Ongoing research projects

Reproductive coercion and abuse (RCA) has been defined as attempts to control pregnancy through interference, abuse, threats and violence. RCA can take different forms, including interfering with birth control, and threats and physical violence aimed at influencing the commencement, continuation, or termination of a pregnancy. RCA typically overlaps with other forms of abuse - such as trafficking, child sexual exploitation (CSE), and domestic abuse. Although recognition of RCA in the UK is increasing among policy actors and relevant practitioners, cross-learning between healthcare professionals and those working in the gender-based violence sector is currently under-developed.

Led by Dr Pam Lowe (Aston University), this project will undertake research to identify, analyse and disseminate knowledge relating to RCA, drawing on both national and international expertise. It aims to facilitate cross-learning, and build innovative responses to RCA to support reproductive health services, with a particular focus on innovation, service development, and learning from the recent introduction of telemedical services in abortion care. It will also establish a practice-oriented network on RCA of national and international policy actors, healthcare and gender-based violence professionals, and academics to support future knowledge exchange, ensuring self-sustaining developments in best practice after the fellowship is completed.

It has been funded through the British Academy Innovation Fellowship Scheme (2021-22).

The Responses to Alcohol and Pregnancy Policy (RAPP) project is a collaboration between the CRRC and the University of Southampton, funded by the Public Policy|Southampton New Things Fund. The research team includes Rachel Arkell (CRRC), Professor Fiona Woollard (University of Southampton) and Rebecca Brione. The project aims to understand the impact of the introduction of mandatory alcohol screening from the perspective of midwives based in the U.K. The project has two stages: an anonymous survey, followed by a focus group.

The anonymous survey is now closed to responses.

The focus group is open to qualified midwives working in the UK and will discuss antenatal alcohol screening. If you would take part in the focus group, or to find out more, please contact: f.woollard@soton.ac.uk 

The CRRC is collaborating with researchers at the University of Brighton who are UK leads for a WHO-funded project to assess the contraception, abortion/post-abortion care, STIs (including HIV) and violence against women (VAW) services available at local health facilities during the COVID-19 pandemic. 

The CRRC team and Professor Lesley Hoggart (Open University) are interviewing BPAS clients who've had more than one abortion - one with an ultrasound scan and one without. This qualitative research aims to understand the experiences and opinions of women who have undergone telemedical abortion without a pre-procedure ultrasound during the COVID-19 pandemic. 

The CRRC team and the University of Illinois at Chicago (UIC) are collaborating on this survey to assess how the COVID-19 pandemic is impacting people’s choices surrounding fertility-related intentions, abortion, and pregnancy choices. Knowledge gained from the study may shed light on how pandemics impact pregnancy choices, allowing us to better prepare and meet the needs of people in similar situations in the future.

Following BPAS’ submissions (first submission) to the NICE Quality Standards FASD Consultation, with CPCS, the project After Choice: FASD and 'the managed woman' was formed. 

This project takes policies, guidance and healthcare practices about Fetal Alcohol Spectrum Disorder (FASD) as its focus. It builds on previous research considering the ascendence of claims about the salience of the ‘precautionary principle’ for providing advice to women about alcohol and pregnancy. The full paper can be read here or a short briefing is available here. 

This project is a collaboration between Professor Ellie Lee (University of Kent) and CRRC’s Rachel Arkell. For more information please see the project webpage. 

The CRRC has further formed the ‘Alcohol and Pregnancy Research Network’ which welcomes academics and policy makers working in this area. Contact us for more information or to join the network.

We are collaborative partners with the University of Kent on the SeNSS PhD project: Communicating the risk of taking medicines to (potentially) pregnant women post-Montgomery: a socio-legal exploration which is being undertaken by Rachel Arkell.

We are working with researchers at the London School of Hygiene and Tropical Medicine on the SACHA study.

The objectives of this project are to:

• collate, synthesise and summarise recent evidence for innovative models of abortion care with the potential to enhance access, quality of experience and cost-effectiveness
• explore the potential for beneficial and harmful consequences of current trends in abortion provision and identify implementation strategies to harness positive outcomes of current developments and mitigate adverse outcomes
• assess the potential of General Practitioners (GPs) and non-clinician providers in abortion provision, their education and training needs and their views on innovations in care
• elicit women’s views on current experiences of abortion and on preferences for abortion techniques, models of care and sources of support
• consult decision-makers on the range of innovative abortion practices and procedures and on the potential feasibility, acceptability and sustainability of their adoption in UK health services and systems.

This project aims to gain an understanding of the views and questions women have about alcohol and pregnancy as raised in online peer support forums. This aim is of particular importance given the recent UK press coverage of an emerging policy framework on Foetal Alcohol Spectrum Disorders (FASD). The project is funded by the Institute of Alcohol Studies (IAS) and is a collaboration with Dr Lisa Schölin (PI, University of Edinburgh).

Providing the offer of contraceptive advice and options after an abortion is a key part of good abortion care. Since 2020, most medical abortions (abortions with pills) in England and Wales are done via telemedicine, meaning consultations occur over the phone, and pills are sent to patients at home. This has an impact on how post-abortion contraception can be provided and warrants investigation.

We will study contraceptive use after abortion at BPAS, examining contraceptive methods chosen by patients who have abortions up to 10 weeks of pregnancy, both at the time of the abortion and six weeks later. We will compare contraception use between medical and surgical abortions and between those who have had fully remote vs in-clinic care. Additionally, we will gather information from patients who received contraceptive advice and planned to use a specific method to see if they could start using their preferred contraception. This will be done through an online survey sent via email or text message six weeks after the abortion.

The information we find will help design better services, plan budgets, train staff, and improve quality for any organisation around the world that wants to use telemedicine for medical abortions up to 10 weeks’.

Since 2020, there have been radical changes in the way that abortions are provided across Britain. The majority of patients now have a medical abortion at home, supported by telemedicine. Research has shown this way of providing care to be safe, effective, and acceptable to patients. It allows some patients to access abortion earlier, reduces travel to clinics, and offers greater privacy. However, the evidence for how this change in care has impacted different groups of people is very limited. Barriers to care are likely to be experienced unequally, and those who are marginalised in multiple and intersecting ways are likely to experience more, compounded barriers to accessing abortion. The introduction of telemedicine may have also introduced new inequalities in abortion care. 

This doctoral research aims to explore how the introduction of telemedical abortion has affected the accessibility and equity of abortion services in England and Wales using a combination of quantitative and qualitative methods. The work is co-produced with a range of stakeholders including abortion providers and patients, and will help to inform the development of more equitable abortion services for all.

This doctoral research seeks to explore how risk is communicated to (potentially) pregnant women in clinical practice, following the legal precedent set by the Supreme Court in Montgomery v Lanarkshire Health Board, a clinical negligence case, in 2015. This research sits at the intersection of on-going developments in two separate, and arguably, competing contexts. The first being the legal framework, which works to protect both the independence of clinical practice and the rights of the patient; and the second, being the specific way in which society manages the uncertainty inherent in pregnancy.

This research uses the case study of sodium valproate, a highly effective but teratogenic anti-seizure medication, which is currently regulated via a Pregnancy Prevention Programme. Through the use of an interview study, this research reflects on how clinicians navigate competing obligations within the clinical encounter, and how they manage topics of risk, uncertainty and choice within their practice.