The University Observer 28 April, 2009
Farouq Manji explores the circumstances of abortion in Ireland, and the lengths women go to pursue them.
According to the British Department of Health, between December 1980 and January 2005 more than 123,000 women travelled to the UK for abortions. For these women, the reasons for pursuing abortion were likely complex and multiple, however the reason for travelling to the UK was, and is, straightforward – according to Irish law, it is simply illegal to have an abortion.
The offi cial numbers published by the British Ministry of Health are likely an underestimation, as many women may not list their Irish address when visiting British clinics. And these values do not refl ect those who travelled to other countries, such as the Netherlands in the pursuit of terminations of pregnancies.
Ireland’s abortion laws are among the most restrictive in Europe – amongst the most restrictive of all developed nations. Under Irish law a woman can risk life imprisonment for pursuing an elective abortion within the State, unless the pregnancy risks the mother’s life, or she is suicidal as a result of it.
To complicate matters, an abortion that occurs indirectly as a result of standard medical care for the mother – for instance an emergency heart transplant – is not against the law. It is important to note that the law differentiates between risk to maternal life and risk to health. Abortion within Ireland can only be considered if the mother’s life is at risk. And that distinction is very diffi cult to make.
In 2007, ‘Miss D’, a 17 year-old female, was told her foetus had anencephaly – missing its brain and a portion of its skull. After it was explained that the baby would not be able to survive once born, she decided to pursue an abortion – otherwise she would have to carry the baby to term – avoiding both the physical and psychological trauma.
But since the pregnancy itself wouldn’t risk her life – she was forced to travel abroad to terminate the pregnancy. Once the Health Service Executive (HSE) were alerted to her intentions, they tried to bar her from doing so, but many court cases later, and after the HSE changed their position, the Supreme Court upheld her decision to travel.
Women who choose to terminate an abnormal foetus also forfeit the post-mortem analysis and counselling that would be afforded other women in their native countries. According to Dr McKenna, Master at the Rotunda Hospital, during his comments to the All-party Committee in 2000, “[foetal abnormalities] are diagnosed in maternity hospitals, and because those foetal abnormalities have recurrence rate in future pregnancy, it is important that these patients should have the best information available on their babies’ post mortems and on the likely risk of recurrence.”
“Ireland’s abortion laws are among the most restrictive in Europe – amongst the most restrictive of all develped nations”
By law, Irish doctors cannot condone or support abortion in any way. Therefore, it is more diffi cult for women to obtain their medical records before they travel – increasing the risk of complications and making management more diffi cult. The issue of complication is especially relevant for those women who decide to terminate due to foetal abnormality, such as with Miss D.
Dr McKenna illustrated the problem during the 2000 All-party Committee. “We are probably a little bit guarded as to what advice we can give, or we feel we can give. What I would like to move to is a situation where we could discuss this openly”. And after such instances as the Miss D case, women are less likely to speak openly with healthcare professionals about their intentions.
In 2006, over 5000 women travelled to the UK for an abortion. The majority of these women were between the ages of 20 to 30. Contrary to belief, in recent years teenagers only comprise approximately 12 per cent of the overall total.
The Irish Family Planning Association (IFPA) is a front-line agency that deals with women in crisis pregnancies and therefore is in an ideal position to convey their experiences. According to Niall Behan, the Chief Executive of the IFPA, women who pursue abortions are “from all social classes, and all age groups. We see single women and we see married women.”
The emotional burden of abortion is tremendous for all women, and even more so for Irish women who must travel overseas. Many do so in secret, for risk of social stigmatisation, harassment or embarrassment. They often cannot confi de in their friends or family, and are isolated with an incredibly taxing ordeal.
The fi nancial cost of an overseas abortion is also burdensome. According to Behan “with travel and with getting the procedure carried out and accommodation you’re talking about €1,000”. Women who pursue abortions have to make preparations and raise the money in a very short amount of time.
“By law, Irish doctors cannot condone or support abortion in any way”
Though unplanned pregnancies comprise the majority of cases, a number of women travel due to unviable pregnancies. Behan estimates that these comprise of 1-2 per cent of all cases. Concurrently, Dr McKenna estimates that approximately 50 women leave Ireland each year to terminate severely abnormal foetuses. Ireland has one of the highest incidence rates of neural tube defects in the world, which increases the rate of unviable foetuses and thus compounds the problem surrounding abnormal foetal termination.
These abnormalities are due, in part, to the lack of folic acid in the Irish daily diet. Many other countries mandate folic acid supplementation in common foods such as orange juice and bread – not so in Ireland.
Irish abortion law is simply exporting a problem that exists in modern society. The current legislature was implemented in 1861, and amended in 1983. It is not surprising that such an archaic law – written and introduced more than 100 years ago, is inept in the current social climate. It has failed to curtail the rates of abortion, is simply driving the problem underground, and forcing women to undergo unnecessary hardship.
In fact, from 1992 to 2004, total numbers of Irish abortions in the UK have increased steadily. In 2005 and 2006 the rates of abortion did decrease, however this may be due to the fact that more women are travelling to nations other than the UK.
Medical professionals and agencies such as the IFPA argue that the law needs to be changed. “It would be our view coming from our services that it should be, the law itself has done nothing to reduce the number of abortions, what we’ve seen the amendment in 1983… is a huge increase in the number of women travelling to the UK for terminations. Having a law that criminalises abortions does nothing to reduce the abortion rate at all.”
Master and consultant Obstetrician at Coombe Hospital, Dr Sean Daly’s comments to the All-committee in 2000 underline this idea. When asked whether in the case of a fatally abnormal foetus, a woman should have the option of termination in Ireland or a referral overseas, he replied “Yes I do. I think women deserve a choice there, though, because ultimately being pregnant is a more dangerous time than not being pregnant, and the reason that we justify that increased risk, albeit a small increase in risk, is because a pregnancy is going to result in the birth of a live baby.”
In other words, in the case where a foetus is not viable, it is both unnecessary and potentially perilous to force the woman to carry to full term. Yet medical professionals who concur with this opinion feel handcuffed by current law. Under these circumstances, agencies such as the IFPA are stepping in to fi ll the void. They provide pre and post-abortion counselling and impartial advice for pregnant women.
According to Mr Behan, “What we do is… give non-directive counselling. If a woman has a crisis pregnancy, what we’re compelled by the law to do is discuss her options. There are three options: she can go for adoption, she could go for parenting, or she could go for termination.”
The example of Miss D, and the thousands of women who travel abroad every year for terminations, serve to illustrate the necessity to re-examine current abortion law. The adversity Irish women must endure, due to outdated and ineffective policy, is unjustifi able. Regardless of the public opinion regarding abortion, it goes without saying that those who require the most representation – and protection – are getting none at all.