EXPERTS and politicians will this week warn against a new Dundee scheme which offers mental health and addiction support to women who have had children removed by social services on the condition that they agree to go on long-term contraception.

The Scottish Parliament’s cross-party group on women’s health will meet on Tuesday to discuss the Pause Project, a London-based charity which will launch in Dundee this month.

They will hear concens that the project is incompatible with universal health care and represents a significant step backwards.

Dr Alison Scott, who runs Wishes (Women’s Inclusive Sexual Health Extended Service) in Edinburgh, will present at the meeting on the potentially adverse impacts of the project on women with complex needs – the very group for whom it is intended.

Scott told the Sunday National that Pause could exclude many of the women she works with – such as those facing homelessness, gender-based violence, drug and alcohol use, or who are involved in selling sex – by failing to understand the effects of trauma.

She explained: “Lots of women need this support, but they are excluding many of the women who would benefit and they are asking women to behave in a certain way in order to access it. There’s a carrot there of getting help, but getting that help might be very traumatic for them.

“Some women who have been raped or sexually assaulted don’t want a coil or implant. Some women who use substances or have had substances injected in the past are needle-phobic, and it’s traumatising for them. You can get there with women once they’ve built up a relationship of trust, but that can’t happen at the start of the process.

“I start to think that our understanding of ACEs [Adverse Childhood Experiences] and trauma in Scotland is improving, then we see something like this and it’s like we’ve gone a step backwards.”

The Pause Project has been delivered in 31 areas of London since its launch in 2013. Now, Dundee City Council estimates that its 18 month pilot of the programme could prevent up to 10 pregnancies, saving up to £1.6 million over five years by reducing the number of children taken into care.

Engender’s policy and parliamentary manager Eilidh Dickson, who told the Sunday National last month that the Pause approach is part of a “long and ignoble history” of the state “coercing women’s reproductive choices”, will also speak at Tuesday’s meeting.

Ahead of her presentation, Dickson said: “Engender has significant concerns about the Pause programme and the way in which it forces women to use birth control in order to access vital support. Mental health, violence against women, substance misuse and other health and social care services should never be contingent on women foregoing their reproductive autonomy.”

Dickson pointed to findings of a 2017 evaluation of Pause which revealed that two participants who became pregnant during the programme were “transitioned out it”. This, she said, was one example of Pause’s clear conditionality.

Pause has contested these criticisms, stating that the project will work with women for up to 16 weeks before they decide whether or not to take part in the full programme.

At that point the women will be asked to “use the most effective forms of contraception for them,” in consultation with NHS sexual health staff to ensure that the women’s choices are “well-informed, fully consensual and are right for them”. A Pause spokesperson said: “Pause is a trauma-informed programme in which a consistent and dependable relationship is built between a skilled and experienced practitioner and the women.

‘‘We have a strong track record and a growing evidence base in providing individual support for women who have had traumatic experiences and complex needs which often includes women with significant substance misuse and women who are victims of sexual violence.

“Pause works with women to enable them to exercise their right to choose. This includes making an informed choice about whether she wants to take a break from the cycle of pregnancy and removal of children that has caused such deep trauma.”

NONETHELESS, MSPs have echoed the ethical concerns of campaigners and health professionals. Labour MSP Monica Lennon, convener of the cross-party group on women’s health, said the approach was “incompatible with universal healthcare”.

Lennon commented: “The NHS was built on the ideal that good healthcare should be available to all, accessed according to clinical need and free at the point of delivery. The Pause Programme, on the other hand, is based on a model of conditional healthcare.

“I strongly support a woman’s right to choose what is right for them and I also feel strongly that people experiencing substance misuse should have access to the support they need, free from judgement. It would be concerning to see the model that underpins the Pause Programme become the mainstream approach in Scotland.”

Scottish Greens health spokesperson and deputy convener of the cross-party group Alison Johnstone MSP echoed this view, stating: “Women must be able to access the support they need without intrusive preconditions. Whether someone uses contraception and what kind should be a matter for them.

“Refusing to offer support to vulnerable people unless they abide by these draconian rules is heartless and will self-evidently exclude many vulnerable women who are unable to use contraception.”

Liberal Democrat MSP Alex Cole-Hamilton, who sits on the group and was formerly director of a children’s rights charity, said that while he was aware that “the number of children who end up in care continues to be a rising problem in Dundee”, he has “trepidations” that this approach could be “a regressive step for women’s reproductive rights”.

He added: “Whilst I agree with the Pause Project’s aim of reducing the number of children who end up in the care system, I do not agree with this being conditional on women agreeing to go on long-term contraception – for me, it raises some big ethical questions.”