Did Ireland Really “Repeal the Eighth”? Hurdles and Opportunities in Abortion Access in Ireland
Maja Ochojska (COL’23) is a senior in the College majoring in Government and minoring in Justice and Peace Studies. She served as a GIS Fellow during the 2021-2022 academic year.
In May 2018, a historic referendum was held in the Republic of Ireland; voters were given the opportunity to answer ‘yes’ or ‘no’ to the prompt, ‘provision may be made by law for the regulation of termination of pregnancy.’ For many of Ireland’s neighbors and allies, it may have been surprising that this question even had to be asked in the 21st century. In Ireland, however, this prompt was the culmination of centuries of struggle against a repressive religious doctrine and regressive social norms; even as it was happening, the referendum was being ferociously protested by the country’s vocal and powerful conservative faction.
66.4% of voters in the Republic of Ireland approved an effective repeal of the eighth amendment of the Irish constitution, which limited abortion access only to pregnant women whose lives were judged to be at risk. In the aftermath of the referendum, a law was introduced that provides for free and accessible abortions up to 12 weeks of gestation, for which services were rolled out in early 2019.
However, this hasn’t just been a flick of a switch. Just like the battle for the referendum, the implementation of these laws and access to abortion services for women in Ireland will be a long and hard fight. Therefore, it is important to evaluate how these laws and services have fared so far, nearly 4 years since their implementation, and what obstacles remain for women in Ireland who are seeking an abortion.
Did Ireland really “Repeal the Eighth”? It depends who you ask. Kitty Holland, social affairs correspondent for The Irish Times, who has written extensively about abortion access in Ireland, contemplates the issue in Una Mullally’s Repeal the Eighth anthology. She writes that, prior to 2018, abortion was a middle-class issue. Not only was the debate dominated by middle-class identity politics, but also access to abortions was in fact limited to middle-class women. Travelling to Great Britain or France to obtain a legal abortion was common practice for those who could afford it, and many could not. While many of these obstacles have been lifted in the post-eighth Ireland, abortion is not as accessible in Ireland as it may seem, nor as it should be.
Economic Obstacles and Accessibility Issues
In a multinational study conducted by scholars at the London School of Economics in 2021, costs associated with getting an abortion were cited as by far the most influential factor influencing women’s choice. These costs extend beyond the price of the procedure itself and include everything from traveling to the clinic and accommodation to taking time off work, childcare, and companion costs. While the new law in Ireland has at least partially lifted some of these financial burdens, many have remained due to a range of accessibility issues.
In 2018, the UK Department of Health recorded nearly 3,000 Irish residents undergoing abortion procedures throughout Great Britain. By 2019, that number dropped to fewer than 400, and in 2020 to fewer than 200. At the same time, the number of abortions in Ireland jumped from 32 to 6,666 between 2018 and 2019. These number clearly illustrate the relative success of the new law; many women were spared the journey to Britain and were able to obtain abortion services in Ireland.
However, accessibility has proven uneven across the country. Journalists like Kitty Holland and Caelainn Hogan highlight important spatial disparities: only one in three General Practitioners (GPs) provides the service, and in rural areas that proportion drops to one in ten. This not only means delayed access, but it also continues to mean travel requirements for many women, which the new law was designed to remove. Additionally, Ireland only has 19 maternity wards throughout the entire country, of which just 10 provide abortion services. The issue of accessibility is compounded by a number of additional factors, including the twelve-week cap, and a mandatory three-day waiting period between speaking to a doctor and receiving services.
This combination of complicating factors means that Irish women really do not have much time to get an abortion, considering that many find out that they’re pregnant already multiple weeks into the pregnancy. Moreover, when the professional and personal lives of women are factored into the equation (as they should in every conversation around this topic), then the hurdle-ridden system starts to look significantly less accessible than numbers may suggest.
The twelve-week cap in particular has been a subject of fierce debate, and has been described as arbitrary and conservative by many. In the UK, women can terminate a pregnancy up to twenty four weeks of gestation without any restrictions. There are no provisions to make exceptions for women to obtain an abortion past twelve weeks, even if difficulties securing an appointment, were a factor. The medically arbitrary nature of the twelve-week cap could be interpreted as the Irish government de facto declaring when they think life begins, which has serious repercussions for further progress and the improvement of existing services.
Social and Educational Barriers
The above are issues that arise from the law alone, but there are other setbacks that emerge from the social backlash against the result of the referendum, and the continued effort of anti-abortion activists at limiting services. There have been multiple reports of women being intimidated outside of clinics, rogue pregnancy centers popping up in which workers lie to women about the availability of services, and ‘vigils’ held outside maternity wards which provide the abortion services. It is important to remember that these behaviors affect, again, those already disadvantaged who may find it hard to obtain services in the first place. Many women are not only experiencing the systemic hurdles and accessibility issues discussed above, but are also struggling to find reliable sources of information, dealing with language barriers, or battling other health or mental health issues related to their pregnancies. There is a profound lack of support structures that are crucial for the accessibility and sustainability of abortion services. The responsibility to care for over six thousand new patients annually cannot be spontaneously sprung on the already strained healthcare providers; there must be a careful and purposeful effort to expand services and allocate funding for the range of services that will be required to repeal the eighth.
Moreover, and as many activists have pointed out, repealing the eighth is not simply a matter of implementing the referendum vote; it requires the dismantling of centuries of rhetoric and misinformation that have dominated discourse about reproductive rights in Ireland. There is a dire need for continued policy debates about the referendum and an extension of the legislative effort to address all the issues that are entailed with such a policy shift; for example, funding for educational initiatives to destigmatize abortion and provide information about the physical and mental effects of the procedure. A study in Northern Ireland found that adult community education can help reject deep-rooted patriarchal, and religious norms surrounding the understanding of abortion through open lived-experience discourse.
The National Women’s Council of Ireland produced an extensive parliamentary testimony regarding the new law. Some of the other failures that they highlighted that have not already been discussed here include: lack of monitoring of conscience-based refusal of care; failure to address additional barriers posed to marginalized groups; lack of proper training to healthcare providers; and absence of modern and useful sex education in schools. Some of their recommendations include: repealing the three-day waiting period and the twelve-week cap; strengthening telemedicine and interpreter services; urgently expanding access in rural areas; regulating and banning rogue pregnancy centers.
Beginning the scheduled review of abortion services three years after the referendum, Irish Health Minister Stephen Donnelly said that the expected “ease of access” of abortion services is far from being achieved. The review will investigate how abortion services have fared, and what some of the major setbacks have been in terms of accessibility. However, the law review itself is only based on the success of operation of the current laws, and that it is not an evaluation of the actual policy or terms of provisions.
Various economic and social obstacles to abortion access remain in place for women in Ireland. The experiences of women seeking abortions in Ireland highlight how, while the eighth has been repealed in theory, the religious and ideological zeal that fueled its sustenance throughout the 20th century, is alive in many politicians, doctors, and ordinary citizens. The actions of these individuals and their lobby have consequences for women seeking reproductive healthcare in Ireland, and their persistence throws into question the future of the abortion provisions. Nonetheless, it is important to acknowledge the strides that this law has made, both in terms of allowing underprivileged women to access abortion, and the effect they have had on public opinion. If the referendum were to take place today, over 80% of Irish voters would vote ‘yes’ to allow abortions; a 14% increase in public support in just 4 years! The Irish abortion journey has been a strenuous but rewarding one, that still owes so much to women in Ireland.
In the light of the Dobbs vs. Jackson Women’s Health Organization ruling by the United States Supreme Court, which effectively eliminated the constitutional provision for abortion access in the U.S., Irish activists are on high alert. Can this resurgence of anti-abortion sentiment and rhetoric on a global scale pose a threat to progress in Ireland? What is the best strategy to improve services and expand their scope in this volatile and uncertain political climate?
Sources:
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