Controversial Pause project 'supporting' vulnerable women to expand

The London-based charity Pause began working in Scotland last summer with the launch of a project in Dundee and it is in talks with local government in other parts of Scotland, Northern Ireland and England.

A progress report by Dundee City Council published last week explains that more than 30 women have been supported by the programme which is delivered by Tayside Council on Alcohol. Addictions and mental health support is a core part of the project, as well as practical help with housing, benefits and child contact.

READ MORE: Is Dundee contraception scheme the family cap by another name?

Coupled with a requirement to go on long-acting reversible contraception in order to continue beyond the first 16 weeks of the programme, Pause explains that the aim is to “prevent the damaging consequences of children being taken into care”.

However, a number of experts and MSPs have warned against other local authorities following suit, arguing that it amounts to “conditional” support.

Speaking to the Sunday National, CEO of Scottish Drugs Forum David Liddell said: “It is a matter of urgent concern that Scotland has not been able to make its view clear – these types of initiatives are not compatible with the rights-based approach adopted most recently in the new drugs strategy.

“Concerns have been raised by experts across various fields. We share those concerns and would encourage national and local bodies to reject an approach that exploits and further disempowers some of the most vulnerable women in Scotland.”

Ahead of the Dundee launch, feminist organisation Engender described the project as the state “coercing women’s reproductive choices”.

READ MORE: Warning over Pause project that only supports women using contraception

Sixteen professionals and academics specialising in addictions signed a letter, published in The Herald, which said the women targeted are likely to have “a mistrust of official institutions” and that “offering badly needed services contingent on reproductive control may exacerbate” this.

The Sunday National understands from senior sources that Pause is already in talks about working in Aberdeen City. A spokesperson for Pause confirmed that the organisation is in talks with local governments in Scotland but would not name the specific areas, lest this compromise the process. Aberdeen City Council did not respond to a request for comment by the time of publication.

Dr Alison Scott, who chairs the Scotland committee of the Faculty of Sexual and Reproductive Rights and who last week began a new role with the Scottish Government implementing a national women’s health plan, has also cautioned against wider adoption of Pause’s approach.

Referring to the organisation’s policy of “transitioning” women who become pregnant out of the programme, she said: “Pregnancy is the time when you most need support. The people with the greatest need are who they’re withdrawing the support from. That’s what happens when you have restrictive, conditional support.”

Dundee City Council said that if the women become pregnant, the council’s New Beginnings team “will offer assistance”.

Scott is also critical of the cost to the local authority of commissioning Pause, which she pointed out is a more common practice in England “where they commission companies like Virgin to provide care” but which is “an alien concept in Scotland”.

Responding to these criticisms, CEO of Pause Jules Hillier said: “Pause works with women who are caught in traumatic cycles of repeated removals of children from their care – sometimes many times. The women who work with us tell us that we are different from other services and evidence tells us we can help them make positive change in their lives.

“Our work in Scotland to date has shown high levels of need and, disturbingly, that women are dying as a result of their complex and difficult lives. We, in partnership with other organisations in Scotland, can make a real difference.”

Convener of the cross-party group on women’s health and Scottish Labour health spokesperson Monica Lennon has said she would be “concerned” to see the model become mainstream.

She added: “People living with substance misuse, whether drugs, alcohol or both, face constant battles to get the help they need. Addiction is an illness and healthcare and social support should be accessible on the basis of need.

“The Pause project provides services that can help women recover from substance misuse, but requiring them to take long-acting reversible contraception in order to get this help raises a number of concerns.

“Women must have the right to choose what contraception is right for them, free from judgement.

“Pause is incompatible with universal healthcare and sends out an unhelpful message on women’s reproductive rights.”

Scottish Greens health spokesperson and deputy convener of the cross-party group Alison Johnstone agreed: “Imposing draconian conditions on support is not a responsible or respectful method of dealing with vulnerable people.

Pause has requested funding from the Scottish Government for its work in Dundee, but the decision remains pending while concerns are considered. The project has been funded by the Robertson Trust and the National Lottery Community Fund.

A Scottish Government spokesperson said: “The Scottish Government is committed to supporting vulnerable mothers with complex needs. We support the aims of Pause to provide support for women who have experienced repeated removals of their children from their care.

“However, we are aware of the concerns being expressed by some about particular aspects of the programme. Ministers are engaging in an open discussion to ensure that these concerns can be considered and resolved. We will continue to consider the request for funding while those discussions take place.”