IN THE WAKE OF THE EIGHTH
It is three years since Ireland repealed the Eighth Amendment, but with women still travelling to the UK to access abortion care, Nikki Walsh asks what has really changed?
Three years on, Nikki Walsh asks what has changed for Irish women
When Louise* attended her anomaly scan, alone due to Covid restrictions, the sonographer asked her to take a walk to the lift, as she wanted to see the baby move. “I knew then,” Louise says. “When I got to the lift, I wanted to keep walking because I didn’t want to hear what she was going to say.” The sonographer told her that her baby girl’s limbs were not developing, she had fluid on the brain and her lungs would not develop. “I knew my daughter had catastrophic issues and she would not survive,” says Louise. “I also knew I could not bear to watch her suffer.” Another scan was organised at a different hospital. Here, Louise was not offered a second opinion or given advice on her daughter’s condition. “Instead,” says Louise, “the consultant told me that no consultant in the country would touch me.”
In the days that followed, Louise could not sleep or eat. She knew if she could not find anyone to help her end her pregnancy in Ireland, she would go to the UK. “It was the only thing I could do for her,” she says. But because of medical issues that arose during her last birth, UK abortion care clinics could not give her the care she needed. Eventually, she found a hospital in London that could help her, but she was denied access to her medical records by the Irish hospital who had refused her care following the second scan. Fourteen airline service agents hung up on her when she tried to organise the safe return of her baby’s remains. “There was no way I was leaving her there,” she says.
In the end, her own consultant, who she had had since the beginning of the pregnancy, managed to assemble a team for her at yet another hospital in Ireland. Here, a doctor with experience of her baby’s condition, told her that he knew with all certainty from the scan that her baby would not live once the cord was cut. The option of a compassionate induction was offered and Louise laboured for 20 hours before her daughter was born. “The staff were incredible. Their support and compassion through the labour and the birth kept me going. They did hand prints and foot prints, they had organised a little outfit for her, for the priest to come and bless her, and a cold cot so we could keep her with us longer. We brought her home to meet her grandparents.” Now people tell Louise she was lucky she didn’t have to go to the UK. “I get that,” she says, “but I do sometimes stop myself and say to myself, why should any woman have to feel grateful someone did their job? That they provided me with the palliative care decision I had the right to make for my child and for my own health and allowed her the dignity she deserved. Isn’t that how every family should be treated?”
It is three years since some 66.4 per cent of voters voted to repeal the Eighth Amendment, giving women the right to abortion care in Ireland. Under the new legislation, women could terminate pregnancies that were less than 12 weeks in gestation and until viability if there were risks to maternal health or life and if there was a fatal foetal anomaly. In 2019, the year the legislation was introduced, some 6,666 women had a termination in Ireland. Yet every day in Ireland a woman also travels to the UK for abortion care. Brexit and Covid have made these journeys enormously difficult, with some women making wills before they leave, while others have received the ashes of their babies late due to Brexit delays at ports. Why are they travelling?
Claire Cullen Delsol is a campaigner with the Terminations for Medical Reasons Ireland (TFMR), a group that supports women carrying babies with fatal foetal anomalies. “Diagnosing a fatal anomaly is a complex issue. Two doctors have to agree in good faith that a baby’s condition is fatal, that the baby will die in the womb or 28 days after the birth. And with doctors liable to 14 years in prison for performing an abortion that could be considered illegal, understandably many are fearful. Some babies’ conditions are too complex to be diagnosed in this way, and some babies’ conditions end up not being considered fatal enough. Some also argue that our anti-abortion laws have attracted obstetricians who are obstructing the process.”
Claire lost her own baby in 2015. “The idea that a woman has to jump through all these hoops to do something she doesn’t want to do – end a wanted pregnancy – is horribly punitive. These women are sparing their children, and this has been misunderstood. We took on the pain so our children wouldn’t have to.”
Others have travelled to the UK during the pandemic because they had missed the 12-week window or simply didn’t have access to abortion facilities. According to a recent report commissioned by the National Women’s Council of Ireland, only one in ten GPs in Ireland are offering abortion care, while only just over half of maternity hospitals are offering abortion services. In a report published by the World Health Organization, “the leadership expected from the management is lacking” in hospitals not providing abortion care. JoAnne Neary is co-convener of Ireland’s Abortion Rights Campaign (ARC). “If you are a disabled woman who lives in a remote rural area in Ireland, travelling to a doctor who might offer this service isn’t easy. And because there is a three-day waiting period (between being certified as meeting the criteria by the doctor and having the actual procedure), she has to turn around and do the whole journey again. It is actually easier to get a plane to Liverpool.” The introduction of telemedicine during the pandemic has made this whole process easier for women, and JoAnne hopes it can continue. With pickets outside hospitals and GP surgeries, the stigma lives on.
“It affects everyone who crosses the threshold,” she says. “The research on the impact of this is really devastating.” In 2018, the then Minister for Health, Simon Harris, advocated for safe access zones around family planning clinics, doctors’ surgeries and maternity services, but these have yet to be realised.
This year sees a review of the legislation.
The National Women’s Council of Ireland is calling for the removal of the obligatory three-day wait, the removal of the 28-day limit, a review of the 12-week limit, the recognition of abortion as an essential part of healthcare, the end of criminalisation of doctors, broader access to services, relationships and sex education, and an independent external review. “We need the Government to take the lead on this,” says women’s health co-ordinator Alana Ryan. “We want a robust review process that will design a better model. We would like them to acknowledge that abortion is an aspect of healthcare, to realise this is part of a woman’s reproductive rights and that it should be regulated like any other healthcare service. We would also like them to recognise that women are the best people to make decisions about their own bodies.” On a societal level, there is further to go. “We need to mind our own business,” says JoAnne. “Stop policing, stop judging.”
For Niamh Uí Bhriain, a speaker for the pro-life political pressure group, The Life Institute, and the author of Gript, the polarisation of opinion on this debate has led to some dangerous thinking. “Serious issues are being masked. Women are still dying under this legislation. They are dying from lack of care, from staff shortages. All the deaths we have seen in women have occurred on understaffed wards. We need to demand better care.” She worries that the legislation has put undue pressure on women. “The message is: this is all on you. That’s not right. We have to support women better. When it comes to women having repeat abortions, we need to ask why are women having multiple unplanned pregnancies? What can we do to help them?”
It is three months since Louise lost her baby. She tells me if she didn’t have her daughter to care for, she doesn’t think she would be able to get out of bed. She doesn’t want counselling. “I can’t tell this story anymore. I had to tell it to so many people, so many times, and I have had so many doors slammed in my face. It’s re-traumatising.” She is not alone. Many of the women who shared their stories during the campaign feel betrayed. “They laid themselves bare,” says Claire.
It seems that in the great shaming and silencing of women that has been part of our culture for so long, we still have a long way to go.