The Law Changed, So Why Are Irish Women Still Having To Travel To Access Abortions?

Six months after terminations were legalised in the Republic of Ireland, Anna Silverman finds out why women feel the 'revolution' wasn't nearly enough...

Abortion Ireland

by Anna Silverman |

In a café in Donegal, Republic of Ireland, a GP walks in and looks around nervously. She spots me and suggests we sit outside, where no one can hear us talk. She’s been careful to keep our meeting a secret from her colleagues. What she’s here to discuss concerns a practice that’s perfectly legal, which she carries out each week at work.

The GP, who we’ll call Elle*, explains she’s one of 335 GPs (out of 4,000 in the country) who have ‘opted in’ to provide abortion in Ireland since it was legalised last May. But she keeps this quiet. ‘If our practice was to attract publicity for being a centre where terminations are carried out, I’m not sure how some of our patients would view it,’ she says. ‘It would also be very uncomfortable for doctors and staff who genuinely have issues with it. I don’t want to be singled out or create a bad atmosphere. I’m trying to keep the peace.’

In Ireland, abortion is now allowed at a GP surgery if the woman is less than 10 weeks pregnant. Yet some women Elle sees have to travel three hours each way for an appointment because no practice has signed up to provide abortions in their area. And, out of the 335 GPs who do provide terminations, only 182 have agreed to be publicly listed, meaning women may not always know where to access the service. ‘The majority of GPs in Ireland aren’t providing: some are conscientious objectors, others say they just don’t want the negative publicity or they’re too busy. There needs to be more availability,’ says Elle.

This secrecy feels at odds with the jubilant celebrations beamed around the world in May 2018, when the country overwhelmingly voted to repeal the eighth amendment to legalise abortion. Social media was full of Irish people proudly travelling #hometovote and the Prime Minister, Leo Varadkar, hailed the result a ‘quiet revolution’. The new legislation was swiftly brought in in January. Yet, six months later, some doctors who have agreed to provide abortions are staying quiet, while some women are still travelling overseas for terminations.

Mara Clarke is founder of the Abortion Support Network (ASN), which helps women who need to travel to the UK to access safe, legal abortions. Since January, around 18 women a month are still seeking their help, they say. Mara thinks there are three key problems with Ireland’s abortion laws. First, the number of doctors and hospitals choosing to provide abortions: ‘Maternity hospitals in particular shouldn’t be allowed to opt out,’ she says. Second, the strictness of the criteria: a woman cannot choose to end her pregnancy after 12 weeks (between 10 and 12 weeks it has to be carried out in a maternity hospital). After 12 weeks, abortion is only legal if there is a serious risk to the woman’s health or the foetus is likely to die within 28 days of birth. ‘People are finding this 12-week cut-off extremely challenging,’ she says. In contrast, abortions in England, Wales and Scotland can be carried out up to 24 weeks – or, in certain circumstances, after this. ( Just 1% of abortions were carried out after 20 weeks of pregnancy in England and Wales in 2017.)

The third issue in Ireland is that there’s an enforced three-day wait between a woman asking for an abortion and actually getting one. ‘This can cause all sorts of problems,’ says Mara, ‘especially if women are nearing the 12-week cut-off or they have to travel for hours for each appointment. I think it’s been purposefully put there to run down the clock. It’s condescending to assume a woman needs three days to think about it. It’s a victory that some women aren’t getting on a plane or boat any more but we’re still seeing a lot of people fall through the cracks. Ireland’s abortion laws don’t go far enough.’

One woman ASN has helped since abortion was legalised is Eva*, who tested positive for a serious foetal abnormality, but it was not deemed severe enough to warrant an abortion after 12 weeks. ‘I had to wait until a certain point in pregnancy to have the test, and by the time I had the results I was beyond 12 weeks,’ says Eva. ‘That meant I had to travel [to the UK]. I work on contract and was not paid for the days I took off. I already have a special-needs child and other children and I’m barely managing.’

Amy* also had to travel to the UK, after she unwittingly went to one of Ireland’s rogue crisis pregnancy centres – claiming to offer unplanned pregnancy support, these are actually associated with anti-abortion campaigners. There, she was told she was more than 12 weeks pregnant, although she was actually only nine weeks at the time. Then there was the couple who were told by doctors that their foetus had a fatal abnormality (meaning they were eligible for an abortion post-12 weeks). But then a separate committee told them that ‘the complex foetal anomaly’ was not severe enough for them be treated in Ireland.

In a seaside town near Dublin, I meet GP Siobhán Donohue. She travelled to Liverpool for a termination in 2011 – when abortion was still illegal in Ireland – after getting the diagnosis that her baby wouldn’t survive. Now she’s chair of Terminations For Medical Reasons (TFMR), a group that supports people who have been given a severe or fatal foetal anomaly diagnosis. She still sees many women who have been told their baby will be severely disabled but, as they’re over 12 weeks, those wanting an abortion have to travel to the UK. ‘You’re talking about somebody whose baby might only survive for a few weeks or months, but it doesn’t fit into the “fatal” definition,’ she says. ‘What wasn’t discussed during the campaign last year was women who get a catastrophic diagnosis that’s not considered fatal. They’ve not been considered.

Since January, she says about two women a month with this diagnosis have been asking TFMR for help. ‘They’ve already got this awful diagnosis, they shouldn’t then have to get on a plane,’ she says. ‘When they come to us, they’re shaken and a shell of themselves. They ask where one finds the strength to get through it, because the biggest thing is waiting around for that flight to England. It was the hardest journey I ever had to make.’ Fiona Dolan, 28, in Bundoran, Donegal, thinks doctors shouldn’t be allowed to opt out of providing abortions. ‘It shouldn’t be their personal choice. We have a legal right to it now, but it’s still not always easily available and that’s not fair,’ she says. She thinks the three-day wait is ‘ridiculous. They should trust the woman has already thought about it. It’s so condescending.’ Aoife Mc Eniff, 23, also in Bundoran, agrees, and says she wouldn’t want to go to an older doctor if she needed an abortion. ‘I feel like they’d try and persuade you not to go through with it, even though it’s their right to be neutral and say, “These are your options,”’ she says.

But, despite the feeling there’s work to be done, there’s also resounding agreement that a lot of progress has been made in a short space of time. Mary Favier, founder of Doctors for Choice, which campaigns for the decriminalisation of abortion, points out that Ireland is now the first place to provide abortions through a GP-led service. ‘We’ve proved it can be done,’ she says. HSE – the Republic of Ireland’s health service – says they are satisfied there is ‘a good geographic spread of GPs taking part, enough to meet the needs of people who may need to access the service’. Now, many campaigners’ sights are on Northern Ireland – where abortion is still illegal, although a promising development this month means the UK must legislate on ending the ban. If the law can change in Ireland, where stigma has been deep-rooted for centuries, many hope this means the North is next.

As for the Republic of Ireland, Elle hopes this element of her job as a GP will soon shed some of its stigma and secrecy. ‘We need to roll out more of a nationwide service, put pressure on those who aren’t providing and show more compassion to women,’ she says. ‘Yes we won the vote, but people have moved on thinking that the fight is over. But it really needs more work.’

Visit ASN to donate or if you need help travelling for an abortion; asn.org.uk. Unplanned pregnancy counselling services are available at myoptions.ie

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