Research on Provision of Long Acting Contraceptives

Long-acting reversible contraception or ‘LARC’ describes contraceptive methods that you don’t need to use every day. This includes the copper intrauterine device (also known as the ‘coil’), progestogen-only intrauterine system (also known as the ‘hormonal coil’), progestogen-only injectable contraceptives (‘depo’) and subdermal implants (‘implant’). I recently mentioned another group conducting research on provision of long acting contraceptives. Looks like it’s a hot topic this year!

LARC is popular as it’s a highly effective method of preventing pregnancy. For some people it can be a positive option, but there are concerns that some may experience pressure to use LARC, or may find it difficult to get removed. Researchers from Lancaster University, working with the British Pregnancy Advice Service (BPAS), are studying LARC in the UK.

If you’ve been encouraged to use LARC, are over 13 and living in the UK, the researchers would love to talk to you!

Recruitment advertisement giving the details of the participant criteria - 13 yrs+, using contraception or have a need to use it, living in the UK.

For more information, please read the attached documents:

For further information, or to take part, please contact Taylor Burgess by email: taylor.burgess@bpas.org, or complete the form below with your details.

Lancaster University Faculty of Health & Medicine logo
British Pregnancy Advisory Service logo

Permission to Contact Form

Please read the project information sheet, then select yes or no to answer each question.

Pictures of 4 different Long Acting Reversible Contraceptives


Our PSG Research at the Medical Sociology Conference 2019

The best thing about ParentingScienceGang was discovering all the other articulate people passionate about the issues of high BMI pregnancy. One such woman is Dr Mari Greenfield, who presented our research at the Medical Sociology Conference in York in September. Mari has written a guest post about the experience:

Dr Mari Greenfield, who presented our PSG research at the Medical Sociology Conference 2019
Dr Mari Greenfield

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

I took part in the Big Birthas Parenting Science Gang as a Parent Scientist. I helped to decide the research question, design the methods we would use, and undertake some of the analysis.

When the project ended, we Parent Scientists had the data and the findings, but needed to decide what to do with them. My day job is a doula and researcher, and I’m passionate about choices in birth for all, regardless of BMI. Some of the stories women had shared with us were heartbreaking; stories of choice and power taken away, and of upset and trauma as a result.

Some of the stories were also uplifting, when women took power back; asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much, giving time and investing themselves by telling their stories. I want to make sure we do justice to that. 

One way I can do that is to present our findings to a diverse range of audiences. In my day job, I frequently present research to conferences of academics, so I applied to the Medical Sociology Conference. Hosted by the British Sociological Association, it is a brilliant event which focuses not on what we do within health care, but how we do things, why we do things, and how we could do health care better.

our research at the Medical Sociology Conference 2019

Pecha Kucha!

My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus on the key points you want to make. There is no room for waffle!

I wrote the both the initial application and the presentation collaboratively with Big Birthas and several of the other Parent Scientists, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working. This is quite different from the creation of most other academic and medical presentations.

The high BMI ‘box’

I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women explained how, once in this category, BMI was the only thing anyone seemed interested in. They described having serious medical conditions ignored. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but in one this was ‘normal BMI’, while the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.

Programme excerpt about our research at the Medical Sociology Conference:

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

What does it mean to be labelled as having a high-BMI whilst pregnant? How does this label affect women’s experiences of navigating maternity services?

This presentation is based on a novel user-led Citizen Science collaboration between Big Birthas (peer information and support service) and Parenting Science Gang (Wellcome Trust funded user-led citizen science project).

The results described complex journeys, where interactions with healthcare professionals revolved around conversations of BMI-related risks to the exclusion of other factors, and ignored other events of the pregnancies.

Women also reported disrespectful and shaming language from healthcare professionals, and conflict if they asserted a decision that was not in line with the healthcare professional’s views.

This led some women to decline care that they actually wanted, or avoid attending appointments, to avoid conflict or denial of choice; a consequence which was particularly apparent when we examined how those women chose to approach their second pregnancies.

The presentation and our research at the Medical Sociology Conference was well received. Questions after the talk asked about both the Parenting Science Gang methodology, our methodology, and our findings. People spoke about how our research overlaps with work they are doing.

The Parenting Science Gang’s project is over, but the journey of the stories we collected is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…

Dr Mari Greenfield

Academic researcher in maternity care, doula, birth activist. Special interests in traumatic birth and LGBTQ experiences.

Huge thanks to Mari for bringing our research to a wider audience, and for writing up the experience too!

Would you like to write a guest post for Big Birthas? Have you got experiences or a perspective that the Big Birthas audience might be interested in? Do you have a birth story you want to share? Please get in touch via the Contact Big Birtha page.

Why I’m Never Again Donating To Cancer Research UK

Well, this probably seems uncharitable, but here are my reasons why I will never again be donating to Cancer Research UK (CRUK).

Don’t get me wrong, if you’re a friend of mine, and you’re planning on running, swimming, knitting in a bath of custard etc in future and need sponsorship, I will happily donate to a charity in recognition of your efforts. But not to CRUK. You can pick another charity. You can choose one doing great work in cancer treatment or care or awareness or research; Macmillan, Marie Curie, Breast Cancer Now, there are hundreds! Just not Cancer Research UK/Race For Life/Stand Up To Cancer, which are many faces of the same charity.

Why? What’s wrong with Cancer Research UK?

Maybe it’s just me, but I’d hope that a charity which puts research at the forefront of its identity (it’s in the name, for heavens’ sake!) would understand the need to not make wild claims. I’d hope they understood the difference between causation and correlation – it’s usually taught in secondary schools! Here’s a really useful TED talk explaining the danger of mixing correlation with causation:

So we can see from the example given in the video (if you’re reading this on mobile data and don’t want to watch it!) is that just because the incidence of drownings increases when the sales of ice creams increase (a correlation), does not mean that we can infer ice creams are responsible for drownings (causation). Or conversely, decide that drownings are responsible for ice-cream sales!

We can suspect one leads to the other. We can theorise what might cause this, but without further evidence it is merely a theory. It may be difficult to prove. That doesn’t mean you can ignore the lack of proof and state it as fact for the sake of convenience. Furthermore we must not forget to look for other influencing factors which might explain both results, like the weather, in the TED example.

So, where does Cancer Research UK come into this?

CRUKs 2018 OB_S__Y is a cause of cancer ad campaign.

When CRUK released their ad campaign last year stating, quite categorically, that obesity causes cancer, I was a bit concerned. I knew of the link between being of higher weight and increased risk of certain cancers (and decreased risk of others that we rarely hear about!), but there has never been proven causation. Yet CRUK were happy to state it.

Wait, obesity isn’t a cause of cancer?

No one (and there’s been plenty of research!) has yet proven that obesity causes cancer. It is possible that there is a causal link, of course. The theories may be spot on. I don’t deny that. But you’d hope a charity spending hard-won donations, and with ‘research’ in their name, would be a bit more responsible and careful not to overstate a theory as fact? It’s an important distinction.

As with the TED analogy, research has suggested that common factors could be responsible for the connection. Genetics are particularly suspect. Did you know tall people are more likely to get cancer than short people? Don’t see them putting that on a bus shelter, or claiming that height causes cancer. It’s an accepted correlation. Strangely CRUK don’t feel the need to make anyone feel crap about being tall…

But being fat’s not the same as being tall!

“But people can’t help their height!” I hear the virtue-signallers cry! “It’s not the same! Fat people can lose weight!” (with a in implied side-order of “they’re just lazy/stupid/lack willpower!”).

Except if you’re overweight, and have always been overweight, come from a line of people who are and have always been overweight, and have repeatedly watch them try and fail to lose weight, you know that while the maxims of ‘just lose weight’, ‘just eat less’, ‘just exercise more’ sound so deceptively simple in theory, they’re incredibly difficult in practice.

Of course, there’s always surgery, the one reliable intervention to lose weight – but if that’s so desirable, why wouldn’t we suggest tall people lop off a couple of inches to reduce their cancer risk? (I’m not suggesting that either!) There are significant risks associated with surgery, and significant downsides. It is not a one-size-fits-all solution. Yes. Pun intended. Let’s not lose sight of the fact that there’s a lot more to being healthy than merely a BMI.

But obesity IS preventable! You just don’t want to hear the truth!

Many overweight people struggle with their weight their entire life. Many lose weight, only to put it all back on again and more, often over and over, getting bigger with every cycle. We know this, and we don’t fully understand why. But we’re beginning to understand that willpower and behaviour are probably only a small part of the puzzle, maybe as little as 5%, with many other factors coming into play .

If it was so easy, Slimming World and Weight Watchers would have gone out of business years ago. The fact of the matter is that their business model works precisely because most people don’t and can’t lose the weight and keep it off long term in our modern society. We know this. It’s a problem we’ve been trying to solve for years, and CRUK campaigning that obesity is a ‘preventable’ cause of cancer completely ignores this.

Every time I drove past one of the CRUK adverts last year it irritated me. I knew it was inaccurate, felt it was irresponsible, and I was frustrated that they were choosing to oversimplify a complex problem as a personal failing. I, and many others felt it insidiously feeds the narrative of blame and shame that is so common with obesity.

It allows those who don’t have a high BMI to feel just that bit more smug, just that bit more superior; safe in the knowledge that their predominantly genetic disposition to not be overweight is saving them from cancer, with the added implication that us fat people should really do something about it for the sake of our health…

Maybe they didn’t realise…?

Not everyone reacted as mildly as I did, of course…

But those ads didn’t quite push me to the point of saying never again will I be donating to Cancer Research UK. That only happened this week…

I decided to give them the benefit of the doubt last year. Maybe they didn’t realise? Perhaps they felt the shock factor they wanted to use outweighed the risks of that approach and misjudged it? Maybe in wanting to keep the message simple they went further than they should have in overstating the point, but have learned from it?

So, what happened next?

Firstly, don’t be tempted to read the responses Sofie Hagen received on Twitter. Let’s just say plenty of people decided to tell her she was wrong. Haters gonna hate and all that… We don’t need that kind of negativity!

The campaign garnered lots of attention, was widely accused of fat-shaming and stigmatising obesity, and lauded by others for ‘telling it like it is’ (or as we know, isn’t, but hey-ho). These comments mainly came from smug-thins who think it’s simple to solve the ‘obesity problem’; just regularly tell fat people how crap they are and they’re sure to take it on board…

It also prompted amusing but entirely predictable responses implying the only reason people are overweight is because they eat fast food… yawn. Never saw that one coming. Oh, wait. Yes we did. It’s exactly these kinds of lazy tropes and attitudes that such a campaign fuels and that we’re entirely sick of.

Didn’t anyone explain to CRUK where they’d gone wrong?

Of course! Aside from the discussions on Twitter and in the media, various organisations and experts connected to the study of obesity contacted CRUK to offer their services.

They told CRUK how the adverts were stigmatising and misleading. They explained how simply telling people with obesity that they’re at increased risk of cancer does nothing to help, but does everything to make people feel more marginalised. Experts met with CRUK to explain how a more useful and sensitive campaign could be launched in future…

So, what happened this week?

Cancer Research UK's latest ad campaign - comparing obesity to smoking.

This week, CRUK went one further with this ad campaign.

Cigarette packets branded with “Obesity is a cause of cancer too”. Eyecatching and emotive, certainly. Accurate and helpful? Not so much.

Marvellous. They’ve taken on board precisely …erm… nothing at all from last year’s campaign feedback!?

Or perhaps they enjoyed the publicity last time?

Good grief, I feel sorry for the people who gave up smoking and gained weight as a result. They must feel like they can’t do right for doing wrong! They’re probably having their nicotine addiction triggered by the enormous images of cigarette packets, all while wanting a cigarette to deal with the stress of finding out that they’re doomed to get cancer…

Of course, the media reported the release like this:

Google News search for 'cancer obesity' showing misleading headlines and the standard 'headless fat body' image

With the word ’cause’ prominently repeated, with images of fast food and headless fat bodies galore – despite organisations such as the European Association for the Study of Obesity and The World Obesity Federation campaigning widely against such reporting and providing and free usable non-stigmatising images… Here we go again. Entirely predictable. Blame and shame. Emotive stuff.

There was a swift backlash. The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (what a title!) wrote this great article:

Only this time there’s no room for the benefit of doubt; CRUK know these campaigns are hurtful, and they clearly don’t care.

And then, despite the complaints, CRUK continued the narrative this morning by tweeting this:

What, are we just pointing out random statistics we observe now? No. Clearly CRUK has decided this is the hill they want to die on; might as well be hung for a sheep as a lamb. If you don’t like it, go chew some obesity gum or puff on your obesity inhaler… Oh, wait…

Cancer Research UK Budget

Here’s how much CRUK spends in a year.

Caner Research UK's 2017/18 Budget spend by sector (total £652m)

It’s a lot. A sizeable amount is spent on research. So far so good. But when £43 million pounds in 2017/18 was spent on ‘information and policy’ (admittedly, it’s only half of what they spend on raising the cash in the first place…), and when that information and policy is based around misrepresenting that research, enough is enough.

What does CRUKs CEO have to say?

Luckily not all media outlets have responded to CRUKs latest campaign by parroting it blindly… Sky News at least have responded by reporting some of the criticisms the new campaign has received:

https://news.sky.com/story/cancer-research-advert-criticised-for-comparing-smoking-to-obesity

They even quote CRUK chief executive Michelle Mitchell:

“We have a responsibility to tell people about what might increase the risk of cancer.”

Yes, Michelle. Might. So why are you so ready to be certain that it does cause cancer when you’re plastering it on a poster?

I might never again donate to Cancer Research UK. Oh, actually sorry, no. I’m never again donating to Cancer Research UK. Put that on a poster, Michelle.

Help identify the top pregnancy research priorities

RAND Europe is seeking the views of a wide range of people across the UK to help identify the top pregnancy research priorities.

20wk scan pic - Help identify the top pregnancy research priorities

Click here to go to the survey!

This aims to identify the most important questions for future pregnancy research in the UK. It is part of a wider study on pregnancy research funding. You can choose what matters most to you from the suggested research questions.

Who is doing the survey?

It is part of a study being carried out by RAND Europe and was commissioned by the National Institute for Health Research (NIHR) and The Wellcome Trust on behalf of the UK Clinical Research Collaboration (UKCRC).

What’s the study about?

The aims of the study are to review current research funding in the UK and to identify pregnancy research needs, priorities and gaps which should be addressed in the future. The researchers have organised the questions into different areas (e.g. managing conditions such as gestational diabetes, mental health, etc). Every question is optional: if you do not want to give an answer, you can just skip the question.

Why are they seeking so many different people’s views?

The researchers particularly want to hear from women and their partners, from researchers already conducting pregnancy research, and from health care professionals working in maternity services. Collating all these views is important when it comes to defining future priorities; this survey hopes to identify the research questions that are most relevant to and might affect different groups of people.

How long will it take to complete the survey?

If you provide answers to all questions, it should take you about 15 minutes to complete.

Where can I find more information?

Please click here to learn more about this study. If you have any other questions, you can email pregnancy@rand.org.

Thank you for taking the time to add your voice to this survey – there are actually a few research studies looking to hear from women right now – try this one and this one!