as possible seems to me a perfectly logical response to trauma. Hence I am somewhat defensive of pro-ana websites and irritated by “body acceptance” drives. As a student, I remember being annoyed by a slogan touted by our college women’s officer: There are 3 billion women who don’t look like supermodels and only eight who do. Don’t think thin, think different. “But,” I’d think, “being like 3 billion other women isn’t being different!” While I didn’t want to look like a supermodel, neither did I want to be told to be “normal”.

In some ways anorexia felt like a great big “fuck you” to everyone’s values. In those days I didn’t wash my hair or wear makeup. I wore children’s clothing. I knew I looked unpleasant but it was an unpleasantness I owned (whereas now I merely fail to be beautiful; there is no active rejection, I just glide into the failing that is the lot of most women).

When people told me anorexia was controlling me, I felt outraged. Anorexia was me. How dare they deny my agency! And in this way I see difficulties in the line choice feminism seeks to tread. Whether we’re talking about behavioural trends in parenting or sex work or body modification, no woman wants to be told she is a victim – and yet some of us are. You can be a victim and an agent at one and the same time. You don’t even have to feel like a victim.

Mental health is a fuzzy area, particularly in terms of how diagnoses have been used against women. To be told you are mad is to be told you cannot judge your own reality. Women are told this time and again. It’s rarely true and there’s no definitive test that will tell you when it is true. Even so, it doesn’t mean madness can’t kill you.

I don’t know what happened to most of the women I met during my later treatments. Those that I am aware of have either died in their thirties or spent the past two decades drifting from one hospitalisation to another. I’m the only one who is relatively unscathed, yet part of me believes this is because I am a sell-out or a fraud. At the same time, I am furious that these lives have been wasted (and yes, to talk of “wasted lives” is judgmental, but it is a waste, a terrible one). But what would I do? Tell these women what bodies they should occupy? Hold them down and force in a feeding tube myself? Or endorse their reality, since perhaps that’s all they’ll ever have? As feminists we need to admit that sometimes, the answers aren’t clear-cut.

VJD Smith (Glosswitch) is a lifelong feminist and mother of two who edits language books when she’s not tied up with parenting, blogging and ranting.  Find out more @Glosswitch or glosswatch.com

If you have been affected by an eating disorder, visit beat or Mind for information and support, or call the beat helpline on 0845 634 1414.

Photo: Wikimedia Commons

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The march backwards: Women’s sexual & reproductive rights at risk

Thilde Knudsen is head of Marie Stopes International’s Europe office.

Spain is about to criminalise abortion; politicians in the UK repeatedly attempt to reduce the 24-week limit; and last week in Brussels, a Parliamentary hearing discussed a European Citizens’ initiative that, if successful, would block European Commission (EC) development funding for maternal health.

Working for sexual and reproductive health charity, Marie Stopes International, I know that every day 800 women die during pregnancy or childbirth, and 99% of these women are from the developing world. This is why the international community identified maternal health as one of the eight Millennium Development Goals and why the European Union (EU) apportions development funding to maternal health each year.

But the ‘One of Us’ initiative, which aims to block EC funding for any activities that involve the destruction of the human embryo, would adversely affect development aid to maternal health projects: projects that enable women in developing countries to make life-saving choices over their fertility; projects that help young women delay pregnancy until they are physically developed to safely deliver; and projects that give mothers time to recover before giving birth to their next child.

Data proves that the initiative is sadly misguided. Restricting safe abortions through similar interventions like the global gag policy in America does not lead to lower abortion rates, it just pushes it underground. The only proven way to reduce the number of abortions is through access to modern contraception and sexuality education, both of which could be adversely affected by the ‘One of Us’ initiative.

Today, it is estimated that roughly half of all women living in developing countries do not have access to adequate basic maternal health care and that 220 million have an unmet need for family planning. The consequences of this include almost 300,000 preventable maternal deaths every year, millions of women affected by debilitating injury such as obstetric fistula, and the perpetuation of poverty and disempowerment as women are unable to delay childbearing or to choose their family size. This is why continued EU support for maternal health and family planning is essential.

The EC currently spends an estimated €121.5 million per year on maternal health and family planning – equivalent to approximately 1.3% of the funding gap to meet the unmet need for maternal health and family planning.

Thankfully, ‘One of Us’ is unlikely to achieve its aims. The initiative, which celebrated its 1.8 million signatures with much fanfare, is in reality just over a quarter of one percent of the population of Europe. Critics have also pointed out that the way European Citizen initiatives are structured give an advantage to large organisations, like the Catholic Church, to mobilise their supporters.

However, this is not a green light for complacency. On the contrary, it should be a warning to everyone who believes in women’s rights that we have been silent too long. In Europe women are often deemed to have achieved equal rights. Since the 60s – when women’s liberation movements stood up and called for sweeping changes to access to equal pay, divorce and abortion – the passionate demonstrations, speeches and rallies have gradually gone quiet, and today many young women would never dream of calling themselves a feminist.

Yet our complacency is proving to be very dangerous, as the hard-won rights our mothers fought for are slowly being chipped away. Who would have predicted that Spain would be bringing in a draconian bill to end women’s rights to safe abortion, making it one of the most restrictive countries in Europe? If Spanish prime minister Mariano Rajoy has his way, abortion will be illegal except in the case of rape or when there’s a risk to the physical and mental health of the mother, and women could soon be resorting to the same dangerous methods they relied on decades ago: seeking out backstreet abortions or attempting to end the pregnancy themselves.

Just outside Europe’s borders in Turkey, where abortion was legalised in 1983 because of the high numbers of deaths by backstreet abortions, a new law just passed that health professionals and human rights activists have warned will make it impossible for women in the country to gain access to legal abortions.

While movements like ‘One of Us’ are attempting to erode women’s rights and mislead European citizens about the importance and value of our development assistance and maternal healthcare, we need to make our voices heard and Make Women Matter. There is an urgent need for the global community to work together in meeting the full funding gap, in order to save and transform the lives of millions who live in poverty. Europe must stand for access to the whole range of sexual and reproductive services – including access to safe abortion when needed – here at home in Europe, and in partnership with other governments around the world.

Marie Stopes International provides millions of the world’s poorest and most vulnerable women with quality family planning and reproductive healthcare. It has been delivering contraception, safe abortion, and mother and baby care for over thirty years and operates in over 40 countries around the world. By providing high quality services where they are needed the most, it prevents unnecessary deaths and makes a sustainable impact on the lives of millions of people every year.

Photo: Marie Stopes International’s work in India

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Manifesto: Doctors of the World campaign for women to be “Names not Numbers”

Doctors of the World provides essential medical care to excluded people at home and abroad while fighting for equal access to healthcare worldwide. We are part of the Medecins du Monde global network, which delivers over 300 projects in more than 70 countries.

Whether it’s providing mental healthcare to Syrian refugees, vaccinating children in Mali, or delivering babies in the DRC we meet the health needs of vulnerable people across the planet. And where possible, we share our skills and training locally so communities stay strong in the long term. We also work with the most marginalised to report on violence, injustice and healthcare barriers wherever we see them.


Our work with women in the UK

  • We run a clinic and advocacy programme in east London staffed by volunteers who provide care to excluded people such as vulnerable migrants, sex workers and people with no fixed address.
  • We have a team of doctors, nurses, and support workers who endeavour to help everyone who comes to see us with medical care, information and practical support.
  • We see heavily pregnant women who have received no antenatal care and children who have been denied basic healthcare after being de-registered by a GP.
  • We help these women find the care they deserve with GP’s and hospitals, ensuring that they are not at risk of further harm.

Our work with women overseas

  • Women and children living in developing countries lack access to obstetric healthcare services, resulting in high rates of morbidity and mortality.
  • Many of Doctors of the World’s women and child health programmes are based in rural areas, where affordable pre and post-natal health services are unavailable.
  • Globally, over 300,000 women die every year during pregnancy or childbirth, with 56% of these in sub-Saharan Africa. Most maternal and infant deaths are caused by infections that could have been easily prevented.
  • Doctors of the World works to combat high rates of maternal and infant mortality by improving access to basic healthcare services in areas where women and children have no means of receiving care.

Women’s right to choose

  • We support the universal access to modern methods of contraception and the abolition of all legislative barriers which limit it, and access to quality sexual and reproductive health services that are underpinned by a woman’s right to choose.
  • We believe that it is every woman’s right to choose to access safe, legal abortion services by decriminalising terminations and reducing unsafe abortion-related deaths and complications.
  • We recognize that 300,000 women die every year from complications during pregnancy or unsafe abortions, which could be avoided through straightforward access to family planning.
  • We have started an advocacy campaign, Names not Numbers, to raise awareness of the legislative changes necessary to prevent further senseless deaths.
  • We consider that governments should put the following in place to protect women’s health and their right to choose:
      1. To guarantee universal access to contraceptive methods
      2. To consider illegal abortion as a public health issue
      3. To cater for post-abortion complications

Find out more at doctorsoftheworld.org.uk or follow @DOTW_UK

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Womb with a View: Bounty – I’ve got my best “fuck-off face” ready

We asked Bounty for a response and have published it directly below the article. It includes contact details for anyone who has had a difficult experience and for those wanted to take themselves off the Bounty database.

Two weeks to go… or rather, not two weeks to go. I’m 38 weeks pregnant today, and his Highness could plausibly arrive this afternoon. Or tomorrow. Or next week. Or the week after that.

Between the 37-week mark and the 42-week “we’ll try anything” cut-off, a pregnant women is ready to roll, set to go, fully cooked. So what are women like me really thinking about now? The small issue of pushing a baby out between our legs, yes. But also what happens soon after, and who we want to be with us.

This brings me to Bounty, an organisation in the news frequently last summer. A profit-making company that provides “support to families in the transition to parenthood”, their representatives are present on many post-natal wards in the UK. Here, they sell women photographs of their babies hours after they’ve had them, get paid by HMRC to pass on Child Benefit forms (some Bounty reps have told mothers it was the only way to get them) and sign away patients’ details to parent-friendly businesses. Yep, you read that right.

This isn’t the brave new world of the stripped-down NHS either. Bounty has been around in hospitals for over 50 years, although what they do there has changed significantly.

These days, women encounter Bounty very early on in their pregnancies. At my 10-week check – at which the risk of miscarriage is still significant – I was presented with my free Bounty folder. This is a heavyweight plastic bag full of free samples and advertising. No, I’m not averse to a freebie but this didn’t seem the right environment so, after a cursory look through, I chucked the lot in the bin. (One leaflet also offered dietary advice that contradicted NHS guidelines – yes, I can eat stilton, you demons – which I emailed them about and, to their credit, they responded.)

A note on the back of the Bounty bag was more galling, however. “Mum to be tip: baby brain? Keep your maternity notes in here so you know how to find them,” it gushed. There, there, dear, went Bounty, patting our silly little heads. We’d much rather be patronised than supported.

Then I started hearing about other women’s experiences of Bounty. One friend was pressured to sign up by her midwife, before miscarrying, then kept getting information from the company on what would have been her due date. Another had a very poorly baby and kept getting harrassed in intensive care. Another thought the Bounty rep was one of many health professionals at first, before handing over her email to send her away – only to get bombarded with spam emails ever since, selling life insurance, kids’ ISAs and toddlers’ ballet lessons.

The first issue to tackle here is transparency. Why don’t these reps say who they are straightaway? I’m told that, in the hours after giving birth, medical staff pop in constantly; a new mother isn’t necessarily going to be ready to deal with uninvited guests. Also, why are these reps allowed into wards when only a few other family members are, especially given the risk of infection? Are these reps monitored and checked properly? Are they made aware of women’s different medical circumstances? A woman could have had an easy labour or a very traumatic one. Neither kind, from the anecdotes I’ve heard, is spared the sales treatment.

So what do Bounty bring the NHS? In a word: money. Amy Willis’ June 2013 investigation for The Telegraph revealed that 150 NHS hospitals were signed up to cash-for-access contracts. Some hospitals were paid according to the number of babies born, while others got bonus commissions when Bounty managed to take their bloody photographs. Furthermore, as of last summer, HMRC paid Bounty £90,000 a year to distribute child benefit forms – forms that can be picked up in post offices for free or downloaded online.

No change has been reported about this figure yet. It isn’t exactly the best use of taxpayers’ money, whichever way you slice it.

But things are hopefully changing. Last summer, a Change.org petition against Bounty attracted over 25,000 signatures. As a result, Parliamentary Under Secretary of State at the Department of Health, Dan Poulter – a medical doctor himself – wrote to the Chief Executives of NHS Trusts expressing his concerns, albeit it, of course, in a very privatisation-friendly way.

“Whilst it is beneficial to have accessible information available to women when they are responsive to messaging”, he wrote – a touch of the “baby brain” schtick there, so thanks for that, Dan – “I am sure you will agree that it is unacceptable for parenting support organisations including Bounty to use this as an opportunity to collect private data and share it without the expressed informed consent of the parents.” Which is all well and good.

This letter was written last June. By July, Poole and Highland NHS Trusts had severed their Bountry contracts. By August, Poulter was saying that the Care Quality Commission would be enabled to take action against maternity wards that “did not ensure the protection of women’s dignity and privacy”. The worry I have now, however, is that this story loses traction. That overworked staff on maternity units forget the complaints that have been made. That the existence of Bounty reps on the wards for so many years makes the issues blend into the background – rather than the practices of individual reps being questioned.

After all, these are some of my friends’ experiences of Bounty, on post-natal wards, since last August. There’s the friend who was having difficulty breastfeeding when the rep appeared – a woman who didn’t take a strongly-worded hint to leave well alone. There’s the friend who was told by an anonymous woman that she needed her details, without being told how these details were going to be used – expressly against the advice recommended by Dan Poulter. A few others had better, hands-off treatment, and I’m hoping for the same – but I have the advantage of being prepared for it, which many women don’t.

Whatever happens in the next four weeks, I’m taking the advice of my friend Ellie. After the birth, whatever happens, I’ll have my best “fuck-off face” ready.

Jude Rogers is a writer, broadcaster, journalist, romantic, Welsh woman and geek. Follow her here @juderogers

Response from Clare Goodrham, Bounty General Manager said: “As a proud partner of the NHS for over 50 years, which sees over 2,000 new mums every day, we have worked to provide free products and important health information to generations of new mothers. We work closely with hospitals to ensure that mums and hospital staff are happy with the service we provide, and 92% of mums say that they love our packs as it gives them free products and money off coupons.

We are proud to give mums such offers and we take a responsible approach to sharing information with our partners. We audit and approve all the communications that our members receive and enforce a strict policy that data is only shared with our partners when a member has given us permission. We understand that some members might change their minds about this, so anyone who does not wish for their data to be shared can be removed from our database within 24 hours and no longer receive correspondence from Bounty or our partners if they wish.

Whilst expecting a baby should be such a joyful event, we know from our long term partnership with Tommy’s the baby charity that for one in four women things can go wrong and they lose a baby in pregnancy or birth. Bounty takes its responsibility seriously and has systems in place so that our members can privately update their membership details on our website or unsubscribe using a link at the bottom of our home page www.bounty.com and any of our emails. Additionally, Bounty signposts to the Baby Mailing Preference Service on our website and through our customer services team as the service will ensure that any communications from other sources they may have signed up to are also stopped.

At Bounty, we want 100 % satisfaction with our service and regularly assess all aspects of our practices to ensure that mums continue to get the best experience possible. Our Independent Advisory Board is also in place to provide us with recommendations for how we can continually improve our service and the experience for mums across the country. If anyone has any specific complaints or suggestions for improvement, then please let us know straight away at telluswhatyouthink@bounty.com.”

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Happy 40th Birthday, free contraception!

From 1 April 1974 all contraceptive advice and supplies became free on the NHS, and available to all women. 40 years on, bpas (the British Pregnancy Advisory Service) celebrate the anniversary of free contraception in the UK and call for the next step forward.

The contraceptive pill was first licensed in 1961, yet initially restricted to those deemed wise enough to use it, and worthy of its privileges – those bastions of moral responsibility who are older married women. So hoorah for the less celebrated year of 1974, when contraception became free of charge for all women, regardless of age or marital status.

It’s hard to think of a development which has brought about such a monumental change in women’s lives, their role in society, and their relationships with men as free access to contraception.

The Pill enabled women to take control of their biology. Family sizes shrunk, motherhood was delayed, and women began to occupy those spaces that had previously been the sole domain of their male counterparts. Alongside access to safe, legal abortion, women could start to make genuine reproductive choices.

Yet while we can celebrate the 40th anniversary of free access to this revolutionary pill, this birthday is also the occasion to reflect on what we want from contraception over the next four decades – and ideally before we reach the last half of the 21st Century.

We should be asking why we are not seeing the investment, effort or drive to develop new methods of contraception that actually meet women’s needs. There seems to be a prevailing sense of “job done” when it comes to contraception, and ongoing barriers to technological advances in this field. While we have seen a few new methods enter the market over the last decade of so, these are by and large variations on the dose and delivery of the same medication.

Hormonal contraception should be celebrated for the huge advances it has brought, but it’s not for everyone. While there are women who will swear by their contraceptive implant, there are others who find themselves begging the doctor to remove it. We need new methods
without the side effects such as irregular bleeding, weight gain, nausea or lower libido. We need a greater choice of non-hormonal methods for those women who do not wish to use hormones or who cannot.

We need methods better suited to the reality of women’s lives and an acceptance that some women don’t want to use barrier methods like condoms or diaghrams but also don’t feel they are having sex regularly enough to warrant remembering a daily pill or having a long acting IUD or implant inserted. A pericoital pill, which could be taken at the time of sex, would represent a huge breakthrough for those women.

And we need to take politics out of pills. Researchers have noted that one of the major barriers to contraceptive development is the fear of controversy – so, for example, it would be possible to create a monthly pill that would either stop a fertilised egg implanting or detach it from the lining of the womb, yet concerns about the reactions from those who would see this as an abortion have put the kybosh on its development. Some women may well have their own personal position on whether this method is right for them – but shouldn’t that be their choice to make?

And lastly, we need methods for men. Men need something in between the two extremes of condoms and vasectomies, and the argument that most women wouldn’t trust men with their birth control is insulting to the many men who we know are keen to share the burden of contraception with their partner.

So hooray for free contraception. Thank you 1974. But it’s 2014 now – and women deserve more.

bpas is a reproductive healthcare charity, providing counselling and abortion care, contraception and STI testing on a not-for-profit basis. Follow them @bpas1968

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A Womb With A View: Antenatal depression

Read the first in Jude Roger’s series, A Womb With a View: The Anti-Medicine Brigade.

Thirty-five weeks in, I am enjoying lots of things about pregnancy. Watching my stomach doing a John Hurt in Alien. Getting seats on trains (when people aren’t cocooned in their technological bubbles, anyway). Waddling. Napping. And my favourite: not holding my belly in.

But then there are the other things, of course: the niggles, the concerns. The guilt about what food and drink you can eat. The worries about whether baby is moving enough. Random pains. Itchy skin. Recently, I’ve been physically monitored to check some of these out (and I’m fine, all is well), but I’ve been surprised how rarely their psychological repercussions are acknowledged by health professionals.

The thing is, everyone knows about post-natal depression. It’s a regular headline on women’s magazine covers and something addressed, very rightly, in many birth preparation courses. Antenatal depression, however, is a fairly unknown term. Perhaps, once again, it’s because pregnancy is meant to be a blooming, beautiful time, when an ordinary woman becomes a walking, talking miracle. For many of those people, pregnancy is not the easiest draw, though. The pregnancy may have been unexpected or unwanted. It might bring up difficult emotions from the past. It might feel uncontrollable.

According to pre- and post-natal charity PANDAS (Pre and Postnatal Depression Advice and Support), one in ten women will experience antenatal depression. In the UK, it’s meant to be on the health agenda too. In 2007, NICE [the National Institute for Clinical Excellence] published guidance to help women at risk from the condition, and encouraged healthcare professionals to ask women at risk of it three simple questions: if they had felt down or hopeless, found it hard to find pleasure in doing things, and whether they wanted help with these feelings. Even if these women didn’t have specific mental illnesses, NICE advice continued, they should be encouraged to get support from professionals or voluntary organisations.

From my experiences, and those of others I’ve talked to, this isn’t always the case. At 19 weeks, I texted one of my healthcare contacts in desperation, worrying madly about having felt the baby move a few weeks previously, but not since. I felt bleak and couldn’t stop crying, I said. She replied to say sometimes movement changes happen, but didn’t address my state of mind.

At my next appointment, she had forgotten our exchange entirely. Ah, everyone gets anxious, she said, when I reminded her. Worry is normal. Which is all correct, of course, but that wasn’t the point.

A lot of anxiety in pregnancy is put down to hormones – and yep, there’s a lot of them, swirling and rollercoastering around. But bring up slight concerns about your state of mind and most health professionals plump for the “don’t worry, dear” response. A friend of a friend of mine who felt very low during her pregnancy was asked if she wanted to be monitored on machines more often for reassurance. She was never offered what she really wanted: services to help her emotionally.

In October 2012, Netmums, in association with the Royal College of Midwives, published more research about antenatal depression. Their findings reinforced a causal link between antenatal and postnatal conditions. Press headlines at the time had a specific focus, as a result: ITV’s typical example was “Report reveals antenatal depression affects relationship with baby.”

There’s something missing from that headline, of course – the mother herself, and her initial experiences. Once again, the individual growing a new life inside her doesn’t have her own taken seriously. This makes me wonder, dispiritingly, if post-natal depression is given more time because there are two people involved by that point. Still, in so much rhetoric and care, the woman alone, the mere vessel, doesn’t matter as much.

What this comes down to is how psychological illness is treated in healthcare, of course. This requires resources and money, but more importantly the communication of guidelines to all staff working within the system – something that should make the treatment of these issues frustratingly simple. After all, sometimes all that pregnant women want is a listening ear, and a mouth that responds. They want the opportunity to tell someone, “this is how I feel when I wake up in the morning… this is how unmanageable things feel when I think that’s something’s wrong”, and then be given some leaflets, or website addresses, rather than flail around in the dark.

Only then can pregnant women start getting on with the business of enjoying their strange, pregnant lives – something we can only do if we can feel happy with ourselves.

Jude Rogers is a writer, broadcaster, journalist, romantic, Welsh woman and geek. Follow her @juderogers

For more useful information on antenatal depression, go to:

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Not into trains: Gender bias & Asperger’s Syndrome

When I tell people that I have Asperger’s Syndrome, I get a variety of responses. Some of the less impressive ones have been: “But you look alright at the moment,” and “I know I’m not a doctor, but I don’t think you have got it.” These have been from people who should know better – people who are, by profession, linked to the world of autism spectrum conditions.

It is perhaps not surprising though, given that almost all of the research, literature and diagnostic criteria have evolved from a starting point in the 1940s when Hans Asperger first identified the condition through studying groups that consisted solely of young boys. He noticed these children were all high-functioning but had difficulties with social communication and displayed repetitive behaviours.

Most people will recognise the same stereotype that is still perpetuated by the media – The Big Bang Theory’s Sheldon Cooper or Coronation Street’s Roy Cropper.

My son was diagnosed last year at the age of seven, with his love of lining up toy trains and regurgitating strings of facts. But during the long assessment period I came to learn that one size doesn’t fit all. My son doesn’t mind eye contact, he has a great sense of humour and he is extremely loving and affectionate. It was when I stumbled across some information on women and girls on the autistic spectrum that it suddenly dawned on me: Asperger’s can look even more different, and I have it too.

Clinical psychologist Professor Tony Attwood writes: “Girls and women who have Asperger’s syndrome are different, not in terms of the core characteristics but in terms of their reaction to being different. They use specific coping and adjustment strategies to camouflage or mask their confusion in social situations or achieve superficial social success by imitation.”

Many women with Asperger’s appear to have no problems on the surface. These girls, perhaps helped along by a higher than average IQ, use intellect to work out how to interact rather than learning it intuitively.

The disadvantage of this is that none of it comes naturally. A conversation with a friend may be accompanied by an interior monologue: Am I making enough eye contact? Don’t forget to ask her something about herself. Keep nodding and laugh at the right times… It is in essence, an act, a conscious effort, which is literally exhausting.

Asperger’s was barely heard of when I was a child, but I can’t help but wonder what difference a diagnosis would have made to me back then. I was lucky I had a large group of girl-friends in high school that I could hide amongst. But when one of my two best friends left for a different college and I had a falling out with the other one, for reasons I never fully grasped until years later, I was left on the edge of a group that I was starting to feel more and more distanced from.

Everyone else was growing up emotionally and socially, but I found the unstructured setting of free periods in the common room to be something far too excruciating to bear. I couldn’t understand the reason for social chit-chat or see the point to a lot of the conversations. I didn’t know how to be part of that. I suffered a kind of breakdown. I was depressed and anxious and most days would either fall asleep in lessons or have to leave the classroom in floods of tears. Years went by of failing to make meaningful friendships, self-medicating, bulimia and eventually, suicidal thoughts.

Many women have similar stories to tell. It is essential girls understand why they feel different to everyone else – they are not defective and it is not their fault. It has only recently started coming to light just how many undiagnosed women and girls remain, and how many young girls are still slipping through the net, despite increased awareness of autism in schools and health and social care settings.

This is because many of the myths of Asperger’s are still circulated as fact. I have attended training sessions that put far too much emphasis on the outmoded theory that autism is a manifestation of the “extreme male brain“, a term first coined by Professor Simon Baron-Cohen.

I also often hear the phrase: “people with Asperger’s have no empathy.” This is not true for many men with the condition, and even less so for women. Many women with Asperger’s join professions such as nursing and teaching, and research now suggests that people with Asperger’s experience higher levels of concern for others when witnessing their distress than neurotypical people do.

Although the medical profession is making advances in its understanding of Asperger’s, it takes years for new knowledge to be disseminated and for mindsets to change. In the mean time, the best all of us can do is talk about women with Asperger’s as much as we can, and hope fewer little girls will have to face a future of mental ill health and unnecessary struggles.  

Michelle Parsons worked for five years for a charity that supports unpaid carers. She has two children with Asperger’s Syndrome; one is a little girl who is yet to receive a diagnosis. Michelle has a degree in Cultural Studies and Creative Writing and has just started blogging at aspergersanxietyadhd.wordpress.com 

Photo: Stephen Woods

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NHA Party: “Your NHS is being destroyed and you don’t even know it”

There is a genuine urgency in the way Dr Louise Irvine talks about her political mission: “Our NHS is being privatised, and people don’t know what’s happening!

“If they did know, they would be completely up in arms about it,” she believes. “And that’s our job. We need a movement to defend the NHS – most people still don’t know that it’s under threat.”

Louise has been a community GP in Lewisham for more than 20 years, and is one of the candidates standing for the National Health Action (NHA) Party’s European election bid this May.

The NHA Party was formed in response to, and with the founding goal of reversing, the coalition government’s Health and Social Care Bill to privatise the NHS. You might not have heard about them yet, but they’re determined to make waves between now and the 2015 general election, and have already gained support from high profile figures including comedian Rufus Hound and author Mark Haddon.

Rufus-150x150Rufus Hound, who will also run as an NHA candidate in the European election, told Feminist Times: “I cannot perceive of what human beings are built for if it isn’t working together. As such, the idea of banding together and creating a system where we look after each other when we get sick seems like one of civilisation’s crowning achievements.

“The fact that it’s currently being divvied up and sold off in the hope that no-one will notice sickens me to the pit of my stomach.

“I looked around for who was trying to draw attention to that fact (and it is a fact), and only one group of people seemed to be doing it. A group of health care professionals who didn’t want to be politicians, but realised that unless they became political, the NHS would die.

“Those folks were the National Health Action Party. Joining them wasn’t a choice – once I’d researched what’s being done to our free-at-the-point-of-delivery health service, it felt more like an obligation.

“Ultimately, I’m just some (very) minor celebrity, but because of the age in which I am a bit famous, I have a big reach – thanks to social media (well, just Twitter, to be honest).

“Knowing I have an opportunity to wake people up to the fact that the NHS is being stolen from us – and knowing that Big Media studiously ignores/obscures that truth – my wife and I decided we had a moral responsibility to do everything in our power to help. So I got involved.”

Meanwhile, in the living room of her southeast London home, Louise is holding fort about the destruction of her beloved National Health Service.

“When the [Health and Social Care] bill went through Parliament, Clive Peedell [Co-leader of the NHA and a consultant clinical oncologist], was so disgusted that he announced we were going to set up a party and stand against them – to fight the Coalition in the ballot box,” Louise explains.

“We’ve fought them every other way – we’ve fought through marches and demonstrations, leafleting and public meetings, and that wasn’t enough.”

As a political party fielding candidates, therefore, the party aims to broaden its reach and, as Louise adds: “if we get anybody elected that’s going to scare the bejesus out of them all.”

Currently, she believes the Coalition “think that the NHS is either not an election issue or that they’ll be able to twist it to suit their own agenda.”

But the opposition isn’t faring much better in her eyes either: “Labour’s been very equivocal about what they’re going to do. Andy Burnham is saying good things, but Ed Miliband is very weak on the NHS – weak on a lot of things.

“Whereas Labour is weak and equivocal and vacillating, I think the Tories are clear,” she says. “They’ve already said there won’t be an NHS after five years of a Tory government.”

This gets to the crux of Louise’s urgency about the situation. In her early teens, Louise was attracted to medicine by the idea of “helping people, putting myself to some kind of service and making the world a better place,” and a youthful idealism borne out of the injustices she was increasingly becoming aware of.

Growing up in Scotland, reading Germaine Greer, Simone de Beauvoir and Spare Rib magazine as a teenager, Louise has always been political, describing herself as “a feminist and a socialist,” with an early interest in left politics and debating women’s issues.

As a medical student at Aberdeen University she got involved in the women’s action group, taking part in Reclaim The Night marches and attending many of the 1970s women’s movement conferences.

After graduating, Louise says: “I wasn’t sure what I wanted to do, and I was quite politically active.” As a result, her first graduate job was helping to set up the charity Scottish Medical Aid for Nicaragua – an organisation that raised money to send doctors and nurses to the Central American nation whose own National Health Service was, at the time, in its infancy.

Although work and family life later took priority over political activism, Louise remains firmly wedded to the belief that “we as a society [should] care for everybody who becomes sick, regardless of ability to pay, and that there should never, ever be any fear of illness from the point of view of ‘can I afford this?’”

For her, the NHS is a “great example of social solidarity, that as a society we stand together and help the weakest and most vulnerable, which should be preserved – not just because it sounds like a nice thought, but also because it actually works.”

Louise already has impressive form where public health campaigning is concerned, having founded and led the successful Save Lewisham Hospital campaign.

From an initial meeting of just 12 people in October 2012, the campaign gathered pace rapidly, with 700 people at the first public meeting, and a staggering turnout of 10,000 protestors for the first demonstration on a miserable day in November 2012.

“We told the police we thought there’d be 2,000 on the day, and that was being really ambitious,” Louise recalls. “Later on we began to get the feeling from doing a lot of street work, going out leafleting and petitioning, that lots of people were planning to come to the demo, so we then said to the police it might be more like 4,000 and the police went ‘nahhh’.”

She laughs: “So yeah, we had 10,000 people. It went with no problems though – the police didn’t need to worry about it.”

Louise’s relationship with the local community has clearly been a big part of her success so far. After her return from Nicaragua, Louise opted to enter general practice because it involved “a whole load of different conditions and problems, and also you were in it for the long haul with people; you become part of a community and get to know people.”

She describes her role as a “therapeutic relationship” between patients and a doctor they know and trust and, sitting with her, it’s not hard to imagine.

Louise’s rallying calls to action make her a powerful and inspiring speaker so, on the one hand, I can fully imagine her manning the barricades in the NHA Revolution; and yet, on the other hand, I can just as easily imagine feeling totally at ease with her doing a smear test or offering advice to an anxious new mum.

“There are a lot of positives about this sort of continuity of care, having a doctor that’s part of the community,” she says. Having been in the same practice for over 20 years, she adds: “I’ve known a lot of patients for many years; I’ve known generations.”

Louise believes that being able to rally the whole community in Lewisham was undoubtedly the key to their success in saving the hospital. “People will fight to defend tangible things that they risk losing,” she says, but is keen to stress the importance of outreach.

“We broke with the main left tradition which is about just talking to people who already agree with you and being snooty about people who happen to be in a faith group or small businesses,” she says.

“We’re not talking about right/left wing here – you’ve got to get out and reach out to people. I think if something matters, like the NHS, it matters to the vast majority of people, whatever their politics are. We kept it as broad as possible and I think that’s why we were successful.”

That same anti-sectarian attitude is carried over into NHA’s election campaign, which Louise says aims to target voters across the board. “People vote Tory or Labour or Lib Dem for all kinds of reasons. There are quite a lot of Conservative voters amongst the elderly, but they are the ones who are actually going to be affected most by the changes to the NHS,” she points out.

“We could definitely appeal to some Lib Dems because they let us down by supporting the Tories bringing in the Health and Social Care Act, and we could appeal to some Labour voters simply because Labour has had a bad track record on the NHS and privatisation, and it’s not speaking out strongly enough about it now.”

As a single-issue campaign with a relatively short-term ambition, the NHA’s biggest battle is convincing the voting public of the tangibility of their cause. “You’re going to lose your local hospital is something very real; what’s going to be happening to the NHS is not yet tangible – it’s still abstract in a way,” Louise says.

It’s particularly difficult to imagine how an MEP candidate standing on a solely NHS focused platform might be relevant on the European political stage, but Louise is, of course, one step ahead of sceptical voters.

“The reason Europe’s important is to do with the issue of the EU/US trade agreement. Most people fall asleep when you talk about this, but it’s not really about trade across borders – this is actually about companies being able to sue the government for any change in law which they think could harm their profits.”

Unless the NHS is exempt from that trade agreement, she explains, “It would make any privatisation of the NHS – which is happening now – irreversible.”

Louise is also keen to stress that the NHA would have plenty to offer the European Parliament on the broader issue of public health: “Europe has a huge amount of jurisdiction on things that relate to health – not just competition law and the possibility of this EU/US trade agreement.

“Europe also legislates around things like the environment, pollution, it regulates medicines and doctors, it regulates doctors’ working hours, it regulates around food labelling and food safety, which is hugely important.”

Beyond the European election in May, she’s equally confident that the NHA can put the privatisation of our health service on the UK’s political agenda ahead of 2015, pointing out that none of the major political parties had environmental policies on their agenda until the Greens appeared.

“One MP is enough to give you a credibility and a voice,” she says, “and someone like Caroline Lucas is very strong and gets that message over amazingly powerfully.

“We need a hundred of Caroline Lucas, but even one can do a lot. If we had one MP or one MEP who’s there on the issue of the NHS, we would be being invited onto Newsnight and being taken seriously – this is the biggest piece of legislation that’s transforming the NHS and the media is hardly covering it.”

Given control of a newspaper publishing empire for the day, Louise’s front-page headline would be simple: “Your NHS is being privatised”, followed by four bullet points laying out why people should care:

“1. It costs so much more to run a marketised system so that money is taken away from frontline care.

“2. It reduces quality because private companies are looking to make money. When 60% of healthcare is staff, the only way to make money is to cut staff, and then the quality goes down.

“3. It leads to fragmentation – most of the gains in cancer, stroke and heart attack care in this country in the last decade or two have come from collaborative work; you can’t have collaboration if you’re all supposed to be competing with each other.

“4. Private companies cherry pick the profitable areas so it undermines and undercuts the NHS, so it actually starts to lead to a breakdown of NHS services, you end up with hospitals in deficit and people want to close them.

“We’re already one of the best healthcare systems in the world – the most cost effective – so it should be improved,” she adds. “It’s not perfect, there are things we could improve, but you don’t improve something by destroying it and then completely rebuilding it from the bottom up with a completely different, untested system.”

Louise’s worst-case scenario is that the UK will end up with “a very divergent two tier system, like they do in America, where you’ve got a basic safety net system, which is not very good, for the very poor and a private healthcare system for the people who are better off.”

This same scenario is part of what drives Rufus Hound’s passion for the NHA: “Healthcare doesn’t work if it’s a market,” he says.

“We live in an age where the political panacea is privatisation. Markets are good at governing all sorts of things – but medicine isn’t one of them. You don’t choose to have chemotherapy if you have cancer. You choose to die or fight. Literally a life or death decision. That’s why marketised medicine is so intrinsically unfair – the desperation that fuels the demand means that the suppliers can charge whatever the hell they like.

“In America – the reigning champion of perverted private medicine – the leading cause of bankruptcy is illness. Even people with health insurance end up broken by medical bills, often due to their “excess” payment.

“The NHS isn’t perfect,” he adds, “but it’s a damn site more efficient and better for us than the alternatives – or at least it would be if it weren’t being vilified by the economic vampires hoping to sell it off to their millionaire mates.”

So what alternative would we see in a world where Dr Louise Irvine was Secretary of State for Health? A return to a healthcare system more like the model they have in Scotland, for a start, she says, where “health boards work out what the [community’s] health needs are and they fund the providers to provide it – which is the model we used to have before Thatcher started bringing in the purchaser/provider split.

“In the bigger picture, I think austerity has been terrible for the poor and that has mental and physical health implications,” she adds.

“I would do something about staff pay and improving staff morale, and we would look at the wider social determinants of health – things like food labelling, housing, some of the social issues like benefits.

“We’d certainly reverse this whole awful Atos work capacity assessment, which is just so oppressive to people with long term conditions and disabilities – that would have to go,” she adds.

Realistically, she acknowledges, we’re not going to see an NHA Government taking power in 2015; instead, the party’s ambition is to “have a huge influence and make this an election issue.

“And, if we get anybody elected, to put the fear of whatever into these politicians – they cannot continue to destroy our NHS and get away with it.”

Find out more about the NHA Party here or follow them on Twitter @NHAparty. You can also follow Dr Louise Irvine @drmarielouise and Rufus Hound @rufushound.

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Profile: Women’s Independent Alcohol Support

Drunken women are laughed at, seen as easy targets for rape, and ‘asking for’ abuse. Women with children who over-drink are in danger of losing them, and ‘being an alcoholic’ is seen as a source of shame and apology for life.

Few women (less than 3%) with alcohol problems go for treatment, and the treatment in any case is likely to focus not on why they need to over-drink, but on stopping it at once and joining groups like AA, which see the problem as an individual weakness to be dealt with by a programme of meetings and lifestyle, developed by and for men, and still found to be uncomfortable spaces by many women.

What is lacking is an understanding of the links between the lives of ordinary women and substance use, including alcohol. Why do some women need to over-drink? Alcohol research is looking increasingly at the way that gender is relevant to how people use alcohol.

Women may drink for different reasons and in different ways, and they may need a different kind of help than is often available. There is strong evidence as to the role of stress, domestic abuse, depression, low self worth, and social isolation. There is also strong evidence of the need for women only services.

Women’s Independent Alcohol Support (WIAS) is a registered charity, run by women who have recovered from alcohol issues and their friends, and which addresses these issues. We are a small, highly motivated group of women, with a feminist perspective, and our social model of recovery is based in personal experience and academic research.

We aim to offer a friendly and supportive ear, and to put women in touch with other organisations who can offer help with particular issues such as domestic abuse and addiction to prescribed drugs. On February 17th 2014 WIAS organised, with Bristol Women’s Voice, the first and ground-breaking ‘women and alcohol’ conference in Bristol – click here to see the programme and presentations.

I founded WIAS, having recovered from alcoholism in 1988 and have since attempted in academic and practical work to influence how women’s alcohol use is understood and how it is ‘treated’. I am often asked: “what’s different about it for women?”

Traditionally, alcohol problems were seen to be something that happened to men. It was men who were seen drinking in pubs and clubs and men who were sometimes seen drunk. A man spending his wages on drink might leave a family without food for a week and often did. It was men who began the famous Alcoholics Anonymous movement, at a time when alcohol problems were understood to be a male problem. It provided a space where they could share their troubles and try to help each other to stop misusing alcohol.

At that time, women’s drinking often consisted of a couple of glasses of sherry at Christmas and half a pint of shandy in summer. Even when drinking wine and other things socially became more acceptable for them, drunkenness was still perceived as shaming, and showing a lack of self-respect as well as lack of proper concern for one’s family.

Women have been reluctant to ‘come out’ about their alcohol use for these reasons and have often preferred to use tranquillisers (‘mother’s little helpers’) and other remedies to help them when their lives were difficult or they were unhappy or even domestically abused. They have often become depressed and suicidal.

Women have emphasised how much they need to have women-only space to talk about how they came to have alcohol problems, what sometimes helps and what doesn’t, and an opportunity just for non-judgmental friendship and support. Unfortunately it can be difficult and expensive to provide this in conventional treatment settings.

WIAS is now a registered charity and plans to run small groups for women, eventually building an interactive website where they can discuss their issues, and holding up to date information about what kind of help is available for women should they be seeking it. WIAS is seeking funding to do these things and to run a helpline, so if you can help in any way please email us. Otherwise, watch our website at www.wiaswomen.org.uk to learn about progress.

WIAS also acts in a consultative capacity and is able to undertake commissions.

You can email WIAS at contact@wiaswomen.org.uk


Staddon, P. (2014) ‘Turning the Tide’, Groupwork, 24 (1)

Wolstenholme A, Drummond C, Deluca P, et al (2012) Chapter 9: ‘Alcohol interventions and treatments in Europe’ in AMPHORA (2012) Alcohol Policy In Europe: Evidence from AMPHORA

Photo: Jesse Millan

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A Womb With A View: The anti-medicine brigade

Blissful, perfect, glorious pregnancy. A woman who is pregnant by choice, rather than chance, floats along like a princess on a cloud. Her child is the centre of everything, the reason for her existence. She is a happy, gracious vessel to the angel growing inside her.

That’s not the Daily Mail approach to childbearing, but the prevailing attitude to modern motherhood – or so it seems to me, experiencing it long-term for the first time. This is my second pregnancy after an early miscarriage a year ago and, 30 weeks in, I can reliably say it’s a messy whirlwind of emotions. There’s excitement and happiness, yes, but also terror and fear, and the people who exacerbate the latter, more than anyone else, are the ones who say they’re there to make it all better – the anti-medicine brigade.

To illustrate this, I’ll begin my first column with a personal, Dickensian story. This Christmas I got ill. A sniffle became a head cold, then a great, gurgly swamp in my chest. Every time I breathed I sounded like a human accordion, but with extra crackle and rattle at the end of each chord.

It being Christmas, and surgeries and chemists being shut, I scurried online for advice from various pregnancy forums. Most of it followed a theme: don’t take any drugs. Try steam inhalation. Concoct a hot drink from lemon, chilli and ginger. I did both, but still sounded like a French cafe busker every time I exhaled. Out of desperation one night, I doused a pillow with Olbas Oil, then looked online the next morning and dissolved into a wreck. Anything could harm your baby, went the chorus. Mum must suffer instead.

I ended up at an NHS walk-in clinic after my third night propped up on three pillows to open up my chest, my third night weeping in bed because I could barely draw breath. A week later, after a course of amoxycillin to treat my chest infection, I was right as rain… but judgement day arrived a few days after that. I made the mistake of telling my yoga teacher that I had been ill (yep, I’m not that un-alternative – my back’s always been dodgy and I’ll try anything to make it not hurt). “How did you treat yourself?” she asked. “Antibiotics,” I replied. Her facial expression suggested I’d said I’d been mainlining heroin.

“What about steam?” she railed. “Oils?” I wasn’t allowed an answer. My teacher moved on to another woman instead, who was anaemic and praised for treating her iron deficiency not through drugs but through diet (my iron’s low too, and you know what – I do both). The night continued from there. I carried on trying to make my dodgy back better while sneers wafted around me – not the most relaxing night ever for someone wanting to make her pregnancy better.

And that’s the rub. This isn’t just a rant about my yoga teacher and her irritation at me being desperate to, you know, simply breathe… but about the anti-medicine brigade and the effects they really have on other pregnant women. You’ll find them in newspapers, on chatboards, in antenatal classes, and constantly in your head. To me, the brigade seem more interested in policing women’s behaviour than improving their situations. Hey, don’t do that. Or do this. Your own needs? Forget them. Call me glib, but isn’t this basically the rhetoric of the right-wing press? Aren’t you, the woman carrying this baby, the one giving them life? As a consequence, shouldn’t you be allowed to exist as comfortably as possible?

I understand why some people don’t want to rely too heavily on conventional medicine, of course. Antibiotics shouldn’t be dished out for every little cold. Big pharmaceutical companies aren’t the greatest businesses on earth. The psychological legacy of the thalidomide has lingered long in our collective consciousness too – but that was half a century ago, and regulation has tightened and hardened like hell. Back then our mothers didn’t worry about every single sip of alcohol and pill they took, but we must. Is this progress?

These days, pregnant women are encouraged to deny decades of regulated, monitored science and behave like martyrs. I ask again: how exactly is it progress for women to deny progress? Because, you know, doctors are bad, girls. And we understand our own bodies, after all. But here’s the biggest thing I’ve discovered about pregnancy: we really, really don’t. Pregnancy is one long trek into the unknown. And the scariest thing about it, I’ve found, is the lack of control that you have – something I’ve experienced first-hand having gone through a miscarriage. Last time round, I ate healthily, rested and didn’t take drugs… in short, I did everything ‘right’, and still it went wrong. This time round, I’ve taken medicine that’s long been approved not to cause harm during pregnancy. It allowed me to breathe, rest and simply be – and surely that’s good for both me and my baby.

After all, before the progress of medicine changed the wellbeing of Western women forever, women ailed, women struggled, women died. This woman wants to be relieved, wants to prosper, wants to live life to the fullest – for both her precious baby, and for herself.

Jude Rogers is a writer, broadcaster, journalist, romantic, Welsh woman and geek. Follow her here @juderogers

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#FeministFatChat: Is Fat Still A Feminist Issue?

Each month Feminist Times hosts an event for our members. After weeks of “New Year, New You!” propaganda from the women’s glossy mags, body image and the diet industry seemed an appropriate topic for our January event. We got together an amazing panel of speakers and asked them: Is Fat Still A Feminist Issue?

There was a huge amount of interest in this event and we had a number of requests to record the discussion for those who couldn’t make it. Check out the podcast below, as well as our tweets from the evening.

A big thank you to our chair Ruth Barnes (BBC and Amazing Radio) and panellists Dr Charlotte Cooper (psychotherapist and fat activist), Natasha Devon (Body Gossip), Audrey Boss (Beyond Chocolate) and Scottee (Hamburger Queen). Thanks also to our hosts Waterhouse Restaurant, Shoreditch Trust and Echo for providing us with such a great venue, and to all the members and guests who came along. Become a member today for free entry to our next members’ event.

We live-tweeted from the discussion using #FeministFatChat – follow the whole discussion, including the Q&A, via our Storify:


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Your dinner’s been spiked

Everyone loves fish and chips, right? Hot and battery, the vinegar fumes gently scorching your eyeballs. Or maybe you’re more of a sushi person, riding the Yo Sushi conveyor belts with raw abandon. Or perhaps you’re more of a shellfish type, happiest scooping mussels from a garlicky bucket or ripping the exoskeleton off some hapless marine insect.

Whatever your inclination, you’re not alone in your fish love. The average person eats around 17kg of fish each year – that’s equivalent to consuming a 4-year-old human child, and we’ve all done that. Today we’re sliding twice as much fish down our oily gullets as we were in the 1960s. Kudos everyone.

Fish is a great source of protein so we should all be extremely chuffed with ourselves. It’s also a fabulous source of flame retardants, which is excellent news if you’re a sofa.

A new study reveals that plastic in the ocean is breaking down into microscopic particles which are harmful enough in themselves, but which also act like tiny lifeboats for grisly toxins from industrial byproducts like PBDE (the aforementioned flame retardant) and PCB (a coolant). The toxins clamber aboard and drift aimlessly, like Robert Redford in All is Lost, until devoured by marine life, and voila – it’s in the food chain.

Pollutants become more concentrated the further you move up the food chain. The tiddlers ingest the plastic and are in turn consumed in large numbers by their predators. These predators are then consumed by a higher level predator (it’s the circle of life, haven’t you seen The Lion King?) and so on, right up to the herb encrusted tuna that’s steaming fragrantly on your plate. I’m afraid someone’s spiked supper.

Many plastics contain chemicals already known to affect human and animal health, mainly affecting the endocrine system. Some contain toxic monomers, which have been linked to cancer and reproductive problems, but the actual role of plastic waste in these conditions is uncertain and there currently isn’t enough evidence to start splashing Daily Mail style hysteria across the globe. But scarily, even less is known about the effects of the toxic hitchhikers.

Some bonkers cosmetic products come with ready-made teeny tiny plastic particles. Exfoliants, shower gels and even some toothpastes contain micro-beads so small they are designed to go down the plughole and straight out to sea. Many companies such as Unilever have pledged to exorcise the evil beads, but not until 2015, so the clever people at Beat the Microbead have stepped in and compiled a nifty list of products for you to avoid  until they’re happily bead-free.

But all this is just the tip of the plasberg. Plastic production has increased 560 fold in just over 60 years and if we continue at this rate we’ll be dumping 220 million tons of the stuff every year by 2025. It doesn’t take a scientist to work out that this can’t be good news for man nor beast.

And it hangs around for so long too. In 2005 a piece of plastic found in an albatross’s stomach bore a serial number traced to a World War II seaplane shot down in 1944. It’s hard not to be a tiny bit impressed by this plucky plastic.

That is until you consider its role in the deaths of hundreds of species – fish, birds, dolphins, whales – who die of starvation, their stomachs bursting with plastic water bottles, carrier bags and the like; or those strangled, poisoned or cut up by our waste.

Something to think about the next time you gob a fish finger. I really hope I haven’t spoiled your appetite.


Rachel Salvidge is a freelance journalist specialising in the environment, with a background in book publishing. Find out more @RachSalv.

Photo: Dan Century

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New Year, New You? Face 2014 with Fatitude

As I’m writing this, I’m snacking on a mini packet of chocolate buttons. Why? Because I bloody well feel like it. I’ve got Fatitude and I’m not afraid to flaunt it. I’ve never gone in for a New Year of restraint anyway. My birthday is on the 3rd of January, possibly the most depressing day of the year to be born. Everyone is skint, three days into not drinking/smoking/eating, and really down about having to go back to work. So I make up for it by completely ignoring “New Year, New You” rubbish.

I may want to ignore calls for unnecessary restraint, but we can’t deny there is an issue with obesity worldwide. It has more than doubled since 1980, with developing countries experiencing the greatest increase. Diet, exercise and radical surgery seem to be failing; so how do we deal with our ever increasing collective waistlines?

I was a contestant in ITV’s Celebrity Fit Club reality TV show a few years back but, unlike my fellow participants, my focus was always on getting healthier, not losing weight. I was a size 26 and now a size 18. I’m still classified as morbidly obese, and told I’m going to die an early death because I like the odd scotch egg. I went from being pre-diabetic to getting a clean bill of health; now the doctors can find nothing wrong with me except the fact I’m FAT. Shock horror. Yes, being fat and healthy is possible; I can only hope that somewhere in the world a Slimfast factory is imploding at that radical but entirely factual statement.

Changing our mindsets to engage with an alternative approach to weight and health will require a pretty massive shift. The media has twisted and distorted what healthy looks like, and the tools used by the medical profession to determine “healthy weight” reinforce this. The BMI index has been proven to be flawed; we need accurate ways to determine health and wellbeing. Or maybe we just need to fundamentally reconfigure how we judge health and wellbeing. The work done by Dr Linda Bacon, nutrition professor in the Biology Department at the City College of San Francisco is pretty impressive. She is the originator of the Health at Every Size movement, and promotes self-acceptance, physical activity and normalised eating as a way to healthy living, no matter what size you are. Respect for the diversity of body shapes and sizes is at the heart of HAES. I think its resources should be available to all girls in school.

Along with compulsory sex and relationship education, serious and desperately needed improvements could be made in the way girls see themselves, each other, and relate to boys and men. Engaging with Health at Every Size will also aggravate the diet industry, which can only be a good thing. Weight Watchers reported profits of $64.9 million last year, all made on selling a dream based on fail-and-return. Their overpriced and nutritionally poor ready meals are another profit boosting, morale-destroying tool of oppression. I nearly smashed bottles of their “low-calorie wine” in the aisle of my local Tesco just before Christmas. At 60 calories a small glass, it’s the same calorific count as any other wine on the shelf, but twice as tasteless (so I’m told). The diet industry and all its permutations needs to be named and shamed as one of the main perpetrators of low self esteem and economic opportunism against women.

There are impressive women making a difference, though. My personal chubby heroine is Dr Charlotte Cooper. She is an architect of Fat Studies, an emerging academic field which gives a more critical understanding of social positioning of fatness and health. She sits on the board of Fat Studies Journal and is a psychotherapist who works mainly with fat people. She is the author of Fat and Proud: The Politics of Size, and has originated events such as the Fattylympics and Big Bum Jumble, a plus size jumble sale. Most importantly, Dr Cooper insists political activism is the key to a healthy future. No matter what size you are, no one can argue with that.

Amy Lamé is a writer, performer and broadcaster. Follow her @amylame

Photo: gaelx

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Comeback: Running? It’s just jogging

Feminist Times reader Katie Stanton responds to Deborah Coughlin’s article Running? It’s just jogging.

I could write a book about my history with dieting and I’m sure you could too. In the same way a man chats easily with a complete stranger about football, we women always seem to find calorie-related common ground when meeting other women (“No cake for me thanks, I’m being good”).

Poor body image is one of the most prevalent issues facing women today, proven by statistics showing 91% of those admitted to hospital for anorexia last year were women. For many feminists who suffer body image issues, there is also the added guilt of caring about it in the first place.

Most feminists are inherently anti-diet and there’s some great writing on why the dieting culture is a form of oppressive patriarchy (Susie Orbach’s Fat is a Feminist Issue is particularly good).

In the past, I have denounced any effort to burn calories to stay thin as anti-feminist, and I’m sure I’m not the only one. I used to read about women spending hours in the gym, slaving away towards size eight, and imagine myself saying to them: “Emily Davison didn’t throw herself under a horse so you could spend half your life on the treadmill.” Did I think myself morally superior to these women because I wasn’t spending my time working towards a thinner version of myself? Probably.

But then I started running. And all that stuff they say about endorphins is true. Suddenly, I was not only healthier, happier and sleeping better, but my life became more goal-orientated, on the track and in the office. All that time I now spend flailing around the streets of Leighton Buzzard gave me time to think about my previous preconceptions of gym-goers and how I fit into my big feminist ideal now that I’m a runner.

Here’s what I decided: The London 2012 Olympic and Paralympic Games gave us all an insight into the exhilaration of sporting victory. Here was a form of empowerment that needed to be tapped into. Worryingly, it struck me that the factor of good health was something feminism shied away from. Was the need for regular exercise being ignored because it sat too closely to the diet industry? Statistics show that 32% of women in the UK are overweight, so why is this women’s issue not being addressed? Where are the feminists against obesity?

I don’t write this to make you feel bad; in fact, quite the opposite. Let me reassure you I think fad diets are fucking repulsive and a societal scourge that oppress women. The best thing I saw at October’s Feminism in London conference was a teenage girl’s placard reading “pizza rolls not gender roles”. I want us to carry on eating pizza. But I don’t want us to ignore the benefits of exercise in the name of feminism. A healthy lifestyle is really important and it is possible to keep fit without selling your soul to the diet industry. Find a sport or activity that makes you feel empowered and go with it. When the revolution comes, we can’t be held up by those stopping for a fag break. For years feminism has demanded that society respects our bodies, so isn’t it about time we start doing the same?

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VIDEO: Afghan Women’s Rights – A doctor’s story

To coincide with International Human Rights Day, Amnesty International today launches two short films on women’s rights in Afghanistan, telling the stories of two women: a teacher and a doctor.

The second tells the story of Dr D, an Afghan gynaecologist, recounted by Dr Caroline Wright – a gynaecologist at Epsom General hospital, Surrey.

Dr. D. works as a gynaecologist providing healthcare to women suffering from abuse, including rape and domestic violence.  Here she tells Amnesty International how her family was targeted by the Taliban as a result of her work. 

The problems started back in 2007 when I was living in Kunar province. I was working in a clinic frequently carrying out abortions on girls who had fallen pregnant after being raped by their male relatives. There were different kinds of cases, for example, girls pregnant by their uncles, others by their brother-in-laws. They came to my clinic because they had to have an abortion [or they would have been killed by their relatives or members or their community as an “honour” killing]. I would receive threatening night letters and phone calls from the Taliban, warning that they would kill me and my family because of my work.

Two years later, in March 2009, it was evening and I heard an explosion and rushed outside. My children had been playing in the front yard. My 11-year-old son was very badly wounded and lying on the ground. I was shocked and don’t remember what happened next.

My son had to have medical treatment for almost a year and we were busy moving him from hospital to hospital. The incident badly affected him. He became mentally ill. He is always tired and depressed and always asks why this incident happened to him.

Six months later, my 22-year old brother was also killed in a grenade attack in front of our house. They threw a grenade at him while he was walking to our home. We have suffered a lot in our life.

We reported the threats to the government, but nobody listened to us and we have felt very discouraged. They have done nothing so far. I tried to seek justice and asked the government agencies to find the perpetrators, but they ignored us and did nothing.

We moved from Kunar in 2009 after my son was wounded in the grenade attack.

Now I have stopped doing abortions and keep a low profile at work. Nobody knows my address. If they know my whereabouts they will start threatening me again.

The situation here is very bad for women.  Women have problems going out to work and girls are prevented from going to school. There are too many cases of violence against women. I have witnessed 30 to 50 cases in a month. When I tell [the women] to report their case to the police they refuse because their family would be ashamed of them and would treat them very badly. They don’t go to the police and they tolerate the violence and harassment.

We have to help our people, particularly women, they need us and we have to serve the country and the people. I can’t sit at home and doing nothing, this is not in my nature.

* Dr D’s name has been withheld for her safety

For more information about the film campaign, follow @AmnestyUK

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London Feminist Film Festival: Body Politics

Alisha Rouse attended last week’s London Feminist Film Festival at the Hackney Picturehouse for us. In the first of three short blog posts, she reports back on the opening session, Body Politics.

It’s been 40 years since Our Bodies, Ourselves came out and caused a right raucous by suggesting that body image, transgender issues and abortion were things women could claim ownership of.

Down here in the 21st century, and the Sunday before last, in fact, ‘Body Politics’ was the premiere session at the second ever London Feminist Film Festival.

A great, week-long film fest based at the Hackney Picturehouse, the opening session featured three feminist documentaries dealing with women’s ownership and power over their bodies.

The Cut was a deeply upsetting film documenting FGM in east Africa, where girls are circumcised from as young as six. FGM is an extreme but very real example of body politics for women living in these communities, and for many women in our own.

The politics of body ownership are still hugely up for debate. More women, like Texan senator Wendy Davis, are standing up (albeit not for as long as Wendy did, bless her) and trying to gain the most basic rights to self-determine the life of their torso and its inners.

I’ve asked some of my friends about this, and as expected, the responses were pleasing and generic.

“So, who owns a woman’s body?”

“The woman, obviously!”

“Do you think a woman has a right to choose what happens with her body?”

“Of course!”

“Good! Well done, right thinking individual.”

“No problem, Alisha!”

But when push comes to sexist shove, the packaging of body politics may have changed, but the product is just the same. While the majority of right-thinking men, women and politicians (a breed of their own) consistently state that a woman has the right to govern her own body, it’s rare that insinuations of male or societal ownership don’t come creeping through.

Still Fighting: The Story of Clinic Escorts showed women and men abusing people on their way into abortion clinics in America – and in liberal-thinking New York state, no less.

In the style of Shirley Phelps and the far-holier-than-thou Westboro Baptist Church, there were placards and Hail Marys, as pretty amazing volunteers escorted women into the clinic, surrounded by vile and unfaltering hatred.

Being in a north-eastern state, the documentary was even more frightening. With Davis filibustering for what felt like days to make sure abortions in Texas weren’t restricted, while still refusing to mention the A word in her political leaflets, the US seem to have no visible heroes for the self-determination of women’s bodies, except these amazing ladies in hi-visibility jackets.

Back in the UK, Blank Canvas, a short but sweet documentary, gave us all hope. A woman suffering from cancer and going through chemotherapy, opted to henna her bald head rather than getting a wig, using the canvas as self-expression: expression that she needn’t pretend all is fine; needn’t look a way that makes non-sufferers feel more comfortable; and needn’t suffer from the lack of control cancer gives you over your body.

She took control, and we all need to learn something from that.

Alisha Rouse is a Newspaper Journalism MA student at City University, desperately missing the north and praying for a job. Find out more @alisharouse.

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Older women in the northwest rally to save our NHS

“The NHS is one of the best things about this country and this government is going to ruin it,” says Sue Richardson, one of a growing number of women who have become active in campaigns to oppose the privatisation of the NHS. In her 60s and a publisher of local history pamphlets, she reflects the new intake into one of the most vibrant political campaign in this country, Keep Our National Health Service Public (KONP).

KONP was started in 2005 by Jacky Davis, radiologist, and John Lister of Health Emergency together with other health professionals to oppose the Labour government’s introduction of the private sector into the NHS. The umbrella organisation has over the last year galvanised opposition to the coalition government’s Health and Social Care Act 2013 which, Davis says: “has aggressively pushed privatisation and dismemberment of the service.”

Richardson lives in a village outside Bolton in Greater Manchester and decided to join KONP when her local hospital A&E was threatened with closure: “Both my late mother-in-law and husband were treated there and I was really suspicious about the bad publicity that came out about the hospital just before they announced the closure of the A&E.” Over the last year she has petitioned, attended meetings and demonstrations and become an active member of her local group.

For Terry Tallis, a social worker for forty years, her own experience has informed her political campaigning: “I have seen at first hand the effect that social and medical misfortune can have on people’s lives and why, today more than ever, we need our health and welfare services”.

Tallis is now chair of her local pressure group, Stockport NHS watch, and spends her time lobbying locally to raise issues about the ongoing privatisation of NHS services.

Both Richardson and Tallis attended a meeting in Manchester in February of this year when over one hundred activists gathered together to form the umbrella organisation, Greater Manchester KONP. Tallis says: “It was very reassuring to see so many people with the same values and objectives as us gathered together in a city such as Manchester, which has such an important labour history.”

Over the last year, Greater Manchester KONP has led the campaign in the northwest to publicise the massive changes being rolled out in local and national health services. The Save the Bolton A&E campaign has led to Richardson petitioning in her local village, as well as taking part in the massive TUC demo in Manchester last month. She says: “It has made me more politically aware and I have been impressed with the committment of the other people who are involved with the campaign.”

Tallis says she has been encouraged by the growth of KONP across the region: “The NHS is one of this country’s greatest achievements, it has been there for all of my life, and to see it being deliberated dismantled is horrifying. What was ours – is ours – is being stolen from us.  We must act to stop this theft.”

Bernadette Hyland is a freelance writer based in the Manchester area, writing about feminism, class and culture for theMorning Star, Big Issue in the North and the Guardian. Find out more at http://lipsticksocialist.wordpress.com

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Garry Mulholland

#ManWeek: How to be a man – Mid-Life Crisis

The most loved television show of the last few years was not, in the final analysis, about crystal meth, cancer or severed human heads on turtles. Breaking Bad resonated because it was about a middle-aged man who had failed as a provider, and therefore, in his eyes, as a man. Walter White took somewhat extreme measures in his attempts to regain control of his recession-hit world. But take away the drug money and elaborate violence and you’re left with a familiar story in the 21st century western world: an impotent 50-something trying to relocate his penis in an unimpressed world.

My mid-life crisis hit ten years earlier than Walt’s. If I’d been outstanding at chemistry maybe I would have considered becoming a drug kingpin, but a key part of my meltdown was an overpowering feeling that I wasn’t outstanding at anything. This meant that the popular, almost jocular view of mid-life crisis – you know, middle-aged bloke confronts mortality, buys sports car, pulls young hottie with Daddy issues, starts running half-marathons – didn’t have a great deal to do with my nightmarish 40th year. I contemplated mounting debts and failing career, and crashed. I drank too much, ran up more debts, became depressed, contemplated suicide, had a complete nervous breakdown, and bottomed out, not in some dramatically resonant crack house or dark alley, but at A&E in a hospital in Chichester, with my sister-in-law holding my hand while I gibbered and sobbed to the duty psychiatrist. He offered me happy pills or sectioning. I opted for something dreamy in pink. And so began a ten-year climb back to the point where I can actually write about this without shaking and clinging on to a small cardboard security blanket with Mirtazapine written on it. I’m winning like Charlie Sheen.

So… what is my magic formula for a successful journey from 40 – worst year of my life – to 50, one of the best? Again, you may be underwhelmed. I took the medication for six years. I went into therapy for two years. And I clung on to my happy marriage for dear life. That last one was the pathway to what I actually needed to do, rather than distract myself with chasing teen-twenty totty or taking up skateboarding. I needed to get real.

As my 40th birthday slump hardened into something darker, I increasingly convinced myself that I was the worst man living. Working-class men are supposed to be salt-of-the-earth providers, and I was a very bright working-class man so, by the age of 40, I should have been wealthy, famous, universally respected and able to lavish my wife, son and mother with holiday homes in Cancun while bankrolling their own successful businesses. Instead, I was a failed and anonymous writer with mounting debts, living in fear of bailiffs and – and I want to stress that this was the depression-induced paranoia talking – the rest of the media world pointing and laughing at the ghetto brat who had dared to share space with the Oxbridge set. One of the horrors of depression is its narcissism. The media world was far too busy to notice me, never mind collude in collective Garry-taunting.

So, in the spirit of getting real, I took the therapy seriously and realized that the black hole sucking me in used money as its most potent magnet, but was actually made of the same kind of childhood issues that everyone else had. I’d repressed them for so long that I’d developed them into shadowy beasts with loud voices, loud enough to drown out all the real voices around me, like my wife’s, when she would tell me how much she loved and admired me. She must be lying, the beasts roared, and I believed them and took my self-loathing from there.

The therapy didn’t cure me, exactly, but it introduced my self-image to my real self, made us some tea and sandwiches, encouraged us to hang out to see if we got along. Ten years down the line, and we get along pretty well. I still don’t trust the notion of loving oneself – sounds like megalomaniac kinda business to me – but I began to realise, a few years ago, that I quite like real Garry, with his fear of failure, uselessness with money, tendency towards solipsism, but also decent amounts of intelligence and talent, loyalty to his loved ones, ability to open up and be open. Garry’s alright. And now he’s past medication and suicidal impulses, and managed it without abandoning his marriage or his family, he’s a little more alright.

So, eventually, I got my penis back. I’d missed him, funny little fella. Whether Walter White would see my crime and cash-free recovery as possession of a truly thick and meaty Heisenberg, I doubt. But I related much more to his apprentice Jesse Pinkman anyway. Young and pretty (some self-images die harder than others) and buffeted hither and thither by powerful forces he’ll never control. His future is uncertain. But at least he’s alive.

Garry Mulholland is a journalist, author and broadcaster. He has written four books on music and film published by Orion Books, including This Is Uncool: The 500 Greatest Singles Since Punk And Disco. Find out more @GarryMulholland

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#ManWeek: Feminist Toolkit – Psychoanalysis

Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways.‘ ― Sigmund Freud

Psychoanalysis is a theory of the mind first brought to the world by Freud, a neurologist whose early theories emphasised the repression of sexual desire, incest fantasy, and penis envy.

Since its conception in Vienna in the late 19th Century the discipline has changed with the advent of the neo-Freudians and feminist psychology. From the psychoanalytical hiatus in the 20th Century to the rebirth of biological psychiatry in the 1970s, psychoanalytical theory remains integral to the understanding of mental processes, and provides us with a model with which to try to understand a little of that most complex of organs: the mind.

Psychoanalytical theory started with Freud, but it developed into theories that encompass the personality and development, object relations (both internal and external), the understanding of the self, and much more. But its influence is not limited to the fields of psychology and psychiatry. Its application can help us understand the world around us; the arts, literature, philosophy, sociology and politics.

As humans most of us unknowingly practise the art of psychotherapy, with the engagement in empathic listening to our friends and family. This ability to reflect and understand allows conflicts to emerge into the conscious mind, which forms the basic premise of relief from the psychic pain and distress associated with them. Psychoanalytical theory offers us language with which to recognise these underlying conflicts.

The basics:
• Freud conceptualised the human psyche into the Id, Ego and Superego.
• The theory gives recognition to the fact that many mental processes happen without conscious understanding.
• According to Freud the Id is: ‘…the dark, inaccessible part of our personality…. We approach the Id with analogies: we call it a chaos, a cauldron full of seething excitations…. It is filled with energy reaching it from the instincts, but it has no organization, produces no collective will, but only a striving to bring about the satisfaction of the instinctual needs subject to the observance of the pleasure principle‘. Sigmund Freud, New Introductory Lectures on Psychoanalysis (1933)
• The Id is the set of innate instinctual desires that we strive to satisfy. It is present at birth and is the unconscious will to satisfy our needs, including sexual and aggressive drives.
• The Id acts in accordance with the pleasure principle, which seeks to provide immediate gratification to any impulse, and to avoid pain and unpleasure.
• The Ego serves as the self, the conscious aspect of our personality which also acts in the unconscious. It acts to satisfy the Id, but in a way that is morally and socially acceptable, acting according to the reality principle.
• ‘The Ego represents what we call reason and sanity, in contrast to the Id which contains the passions.’ Sigmund Freud, The Ego and the Id (1923)
• The Superego is a set of internalised moral standards and ideals that we have developed. This includes standards from our parents, or childhood caregivers, and from society in general. It serves as our view of right and wrong, and attempts at an unconscious and conscious level to suppress the unacceptable drives of the Id, and make the Id act in an idealised way.
• The mind in this model can be seen as an iceberg, where only a small conscious part of the Ego and Superego is visible. Below the surface lies the larger area of conflicts and desires, where the Id resides with the remaining Ego and Superego.


Conflict between these aspects of our mind causes psychic tension or anxiety, and the mind deploys defense mechanisms to decrease the level of tension. Defense mechanisms can be adaptive and helpful and allow us to manage a problem for a certain amount of time until we are able to deal with our internal conflict. However defense mechanisms can themselves cause problems in our functioning and serve as overused methods of dealing with anxiety and distress that distort our reality.

Some examples of defense mechanisms employed by people to manage psychic pain and distress include:
Denial: The outright refusal to face reality. Frequently seen in people with drug and alcohol problems who deny their use is problematic despite the growing dysfunction and chaos in their relationships and life.
Repression: This acts to keep information out of our conscious awareness, such as the movement to the unconscious of traumatic memories of abuse or neglect.
Regression: A mechanism to regress back to a more childlike and dependent way of being to cope with distress. This can be seen in people facing hospital admission accepting painful tests and restrictions that they may have refused without the stress of their illness.
Displacement: If we feel afraid or otherwise unable to express our feelings of displeasure to the cause of our distress, we often will displace them elsewhere. This may include external displacement. The common example in everyday life is evident when we take out our frustrations at our boss by returning home to take this anger our on our family or friends. Self-harming behaviours can be seen as aggression inflicted on ourselves to deal and cope with anger at others.
Projection: Externalising unacceptable feelings and attributing them to others. For example feelings of guilt may be projected onto another with associated false accusation. This can be seen in a partner who is having an affair being suspicious that their lover is also cheating on them.
Reaction formation: Doing the opposite to that which we are driven to do and obscure unacceptable impulses. For example a drive to excessive cleanliness may obscure an internal unconscious desire for mess.
Rationalisation: An unconscious impulse is justified by a rational explanation. Consider Aesop’s fable of the fox that could not reach the grapes, and rationalised that they were sour anyway. The fox successfully defended against the psychic pain of his unfulfilled Id.
Sublimation: Can be seen as the conversion of an unacceptable impulse into something that serves a higher purpose such as a person with aggressive impulses sublimating them into a sport such as boxing.

Anna is a Psychiatrist, feminist, mother of one preschooler and fan of the arts. Follow her here @annacfryer

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Fit is the new Thin

Twice in the past couple of months I have been told by enthusiastic brand-hobbyists that Special K is changing it’s “message” and that this is probably good for feminism. No longer is the cereal about being slim enough to fit in that red dress, no my friend, now it is about being “healthy” enough to fit in that dress. The hobbyists continued: this is to be seen as part of a massive cultural shift that includes that trend “running”. Diets, size zero, meal skipping, purging, speed, these are all out. Health is King and Fit is in.

Fit, only one letter away from Fat, its out of breath sister, is all about being who you really are. You really are a warrior, an athlete, a competitor, an animal, built to chase, build and carry. You are a biological machine, measured and capable of balance. Food is fuel and thousands of people find themselves jumping up and down in their bedroom, before they can sleep, just to get their Nike Band in balance.

The Sunday Times declared 2013 the year of ‘Fit not Thin’ with Daisy Lowe as their ambassador for a summer ‘campaign’ of the same name. Lowe, the model, can dead-lift 80kg and finds it empowering. She would rather be Fit than Thin she says, but is this the choice the majority of us worry about?

Fit, I am afraid, is Thin but in trainers. It’s no easier to obtain, no easier to stick to, no cheaper to join than all the thousands of useless diets, shake programs and aerobics lessons many of us have failed at.

Fit is just as aspirational as Thin. It’s as cool, sexy and powerful. Successful people squeeze in fitness before work, they don’t hit snooze and make excuses. They do not end up getting carried away making a running playlist and forgo the actual run.

The trick of this idea – the idea underpinning the rebranding – is of course that you will be thin if you are fit. You will be sexy, energetic and fun. I can appreciate that exercise has incredible benefits for both body and mind, and that women need to hear that something is just as good if not better than Thin, but Fit is just not as uncomplicated as it may seem.

When aimed at a teenager who is starving themselves, spending their evenings into nights on pro-anorexia social networks, would the new choice ‘fix’ them? Of course I’d rather my anorexic and bulimic friends had taken up yoga instead of downing laxatives, though of course most of them excessively exercised as well. The most ‘healthy’ people I know are recovering anorexics who have found an acceptable new way to control their bodies.

For me, as one of the majority of women in the UK who is neither fit nor thin, and certainly not managing to control her body, this new message falls on cynical ears. Nothing more than a new sales patter, a more socially acceptable form of the traditional weight-loss industry in an era when both anorexia and obesity are rising; a rebranding where the inferred wisdom is you can be any size and Fit. But of course, Daisy Lowe is both Fit AND Thin.

In this year’s Jacques Perritti BBC Documentary series The Men Who Made Us Thin, we discovered that the in/out calorie “balance” does not work for everyone, that the gym industry knows exercise does not help people lose weight long-term and that it is possible to be both Fat AND Fit. This all means that we are not machines. What is balance for one person causes another to fall down.

Fat is very much a Feminist Times issue. When Liz Jones said that the Feminist Times had no right to do a piece on the burning of Spanx because our editor is very thin, she was unaware that the Deputy Editor (me) is a size 20. I do not believe the commodification of “Fit” is the answer to obesity or anorexia. Telling us we’ll be healthy if we eat a cereal is no better than telling us we will be thin, if it’s not true. Telling us a Playboy model is fit instead of thin is no more helpful either. And neither message is “good” for feminism.

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Feminist Toolkit: First Aid

Every week Feminist Times bring you an essential skill you need in your Feminist Tool Kit. 

From First Aid, to unblocking loos blocked with wet wipes, to writing your PhD Dissertation and taking the radiator off the wall – we want to hear what you want in your kit.

Email editorial@feministtimes.com Subject: Toolkit


It’s a Monday morning, mid summer, you’re working on the launch of a new feminist magazine, have a to-do list the size of your forearm and are coffeed up to your eye balls.

Working from your Editor’s kitchen, with her kids at home, means that your boss is very often multi-tasking between wiping bums, bike repair, lunch making and commissioning amazing content.

In amidst this whirlwind of activity she goes to empty the dishwasher, her hand slips, a glass smashes on the hard sideboard, the jagged remains falling to the floor scewering her foot on the way down.  It’s summer so she is only wearing flip flops.

“Mummy” screams her oldest as blood begins pouring onto the floor.  What do you do?

  1.  Sit the patient down and raise her foot.
  2. Be calm, explain to the oldest child that you need a phone, first aid box and some clean towels.
  3. Look at the wound and check there is no glass in it.
  4. Press hard on the wound with clean towels to stop the bleeding.  Keep the foot up in the air.
  5. Try to clean the wound with water/antiseptic.
  6. Bandage tightly.

Arrange childcare and take the patient to A&E so they can xray to check there’s no more glass in the wound and stitch it up.




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Radical Agony Aunts: “too much of a turnoff”?

Dear Radical Agony Aunts,

I’m single and haven’t had the courage to attempt a relationship since I had breast cancer some years ago. A couple of years after the cancer I had plastic surgery and I think they did a rubbish job; I think it’s unsightly and I have no sensation in either breast. They did another operation to try to fix it with only slight improvement. I was worn out by surgery and refused to let them try again. So now I have what I think is a body that no person could ever feel aroused by. And a relationship has to have a sexual element, doesn’t it? Well, I want sex! I keep thinking through scenarios where I meet someone who’s attracted to my personality but when we try to go to bed they just can’t get aroused by my body and say “no, it’s just too much of a turnoff”.

I hope this isn’t taken as in any way insulting other women whose bodies have been damaged by breast cancer. Lots of women are already with a partner when cancer strikes and their partner simply continues to love them. But there are probably also lots of women like me who weren’t in a relationship at the time and who now don’t have to confidence to attempt it.

I doubt that more surgery would help and in any case the NHS (can’t afford private) might not be willing to do it now so many years have passed. I’m 46 and hetero. It was many years ago that I had the cancer. It’s been a long time.

Duh that reads back as very depressing. On the other hand I’ve always been a FEMINIST and that’s something to feel good about. Yes!

Personal agony aunt

Personal agony aunt

The Personal’s response:

Dear Feminist,

You’re right, it IS something to feel good about – and you’re here and you’re well and you want something new. Congratulations!

I started down the wrong road when I first read your email. I spoke to a breast cancer survivor friend about her experience, I searched the Breast Cancer Care website for answers, I thought about conversations you might have with your doctor. Wrong approach.

Because as you say, confidence is what you’re missing. If you had your version of “perfect” boobs, I’m guessing you’d still feel nervous about a new relationship. I can’t deny body image has a huge impact on our confidence. We’re constantly under pressure to conform to some notional ideal and force-fed images of “perfection”. We all feel that pressure all the time, but it’s all a lie. There’s the actual lie of airbrushing and other digital manipulation. There’s also the lack of truth and the artificiality of us plucking every hair, whitening every tooth, whittling our bodies down so we can be the pocket-size dolls these images say we should be. But you and I are feminists, so let’s not breathe life into that lie by believing it. We know there is no perfect woman. There’s only you and me, and our friends, sisters and mothers with the various pesky body parts that we love or hate, but which are never going to add up to the perfect ten. There’s only our beautiful individuality.

But exposing that individuality needs confidence. I once dated a few people through a phone-based singles service. The initial phone chats were great – we were witty and flirty and could be anyone we wanted. But then the “So… shall we meet up?” question would arise, and suddenly everything seemed scarily serious. But how do we get what we want if we can’t open ourelves up to it?

All I wanted to be when I grew up was a fiction writer. I dabbled but never took it seriously enough or worked hard enough to make it happen. I read a lot of “how to write” books, I joined a number of writing groups, I went to conferences. I made time for all of that but never put the hours into writing. And now in my day job away from agony aunting, I do write for a living – fundraising and communication for a charity whose aims I respect. So I kinda like my job, and it’s kinda got a creativity to it, and a regular salary is nice – but I know I haven’t achieved my ambitions. And that’s because I haven’t taken risks. Sound familiar?

I don’t want to play down your issues with your breasts, especially the lack of sensation. Medical knowledge and response to breast cancer is increasing all the time. If you can bear the thought of putting yourself through it, maybe there are more up-to-date approaches that can help, even in the NHS.

But whether or not you decide on more medical intervention, exposing your body is a big deal. Exposing yourself to the possibility of something new feels even huger. You might be disappointed. You may meet some fools. It’s going to be hard to start with, but you have to risk it.

You survived cancer, lady. Don’t be afraid that dating will be too big a challenge. We can spend a lifetime waiting to feel brave. Or we can just be brave.

Political agony aunt

Political agony aunt

The Political’s response:

Dear Feminist,

In search of the conceptual key to your problem, I returned to Deleuze and Guattari‘s notion of the body without organs (in A Thousand Plateaus). Basically, the concept of the “Body without Organs” is a critique of the notion of the “body as such”, the natural body. The “body as such” is for Deleuze and Guattari the “organised” body, the body that has been defined by utility, by its separation into distinct, zoned, functioning and comprehended elements (a breast is for sucking, etc.). That process of definition/organisation is always repressive.

For Deleuze and Guattari, almost every imaginative activity of men and women – including sexual activity – is evidence of the fact that we cannot be reduced to the fact of our merely organic existence. Insofar as we see the breast as a “normal” part of the female body, as having a beautiful (that is to say, natural) form, and as necessary for the attraction of a sexual partner, we are existing in a highly normative and repressive system of the body, the ultimate logic of which is theological.

For Deleuze and Guattari, the only body worth talking about is not the organized body (the medicalised, zoned body reduced to its functions, the “body as such”), but the Body without Organs: a body that is always in the process of being produced. For in fact, there is nothing natural or given about the “natural” or “organic” body:

“The BwO is not opposed to the organs; rather, the BwO and its ‘true organs’, which must be composed and positioned, are opposed to the organism, the organic organization of the organs”.

Even the organism is produced: “The organism is not at all the body, the BwO; rather it is a stratum on the BwO, in other words, a phenomenon of accumulation, coagulation, and sedimentation that, in order to extract useful labor from the BwO, imposes upon it forms, functions, bonds, dominant and hierarchized organizations, organized transcendences.”

Desire, for Deleuze and Guattari, is a force that cannot be contained by these processes of organization (“sedimentation and coagulation,”), which are for Deleuze and Guattari counter-productive forces: ways in which the dominant society (for want of a better term) attempts to discipline and regulate the productive forces, which are desiring forces. Desire, for D&G, has nothing to do with fulfilling a primary “lack”; nor does it have anything to do with pleasure (Freud’s “pleasure principle”); nor is desire about fantasy.

In fact, all these “explanations” are for Deleuze and Guattari ways in which the BwO is regulated and normalized. For D&G, desire has everything to do with production, i.e. with the project of creating the BwO. Desire is creative: it’s a wholly positive force; so masochism, for example, is not a “symptom” of a childhood trauma (as it was for Freud), but an example of the project to produce the BwO that is entirely of a kind with the projects of painters or writers: none of these activities should be subjected to interpretation, but should instead be considered as experiments, “programs,” undertaken in the cause of the BwO.

The other D and G would advise you to be more perverse, to denormativize the breast, indeed, to see the very normalisation of the breast as the perversion of a repressive society founded on the fascism of the normative body.

For what it’s worth, D&G would fancy you more than before. Hope this helps.

Further reading: Gilles Deleuze and Félix Guattari, “How Do You Make Yourself a Body without Organs?” A Thousand Plateaus: Capitalism and Schizophrenia, trans. Brian Massumi, Minneapolis: University of Minnosota Press 1987, pp. 149-66.

Email your questions and dilemmas to agony@feministtimes.com

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