Five women who told their stories in this paper earlier this year would not qualify

IT IS being billed as the first clinic on the island of Ireland to offer abortions and the news of the imminent arrival in Belfast of Marie Stopes International has provoked flurries of excitement from Canada to Australia.

Most noteworthy among its full array of sexual health services is medical abortion up to nine weeks’ gestation.

In the Republic, the reaction among pro-choice campaigners was more measured, more “wait and see”.

In Britain, four out of five abortions take place before 10 weeks’ gestation, according to a recent report. On the face of it, then, the Belfast clinic would appear to offer a less traumatic, less invasive, cheaper solution to the majority of the 4,000-plus women from the Republic who travel abroad for an abortion each year.

“But there is a huge difference between the law in Northern Ireland – where abortion is available only to save the life of a woman – and the 1967 Act [which governs the rest of the UK],” said Dr Sandra McAvoy, who co-ordinates women’s studies in UCC and is a member of the Corkwomen’s Right to Choose campaign.

Since the clinic proposes to operate under the current, deeply ambiguous, legal framework in Northern Ireland, how many of those 4,000 Irish women would meet the criteria?

Mara Clarke, a London-based American, runs the Abortion Support Network charity for poorer women from the Republic and Northern Ireland and at our request some months ago she analysed the network’s conversations with more than 400 callers.

These suggested that more than 16 were in, or escaping, abusive relationships; more than nine had serious mental health issues; at least 10 were pregnant as a result of rape; three were in homeless shelters; another three were drug-addicted or recovering drug addicts; at least eight were under 16 and another 10 were 16; more than 10 had serious health issues that pregnancy would compromise; at least eight had existing children with health issues or disabilities; and at least 15 had catastrophic foetal abnormalities. How many of these would qualify for abortions under Northern Ireland law?

“Lucy”, a 30-something woman who told her story to this paper on February 25th last, saying she would probably have changed her mind about an abortion six years ago had she not already been in an English clinic, believes that the Belfast service would have spared her “a lot of unnecessary hardship and misery. I could have made two separate visits to the clinic, one a consultation, and a second if I had decided to go ahead with the procedure. I could have had aftercare if I’d needed it. Instead the experience was telescoped into one short and painful episode that felt like a point of no return as soon as I left Ireland.”

But would she have qualified for the termination under Northern Ireland law? Almost certainly not. The four women whose foetuses were diagnosed with fatal abnormalities, and who told their stories in this paper last March, would not qualify either.

“Such abnormalities are only picked up between 12 and 20 weeks of pregnancy and do not necessarily involve a risk to the life of the mother – so it’s of absolutely no benefit to people in our situation. But it’s happening every week to people like us and these people are being forced to travel. This has to change and we are not going to stop trying… ”

But there are some who might benefit. Niall Behan of the Irish Family Planning Association believes the new service “could reduce the financial, physical and psychological burden for some women who currently have to travel to England and elsewhere for abortion services, but we can’t be that definitive yet.

“We need more information from them about medical protocols and the legal situation. For example, who will they accept or not accept…? Where will they draw the line about where the woman’s life is at risk?”

A second difficulty is that this will be a private clinic, set to charge £350 for a non-surgical procedure, excluding the consultation fee. “That is a huge issue in terms of affordability and accessibility,” said Orla O’Connor of the National Women’s Council. “We have been calling for this kind of full sexual health service but for one provided by the State.”

According to Mara Clarke, money is “what really determines a woman’s access to an abortion”. The projected cost of £350 for an early medical abortion in the new clinic has raised eyebrows. The drug used in the procedure to induce a miscarriage, RU486, is already being imported through the internet by women in this State and in Northern Ireland. Although considered safe by the World Health Organisation, it is not recommended for use by woman without back-up.

“There is remote support on the net,” said one woman familiar with the procedure, “but their advice is to go to hospital and say you’re miscarrying … The problem is that a lot of women will keep delaying that moment …”

Medical abortion is not the obvious choice for many Irish women travelling abroad for early terminations. Medical abortions, in which pills are administered, require patients to stay within a certain radius of the clinic for a time. A surgical abortion is over in a few hours.

Will the Belfast clinic “open the floodgates”, as anti-choice campaigners fear? “That’s not our concern,” said Ruth Bowie. “It’s up to the legislators to frame the law. That’s their job. Other countries have managed to do it.”

To Mara Clarke, “any advances in reproductive healthcare in Northern Ireland, any place that provides unbiased, factual information on the options available, has to be positive”.