Making decisions about fertility--three facts GPs need to communicate to women.

BACKGROUND: Average annual fertility rates in industrialised countries have been below two children per woman for the past 3 decades. The reasons behind women's childbearing behaviour are complex. However, a lack of awareness regarding the consequences of delayed childbearing and the inability of reproductive technologies to overcome the 'biological clock' may be contributory factors. OBJECTIVE: A narrative review guided by the research question: What do women need to know about the consequences of delayed childbearing in order to make informed decisions about their fertility? DISCUSSION: There are three facts that women need to know in order to make informed decisions around their fertility: Some women want to have more children than they are able to have because they postpone childbearing; there can be medical consequences to delaying childbearing and; some women's ideas about their fertility don't match the 'the scientific facts'. General practitioners are well placed to play a strategic role in the provision of timely, relevant information to help women make informed decisions about their fertility. Further research is needed to identify the most appropriate ways for GPs to communicate this information.

Understanding and responding to anti-choice women-centred strategies.

This paper discusses the rise and use of a "woman-centred" anti-choice strategy to oppose abortion in Australia and the USA. It argues that this strategy seeks to imitate and exploit aspects of the pro-choice, women-centred position on abortion. The strategy contends that women do not really choose abortion but are pressured into it by others and then experience a range of negative effects afterwards, including an increased risk of breast cancer, infertility and post-abortion grief. Rather than evaluate the truth of such claims, this paper seeks to explicate from a feminist perspective the design, intent and implications of this strategy and how it is being used in legislative tactics, counselling, law suits and anti-choice activism. Such an analysis is necessary for pro-choice efforts to respond effectively to this new strategy, not only through literal rebuttals based on evidence, but also through responses that counter its ideological power.

Regulation, consultation and divergent community views: the case of access to ART by lesbian and single women.

In the many countries which have some form of regulation of ART, a public consultation of some sort is a frequent feature of either the process leading up to regulation or of the regulatory mechanism itself. Not surprisingly, widely divergent views on the moral and political acceptability of ART are expressed during such consultations. And while such diversity of opinion is to be expected, and some even argue welcomed, in pluralist liberal democratic societies, it is often unclear how these divergent community views are and ought to be fed into the opinion-forming and decision-making processes of governments or the bodies that advise them. This article discusses first why regulation of ART may be justified, even when there is radical moral disagreement in the community, and why public consultations should play a central role in the work that advisory bodies undertake in making regulatory recommendations to government. Then, it both proposes and justifies a method for dealing with the contradictory moral views expressed by interested parties during the consultation process. To illustrate this method, the example of the attempt by single and lesbian women to access donor insemination services and ART is used.