Until 2018, abortion was only permitted in Ireland if a pregnant woman’s life was at risk. Following years of campaigning and after some harrowing cases because of the strict abortion laws — including the death of Savita Halappanavar in 2012 — Ireland held a national referendum and the country voted in favour of repealing that part of the Irish Constitution which effectively gave equal rights to a pregnant woman and the fetus she was carrying.
The government had to deliver legislation legalising a more liberalised abortion regime, which became effective from 1st January 2019. Part of that legislation stated that a review of the implementation of the new abortion legislation and services was to be conducted by the government after 3 years.
The three-year review was due to be published in 2022, but after several delays the final review report, carried out by an independent barrister, has now been submitted to the Minister of Health for consideration. The Minister has stated that he expects to publish the report in mid-April 2023.
Even though the new abortion legislation is being implemented, many people in Ireland are not aware of current barriers to abortion care that women are experiencing when attempting to access the services. There are in fact major concerns with the current availability of abortion services in Ireland and problems with the sustainability of the service. Only 11 out of 19 maternity hospitals provide abortion services, and access to surgical abortion is unavailable in most of those. Conscientious objection is proving to be an issue in the healthcare system, which also has serious staffing problems. Too many women are still having to travel abroad for abortion care such as in cases of fetal anomaly or where an early medical abortion has failed and the pregnancy is after the 12-week time limit. These are examples of issues which need to be addressed in the review process.
To inform the public of the current situation, Abortion Access Campaign West held a public meeting with experts in the field of research on access to abortion care in Ireland. The topics of conscientious objection, ethics, and abortion care were raised. We also heard from the Abortion Support Network on examples of situations where they are still having to help women travel to England for care.
Our action campaign includes pressurising the Minister online to publish the report. We have called for the final report with its recommendations to be made available to all legislators and the general public, so as to make them aware of the problems that currently exist. The report and recommendations must also be openly discussed by the parliamentary Health Committee before decisions about going forward are made by the Minister. We are also asking members of the Health Committee to request that the report be made available to them for a public hearing.
A full and true picture is essential for measures to be taken to make improvements for patients and providers, and to deliver the abortion access that so many people have fought for over many decades in Ireland.
In March 2022, the Department of Health invited members of the public and interested parties to make submissions expressing their opinion on the operation of the legislation. Members of AAC West carried out significant research on the legislation, policy and service provision in Ireland making comparatives with international practices and global best standards.
Based on this research, AAC West compiled an in-depth Report, including the following 20 key recommendations (Please feel free to download and share it):
– Broader and more consistent advertising of the MyOptions helpline
– MyOptions provides an appointment service for those seeking an abortion
– Women have the choice between in-person and telemedicine consultations and between medical and surgical abortion procedures
– The extension of full abortion services to all public hospitals as a matter of urgency
– A public database of abortion service providers in community settings and hospitals is made available
– Mandatory disclosure of conscientious objection for all relevant medical professionals
– A public database of conscientious objectors in hospitals is made available
– Full decriminalisation of abortion with the removal of Section 23 of the Health (Regulation of Termination of Pregnancy) Act 2018
– The removal of the mandatory 3-day waiting period
– The development of an accessible public database of what services are available in each hospital and the extent of conscientious objection.
– Telemedicine and self-managed abortion at home continue as standard care
– The provision of ambulatory abortion services by nurses and midwives
– Guidelines should allow for abortion post-12 weeks in cases of failed early medical abortion
– The decision on termination be made by the woman and supported by the health care team who place her wellbeing front and centre
– The interpretation of Section 11 on fetal anomalies be broadened to eliminate the need to travel abroad to access care
– Detailed guidance on the interpretation of ‘health’ under Section 9 be consistent with the WHO definition of health and includes mental and emotional health
– The full range of clinically recommended surgical options be made available for women post 12 weeks gestation and the choice of procedure be hers
– The introduction of adequate safe access zone legislation immediately
– Comprehensive contraception be accessible and cost free for all
– Evidence-based sexuality education be implemented in educational settings for all children and young people
We urge the government to consider these recommendations to ensure equitable and timely access to abortion services in a respectful and caring environment for all.
Thanks and in solidarity,
Lorraine, on behalf of Abortion Access Campaign West, Ireland
Abortion Access Campaign West (AACW) is a nonpartisan, non-affiliated women’s collective based in Galway set up to lobby government on legislation and ensure that abortion access is widely available in the West of Ireland.