May 25th, 2018, was a historic day for women’s rights in the Republic of Ireland when a country-wide referendum voted for the 8th Constitutional Amendment – making abortion illegal – to be repealed. This vote demonstrated the Republic of Ireland’s social movement development towards acknowledging the rights of women, and towards equality. The result rang across international communities fighting for the right to safe and legal abortions: proof positive that orthodox views on women’s lives, bodies, fertility, and sexuality can change. Yet, just across the border from this historic victory, Northern Ireland – legally distinct from the Republic of Ireland, and still under the governance of the UK – remains beholden to legislation over half a century old.
For England, Scotland and Wales, the 1967 Abortion Act enabled legal abortion in certain circumstances. However, the Abortion Act was never extended to Northern Ireland (NI). Today, the Offences against the Person Act (1861) and the Criminal Justice Act (1945) of NI remain in full force; meaning that the women of Northern Ireland are some of the only women in Europe who are forbidden to access legal abortion in almost all circumstances inside their own country (with Malta being the only country in Europe where abortion is entirely illegal). Punishment in Northern Ireland for having an abortion, or assisting a person to have an abortion, is some of the harshest in the world – and easily the harshest in Europe – extending up to life imprisonment, with no exception for rape or fatal fetal abnormality.
The issue of abortion is far from clear-cut. Even allowing for moral, religious and cultural complexities, abortion rights cannot be discussed in isolation – and must be seen as part of an embedded system with social and economic repercussions. To discuss abortion is to, fundamentally, discuss the matter of life. Indeed, the protection of life was why the 1967 Abortion Act was formalized. Foremost the act acknowledged the commonality of “backstreet” abortionists (and the often fatal implications of their bloody, unregulated, methods). Furthermore, considering the demand for viable abortion due to the financial and welfare repercussions of unwanted pregnancies, the English government sought to create legislation to control the quality of abortion services – and reduce the number of women being maimed and killed in backstreet alternatives. The 1967 Abortion Act was, at the most basic level, introduced not only to provide women increased bodily autonomy but to also save their lives. It created a standard for access to abortion services: two doctors appointments to peer-review the potential ramifications on the woman’s health, and the requirement that the abortion itself must be carried out by a registered doctor. At the time, the Act was heralded as some of the most liberal abortion law in Europe. Over half a century ago, the UK government recognized that providing access to abortion was necessary to preserve life – so why has Northern Ireland been left behind?
Even if one considers a fetus’s (potential) life as equitable to that of the person’s carrying it, the fact remains: there is a “correlation between restrictive abortion laws and higher rates of maternal mortality and morbidity” (All-Party Parliamentary Group on Population, Development, and Reproduction (APPG), 2018). Removing safe and legal access to abortion does not prevent people from seeking it – rather, such restrictions only force people to take desperate and unsafe measures. Indeed, in countries where abortion is allowed only in exceptionally narrow circumstances, or completely banned, three out of four abortions are classified as unsafe. The Centre for Reproductive Rights found that areas with the most permissive abortion laws have the lowest rates of maternal mortality – and some of the lowest abortion rates, period. This is the crux of the matter: abortion rates remain roughly the same across countries where abortion is available and countries where it is legally restricted. In countries with access to abortion, approximately 37 in 1,000 women of childbearing age have abortions. In countries where abortion is restricted, the number is approximately 34 in 1,000 (APPG report, 2018). By removing legal abortion options, countries are neither decreasing the number of abortions nor decreasing the number of lives – including fetuses – lost. Approximately the same number of fetuses are aborted, but more women die.
Not only does the inaccessibility of abortion cost lives; but it makes the vulnerable people of society the most greatly affected by this restricted access. The World Health Organisation (WHO) estimates that around 3.9 million adolescent girls (15-19 years old) have unsafe abortions every year in developing countries. While money and affluence may enable some women to access safe abortion services regardless of legality in their country, poor women face further restrictions and more unsafe options. Progressively unsafe abortions entail an increased risk of post-abortion complications. Meanwhile, the criminalization of abortion ensures that fear of being reported to authorities stops women and girls from seeking life-saving medical attention.
Even in countries with legal abortions – such as much of the UK – the restrictions which were originally enforced to protect lives now act as a barrier to the vulnerable. An analysis of data (Nov. 2016-March. 2017) from Woman of the Web, which supports access to currently illegal services providing abortion pills online in the UK, indicated that almost half of those seeking this illegal abortion service did so due to access barriers e.g. work or childcare issues. It is evident that despite legal access options women are still barred from abortion due to outdated restrictions. While the need to see two doctors (thus allowing for a peer-reviewed confirmation for the need for an abortion) may have prevented abortions being carried out by untrained personnel in the 1970s, the development of safe technologies no longer demands such restrictions. With the appropriate information and medicines, WHO has approved self-use of medical abortion pills, maintaining that “after initial contact with a trained person to assess eligibility, women can self-manage the medical abortion process without direct supervision of a provider”.
As it currently stands, should a person in Northern Ireland have an unwanted pregnancy, they must either travel to England or illegally source abortion pills online. In fact, over 700 women traveled from Northern Ireland to Scotland or England for an abortion in 2017. However, this solely represents a portion of women who have the funds to travel, are able to take time off work, and, if needed, find childcare. Should this person have a foetal abnormality, they face both an increased likelihood of complications and a lack of follow-up care at home. Should this person be in an abusive or controlling relationship, they are likely to be unable to travel at all. On June 7th, 2018, the Supreme Court of the UK ruled that these restrictions on access to abortion in Northern Ireland amount to the UK government breaching human rights – under Article 8 of the European Convention on Human Rights (ECHR). While the Court acknowledged that it had no jurisdiction to issue a declaration of incompatibility between Northern Irish law and Convention Rights, the judgment included a non-binding opinion that such incompatibility existed. Given that human rights – unlike health issues – are not devolved from the UK government to the Irish Assembly, this inclusion of this opinion opens the possibility that Westminster may legislate to relax Northern Ireland’s abortion laws. The recent development – as of March 5th, 2019 – wherein lawyers have stated that the European Court of Human Rights is to raise the issue of abortion in Northern Ireland with the UK government, suggests that pressure on Westminster is mounting. In many ways, the UK has historically been at the forefront of abortion rights – from the (at the time) liberal Abortion Act of 1967, to the 2014 amendment of the UK’s humanitarian aid policy to acknowledge access to safe abortion as covered by the international humanitarian law’s protections. Nevertheless, 5 years after acknowledging that the need for abortion care for victims of armed conflict supersedes the provision of medical care under any country’s national law, the UK parliament has still failed to provide these rights to all of its own citizens. Northern Ireland is forgotten in the shadow of Brexit.
So where does that leave us? It is evidenced that legalizing abortion does not increase abortion rates, and rather lowers the number of women dying through unregulated backstreet alternatives. It is apparent that heavily restricted legalization can negatively impact the most vulnerable in society. Furthermore, it is evident that the UK government is fundamentally losing ground as a world leader in abortion rights by failing to extend legislation to Northern Ireland.
Landmark cases such as Repeal the 8th indicate that, slowly but surely, countries bound by outdated laws – laws which reflect the ideals and practices of societies built on discrimination – are being dragged into the 21st century. It is our job, as activists, to ensure that no woman, transman, or person capable of having a child is left behind. It took the Republic of Ireland 30 years to legalize abortion; let’s not wait another 30.
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