The abortion referendum was a defining moment for Ireland.
Together as a nation in 2018 we said clearly that abortion was a key part of women’s reproductive rights, that it should be available locally, and that no woman should be forced to travel in shame and secrecy for essential healthcare. And in many cases, the law has worked. But we know in many others it has not.
A review of the legislation is to be carried out after three years, a process which was started by the Minister for Health Stephen Donnelly last week.
It is a process that the National Women’s Council believes to be crucial in ensuring our abortion laws work for those who need them, yet as it stands, we have serious concerns.
In Ireland, access to abortion is not equal. Many women still face systemic barriers to this fundamental healthcare
Although the Minister appeared before the Oireachtas Health Committee for questions on the review, we were left with few answers. We are hugely concerned that the review process does not have an independent chair, which undermines the process and calls into question its independence.
The unprecedented move to have a public tender process for the expert chair will delay the review, and means effectively there is no independent oversight for stage one. There are comparable reviews with independent chairs which were not subject to a procurement processes via tender. The Minister needs to clearly outline why this is required for the abortion review.
Furthermore, it is crucial that there is an advisory group to support the independent chair, when appointed. The inclusion of service users, providers, reproductive rights experts, constitutional and human rights experts would ensure an inclusive and balanced approach.
We have concerns about the absence of a guarantee in the terms of reference that proposed changes to improve the operation of the legislation, based on evidence gathered from the review process, will be brought forward by the Minister.
We cannot have a situation whereby – through the public consultation – we ask women and couples to share sensitive and distressing information on barriers that arise from the operation of the Act, without any guarantee that this will lead to legislative and policy changes.
The terms of reference must be amended for clarity on this point, if we are to ensure that we can overcome any barriers to equitable, accessible and legal abortion that may be found to exist in law, policy or practice.
Importantly, the experiences of women must be at the centre of any planned review. It is they who are best placed to make decisions regarding their health, with the advice and support of their doctor.
There is much that can and should be done to ensure that all women who require an abortion can avail of one
Currently, there is a mandatory three-day wait period between a woman being certified as no more than 12 weeks pregnant and having an abortion. The waiting period has no medical purpose or value and can act as a barrier to access.
Many women who need access to abortion still cannot get it. Coverage is poor across the country, with only half of our maternity hospitals providing abortion and only one in 10 GPs. In order to procure an abortion, you need to have a PPS number, which is a significant barrier for immigrants and asylum seekers.
Access to healthcare at home was a clear call from the people of Ireland in 2018, yet sadly, we know many women are still travelling to access crucial healthcare. In the case of fatal foetal anomaly (FFA), a termination may be carried out when two medical practitioners have concluded that the death of a foetus is likely either before birth or within 28 days of birth.
While in some cases of FFA it is possible to predict death soon after birth, it is not possible to predict the exact timeframe within which it will occur. The Act also clearly excludes cases where the foetus’ life expectancy after birth is short, but not as short as 28 days.
The latest statistics from 2019 show that 375 residents had to travel abroad for abortion services. Of these, 20 per cent were seeking a termination on the grounds of a foetal anomaly.
In Ireland, access to abortion is not equal. Many women still face systemic barriers to this fundamental healthcare. Our health system is not delivering what women need: equitable access to abortion.
There is much that can and should be done to ensure that all women who require an abortion can avail of one. This is the critical moment to make improvements for the women of Ireland but the Minister is dragging his heels, and we cannot wait any longer.
Name an independent chair without further delay, and amend the terms of reference to ensure that if the evidence suggests legislative and policy changes, these are brought forward.
Orla O’Connor is director of the National Women’s Council of Ireland and was co-director of Together for Yes