Q&A: Your key questions answered from the abortion campaign

Voters will go to the polls this Friday to determine the future of the Eighth Amendment to the Constitution.

The ballot paper will ask whether article 40.3.3, which gives the unborn an equal right to the life of the mother, should be repealed and provision be made for the regulation of the termination of pregnancy.

The Government has published the general scheme of a Bill, which outlines how it intends to legislate in the event of a Yes vote.

Here The Irish Times aims to answer the questions that have been circulating during this referendum campaign.

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What are people voting on?

The ballot paper will ask voters if they want to remove article 40.3.3 from the Constitution and for provision to be made for the regulation of the termination of pregnancy.

The Referendum Commission has said this is not a vote on any legislation that could follow the repeal of the Eighth Amendment.

If a majority votes Yes, the Oireachtas will be allowed to pass laws regulating the termination of pregnancy. These laws need not be limited to the availability of termination in circumstances where there is a real and substantial risk to the life of the mother.

In the event of a No vote, article 40.3.3 will remain in place as well as the Protection of Life During Pregnancy Act, which allows for terminations when a mother’s life is at risk, including on the grounds of suicide.

What is the current situation?

Ireland has one of the most restrictive abortion regimes in the world with the Eighth Amendment prohibiting abortion in all circumstances bar one.

Terminations can be provided – under the Protection of Life During Pregnancy Act – when there is a real and substantial risk to the life of a mother, including by suicide. Seventy-seven terminations have been carried out since its introduction in 2014, seven on the grounds of suicide.

What is  Government proposing to do if  amendment  repealed?

In the event of a Yes vote, article 40.3.3 would be removed and be replaced with an enabling provision stating: “Provision may be made by law for the regulation of termination of pregnancy.”

The current law remains in place until any new legislation is passed by the Oireachtas. The Government is proposing it be replaced and has published the general scheme of a Bill.

In what circumstances would abortion be available under the proposed new legislation?

Under the Government plans, terminations would be accessible within the first 12 weeks of pregnancy. A woman would seek a termination from a medical practitioner, who would have a legal obligation to discuss the woman’s options with her. A three-day waiting period will then be enforced. After that, the woman can have abortion if she still intends to terminate the pregnancy.

Will abortions be available after 12 weeks?

In very specific circumstances, yes. If there is a risk to a woman’s life or of serious harm to her health, two medical practitioners will be asked to determine if an abortion should be permitted.

Terminations in these instances will not be carried out beyond viability, which is reached at 24 weeks. In the case of an emergency, one medical practitioner will be permitted to perform an abortion if there is an immediate risk to the life of the pregnant woman, or of serious harm to her health. There are no gestational limits applied in these circumstances.

Abortions will also be available if a woman is informed that the foetus will not survive outside the womb or will die shortly after due to a fatal abnormality.

Will there be late-term abortions?

Beyond the 24th week of pregnancy, there will be no abortions except in the cases of fatal foetal abnormalities or when there is an immediate risk to the woman’s life or health. No gestational limits will apply in these circumstances.

Will abortions be permitted on the grounds of a disability?

No. Within the first 12 weeks of pregnancy, terminations will be provided without specific indication, meaning a woman would not have to state a reason for seeking an abortion.

However, it is extremely difficult to identify a foetal abnormality, such as Down syndrome, within the first trimester of pregnancy. There are tests available from the ninth week of pregnancy. These are not available on the public health system and must be requested, and paid for, by the mother.

A screening test is carried out and the result takes two weeks to return as the sample is sent to the UK or US for examination. This is not a diagnostic test and therefore a further test is required, which takes three days to complete.

In addition there is a three-day waiting period before a termination can be performed which means it is virtually impossible to identify such a foetal abnormality within the first 12 weeks and for an abortion to be procured on that basis.

Beyond 12 weeks, terminations on the basis of a disability are outside the scope of the law and are therefore illegal. Those campaigning to retain the Eighth Amendment warn that advances in technology may provide a more accurate diagnostic test within the first three months of pregnancy. It is unclear if and when such advances may occur and their effect.

What about mental health?

Under the proposed law, there must be a risk of serious harm to a woman’s health for a termination to be provided. There have been comparisons made to the situation in the UK, where the law states terminations can be provided if the “continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family”. It also allows terminations to prevent “grave permanent injury” to the woman’s physical or mental health.

The proposed Irish law states that a termination can only be permitted when there is a risk of serious harm to the health of the mother, with no distinction made between mental and physical health.

Who will pay for abortion services?

Currently, terminations provided under the Protection of Life During Pregnancy Act are covered by the public health service. This will be expanded to cover terminations when a there is a risk of serious harm to the mother’s health.

Up to the first 12 weeks of pregnancy, it is expected terminations will be provided by the public health service when the patient is on a medical card. Private patients will have to pay for services.

It is unknown how much the service will cost but indications from the Government suggest the woman would pay the standard fee to see her doctor, and in addition pay for the pill or the procedure. In the UK, the cost varies from €470 to €1,555. The abortion pill or the surgical procedure is €70 and treatment costs make up the rest of the final price.

What if a medical practitioner morally objects to abortion?

The legislation provides for conscientious objection for medical practitioners. Doctors will be obliged to make arrangements for the transfer of care of the pregnant woman to another practitioner. This is included in the current law, the Protection of Life During Pregnancy Act. There are no consequences for those who object.

Will the health service have the capacity to provide this service?

The Government has insisted it will provide financial resources to provide terminations in the event of a Yes vote and that it will enter into a period of consultation with medical representative groups.

Will a woman still face prosecution if she procures an abortion?

Currently, a woman who accesses an abortion in this country faces 14 years in prison. The same penalty applies to a medical practitioner, or indeed anyone, who assists a woman in procuring a termination. Under the proposed new legislation, there will be no circumstances where a woman who procures an abortion can be criminalised. However, anyone who performs an abortion outside the law will face a potential penalty of 14 years in prison.

If the Eighth Amendment is retained, can the Government reduce the penalty a woman faces?

The attorney general advised the Cabinet in 2016, in response to a Private Members’ Bill, that the penalty must match the Constitutional protection given to the life of the unborn. As the Constitution currently stands, the termination of pregnancy is equal to the taking of a life and the penalty has to equate to that.

How will Ireland's abortion regime compare to the rest of Europe? 

Ireland, Northern Ireland, Poland and Malta have the most restrictive abortion laws in Europe. If the legislation is passed, Ireland will be in line with 20 other European countries in allowing access to terminations up to the 12th week of pregnancy. Romania, Spain and Iceland allow for access up to 14 weeks; Sweden permits access to abortion until the 18th week; while it is lawful until the 24th week in Britain and the Netherlands.

Will Ireland have as liberal a regime as Britain?

Terminations are accessible up to the 24th week of pregnancy in the UK. They can be carried out after 24 weeks in certain circumstances – for example, if the mother’s life is at risk or the child would be born with a severe disability.

The law in the UK states that two medical professionals must certify the pregnancy has not exceeded 24 weeks. Terminations will be provided if the continuation of the pregnancy involves a risk of injury to the physical health or mental health of the pregnant woman, or any existing children of her family.

Ireland, if the legislation is passed, will allow for access within the first 12 weeks of pregnancy and up to the 24th week of pregnancy when a mother’s life or her health is at risk, and when the foetus would not survive outside the womb. Terminations on the basis of an abnormality will not be permitted and abortions will be prohibited beyond the point of viability, except in the case of a fatal foetal abnormality and in emergency cases.

Can people be sure the legislation, as it is proposed, will be passed?

The recommendations were borne from an all-party Oireachtas committee and have been translated into the general scheme of a Bill. Voters are being asked to vote Yes with a clear outline on how the Government would legislate.

A significant number of TDs and Senators are in favour of the proposals as they currently stand but it will require a policy change from Sinn Féin for the measures to pass. Their current policy does not match the Government Bill. However, it is expected to change that position at an ardfheis in June.

Many of those who do not support the legislation have stated that in the event of a Yes vote, they will implement the will of the people.

What about a future Dáil, though?

If the people vote Yes, the Oireachtas will be given the authority to legislate for the regulation of the termination of pregnancy. As with any piece of legislation, it is open to the Oireachtas to change it.

Some say this may lead to liberalising the law, but it equally could lead to the restriction of laws by a future parliament.

If there is a No vote, what happens?

The current situation remains.