Above: Photos by Cathy Flynn & Eoin Madsen. Capturing the recent March For Choice. Then some archive material that appeared in a promotional video for the march from referendums long ago.

It’s been thirty four years since the eight amendment was added to the constitution, and it looks like 2018 will be the year we may finally get rid of it. What we’ll actually get to vote on remains to be seen. With the repeal movement so giddily high, it’s easy to forget that removing the amendment mightn’t be enough. Cathy Flynn surveyed campaigners across the island to suss out what battles might be on the horizon.

Word on the mean streets of Dail Eireann suggests the the real talk is happening outside of the Joint Oireachtas Committee which was set up to consider the findings of the Citizens’ Assembly. Fine Gael, as the majority party, are conducting their own talks on the side, out of public view, aiming to water down the Citizen’s Assembly recommendations, which were far more liberal than anyone anticipated.

Various politicians, both within and outside of Fine Gael have begun saying to the media that the Irish public will reject these liberal recommendations, as if to prepare us for a referendum where the only choice presented is to vote for super restrictive abortion access or keep the status quo. “They don’t know what they want!!!” is bandied about when anti-choicers discuss the Repeal movement, as if it’s all one homogeneous blob. Pro choice campaigns in Ireland range from NGOs to small radical action groups. But all pro choice campaigners in Ireland agree that the first step to any kind of abortion access in Ireland is to Repeal the 8th amendment.

Abortion access on request (demand if you prefer) up to twelve weeks of pregnancy is the norm across much of the EU. However, barriers still exist even in places with relatively liberal abortion laws. Costs can be prohibited, stigma exists and some areas may lack doctors who can or will perform abortions. In the UK, abortion is still technically a crime, despite it being easily accessible, and free from repercussions.

In Ireland, a penalty of 14 years exists for procuring or helping someone to procure an abortion, including via abortion pills, which are on the World Health Organisation list of essential medicines.

Geography is a factor in abortion access which is being considered by Irish abortion rights activists. Geography and stigma can come together to render abortion inaccessible even where it is technically legal. In rural areas of Canada, there is a lack of doctors who perform abortions, though the abortion pill is available.

Scarcity of doctors and clinics is an issue in the US and rural Australia also. In Sicily, 98% of doctors are conscientious objectors to abortion – which makes abortion basically impossible to access despite it being legal in Italy.

The Abortion Rights Campaign is the largest pro choice activist group in the country. They want free, safe and legal abortion, for anyone who needs or wants one. To achieve this, the 8th amendment needs to be removed from the constitution. ARC is a grassroots organisation, with over 20 regional groups around the country and solidarity groups around the world.

Though all Irish women have the right to travel to access abortion, the fact is that it is more difficult to travel from rural areas. Costs of travelling to an airport may push the travelling option out of reach for women in rural areas. Abortion stigma and fear of the neighbours might be more pronounced in small towns.

Denise O’Toole of Sligo Abortion Rights Campaign believes that conscientious objections could limit access to safe abortion providers and care. She pointed to European Court of Human Rights whose rulings make it clear the state needs to ensure access to legal services.

“The Irish Government will have to ensure any conscientious objection here is well defined, legislated for, well regulated in practice and complies with international and European law in order to avoid limiting women's access to reproductive healthcare,” Denise tells me.

“Barriers which discourage women from having safe legal abortion potentially lead to women seeking unsafe and dangerous abortions. We have seen how the role of conscientious objection has led to a fatal outcome for women like Savita Hallapanavar and also other cases in Europe.”

Denise points to the European Court Of Human Rights rulings in 2011 and 2012 saying “states are obliged to organise the health services system in such a way as to ensure that an effective exercise of the freedom of conscience of health professionals in the professional context does not prevent patients from obtaining access to services which they are entitled to under the applicable legislation”.

“Women in rural areas already face greater barriers with travel, time and financial costs to access healthcare they need and certainly don’t need any more,” Denise concludes.

“Rural hospitals will need to provide abortions and comply with Irish and European legislation.”

Inishowen is one of the most wild and rural areas of the country. In fact, the nearest hospital is across the border in Derry, and it it where most residents go when they need emergency care. I talked to Cathleen Shiels of Inishowen Abortion Rights Campaign about what might happen after the 8th Amendment is repealed.

“We need to make sure that abortion is accessible for women in Donegal by making sure we look practically at provision,” she tells me. “The abortion pill could be prescribed by GPs. In those rare and often tragic circumstances when a late term abortion is required, families must be able to access compassionate care at home.”

It’s a numbers game. If the one available doctor in a rural area conscientiously objects, then women in that area have no access, and they still will have to travel. Which has a knock on effect, because lower income people can be prevented from travelling due to financial constraints. Our rural transport services are shit and expensive.

For some women, travelling all is not an option at all. For refugees, people in direct provision and undocumented migrant women, a trip on the plane or the sail and rail to the UK for an abortion is not possible. For non EU citizens, UK visas can be prohibitively expensive, or impossible to access.

You may recall the case of Ms Y, a migrant women who arrived in Ireland pregnant after being raped in the country she was escaping from. The Irish state saw fit to deny her an abortion here, deny her the right to travel, and forced her to remain pregnant until her foetus could be brought to viability. She went on hunger strike, and eventually was forced to give birth via caesarean.

Migrants and Ethnic Minorities for Reproductive Justice (MERJ) is a new pro choice group. They represent people in Ireland who are affected by the 8th amendment more than most – those that cannot travel to access abortion.

According to Emily Waszak of MERJ, the narrative of this being only a problem for ‘Irish women’ needs to challenged.

“The right to health care shouldn’t be predicated on whether or not someone is a citizen or has money,” she says. “It should be the right of all people who live here within the Irish context and more generally the right of everyone everywhere.”

After the 8th is repealed, Emily says MERJ hope to see free, safe and legal abortion “with the understanding that it must also be accessible to everyone regardless of where you live or your legal [citizenship] status.”

There is a problem of institutional racism in Irish hospitals. 40% of maternal deaths recorded in Ireland are ethnic minority women. The 8th amendment affects all aspects of maternity care, not just abortion access. It can also affect consent in childbirth and pregnancy. The Association for Improvements in Maternity Services (AIMS) represents maternity services users in Ireland.

Krysia Lynch is the chairperson of AIMS. She said at a recent press conference that “the 8th amendment hangs like a spectre over the entire Irish Maternity services. It doesn’t just influence women who chose not be pregnant…we already know that. It influences women who do decide to be pregnant who want to continue their pregnancy. It influences the care that they receive because it influences decisions that healthcare professionals take for them. It influences the way the pregnant people make decisions or can not make decisions for themselves.”

AIMS wants the repeal of the 8th amendment and greater rights for users of maternity services and say women “should not be forced to travel to another country to receive basic health care. They should be entitled to it in their own country, freely safely and legally.”

Parents are a group that have experienced the spectre of the 8th too. 54% of people who access abortion services are already parents. Parents4Choice are a group who represent the voice of pro choice parents in Ireland. I spoke to Linnea Dunne from the group to get more insight.

In a post-repeal Ireland, Parents4Choice hope that “abortion would be free, safe and legal, and available to anyone who needs it as part of our maternity services.”

Like AIMS, Parents4Choice hope for an improvement in our maternity services.

“A repeal of the 8th amendment would not only enable new legislation for access to abortion in Ireland,” Linnea explains. “But it would open the door to a reform of the HSE Consent Policy, improving care for everyone going through our maternity system, whether they want to continue their pregnancy or not.”

For both AIMS & Parents4Choice all of this is an important juncture in a wider change of culture and modernising of our maternity services.

When it comes to the actual nitty gritty of legislating for abortion in a post-repeal scenario, Lawyers For Choice are on the case. “Free, safe, and legal is often mooted as the gold standard for abortion access,” Sandra Duffy of Lawyers For Choice says. This echoes the concerns of the ARC regional groups and MERJ. “We also remind people that accessibility itself is an important factor” Sandra continued.

Sandra says the group is concerned that “the potential for conscientious objection to create lacunae [it means a gap, I had to google it!] in distribution of doctors who are willing to perform abortions, are all factors which will have to be dealt with in order to ensure accessibility.”

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