Abortion: The Facts


As Ireland prepares to vote in a referendum on abortion we lay out the facts surrounding an issue that has divided the Irish electorate for decades.
Sarah Bardon

As the debate on the Eighth Amendment of the Constitution gets under way, the arguments will centre on a few key questions. A number of words or phrases will be often referred to during the course of the referendum campaign. Here is a brief explainer on what each means.

The Eighth Amendment

The Eighth Amendment was inserted into the Constitution after a referendum in 1983. The amendment guarantees to protect as far as practicable the equal right to life of the unborn and the mother. It prohibits abortion in almost all cases. It states: “The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.”

Article 40.3.3

After a referendum in 1983, Article 40.3.3 became the Eighth Amendment to the Irish Constitution. It guarantees to protect as far as practicable the equal right to life of the unborn and the mother, and prohibits abortion in almost all cases. It states: “The State acknowledges the right to life of the unborn, and with due regard to the equal right to life of the mother, guarantees in its laws to respect and as far as practicable, by its laws to defend and vindicate that right.” The 13th and 14th amendments were introduced in 1992. The 13th specified that the prohibition on abortion would not limit freedom of travel in and out of the State. The 14th stated the prohibition would not limit the right to distribute information about abortion services overseas.

The Citizens’ Assembly

The Citizens’ Assembly is a body established by former Taoiseach Enda Kenny to examine a range of issues including the Eighth Amendment to the Constitution. After months of hearings, it recommended abortions should be provided in a range of circumstances including when a mother’s physical or mental health is at risk, and in the cases of rape and fatal foetal abnormalities.It also proposed abortion could be provided when a foetal abnormality is identified, or on socio-economic grounds. Forty-eight percent said there should be no restriction on abortion up to 12 weeks gestation; 44 per cent favoured no restriction up to 22 weeks.

The Oireachtas committee examining
the Eighth Amendment

The 21-strong Oireachtas committee on the Eighth Amendment was tasked with examining the recommendations of the Citizens’ Assembly. It voted by 14 to 6 (with one abstention) in favour of repeal. It accepted the majority of the Citizens’ Assembly recommendations, but voted against allowing terminations when a non-fatal foetal abnormality is identified, or for socio-economic reasons. It proposed allowing terminations without restriction up to 12 weeks of the pregnancy and when a mother’s life, health or mental health is at risk.The committee stated compassion should be shown in the cases of fatal foetal abnormalities and recommended abortions be decriminalised.

The X Case

The X Case was the case of a girl who was raped by a man known to her. She sought a termination in the UK but the then Attorney General sought an injunction preventing her from travelling. She appealed the decision and the Supreme Court found in her favour.It called on the Government to legislate to allow for terminations when a mother’s life was at risk,including a risk to her life from the possibility of suicide.

The Protection of Life During
Pregnancy Act

The Protection of Life During Pregnancy Act legislated for the outcome of the X case. It allowed for abortions when a mother’s life is at risk, including by suicide. In a case of a real and substantial risk to a woman’s life arising from a physical health condition, an obstetrician/gynaecologist and a second relevant specialist must jointly agree and certify that the termination of pregnancy is the only treatment that will save the mother’s life. Three specialists are required when the threat to a woman’s life is at risk by suicide. The legislation created significant political difficulties for Fine Gael and resulted in the party losing five TDs and two Senators.


Where do political parties stand?

Fine gael

Fine Gael has a vote of conscience on this matter. This means each individual TD, Senator and Minister can vote in accordance with their own view. Senior Ministers will be bound to reach an official Cabinet position but can campaign on either side of the argument during the campaign. All senior Fine Gael Ministers support repeal but there are differing views on what should replace the Eighth Amendment in law.

Fianna Fáil

Fianna Fáil members have freedom of conscience on the issue of abortion, again meaning each member can vote in accordance with their own view. Party leader Micheal Martin is supporting repeal and allowing for terminations up to 12 weeks. However, the majority of the party do not support the proposition. The party's ard fheis voted in favour of Fianna Fáil adopting a pro-life position.

Sinn Féin

Sinn Féin’s position is in favour of repealing the Eighth Amendment and legislation to allow terminations when a mother’s life, health or mental health is at risk. The party also believes abortions should be provided in the cases of rape, incest, fatal foetal abnormalities.

However it is expected to change its position at a special ard fheis and support the proposition to allow for terminations on request up to 12 weeks. TDs and Senators will be bound by the party decision and will be disciplined if they do not obey the party whip.

Labour

Labour supports repealing the Eighth Amendment and allowing for abortions on request up to 12 weeks of pregnancy and when a mother’s life, health or mental health is at risk. The party also supports terminations in the cases of fatal foetal abnormalities. Its position was advanced in light of the upcoming referendum.

Solidarity/ People before Profit

Both parties are pro-choice and support a woman’s choice. Both parties advocate for abortions as early as possible and late as necessary.

Green Party

The Green Party supports access to abortion without restriction up to 12 weeks. After that, the party argues the availability of terminations should be left up to medical practitioners, for example when there is a threat to the health or the life of the mother.

Social Democrats

The party has a policy of repealing the Eighth Amendment and supports abortions in the first trimester of pregnancy. The party is in favour of legislating for termination on request up to 12 weeks gestation as part of service provision within the public healthcare system. Legislation should allow for terminations, after this period, on the advice of medical professionals where the mental and/or physical health of a woman is at risk or where there is a fatal foetal abnormality.

Independent Alliance

The Alliance does not have an official position. Three of the alliance’s TDs Shane Ross, Finian McGrath and John Halligan are in support of repealing the Eighth Amendment and the proposal to allow for terminations up to 12 weeks. However two of its TDs Sean Canney and Kevin ‘Boxer’ Moran are opposed to any change to Article 40.3.3 of the Constitution.



Timeline

So what is the date
of the referendum?

The Government has confirmed the date of the referendum will be on May 25th. Ballot boxes will open from 7am to 10pm.

Who is eligible to vote?

The total electorate is 3.2 million. You can log on to checktheregister.ie to be sure you're there. Eligible voters who are not on the register and wish to vote at the referendum should complete a supplement application form, which is available from City, County or City and County Councils by Tuesday 8 May, 2018. An application for inclusion in the supplement to the Register must be signed by the applicant in the presence of a member of the Garda Síochána. If a person is eligible to vote by post, or is unable to vote in person due to a physical illness or physical disability and is resident in a hospital, nursing home or similar institution, and they are not on the Postal Voters List or Special Voters List, as appropriate, they can apply up to Saturday April 28th for inclusion in the supplements to those lists. Application forms are available from City, County or City and County Councils.

What about the legislation that could replace
the Eighth Amendment?

The Government has published a policy paper outlining how it intends to legislate, in the event of repeal. The general scheme is available hereRead our Q&A on what will happen after the referendum here

Will the Oireachtas consider the legislation
before the Referendum?

No. It will not have the opportunity to scrutinise the Bill before the referendum takes place. It is expected to face significant opposition in the Oireachtas, in the event of a vote to repeal.


Abortion by country

Austria: 12 weeks

An abortion is available on request up to 12 weeks of pregnancy if performed by a physician after a previous medical consultation. Terminations are also permitted after 12 weeks to avert serious danger to the woman's life or physical or mental health; if there is a danger that the child may be afflicted with a serious physical or mental defect; or in cases involving a girl under 14 years of age.

Belgium: 12 weeks

Abortion is permitted up to 12 weeks. However there are requirements including asking women to provide in writing her determination to have an abortion. There is a six-day period of compulsory reflection prior to termination. Abortions are allowed at any stage later in pregnancy if two physicians agree there is a serious risk to the health of the mother or that the child has an "extremely serious and incurable disease".

Bulgaria: 12 weeks

Abortion is available up to 12 weeks of pregnancy on request. Terminations between 12 and 20 weeks are allowed but if only if the woman is suffering from a disease that could endanger the life of the pregnant woman or child. Terminations are also provided post-20 weeks when a woman’s life is in danger or evidence of a foetal impairment is found.

Croatia: 10 weeks

Since 1978 abortion has been legal in Croatia within the first ten weeks of pregnancy. A woman must produce a request for a termination in writing. A woman can be granted an abortion in the cases of rape or other seual assaults, potential birth defects or to preserve mental or physical health.

Cyprus: Not available on request

Abortions are not permitted at the request of the mother. Abortions are legal to save the life of the pregnant woman, to preserve physical or mental health of the woman, following rape or incest, or to in the event of foetal impairment.

Czech Republic: 12 weeks

Abortion is provided up to 12 weeks but the consent of the woman and authorisation of her gynaecologist is required. Consent of the woman is required to demonstrate she is not seeking an abortion under duress. If gestation is more than 12 weeks, the abortion requires authorisation by a medical commission.

Denmark: 12 weeks

Terminations are provided within the first trimester of pregnancy. Abortions can be provided over 12 weeks but it must be approved by a committee.

Estonia: 12 weeks

Terminations are provided up to the 11th week of pregnancy. A woman must consent to the abortion. It is allowed up to the 21st week if the mother is under 15 years or over 45, if the pregnancy endangers the mother’s health, if the foetus is suspected of having a serious physical or mental defect, or if the mother’s illness or other medical issue could hinder the child’s development.

Finland: N/A

Abortion is permitted in Finland up to 12 weeks. One doctor’s authorisation is also required when the individual is under 12 or over the age of 40. Over 12 weeks, the approval of two doctors is required. Terminations can be provided up to 20 weeks when there is a risk to the physical health of the woman or in cases involving girls under the age of 17. If a foetal abnormality is identified, abortions can take place up to 24 weeks.

France: 12 weeks

Voluntary abortion is legal without restrictions until the 12th week of pregnancy. A termination can be performed up to the very end if there is a serious threat to the life of the mother or a grave abnormality in the foetus.

Greece: 12 weeks

Abortion is permitted until the 12th week of pregnancy. In addition, a doctor other than the one performing the procedure must confirm that there are valid grounds for an abortion to take place. If the pregnancy is the result of a rape or incest, an abortion can be carried out until the 19th week of pregnancy. In the case of severe foetal abnormalities, the limit for terminating the pregnancy is 24 weeks.

Germany: 12 weeks

Abortions are permitted up to 12 weeks of pregnancy but women must attend counselling with a physician and a three-day waiting period is required ahead of the termination taking place. Abortions can also be provided after 12 weeks when there is a danger to a woman’s life, her health or mental health. A termination can also be provided if a foetal abnormality is identified.

Hungary: 12 weeks

Abortion is available on request up to 12 weeks. However the woman must have counselling prior to the procedure. If the pregnancy endangers the life of the woman, or the foetus shows malformation that renders any form of postnatal life impossible, the abortion can be performed at any time during pregnancy.

Italy: 90 days

Abortion is permitted up to 90 days of pregnancy. A one-week reflection period is imposed unless the situation is one of urgency. A woman must sign a certificate confirming her request for a termination. If the pregnancy involves an individual under the age of 18, parental authorisation is required. After the first three months of pregnancy, abortion is only allowed to save the woman's life or when the mother's physical or mental health is endangered, including if a foetal abnormality is identified.

Iceland: 16 weeks

Abortion in Iceland must be performed during the first 16 weeks of pregnancy. A written report from two physicians is necessary. However, this limit does not apply in cases where the mother’s life or health is in jeopardy or if foetal deformity is identified.

Latvia: 12 weeks

Terminations are provided up to 12 weeks without restriction and up to 22 weeks for “medical reasons”.

Lithuania: 12 weeks

Abortions can be procured up to the first trimester and up to 22 weeks for medical reasons.

LuxembOurg: 12 weeks

Terminations can be provided up to 12 weeks but the woman must give written agreement. This is to demonstrate the abortion is not being sought under duress. A one-week reflection period is required and the pregnant woman must be given an information booklet in which options other than abortion are explained. Under exceptional circumstances, an abortion may take place after 12 weeks. In these cases two physicians must state in writing that there is a serious risk to the woman's health.

Malta: Banned

Abortion is banned in all circumstances. A woman who performs an abortion on herself or consents to the procedure can be jailed for between 18 months and three years. A doctor who performs an abortion could be banned from their profession and face 18 months to four years in prison.

Netherlands: 22 weeks

Women in the Netherlands may terminate their pregnancy up to 22 weeks of pregnancy. A five-day waiting period is required between the initial consultation and the performance of an induced abortion. Terminations are provided up to 13 weeks without surgery. However surgical abortion are provided up to 22 weeks.

Abortions can be provided up to 24 weeks in life-threatening cases.

Poland: N/A

Terminations are only permitted when there is a grave threat to the health of the mother, if the foetus is irrevocably damaged or if the pregnancy resulted from rape or incest. Abortions in these circumstances are only within the first 12 weeks of pregnancy. The country is currently engaging in a debate on its abortion laws. Legislation to liberalise its regime were rejected by parliament earlier this year.

Portugal: 10 weeks

Abortion is provided up to 10 weeks of pregnancy. The pregnant woman must provide her consent in a document signed by her and, where possible, at least three days before the date of the abortion. Abortions are provided up to the 12th week to save a woman's life or to preserve her mental or physical health. In cases of rape, abortions are allowed within 16 weeks. The limit is 24 weeks if there is a risk that the child will be born with an incurable disease or deformity.

Romania: 14 weeks

Abortion is permitted on request during the first 14 weeks of pregnancy. An abortion may be performed later in pregnancy if absolutely necessary for “therapeutic reasons”.

Slovenia: 10 weeks

Terminations are provided on request up to 10 weeks of pregnancy. After this juncture, special authorisation is required.

Slovakia : 12 weeks

Abortions can be provided up to 12 weeks of pregnancy. A request must be made in writing. Abortions after 12 weeks are permitted for medical and genetic reasons and in cases of rape or other sexual crimes.

Spain: 14 weeks

Abortion in Spain is currently legal without restrictions up to 14 weeks, and up to 22 weeks under certain conditions, including when a fetal deformity is identified or if the mother's health is at risk.

Sweden: 18 weeks

Abortions are available on request up to 18 weeks. Between 12 and 18 weeks of pregnancy, the woman must discuss the procedure with a social worker. Terminations can be provided after 18 weeks but approval must be granted by the health board.

Switzerland: 12 weeks

Abortions are permitted on request up to 12 weeks. This was passed by a referendum in 2002. After twelve weeks, a woman may have an abortion if the doctor believes her "physical integrity" is under threat or she will face "profound distress" should the pregnancy be allowed to continue to term.

Turkey: 10 weeks

Abortion in Turkey is legal until the 10th week after the conception. Terminations can be provided after 10 weeks if there is a threat to a woman’s mental or physical health, in cases of rape and incest, and when the foetus has an abnormality.

United Kingdom: 24 weeks

Most abortions in England, Wales and Scotland are carried out before 24 weeks of pregnancy. However two doctors must agree a termination should be permitted. 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.


Abortion pills

On its first public sitting, the Oireachtas committee on the Eighth Amendment was advised to examine the use of abortion pills. Ms Justice Mary Laffoy told members the Citizens’ Assembly, which she had chaired, did not sufficiently examine the matter.

Her statement followed confirmation from the Health Service Executive about the “increasing numbers of women from the island of Ireland from making contact with online abortion pill providers”. The 21-strong Oireachtas committee was advised “the genie was out of the bottle” by chair of the Institute of Obstetricians and Gynecologists Peter Boylan, with regard to the import of abortion pills. There are no concrete figures on how many women access the pills as it is illegal to import them and it is illegal for medical professionals to assist a woman using the pills. However, a British Medical Journal study found between 2010 and 2015, 5,650 women from Republic and Northern Ireland accessed early medication through Women on Web. 26 per cent were aged between 30- 34. 24 per cent were aged between 25 and 29 years.4.4 per cent were under the age of 20. The majority (63 per cent) were mothers. In 2010, 548 sought pills. By 2016, it had tripled to 1,748. This coincided with a fall in the number of women travelling to the United Kingdom for terminations. In 2010, 4,402 travelled. In 2016, 3,265 women made the journey.

The author of that report Dr Abigail Aiken told the committee 99 per cent of the women who accessed these pills were able to end their pregnancy. The medication costs between €70-€90 and are delivered to the woman by post. However members were advised of the potential consequences of using the medication. The two main complications are haemorrhage bleeding and infection. Professor Fergal Malone, master of the Rotunda Hospital, said women have presented to accident and emergency rooms “with bleeding or an incomplete procedure”. “The other problem is that one sources medication like that on the Internet, one would have absolutely no idea what is received. It can be a very challenging issue.” Dr Rhona Mahony, master of Holles Street, added: “It is not just the physical consequences. There are also psychological consequences, and the circumstances in which a young person might choose to obtain tablets from a source she does not know and take them with all that risk, and why she is doing that on her own without accessing good medical care.”

There are also difficulties about the source of some medication, Dr Boylan told the committee. “It is well known that some medications that are supplied over the internet are not what they purport to be. There is another issue of concern, which is that women will be taking these pills without medical supervision and that has its own inherent dangers.”