3 years on from repeal, abortion is still not fully accessible in Ireland
"We’ve already had the debate, the debate is over."
In 2018 the eighth amendment was repealed by referendum in Ireland, with 67% of people voting in favour of legalising abortion.
This landslide vote made abortion up until 12 weeks legal. It was a monumental change in our constitution meaning that many pregnant people no longer had to travel for essential healthcare. However, barriers to accessing abortion still exist in Ireland such as a three-day mandatory waiting period, geographical locations, and the 12 week gestational limit.
The National Women's Council of Ireland (NWCI) recently launched their Abortion Access campaign ahead of a review of the legislation this year. Alana Ryan, Women's Health Coordinator of NWCI says that while some barriers exist because of geography, others are due to legal and policy framework.
"Since the rollout has occurred we’ve seen a number of barriers which inhibit women and pregnant people to access care," she tells Her. "We know that one in 10 GPs, or about a third of GP practises, are offering abortion services.
"In terms of abortion in hospitals, the coverage is also quite bad. Only half of the maternity hospitals are providing the full suite of abortion services, and anyone after nine weeks has to go into hospital."
Research carried out by the Abortion Rights Campaign found that one person who was trying to access an abortion had to ring nine GPs before finding a provider.
As abortion was legalised in Ireland, a mandatory three-day waiting period was introduced between a patient seeking an abortion and actually receiving one. The World Health Organisation has since said that there is no medical rationale behind the wait period and they do not support it.
Alana says the implications of the wait period can sometimes be harsh: “It just delays and increases stress at a time where it can be very stressful for some women and service users as they’re trying to find a service provider and seek urgent reproductive healthcare. They’re facing this three-day wait which can just compound the uncertainty and stress of that.”
What's more is that safe access zones outside practices have yet to be introduced in Ireland, and this can lead to the harassment of those seeking and providing care.
Safe zones are vital in many countries in making abortion safer and more accessible, but potential harassment isn't the only issue that practitioners are facing.
Abortion in Ireland is still criminalised to a certain extent with medical professionals still facing jail time for certain offences. An abortion may be carried out after 12 weeks in the case of fatal fetal anomalies (FFA) but the doctor must be able to guarantee that the fetus will not survive outside of the womb for more than 28 days.
“Doctors can be very uncertain as to the exact time limit that a fetus will survive outside of the womb," says Alana. "So when faced with the criminalisation of care they are understandably very cautious, which means that in practice many people who receive that diagnosis of a fatal fetal anomaly in Ireland cannot access care."
During the pandemic, the number of pregnant people travelling to Britain for an abortion due to FFA actually increased. Those campaigning for abortion rights have concerns that the planned review, which in theory should address this issue, may be insufficient.
Darina Murray, co-convener of the Abortion Rights Campaign (ARC), says: "Minister Donnelly himself started out discussing all the barriers to abortion care in Ireland, and then removed the possibility to address any of them by making it an operational review instead of a policy review.
"There is that fear that it will open up the debate, but that’s not what this review is about. We’ve already had the debate, the debate is over."
ARC's issues with the review include having terms of reference stated before a chair has been appointed, and a fear that it may re-open the abortion debate. The group are also concerned that the review won't consider the threat of 'rogue agencies' as well as the 12 week gestational limit.
"When you use Google 'My Options', it will come up but so will rogue agencies like 'Gianna Care,'" Darina says. "They pretend to be pregnancy support when they’re actually an anti-choice organisation and they try to bully people into continuing with their pregnancy.
"Another massive issue is if you start a termination process here in Ireland and it’s not successful and you go over the 12 weeks, they won’t do anything for you. Then you have to travel.
"If you’re on the cusp of [a 12 week limit] and you have to get scans to date it, all of that is adding to a delay. You now have to find a doctor to certify you, wait three days, then you might need a scan to confirm dates, and now you could be on the cusp of 12 weeks and you can’t get care."
It is clear there is still a long way to go for fully accessible abortion care in Ireland and hopefully, this review can open up that conversation.
"Abortion care is in Ireland," says Darina. "Now what we need to do is listen to those who have tried to access the services and haven’t been able to, and the experience of those who have accessed them. We need to listen to them."
You can watch our full interview with Alana here:
You can find out more about the National Women's Council of Ireland's Abortion Access campaign here.
If you have experience with the abortion services in Ireland and want your experience to be heard, you can do so here.