All hormonal contraceptives carry a small increased risk of breast cancer, according to new research which focused on progesterone-only pills. The analysis indicates that progestogen use is associated with a 20-30% higher risk of breast cancer, which declines after stopping use.
The research has renewed concerns over access to reproductive healthcare in the UK. Why does the contraceptive burden still lie with women and people with uteruses? And why are existing contraceptive methods so fraught with side effects and inconveniences?
The British Pregnancy Advisory Service (BPAS) highlights that innovation in this area of women’s healthcare is being hindered by “archaic abortion laws,” which class methods that work after an egg has implanted in the lining of the womb as abortions, which are criminalised under UK law unless the person meets the criteria for exemption.
A BPAS survey in 2015 found that 48.4% of women (out of a sample of 1000) would consider a once-a-month pill that could work after a fertilised egg has implanted in the lining of the womb. But under UK legislation, anyone who used such a pill could be prosecuted and jailed.
GLAMOUR spoke to Katherine O'Brien, the Director of BPAS, about the potential benefits of a once-a-month pill, what's stopping it from being developed, and why women and people with uteruses deserve better.
It's estimated that 78% of men would take contraception, but they fear the potential side effects.
Available methods of contraception largely work by stopping sperm from reaching an egg, preventing a fertilised egg that will implant into the lining of the womb. We don't have any contraception methods that work post-implantation, AKA after the fertilisated egg has implanted in the womb lining. The 'morning-after pill' prevents fertilisation by stopping or delaying the release of an egg (ovulation), which means it must be taken within a certain period after having sex.
“From the moment a fertilized egg implants into the lining of the womb under our current law,” Katherine O'Brien explains, “that's classed as a pregnancy, and therefore, anything that happens after that point would be seen as an abortion and needs to be regulated as such.”
“Research shows that 48.4% of women would consider post-implantation contraception – don't their preferences matter?”
O'Brien further highlights that for many people, it seems “ridiculous” that only “long-acting methods, whether it's a coil or an implant” are available: “every day you are receiving some kind of medication, you are taking a pill, or you've got hormones being released into you.”
Daily contraception methods undoubtedly suit many women. Moreover, some won't be comfortable taking a post-implantation pill. But BPAS's research shows that 48.4% of women would consider post-implantation contraception – don't their preferences matter?
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In theory, a post-implantation pill – providing it passes rigorous testing and safety regulations – could offer women and those with uteruses more flexibility over their contraceptive decisions. It could mean that you only take the pill when you've had sex or missed a period, sparing you from the potential side effects of a daily hormone pill – as well as removing the pressure of remembering to take the pill on a daily basis.
While a post-implantation pill is scientifically possible, it's far from becoming an option – thanks to archaic legislation, which criminalises abortion. “By using this medication, you could potentially be disrupting a fertilised egg that's implanted in the womb,” explains O'Brien. “Under our law, that is classed as pregnancy. And if you were to use this medication here today, that could potentially be a crime punishable by up to life imprisonment because it would be classed as an abortion.”
Under the Offences against the Person Act 1861, abortion is illegal in the UK. Women or people with uteruses can only legally obtain an abortion if they meet the exemptions outlined in the 1967 Abortion Act, which state that the procedure must be authorised by two doctors on one of the following grounds:
1. That the pregnancy had not exceeded its 24th week and that continuing the pregnancy would involve risk – greater than if the pregnancy were terminated – of injury to the physical or mental health of the pregnant person; or
2. That the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman;
3. That the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated; or
4. That there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.
While progress is being made (for example, the legislation introducing buffer zones surrounding abortion clinics), the UK's abortion laws still leave much to be desired, including their restriction on researching new methods of contraception.
As O'Brien tells GLAMOUR, "We're constantly just told to put up with existing treatments. And sadly, across contraception as a whole, there really hasn't been much innovation since the pill was invented.
“We still rely on the same two synthetic hormones to prevent pregnancy. And [a post-implantation contraceptive] is a method that could be really liberating. But our laws prevent it from being researched and developed.”
It makes me mad and sad that disabled life is presented as so desperately awful that pregnancies are allowed to be terminated right up until birth.
For more from Glamour UK's Lucy Morgan, follow her on Instagram @lucyalexxandra.
