For much of the world, it's the time of year for family, feasting, present giving, and of course the annual review. They always say if you can't beat them join them, so here's Marie Stopes International's look back at what proved to be a pivotal year in sexual and reproductive health, and a peek forward at 2012.
A wonder drug - the new one
A good month for women in Malawi as misoprostol - a crucial drug to treat post-partum haemorrhage and other reproductive health issues - was registered in the country for the first time. Post-partum haemorrhage (severe blood loss after giving birth) causes 25% of the 358,000 global maternal deaths each year, reaching up to 60% in some countries in the developing world.
The World Health Organisation recognises misoprostol as a crucial intervention in the prevention and treatment of post-partum haemorrhage, as it can both be given to women in their third trimester to decrease their risk, and immediately after birth if haemorrhage occurs. Registering the drug in as many countries as possible should be a priority, so women across the world can benefit like those in Malawi.
New challenges to women's health in the US
Sexual and reproductive health once more took on a political dimension in the US. Heated debates occurred in the House of Representatives, with Republicans and a small number of Democrats calling for an end to Title X funding for family planning for organisations also providing abortions. Expect to see abortion dominate the headlines throughout the 2012 Presidential election campaign.
Women in focus
The 100th International Women's Day brought an opportunity to think about the 215 million worldwide who want, but cannot access modern contraception so they can choose how many children to have, and when. High maternal mortality and unsafe abortion rates in the developing world mean that many women die as a result of an unplanned pregnancy, a situation which could so easily be rectified were access to contraception improved. Governments and donors must recognise that family planning is one of the most cost effective and most needed health interventions they can support.
Morning-after pill controversy
The emergency contraception pill Levonelle was controversially made available free on the NHS through pharmacies in Wales. Marie Stopes International welcomed the move, with spokesperson Dr Paula Franklin saying that: "The decision by the Welsh Government to increase access to emergency contraception is an important step forward in preventing unwanted pregnancies and abortions amongst women in Wales." In England, emergency contraception is only currently available free on the NHS via GPs and family planning clinics.
A wonder drug - the original
We celebrated the 50th anniversary of the oral contraceptive pill, a revolutionary development which gave women the opportunity to control their own fertility for the first time and rung the changes for women in their relationships, families and workplaces. The pill is still the contraceptive method of choice for millions of women; 215 million more desperately want that choice to be made available to them.
Marie Stopes International published its annual Global Impact Report: 7 million couples were using a family planning method provided by the organisation by the end of 2010, and an estimated 4.8 million unintended pregnancies, 1.3 million unsafe abortions and 13,000 maternal deaths will be averted as a result. The cost saving to the health systems of the 40 countries we operate in? £428 million.
The biggest challenge
We often open centres in countries new to us. It's a lot rarer that we open centres in countries that are new full stop. In July the people of South Sudan voted to break away from the north, creating a whole new country and one big challenge for sexual and reproductive health organisations in one fell swoop. In a new country, establishing legislative and judicial systems quite rightly usually take priority. However, in a country which on its creation instantly became the most dangerous place in the world to give birth, ensuring that women can access to sexual and reproductive health services is crucial.
Abortion hits the headlines...
Abortion took over the British media with high profile debate on counselling. An attempt to amend the Health and Social Care Bill, led by Conservative MP Nadine Dorries, was soundly defeated in a House of Commons vote. The amendment would have meant that leading sexual and reproductive health organisations such as Marie Stopes International and bpas would have been barred from providing counselling. A public and media outcry, and a strong majority of MPs voting against the amendment, meant that women's access to independent, non directive and supportive counselling was maintained.
... and stays there
The UN published a groundbreaking report stating that access to safe abortion should be considered a human right. The report, by UN Special Rapporteur Anand Grover, was published after extensive research and expert consultation - some saw it as a wake-up call to the many states where women often turn to unsafe abortion, because of a lack of access to legal and safe services.
Seven billion and counting
October saw a media storm and flurry of interest in family planning, as the world's population hit seven billion. The innovative global campaign, led by UNFPA, aimed to build awareness and inspire positive action around the opportunities and challenges of the world at seven billion. This milestone had implications for a range of issues including reproductive health and rights, and hit home particularly hard at a time when donor assistance for family planning stagnated at US$400 million per year worldwide, after peaking in 2002 at $700 million.
A snip in time might save nine
In the developed world vasectomies as a long-term, safe and effective family planning method are commonplace, but it might surprise you to know that in November Marie Stopes International performed the very first vasectomy ever in Burkino Faso. It's just one more choice we can offer to couples in the country, who come to us and ask for help in controlling the number of children they have.
Good news, bad news
World AIDS Day on 1 December had both an upbeat and downbeat feel this year, with US Secretary of State Hillary Clinton talking about the 'AIDS-free generation' in sight thanks to new research showing that anti-retroviral drugs can both keep people with the virus alive, and make it less likely that they will transmit it to others. As ever, the barrier is money, and the costs associated with getting these lifesaving drugs into the right hands - the Global Fund to Fight Aids, Tuberculosis and Malaria has cancelled its next funding round.
At the International Family Planning Conference in Dakar, all the talk was about the potential of integrating HIV and family planning services in the battle against the virus.
So what's on the cards in 2012? Inevitably, given the level of unmet need, it will be another big year in sexual and reproductive health. Marie Stopes International is gearing up to help meet this need, with our focuses for the year including advocating for task-sharing, to allow mid-level health professionals to offer sexual health services; a focus on youth; trying to further reap the benefits of technological advances; working with the private sector; and investing in and sharing quality research.
Also watch out for the second reading of Nadine Dorries' sex education bill in January, which calls for compulsory additional sex education focusing on abstinence to be provided in school. Expect the counselling debate to re-emerge too, as the Department of Health's consultation comes to a conclusion.
Here's to the year ahead and the significant steps we hope to take to reduce the number of women without access to contraception and legal safe abortion services.