The Fight Continues: New Access to Abortion Services in Ireland

It has been almost ten months since the people of Ireland voted to repeal the Eighth Amendment on 25 May 2018, removing the constitutional ban on abortion which had been inserted in 1983. Legislation introduced in January 2019 has allowed many women to safely seek a termination in Ireland. However, protests outside hospitals and surgeries, fraudulent help-lines and websites by pro-life groups ensure that the fight is still on-going. Abortion is allowed up to 12 weeks in Ireland in the General Practitioner (GP) or Family Doctor’s surgery. Abortion post-12 weeks, is only legal in highly restrictive circumstances where there is: a risk to the woman’s life, serious harm to her health, or the foetus has a problem with its development and is likely to die before or within 28 days of birth. Abortion service is an ‘opt in’ rather than ‘opt out’ service and doctors have the right to conscientiously object. While they have the right to refuse to offer the service in their practice, they must refer the patient to a doctor on the public register. Doctors on the public register offer the service to their own patients and also take referrals. Some doctors have stated that they will refuse to refer their patients; however, these are small in number. In December 2018 a group of 40 doctors walked out of a meeting in opposition to the referral obligation. Since January 2019, the public register has been growing in numbers. At present there are currently over 270 GPs in the country offering the service. However, there are a number of concerns for doctors going on the public register: concerns about protesters outside their surgeries, concerns about being overwhelmed by work as general practice is already as breaking point, and concerns that access to hospital supports is patchy.

Dating 12 weeks is causing major delays for many women. At a pre-abortion consultation with a GP, he or she must certify the pregnancy is no more than 12 weeks gestation. There is a shortage of ultrasound equipment as most doctors do not have scanning equipment in their surgeries. The woman may be referred for an ultrasound scan in the hospital to confirm the date of pregnancy. Many women are very nervous about attending the hospital. In Ireland, especially in smaller communities, women may know someone who works there. As well as that, some women who attended the hospital said that they found the experience stressful and bewildering as it was not clear where they were to go and they were waiting in the same area as couples with wanted pregnancies. One woman was given a 10 day wait for an appointment for her scan in the hospital. This is extremely concerning as delays in the service mean added stress for the woman and later terminations. Delays could lead to women being over 12 weeks pregnant and no longer able to avail of the service. In some areas, the scanning service is being offered by private providers. This is also a challenge. Having private providers of scans means that women have another appointment and another place to travel to taking time and money. GPs offering the service should be provided with the necessary equipment.

After the pregnancy has been dated, there is a 3-day wait for any abortion procedure. The three-day waiting period leads to further delay and an additional visit to the Doctor. Multiple visits to the GP and the hospital do not accommodate the different needs and circumstances of women. It makes accessibility more difficult for women in rural areas, traveller women, homeless women, those with low income and women with a disability. Travel costs, time off work and possible child care need to be taken into consideration. If a woman seeking a termination is in an abusive relationship, it could be extremely difficult for her to arrange travel to a doctor, find and cover the cost of travel. Women with a disability whose mobility is restricted should not be required to attend several doctors’ appointments.

The majority of hospitals in Ireland are independently run but funded by the State. There are currently seven voluntary hospitals owned by faith-based organisations and a further five with religious order involvement in their governance. There are hospitals in Ireland which supply services solely in line with a Catholic ethos but these are in the private healthcare sector. In an Independent Review of State-Funded Services, the review raises serious questions over whether the State should continue to fund faith-based hospital services if they refuse to provide abortions or prescribe contraceptives. It also states that there should be an onus on all organisations that refuse to provide certain services based on ethos to tell patients where they can receive such services, even if it is against their ethos. There are currently 10 hospitals offering abortion services in Ireland. However, limited theatre space and under staffing is a problem in a lot of hospitals. Ireland is currently offering abortion services free of charge. However, the cost of contraception is a financial burden for many women. It is essential that the health service introduce free contraception in order to reduce the numbers needing abortion. Abortion Access Campaign West has started an online petition for free contraception in Ireland. Please take a moment to sign our petition.

As an activist in the west of Ireland, it is clear that many women do not know how to access abortion services in Ireland. The national booklet produced by the Health Service Executive on accessing abortion in Ireland is available online in languages English and Irish. It is not available in any other European languages and there has been a major lack in the dissemination of information on how to access the services. Fraudulent help-lines and websites by pro-life groups have left women confused, distressed and upset. One pro-life group has even opened a clinic in Dublin. In February 2018, The Times Ireland reported that an American anti-abortion group was training protesters to approach women seeking terminations, as well as urging activists to phone doctors pretending to seek an abortion to find out which health centres were performing the procedures. Since January, there have been a number of protests outside GPs surgeries and hospitals. Women should not be coerced, intimidated or harassed outside their family doctor’s surgery or hospital. We need to include Exclusion Zone legislation (such as those passed in London and Canada) to put a stop to this and protect the wellbeing of women seeking these essential services.

Abortion is still illegal in Northern Ireland. After decades of Irish women taking the boat or plane across the Irish Sea, where Irish women were being supported by the NHS in the UK, the women of Northern Ireland are now not being supported by the health services in the south. It can cost up to €450 for a non-resident to have an abortion procedure in Ireland. In communication with pro-choice organisations in the North, they have stated that women in the North are continuing to travel to the UK as, even after travel costs, it is more cost effective. There is also a question of women residing here temporarily from outside of Ireland but within the EU. Currently doctors are not reimbursed for providing abortion services to them. This needs to change so that all residents in Ireland can be offered free, safe and legal abortion.

On 25 May 2018, 66.4% voted in favour of repealing the Eighth Amendment, the biggest win in the history of any previous referendum in Ireland. The people of Ireland made their decision. Let’s allow women to make their own personal decision. Free from intimidation, harassment, or judgement and ease of access to all women regardless of income, nationality or circumstances. If you are looking to seek information about accessing a termination in Ireland phone the HSE 24 hr free-phone helpline: My Options on 1800 828 010. From outside of Republic of Ireland call +353 1 687 7044.

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Editorial Credit(s)

Amie Lajoie

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