"The lack of a working Assembly in Northern Ireland means that we are likely to be entering a period of direct rule from Westminster which could present an ideal opportunity to lobby for abortion law reform in Northern Ireland, for at least that equal to the rest of the UK. Now that abortion in NI is firmly on the radar of the opposition parties, we will be working hard to ensure they take action on it. The Labour Party Conference attendance proved to be a fortuitous move. We had 100% support from delegates and many of the higher profile attendees made a particular effort to visit our stall.
While the initial announcement of funding seemed like a chink of light, two months on and we still don’t have details of the scheme, the government has forced MSI to backtrack on free appointments in Belfast, and local civil servants in lieu of a government are dissuading doctors from telling patients about the possibility of funded treatment in GB. We are still bereft of a clear care pathway for those requiring abortions and medical professionals continue to have to muddle through the best care.
In this post, Ulster University academic Dr Fiona Bloomer, sheds light on the work of abortion rights activism in Northern Ireland.
Recently elected DUP MP Emma Little-Pengelly had a go at setting out the facts on abortion law in Northern Ireland. She is a qualified barrister and has years of experience in the Office of the First and deputy First Minister, first as a Special Adviser and then as Junior Minister of the same office, recently renamed as the ‘Executive Office’.
While Little-Pengelly’s summary is not inaccurate, in terms of the wording of the legislation and case law, it does not reflect the true picture of the lack of abortion access in Northern Ireland. Let’s go through each of her statements in turn.
A limited number of legal abortions are performed in Northern Ireland, within the strict legal framework. However following the publication of draft guidelines[i] in 2013 there has been a ‘chilling effect’ on medical practitioners. This has seen the number of legal NHS abortions a year fall from around 50, to just 16[ii] in 2015/2016. Meanwhile around 1000[iii] women a year travel to England for private abortion care and around 400 obtain safe but illegal pills from Women on Web. These numbers are estimates only and true figures cannot be known.
[i] Draft Termination of Pregnancy Guidance (2013) https://www.health-ni.gov.uk/sites/default/files/consultations/dhssps/termination-pregnancy-responses-2013.pdf
[ii] NI Termination of Pregnancy Statistics 2015/16 https://www.health-ni.gov.uk/news/ni-termination-pregnancy-statistics-201516
[iii] Abortion Statistics in England and Wales for 2015 https://www.gov.uk/government/statistics/report-on-abortion-statistics-in-england-and-wales-for-2015
One of our writers gives an overview of the current legal situation surrounding abortion access in Northern Ireland as well as Alliance for Choice's campaign for free, safe and legal abortion, and why decriminalisation is so important.
Our in house Medical Student for Choice discusses our most recent assembly election and candidate's positions on the matter of choice, as well as the importance of transfer votes.
A speech delivered by Kellie O'Dowd, co-chair of AfC, on International Women's Day 2017, on Angela Davis' visit to Belfast and the importance of abortion access.
Voice for Choice response to Nuffield Council on Bioethics Report: Non-invasive prenatal testing: ethical issues
We have compiled this spreadsheet of all of the MLA candidates and their stances on abortion law reform for the NI Assembly Election on March 2nd 2017.
Our in-house Medical Student for Choice discusses her experience of the FIAPAC Conference on Abortion and Contraception in Lisbon, October 2016.
"The health risks attributed to pregnancy and giving birth are not used as a tool to restrict women and their choices to become mothers, so risks of abortion should not be used to restrict women in their choice to not be pregnant.
ASN can offer financial assistance, accommodation in volunteer homes and confidential, non-judgmental information and advice. However, we are not doctors or counsellors. For medical information, help to make your decision, or early medical abortion pills by post, these organisations may be able to help. This list includes local family planning agencies, abortion clinics in England, The Netherlands and Belgium, and reputable providers of safe but illegal abortion pills. Scroll down.
Three women from Northern Ireland are in Washington to receive a prestigious award for their pro-choice activism. Foreign Policy magazine has named Derry women Diana King, Colette Devlin and Kitty O’Kane as joint winners of one of their Global Thinkers Awards for 2016.
A journey into abortion advocacy
Council of the Isles send solidarity to Alliance for Choice campaign for NI Assembly to Trust Women
2nd Year Medical Student and Pro-Choice Advocate at QUB
Among the general public, there seems to be a very common misconception about what most early, first trimester abortions actually involve. Anti-choice activists would have you believe it’s a complicated and dangerous surgical procedure, which has a high rate of complications, but medical practice and the experiences of women show this to be baseless.
The general lack of knowledge around the issue, owing to a lack of unbiased education, means that the majority of people in Northern Ireland are in the dark about early abortions facilitated through the use of two pills: misoprostol and mifepristone (until a woman was recently prosecuted here for obtaining these medications online to induce her own abortion).
Misoprostol and mifepristone are a combination of pills used to induce what is known as a ‘medical abortion’. This is opposed to early surgical abortion, which uses manual uterine aspiration, another safe procedure when done by a trained professional, also with low rates of complications.
Misoprostol is commonly used to prevent the development of stomach ulcers while on non-steroidal anti-inflammatory drugs (NSAIDs), however when used during pregnancy, it can cause a miscarriage.
Misoprostol is usually used in combination with mifepristone to induce an abortion in the first 2-10 weeks of pregnancy. One dose of mifepristone is taken first; it is a synthetic steroid used to block the hormone progesterone, which is necessary for pregnancy to continue. 24 hours after taking mifepristone, multiple doses of misoprostol are taken sub-lingually (under the tongue) and held there to dissolve for 30 minutes. Finally, 4 hours after the first dose of misoprostol, 2 more tablets are dissolved under the tongue for 30 minutes. This induces the same process as a natural miscarriage. From reading the BNF, I know that tablets sometimes come in different dosages of misoprostol.
In countries where abortion is restricted, but misoprostol is readily available in pharmacies, an induced abortion with just misoprostol can be done just as well. This involves 3 separate doses, 3 hours apart of 4 tablets of misoprostol under the tongue.
One of the most common concerns about using pills to induce an abortion is: is it safe? The media has frequently warned about dangerous medications , stating that women will risk heavy bleeding when using these pills. These concerns are easily addressed, as both of these medications are safe when prescribed and used after a consultation with a medical professional, as is the case with WoW and WHW. Bleeding is to be expected, after all, the pills induce the same symptoms as a miscarriage, but the risk of an excessive amount of bleeding is less than 0.2%, and this can be easily treated in a hospital as a problematic miscarriage. If people take these pills and are concerned that they are bleeding too much, they are encouraged to seek medical advice, and do not require to give information that the miscarriage was induced my medication.
Mifepristone and misoprostol are both on the World Health Organisation’s Model List of Essential Medicine, and are prescribed by doctors all over the world to women who seek a first trimester abortion. These medications are also used to treat many women in Northern Ireland for incomplete miscarriages and postpartum complications. Anyone claiming the drugs are ‘dangerous’ is misinformed, and should be aware that this procedure has been researched and recommended for a safe first trimester abortion by the World Health Organisation.
These drugs have even been approved for home use in certain countries. In South Africa, a scheme is being trialled, where women receive a text service from their clinic or hospital to let them know how their abortion process should be going, and telling them to seek medical help if it is abnormal. This is a stark contrast to Northern Ireland, where a woman was prosecuted for using the abortion pill at home. This process is completely safe, and easily managed as an outpatient procedure worldwide, so why do governments prevent women from accessing this procedure somewhere that is potentially more comfortable and less intimidating?
In my opinion, the decriminalisation of usage of misoprostol and mifepristone would be a vital step towards best medical practice whilst providing patients with autonomy and treating them as partners in their own medical care provision, rather than the dangerous outlaw method it is described as in the media.
Here are some links to the research on the safety and effects of Early Medical Abortion, including the Women on Web research into women’s own experiences of using the medicines in this way – legal permission notwithstanding.
International Safe Abortion Day: 28 September 2016
Coverage by the Press and Media
Shared from International Campaign for Women's Right to Safe Abortion
September 28 Global Day of Action for Access to Safe and Legal Abortion forms part of the campaign activities undertaken by the International Campaign for Women’s Right to Safe Abortion, that aims to build an international movement to promote universal access to safe, legal abortion as a women’s health and human rights issue.
As part of the International Campaign, WGNRR engages in September 28 annual campaigning activities, conducted by Campaign and WGNRR members, as well as allies around the world.
September 28 has been a regional campaign for decriminalisation of abortion in Latin America and Caribbean for nearly twenty years before being taken on by SRHR activists all over the world as a Global Day of Action for Access to Safe and Legal Abortion in 2011.
Unsafe abortion is a public health disaster and a major human rights issue. About 47,000 women each year are still dying from complications of unsafe abortion. Others are imprisoned for having abortions. In some countries women are dying or suffering serious injury because of the failure of their governments to provide safe abortions and life-saving treatment when they are too ill to continue with a pregnancy. This is why on 28 September - the International Day of Action for the Decriminalisation of Abortion- women's health and human rights advocates are demanding change.
To find out about ASTRA Network's members' activities on that day go to: http://www.september28.org/
bpas launch a new helpline for abortion seekers taking pills bought online.