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Libby Wilson, who died earlier this year at the age of 89 years, was one of the major names in British family planning. She had become a general practitioner (GP) in Sheffield in the early 1950s and worked with the Family Planning Association, but in 1964 the Association voted to restrict its services to women who were either married or about to be married. Unhappy at this decision and spurred on by the success of a clinic for young unmarried women in London, she and a few other female GPs decided to set up a similar clinic in Sheffield. Condemnation by local clergy created what turned out to be very welcome publicity, and clients soon arrived from all over the north of England.⇓
In 1967, Dr Wilson's husband Graham was appointed to the post of Regius Professor of Medicine at Glasgow University, and although by then she was relishing running Sheffield's family planning service, she reluctantly agreed to the move. In Glasgow she continued her family planning work in a clinic mostly serving young married women in a prosperous area of the city. However, she knew that the real need was in deprived areas, where the poverty shocked her. “Glasgow was teeming with rat infested tenements and vast acres of rundown housing estates with no amenities or civic pride”, she wrote.1 She knew that this would be the perfect spot to launch a domiciliary family planning service. She persuaded the Labour-run council – primarily supported by the Catholic working class – to fund the service, using data highlighting the high number of conceptions among the city's poor and showing that infant mortality in some of the poorest areas of the city was as high as 77 per 1000.
On a trip to Hong Kong in the early 1970s she found out about the new contraceptive injection depot medroxyprogesterone acetate (DMPA; Depo Provera®) and thought this would be perfect for her clients, many of whose husbands would throw their contraceptive pills in the fire or attempt to remove their intrauterine devices. In her memoir she described administering the injection to a woman in the public laundry who had decided – against her husband's wishes – that her tenth child was going to be her last. Dr Wilson led one of the first trials of DMPA in the UK, reporting on her case series of 162 women in the BMJ in 1976, just a year after its use had been approved by the International Planned Parenthood Federation.2
After retiring she spent a year in Sierra Leone, working in family planning and reproductive health; she made some progress, but once her work stopped the status quo returned. She reported on her experiences in this journal.3 On her return to Glasgow she became increasingly interested in end-of-life issues, setting up her own charity, Friends at the End (FATE), which campaigned for a change to the law to allow assisted dying. As ever, Dr Wilson was driven by a desire to let people have choice, but this time at the end of their lives. But although legislative change was an important aim of the charity, she also provided practical advice to people who wished to end their own lives, offering advice about clinics in Switzerland. In 2009 she spent a few hours in a police cell on suspicion of advising a woman with multiple sclerosis on how to end her life. She was released without charge, and carried on her campaigning work as before. FATE supported Margo MacDonald's Assisted Suicide (Scotland) Bill in the Scottish parliament, but even though it was defeated in 2015, she was pleased with the debate it promoted.
Dr Wilson had six children. Perhaps this was family planning by design, rather than by unavailability of means to control family size that had been such a problem for her clients.
Adapted, with permission, from Anne Gulland's Obituary. BMJ 2016;353:i2854. doi: 10.1136/bmj.i2854 (published 19 May 2016).
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