We are extremely concerned however that health trusts are being forced to refer some women and pregnant people to England, (especially those over 10 weeks gestation) and some, such as the Northern Trust are already facing the prospect of no longer being able to provide early medical abortions, due to resources being unavailable from a lack of Department of Health Commissioning.
Self-Managed Abortions do not put anyone at any greater risk...
Or, what we actually responded to the Newsletter’s Adam Kula:
Today the Newsletter once against posted a scaremongering article this time about abortion access; https://donotlink.it/LP6lVy
So Alliance for Choice would like to publish our conversation with the writer in question, in full, as we believe some of the article is misleading and harmful.
”Good evening,
This is Adam Kula at the News Letter, I hope you are well. I am getting in touch because I had seen your upcoming class on 'self-managed abortion' and wanted to run this past you.
The Department of Health says the following: "Women are at risk if they access unregulated abortion services – the Department’s view is that that services should be properly delivered through direct medical supervision within the Health and Social Care system."
In short, I wondered if you wanted to have your say on that. If so, please email me here by noon tomorrow if you can.
Regards,
Adam Kula”
Hi Adam,
Thanks for your email and your interest in our Pills class - are you going to attend the class?
I am drafting a response to the question for you now.
Many thanks
Emma Campbell, Co-Convenor
Hello,
Thanks for that. I'll not be attending, though. It's just that, when I read about the class, it brought to mind conversations I've had with the RCM in the past, where they've told me they were opposed to the idea of DIY abortions, on the grounds that terminations are best performed in a supervised clinical environment.
Adam Kula
Dear Adam,
Many thanks for enquiring about our online class explaining how to use abortion pills at home safely. This is part of the joint activities with our partner the Abortion Rights Campaign to commemorate International Day of Safe Abortion. The theme this year is 'I manage my abortion' and our local theme is 'care at home'. The home use of abortion pills following consultation with a medical professional is safe and it is healthcare that should be commissioned by the Department of Health in NI following the regulations. People should not be forced to travel to GB to access abortion care, which the NIO and DoH suggest as an acceptable pathway. Currently across GB there are measures for telemedicine and home use of pills in place, NI once again stands as a place apart failing to offer those who need abortions care even though there is now a legal obligation for these services to be provided.Our session on abortion pills, details the drugs used for early medical abortion, the methods of taking the pills for the most effective outcomes, the safety measures for afterwards, how to look out for complications and what to do if they arise. Alliance for Choice have been running similar workshops for almost 7 years and the medical advice and evidence we use is based both on the recommendations of the World Health Organisation and the advice of providers such as BPAS, Women on Web and Women Help Women, all of whom follow strict clinical guidelines and ask patients to go through either an online or telephone consultation before accessing the pills.
The World Health Organisation released a report in 2018 outlining the safest methods of delivery for medical abortion, based on global evidence, they concluded,
“Given the nature of the medical abortion process, it is also possible for individuals to play a role in managing some of the components by themselves, outside of a health-care facility. Another existing WHO guideline, Health worker roles in providing safe abortion and post-abortion contraception (2015), recommends that in specific circumstances, individuals may self-manage their mifepristone and/or misoprostol medication without direct supervision of a health-care provider, as well as self-assess the success of the abortion process using pregnancy tests and checklists.”
For women and pregnant people in Northern Ireland, currently the main method of delivery of abortion up to 10 weeks gestation, is with the pills mifepristone and misoprostol, with the 1st pill being taken at a clinic and the second set of pills at home. Despite the law saying abortion should be on request up to 12 weeks and pills being recommended up to 13 weeks by the World Health Organisation, our health service stops at 10 weeks as it has not been properly commissioned by the Department of Health due to political prevarication. This has meant many people are not able to properly access abortion with pills via the Northern Ireland Health Service, even though legally they should.
For some in NI, if they qualify, they can order the pills to be delivered by post from BPAS https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/remote-treatment/ and others continue to use the services of Women on Web and Women Help Women, which is currently not a criminal offence. If you look online, information on how to access abortion in Northern Ireland has not been published by any of our Health Trusts, again, due to a failure of the Depart of Health to provide information and services. Informing Choices NI do sterling work in supporting people with access up to 10 weeks but again are not supported to do this by our Health Department and have to rely on charity funding.
Once England pressed ahead with self-managed telemedicine abortion due to Covid-19, Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said:
“Giving women the option of taking both abortion pills at home following a video consultation is safe and effective and has rightly been judged as a vital and necessary step if we are to limit the spread of COVID-19. Many women will no longer be forced to make the difficult decision between leaving their home and continuing with an unwanted pregnancy. This change in practice will reduce pressure on the health system while limiting the unnecessary risk of infection for women, their families and health workers. We now urge Scotland, Wales and Northern Ireland to introduce similar measures to help protect frontline staff."
Equally on 24th March 2020 when the UK government were failing to allow for home use during covid, the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) stated,
“We are disappointed by the Government’s decision not to allow home-use of mifepristone, the first drug used for early medical abortion. This change in practice which the Government announced and later revoked would have enabled women to access care remotely through video and teleconference, with treatment sent by post. This would have reduced pressure on an already overwhelmed health system, limited risk of coronavirus infection for women, their families and healthcare professionals, while ensuring safe and timely access to abortion care.”
We appreciate your concern for the safety of women and pregnant people needing abortions. We want everyone to have access to free, safe, legal, and local abortion care should they want or need it. Therefore we have asked both the NIO and DoH for all services, as mandated by law, to be provided to people in NI through our Health Service. These services should include home use, as recommended by the World Health Organisation, and telemedicine as in place across GB. We urgently need the DoH to commission services in line with the regulations, fulfilling their legal duty, as well as a public awareness campaign and training for healthcare professionals. Until the government does their job, Alliance for Choice will continue to share international best practice guidance and support those who need to access abortion.
Kind Regards
Emma Campbell & Naomi Connor
Wow - quite a reply! Received, many thanks.
Adam Kula
Access to safe abortion is very important to us, as is up to date and accurate reporting on the issue.
thanks Adam
Emma
Adam, we also have a statement from Women on Web:
In the last thirty years since unsafe abortion was defined, evidence has evolved and new technologies such as vacuum aspiration and medical abortion, have changed the terms and conditions of abortion care provision. Today, the World Health Organization affirms that individuals can self manage their abortions up until 13 weeks and recommends telemedicine abortion services to be expanded to ensure access to abortion. WHO suggests that self-management of medical abortion is non-invasive, cost-effective, acceptable and improves autonomy. The international community, including WHO, as a result has actually moved away from a dichotomous division of safety when it comes to abortion care, to a more three-tiered classification (safe, less safe, and least safe) to better capture the spectrum of varying situations and experiences individuals face on the ground.
The 15 years of service and experience of Women on Web epitomizes this progress and testifies that individuals can self manage their abortions safely when provided with accurate instructions and information, and supported in case of complications. - Hazal Atay, Women on Web
Emma Campbell
Good stuff - it's good to get comment to balance things out where possible, but this is a whopping lot of text! I'll include what space allows. Best,
Adam Kula
well then at least you have plenty of medical evidence-based quotes to choose from!
Emma
Also thought it would be significant for you to know that Pakistan offers the services our Health Department won't.
PAKISTAN – Training in telehealth
by International Campaign for Women's Right to Safe Abortion | posted in: Asia, News, Newsletter, Pakistan, Uncategorised | 0
With physical access to health facilities in Pakistan severely limited by the country’s rapidly growing number of Covid-19 cases, providing women and girls an alternative way to get reproductive health counseling and information “is the need of the hour,” says Ghulam Shabbir Awan, director of Ipas Pakistan.
A new telehealth initiative is helping meet that need. The project is a joint effort by Ipas Pakistan, provincial departments of health and Sehat Kahani Pakistan, a non-governmental organization working to improve low-income people’s access to quality health care. To date, 22 private- and public-sector health professionals have received three days of online training that has equipped them to provide telehealth consultations with women and girls in need of medical abortion, abortion self-care or post-abortion contraception.
In addition, Ipas-trained lady health workers (LHWs) are reaching out to women and girls to make them aware that telehealth consultations are available and free of charge during the COVID-19 crisis. Seventy-eight lady health workers have been trained on how to access the telehealth services and they, in turn, are helping women and girls access the services by smartphones.
SOURCE: Ipas, 22 July 2020
Emma Campbell
Abortion in Contemporary Literature
Abortion rights and reading have long been my “hobbies”. Since lockdown and not going out to talk to strangers about abortion, I’ve been reading a lot. Abortion doesn’t appear as a plot point that often, but when it does it can completely change how I feel about a novel. None of the novels below are about abortion and I’m fixating on minor plot points really, but do be aware if you don’t want spoilers then please don’t read ahead. If you can think of more please get in touch. I won’t be going outside, so I can read!
Daisy Jones and the Six by Taylor Jenkins Reid is one of the best depictions of abortion in fiction. I would have enjoyed more of Camilla and Karen’s friendship overall but Camilla going with Karen for her abortion and supporting her when her partner won’t shows the need for female friendships. It showed the male entitlement: he wanted a baby, why would she deny him this? And it is one of the few novels that addresses that pregnancy is not just you get a bit bigger and then there’s a baby. Karen points out that it will impact her work: how can she be in a touring band while pregnant?
Abortion is a sin and leads to punishment in Discomfort of Evening. This is a Dutch novel and I think that changes the tone than say an Irish novel coming out with the same idea. The abortion is barely noticeable in this novel of a family dealing with grief following the death of their eldest son. The incest, peadophilia and animal abuse are much more prominent. That the mother feels she is being punished is derided by the child narrator. The word abortion never used but her mother’s religious beliefs are not to be trusted.
I read Oh My God What A Complete Aisling last year because it was 99p on Kindle and I thought it was a light read. It was not. I got one of the best depictions of living under the eighth amendment and why the Repeal campaign was so important. It looked at how long the fight was going on for, how the conversations in rural areas were so important and that the access involved more than just getting on a plane to England. It covered who it impacted, why it needed to change and showed various ways to campaign. The two authors were both vocal about getting the law changed and I think continue to support ARC as the fight isn’t yet over.
Another recent Irish novel with a abortion and the lack of it: Lisa McInerney’s The Glorious Heresies. The story is one of a large cast of characters and how their lives are all entwined. Travelling to England for an abortion is just one small sub plot but was just matter of fact.
Marian Keyes has a long history of Irish women “getting the boat”. Her novels are a great way to look at how abortion was treated in Ireland. Her 2018 novel The Break had every interview for its promotion talking about the abortion because of the year of release. But Keyes wasn’t just jumping on the bandwagon trying to make the novel relevant. There are lines in earlier books about women travelling, it’s plot points and character reveals.
Maggie O’Farrell deals with abortion regret with great nuance and subtlety inInstructions for a Heatwave. It uses the same language as Expectation (“my baby would be three”) but it doesn’t just leave her crying and then moving on. We go back to her as a person who doesn’t want children. We get that the abortion changed her relationship with her husband and her sister. The regret isn’t the abortion, it’s how it changed those relationships. O’Farrell is described as British-Irish and her characters in Instructions are second generation Irish in England. I think that the Irish and Northern Irish experience of abortion meant this was more sympathetic than Expectation.
I was so disappointed in Expectation. I can’t say if it is abortion regret or if it is reflection. Sometimes that sort of ambiguity is a strength in a novel and it’s good that we don’t know, but as we know the other two main characters' feelings about having a baby it felt like it was unclear. Maybe I’m being unfair and it is good literature because women don’t always have clear feelings about their abortions but when a novel has so much about pregnancy, yearning for pregnancy, a shot gun wedding for a pregnant character; the feelings on abortion should either be clearer or written better. I thought this was an English novel for an English audience and when I look at how abortion is presented through that lens it angers me less. That it was an option to be accessed readily and easily. To not require more than a couple of sentences. To be a throwaway line.
Abortion in Irish literature has almost become a tick box for a modern novel. Sally Rooney discusses the Eighth Amendment in both Conversations with Friends and Normal People. In neither novel is it a pivotal plot point but is to give insight into the characters minds and politics. Naoise Dolan’s Exciting Times is much the same: her abortion fund pays for her to move to Hong Kong. Thankfully the character did not have a crisis pregnancy as an abortion in Hong Kong costs a lot.
As I stare at my bookshelves I see many memoirs where people talk about abortion as a relief. I see American novels that talk about supporting Planned Parenthood without a crisis pregnancy in the story. I look forward to the days when abortion in Ireland is a thing for historical fiction. I can’t wait for abortion to be so normal in Northern Ireland that I don’t fixate on two lines in a novel. But until then, I will keep complaining and keep campaigning.
Responding to the MLAs contributions to Matter Abortion Regulations 31/03/2020
Responding to the MLAs contributions to Matter Abortion Regulations 31/03/2020
https://niassembly.tv/matter-of-the-day-abortion-regulations-tuesday-31-march-2020/
Mr Allister
Mr Allister suggested people have abortions on a ‘whim’ this is insulting to people who chose to have an abortion, and does not reflect the reality of certifications being required. Mr Allister said abortion would be uncontrolled ‘up to 12 weeks’ this is untrue, abortions must be certified by one doctor up to 12 weeks and currently the first set of pills must be taken under supervision. Mr Allister then alleged there would be abortion ‘effectively on demand’ up to 24 weeks. Again this is incorrect, after 12 weeks 2 healthcare professionals must certify that the criteria are met, namely that continuing the pregnancy would be a greater risk to the health of the pregnant person than termination.
Mr Allister commented that 79% of responses to the recent consultation were opposed to any change – From the NIOs own report 66% of those responses were linked to a single campaign. None of the professional medical bodies opposed abortion law reform.
Mr Allister then raised that the Assembly was not consulted. MLAs had the same opportunity to respond to the consultation as anyone else. This is a human rights matter, and therefore stays in the remit of Westminster.
Mr Givan
Mr Givan also raised the 79% response figure which we have already addressed. It is worth noting that reposes opposing any change were ruled out of scope.
Mr Givan suggested that abortion up to 24 weeks for any reason, we have already shown this is not the case under the regulations. Mr Givan then stated that abortion to term for disability was permitted. This is incorrect. Abortion after 24 weeks, around 2% of all abortions in worldwide figures, would only be permitted for severe foetal impairment or risk to life and health of the pregnant person. Disability is not a permitted reason.
Mr Givan suggests’ that a ‘fine’ is not a serious enough penalty for healthcare professionals acting outside the regulations. This is not simply a fine, but a criminal conviction likely to lead to being struck off. It is intended to be a punitive measure, and we oppose any criminalisation of abortion. We would again state that Human Rights are not a solely devolved matter. Westminster had the power and duty to legislate.
Mr Givan suggests his views are in line with the ‘will of the people’. The NI Life and Times Survey show this is he is mistaken the vast majority support abortion law reform, the 1000s who have travel for abortion also show that this attitude is nothing more than NIMBYism.
Mr Frew
Mr Frew again mentioned the 79% response figure, which we have addressed above, this is mainly from one coordinated anti choice campaign. These responses were not ignored, they simply did not engage with the questions at play.
Mr Frew suggests that he will try and reverse the introduction of regulations. This would be a breach of the Human Rights of those who need abortions. These regulations have been introduced by Westminster legislation, as the body responsible for upholding human rights. It is not in Stormont’s gift to overturn the primary legislation which repealed Section 58 and 58 of the 1981 Offences Against the Person Act.
Mr Frew says he does not want disabled people to fear for their lives – we are not sure why he thinks abortion regulations would make disabled people fear for their lives.
Mr Frew suggests that people were content with NI having a different law than in GB. If this was the case why did 1000 people a year travel to England for abortions they supposedly disagreed with?
Dr Archibald
Dr Archibald spoke broadly in favour of the regulations, saying there is no way to compassionately legislate for access where pregnancy is a result of rape, this is why a 12 week unrestricted period is introduced. We agree with the spirit of this point however we know that many people pregnant as a result of a sex crime, particularly adolescents, are likely to delay seeking an abortion, and are more likely to even be aware that they are pregnant until later term. 12 weeks is not long enough for them.
Mr O’Toole
Mr O’Toole also spoke broadly in favour of the regulations. He said now NI is a place where abortion can be access on par with the Rest of the UK and Ireland. Unfortunately this is incorrect as both jurisdictions have introduced telemedicine and home use of both sets of abortion pills, NI still has not.
Mr O’Toole said this was a step forward for women and girls, we agree and would add this is a step forward for anyone who can get pregnant.
Mr Butler
Mr Butler says it is important to consider the views of parents, particularly women – we would remind him that the majority of people who have an abortion are already parents. He suggests there needs to be sympathy for instances of fatal foetal abnormality, rape and incest. We agree, the UN CEDAW committee has called for action on specifically these circumstances, but sympathy without material action is pointless in these situations. As previously highlighted there is no way to compassionately, or ‘sympathetically’ legislate for pregnancies resulting from a sexual crime.
Mr Butler says the consultation was not adhered to – we have dealt with this previously, responses demanding no change to the law were not in the scope of the consultation.
Mr Butler, we would argue that denying care is ‘draconian’, not the regulations.
Mr Butler brings up that this is an issue for all sides of the community – it is, there is no significant difference in the number of people seeking an abortion from any one community background. 1 in 3 women worldwide will have an abortion, from all walks of life.
Again we will remind the MLA that abortion for disability is not a permitted reason for an abortion under the regulations.
Mr Butler mentions Conscientious Objection – the regulations allow for conscientious objection on the same grounds as in GB.
Mr Muir
Mr Muir spoke broadly in support of the regulations, noting that the Assembly had a chance to make legislation permitting abortion on more limited grounds and didn’t. Mr Muir also highlight the need for home use, which is particularly needed because of the current COVID 19 restrictions. We agree that the inability to travel has already cause real difficulties for people, none more evident that the attempted suicide of someone denied an abortion in NI and unable to travel to England.
Ms Bailey
Ms Bailey spoke broadly in support of the regulations. She noted that while there is access for many up to 12 weeks, there are still many barriers to be addressed. Ms Bailey called for the Health Minister to introduce telemedicine similar to measures in England, noting that abortion pills are on the WHO essential medicines list. She also pointed out that telemedicine protects health workers during this pandemic.
Ms Bailey said the green party ‘do not think it should ever have been a criminal matter, and we believe that any woman should be able to access an abortion as early as possible and as late as necessary.’ And we agree with this position.
Ms Bailey also mentioned the tragic situation brought to light on Monday.
Mr Carroll
Mr Carroll spoke about the reality of denying abortion care, that of the woman who tried to take her own life when unable to travel and refused care locally. We agree with Mr Carroll that ‘abortion is fundamentally a healthcare issue. It is not a criminal issue’ however we must point out that unfortunately there is still a criminal sanction for healthcare professionals who act outside the regulations, which will likely lead to unnecessary bureaucracy for medical staff to ‘prove’ they were acting in good faith.
Mr Carroll is right that not everyone in served by the new regulations, including people in domestic violence situations and rural areas. He also called for telemedicine and home use of abortion pills, referencing WHO guidance that abortion pills are safe.
Mr Caroll points out that the NI Life and Times survey, previously referred to in our rebuttal, consistently shows support for choice and abortion law reform.
Mr Lunn
Mr Lunn welcomed the regulations with some reservations. He particularly welcomed the 12 weeks unrestricted period as a way of providing services for people pregnant as a result of rape. Mr Lunn took issue with one element of the regulations, that of abortion for severe foetal impairment saying this was ‘immoral’. In response we would say that this wording allows for healthcare professionals to use their knowledge and expertise in helping people make an informed choice. The wording of fatal foetal abnormality is too restrictive.
Mr Buckly said this issue transcends party lines. Indeed in there are supporters of change who have spoken publicly in every NIA party, except the DUP and TUV. Likewise the need for abortion care is not restirced to community background.
Mr Buckly rolls out the debunked idea that 100,000 people are alive in NI because of the restrictive abortion law. We ask what about the hundreds of thousands who are documented as having travelled for abortion, and the unknow numbers using abortion pills bought online or more dangerous methods? Mr Buckly suggests he values life from beginning to end, does he value the life of the person who tried to take their own life on Monday because they were refused an abortion? Does he value the lives of the 1 in 3 women who will have an abortion?
Mr Buckly talks about protection of the most vulnerable, does this include the 12 year old who travelled for an abortion under a police escort pregnant as a result of rape by a family member?
Mr Buckly ends with a threat that the DUP will take action to roll back the regulations.
Regulations published for Northern Ireland Abortion provision amidst COVID-19
Alliance for Choice honour the monumental efforts of women and pregnant people, activist organisations, committed healthcare professionals, civic society and political allies that have brought about the new regulations in Northern Ireland for those who will need abortions. Though we welcome the news, it falls significantly short, especially in a time of a global pandemic. If the COVID19 crisis is to intensify as predicted, the Health Minister has a duty to sanction provision that does not jeopardise the health of women and pregnant people by forcing them to travel to clinics unnecessarily for abortions.
Naomi Connor, Co Convenor said;
“We should not place women and pregnant people at risk of unsafe abortion when there is a scientific, safe and readily available alternative. At AFC we have heard directly that barriers and lack of access to abortion pills has led many to use dangerous alternatives. This is not a reality we wish to revisit when there is a body of scientific research that supports abortion telemedicine provision.”
Healthcare workers should not be put at risk by needlessly increasing footfall in healthcare premises when proven alternatives are readily available. Telemedicine is not only safe and effective for patients, but also serves to keep our healthcare staff safe and deployed where they are needed at such a critical time.
Emma Campbell Co-Convenor added,
“We note the NIO has said that arrangements for funded treatment in England will still stand “until we are confident that service provision in Northern Ireland is available to meet women’s needs”. However we are concerned they have not considered the impact on COVID-19 on both travel and the availability of abortion appointments in England as services shut down.”
The regulations make clear provision for the Health Minister to approve further places where medical abortion can be performed at any point in time. Now is that time and Minister Swann needs to ensure that this pandemic does not place women & healthcare providers at unnecessary risk. The Minister must act now, as is his charge, and as is provided for in the recent abortion guidelines to ensure this service is rolled out to women and pregnant people in NI seeking abortion healthcare
ENDS
-----------
Contact:
Emma Campbell 07894063965
Naomi Connor 07505096576
Alliance for Choice
@All4Choice
Further Information
‘Where procedures can take place - terminations to be carried out in General Practitioners premises, clinics provided by a Health and Social Care (HSC) trust, and HSC hospitals, operating under the overall Northern Ireland HSC framework and women’s homes where the second stage of early medical terminations may be carried out. The Regulations also provide a power for the Northern Ireland Health Minister to be able to approve further places where medical abortion can be performed, with the power being able to be exercised at any point in time.’
A summary of key points:
- Abortion on request up to 12 weeks, certification from 1 healthcare professional. For medical abortion, home use for second pill will be permitted.
- Abortion 12-24 weeks with ground specificied in the consultation doc and ground C of the Abortion Act 1967. This is expanded upon in the explanatory notes, and in the explanatory notes which state other factors, like well being, which 'may be taken into account'. Certification of 1 doctor and 1 HCP will be needed.
- There will be a criminal, non imprisonable sanction for those HCPs who act outside of the regs, this will carry a 5k fine.
- No time gestational limit where there is a severe or fatal anomaly
- Conscientious objection will mirror Section 4 of the Abortion Act 1967 and will include a duty to refer.
- No action on safe/buffer zones
- CBS funding will continue.
- the explanatory notes can be amendment by the assembly/depts
Please contact us for a copy of the regulations.
BELOW ARE A NUMBER OF POSSIBLE CASE STUDIES
Someone who has tested positive and whose phase in isolation would push them over 12 weeks by the time they got to a provider.
Someone who is in a high risk vulnerable group and does not feel safe to leave the house.
Someone who has tried to make travel arrangements to get to England but as clinics are closing cannot get an appointment
Someone on a normally low income who has lost their job due the crisis and cannot afford the additional funds that would be needed to travel
Someone who had an appointment in England whose flight has now been cancelled
Someone caring for elderly relatives or immuno-suppresed relatives in their own home and cannot risk infection.
A rise in intimate partner violence was recorded in China during the lockdown, this increases the likelihood of pregnancy as a result of rape and decreases the ability of an abused partner to leave the house safely.
An Asylum Seeker, who would normally be unable to travel, may be further restricted in access to abortion care by movements of asylum seekers within Ireland being completely restricted going forward, and similarly with visitors not being allowed any access in. If/When asylum seekers are locked down in centres due to COVID-19 they may be hindered in accessing abortion support networks and/or abortion care.
Someone who is in the country illegally and/ without papers; with tightening of border control internationally due to COVID-19 crisis, it may be structurally impossible for them to access abortion care within or without of Ireland, due to fear of deportation and/or imprisonment
Someone who is in a high risk vulnerable group medically and/ disabled, travel may normally be restricted due to physical and financial limitations; however being known to medical and state services as high risk and/ disabled may make a case for someone not being granted exceptional orders to travel for abortion care to delimit potential exposure to COVID-19 (ie ‘for your own good’)
Someone who is in a high risk vulnerable group medically and/ disabled, particularly for cases over 12 weeks; if risk of threat to life of continuing pregnancy for pregnant person is already high without COVID-19 diagnosis, and if such same person were to be exposed to COVID-19, thus increasing risk to their own life, they then could be considered a major risk to their own health, and travel for abortion care denied
Someone in state care, a minor, travel may be restricted on guardianship grounds to be in the best interests of the health of the child going fwd, and the lack of agency of the child in such circumstances
Activists across the island call for emergency measures to include abortion telemedicine
Across the Island of Ireland, we are coming to terms with social distancing, and the huge additional burden that will be placed on our healthcare systems due to the virus. In hope of easing that burden, while also ensuring everybody can access the healthcare they require - we want to highlight the option of telemedicine abortions. Legislation to allow telemedicine and home use of both abortion medicines needs urgent consideration before our health services come under severe pressure.
Legal, safe and free abortion: reproductive rights in Argentina.
‘Sexual education to decide, contraceptives to (do not need) to abort, legal abortion to not die’
blog post by Marianna Espinos Blasco, current masters LLM Gender, Conflict and Human Rights student at Ulster University
Protesting in front of the Argentine Parliament with the characteristic green handkerchief of the Campaign for the Right to Legal Abortion (20 of February 2019, photo by N. Pisarenko) Available in https://elpais.com/sociedad/2019/02/19/actualidad/1550608297_024470.html
The struggle for ‘legal, safe and free abortion’ in Argentina took shape in 2005 within the Campaign for the Right to Legal Abortion. More than 70 women organizations mobilized all the country with the slogan ‘Sexual education to decide, contraceptives to not abort, legal abortion to not die’. The claim is asking for an integral work, requiring that the State modifies the Education, Health, Security, and Justice Systems (Senado y Cámara de Diputados, Proyecto de Ley Interrupción Voluntaria del Embarazo, 2019). Larger cultural changes in society are also on the agenda of the women’s movement. Sexual and reproductive rights are human rights and the women’s Campaign in Argentina supports that they should ‘be recognised as a basic right for all’; hence, the universal access to the public health systems must be guaranteed, considering that abortion is healthcare. The following article reviews the historical background of the abortion legal framework in Argentina until the current efforts in the Congress. The 19th of February is the first massive call in 2020 of pro-choice movement around the country for the abortion legislation.
A brief history of Abortion in the Argentinian Criminal Code
Abortion was criminalised within the law since 1921, established in the Argentinian Criminal Code articles 85, 86, 87 and 88. It should be mentioned that, while articles 85, 87 and 88 are enlisting the different abortion offence figures and its respective penalties, article 86 references health professionals’ punishments. The abortion, performed by a qualified medical practitioner, is not punishable when:
If it has been done to avoid endangering the life or health of the or mother's and if this danger cannot be avoided in other ways.
If the pregnancy is the result of rape or is an attack to a disabled woman. In the second case, the consent from the legal representative will be needed to perform the abortion.
There was a debate about these two clauses, modified with more restrictive specifications during the military dictatorship (1976 – 1983). However, an important fact happened in 2012, known as the failure ‘F.A.L’: The Supreme Court of Justice of the Nation (Corte Suprema de Justicia de la Nación, CSJN), hereinafter mentioned as the Court, recognised the right of every women victim of rape to interrupt the pregnancy. Moreover, the Court emphasised on the State obligation to give access to a fast, accessible and safe abortion procedure for such cases. The ‘F.A.L’ also opened the debate of how the role of practitioners that would not perform an abortion because of their own beliefs -also called ‘conscientious objectors’ for some health sectors. The Court expressed the compulsory guarantee to the right to abortion access.
Another turning point was the publication in 2015 of a ‘Protocol to an Integral Attention to People with the Right to a Legal Interruption of Pregnancy’-that mentions being applicable only in the cases that the Criminal Code mentions. However, the protocol lacks ministry support, nor was there adequate implementation strategy across the country. An interesting point from that document is the recognition of gender and sexual minorities. In the publication of 2016, there is the specification about the possibility of ‘trans males to be framed in the grounds of Article 86 of the Criminal Code’ and having ‘the right to receive the same attention as women, adolescents and girls’. The renewed publication of 2019 goes further in the interpretation of the Article 86, in terms of using an inclusive language, while mentioning that the right corresponds to ‘all the people with the capacity of getting pregnant’ and specifying ‘girls, teenagers, women, men, trans people, non-binary people, inter alia.
The Campaign movement and the ‘Choice on Termination Pregnancy’ project
The National Campaign for the Right to a Safe, Legal and Free Abortion (Campaña Nacional por el Derecho al Aborto Legal Seguro y Gratuito), hereinafter the Campaign, was decided by more than 20.0000 women who were gathered in the XIX National Meeting of Women held in Mendoza in 2004. Thus, they decided to start the Campaign on the 28th of May (2005), the International Day of Action for Women’s Health, through more than 70 women organizations from all around the country. The Campaign elaborated a legal project for the ‘Choice on Termination Pregnancy’ (Proyecto de Ley Interrupción Voluntaria del Embarazo) and presented it for the first time in 2007 to the Chamber of Deputies.
2018, a successful year
The ‘Choice on Termination Pregnancy’ project was presented for the seventh time in 2018. That year the social mobilization pro-choice was multitudinous, with the first pañuelazo on the 19th of February, covering green over one hundred cities around the country. It was the first time that the Executive Power included abortion in the legislative agenda and the Argentinian parliament opened the discussion.
Another interesting point was the Committee on the Elimination of Discrimination against Women -the UN body that monitors the implementation of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)-, published the Concluding observations on the seventh periodic report of Argentina on the 23rd of November 2018. Thus, two paragraphs mention the need for a change in the abortion law in Argentina:
9. The Committee urges the State party to initiate accountability procedures to ensure that all provinces approve protocols on the practice of non-punishable abortion, in line with the decision of the Supreme Court in 2012 and the national protocol for the comprehensive care of persons entitled to legal interruption of pregnancy (see CEDAW/C/ARG/CO/7, para. 33(b)) and to accelerate the adoption of the bill for the voluntary interruption of pregnancy increasing legal access to abortion, not only in cases of rape and risk to the life or health of the pregnant woman but also other circumstances such as incest and when there is a risk of severe fetal impairment (CEDAW/C/ARG/CO/7, para. 33(d)).
While the Committee observations are not ‘binding’, it is an important move. Firstly, it gives legitimacy to the Campaign, not only for the recognition of sexual and reproductive rights as human rights but also to see abortion as a basic healthcare service; secondly, it resonates among the international community sphere and pushes the political agenda of Argentina to modify the legal framework.
2019: a loud voice within the Argentine Chamber of Deputies
Protest in front of the Argentine congress during the International Day of Action for Women’s Health (28th of May 2019) Available at
The ‘Choice on Termination Pregnancy’ project was presented for the eighth time before Congress, with 70 signatures from Members of the Parliament from different blocs. The 28th of May, in coincidence with the International Day of Action for Women’s Health, there was an event in Annex C of the Chamber of Deputies. There is a summary of the act in the Deputies of Argentina website.
Among the different voices that sounded during the act, highlight the following:
Mónica Menini, a member of the National Campaign for the Right to Legal, Safe and Free Abortion, said that "we have come to demand a right that is a debt for women and that is a priority for public policies." She summarized: "It's a matter of human rights and social justice,"
Romina Del Plá (Front Left and Workers) called for the urgent discussion of the text in Congress: "We don't have time to wait because women are still dying, we have to have it treated immediately", she said. "We have to use the advantage of the election year to make it clear who we are in favour of defending the lives of girls and women and those who are in favour of clandestine abortion," Del Plá added.
Deputy Brenda Austin (UCR) considered that the bill "is the point of union between the green tide and the institution."
The project was discussed in the framework of the Deputies commissions, with more than 700 exhibitors and the debate lasted for four months. On June 13th there was a historic session of more than 23 hours of debate where it was approved with half sanction. However, on the 9th of August the initiative was rejected in the Senate.
2020: the struggle continues
Practicing the choreography "The Rapist Is You" with Las Tesis ( 17th of February 2020, photo by Nicolás Stulberg) Available at https://www.infobae.com/sociedad/2020/02/17/el-violador-sos-vos-la-version-argentina-para-exigir-aborto-legal-de-la-que-participo-claudia-pineiro/?outputType=amp-type
The 19th of February is the first pañuelazo of the 2020 and the Congress of the Nation of Argentina will be surrounded by a green tide; the protest piece of Las Tesis, "A Rapist in Your Path" - also known as "The Rapist Is You", will be performed loudly. The National Campaign for the Right to Legal, Safe and Free Abortion, that this year is on the 15th anniversary, announced the following in a press release:
‘With the handkerchief up and hands together, we will be millions demanding the approval of a Law consistent with equitable access to integral health, equal care, Complete Sex Education and the secular State. Legal abortion is a debt of democracy. It is a claim of the feminist struggle that has set the future of millions of youths in the region, who demand more rights, freedom and autonomy’.
Choice on Termination Pregnancy’ project: core pints highlighted by the Chamber of Deputies
Civil society efforts: The bill was written by members of different regions of the National Campaign for the Right to Legal, Safe and Free Abortion. An articulation proposal was elaborated, which was then worked in each regional and agreed in a national plenary
Grounds for abortion and gestation time limits: The text establishes the right to voluntary termination of pregnancy (IVE) up to fourteen weeks, inclusive, of the gestational process. Meanwhile, it allows IVE in cases of unwanted or unwanted pregnancy, rape product, or that affects integral health.
Access timing: The IVE project also establishes that every woman or pregnant person will have the right to decide and access the practice of abortion within 5 days, in a health facility and without police or justice intervention.
Who can provide services and where can be performed: Among the main points of the project, it states that health personnel must report on the methods for abortion. This information must be "objective, relevant, accurate, reliable, accessible, scientific, up-to-date and secular.
Public sector coverage and Sexual Education at schools: Likewise, the article establishes that both the public and private sectors must cover the practice 100%, as well as diagnostic, medication and therapy benefits. The text of the law also dictates that the curricular content on abortion "must be taught in public, private and social management schools as a right."
The Choice on Termination Pregnancy project is also very inclusive with sexual diversity rights. Article 3 defines that ‘women and other identities with the pregnancy capacity’ is a synonym of ‘women or pregnant person’. Moreover, article 12, which is about ‘Sexual and reproductive health policies and Complete Education’, references the compulsory training of public services in gender perspective and sexual diversity.
To conclude
The Argentina movement to legalize abortion, mainly within the Campaign, is very relevant and claims loudly to achieve abortion as a basic healthcare service. As said previously, it is important to recognize clearly, that sexual and reproductive rights are human rights. For that reason, the movement that stands for a legal, safe and free abortion, went from the streets to the Chamber of Deputies. The Choice on Termination Pregnancy project, even though pending approval, has some core points that can be used as an example in other legislation frameworks. The emerging LGBTI rights and the challenge to heterosexual and/or cisgender norms in Latin America are being addressed from several spheres and angles, being relevant for the sexual and reproductive rights improvements to be more inclusive.
#AbortoLegal2020 #19F #ProyectoAbortoLegalYa
Bibliography
Argentinian Criminal Code, available in http://servicios.infoleg.gob.ar/infolegInternet/anexos/15000-19999/16546/texact.htm (in Spanish)
Campaña Nacional por el Derecho al Aborto Legal Seguro y Gratuito
http://www.abortolegal.com.ar/
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) ‘Concluding observations’ on the seventh periodic report of Argentina (23rd of November 2018) Available at:
https://undocs.org/CEDAW/C/ARG/CO/7/ADD.1
Protocolo para la atención integral de las personas con derecho a la interrupción legal del embarazo (2016) Available at
http://www.msal.gob.ar/images/stories/bes/graficos/0000000875cnt-protocolo_ile_octubre%202016.pdf (in Spanish)
Protocolo para la atención integral de las personas con derecho a la interrupción legal del embarazo (2019) Available at http://www.msal.gob.ar/images/stories/bes/graficos/0000001792cnt-protocolo-ILE-2019-2edicion.pdf (in Spanish)
Senado y Cámara de Diputados, Proyecto de Ley Interrupción Voluntaria del Embarazo (2019) Available at:
Summary of the Legislative debate about the Legal Abortion Project
(May 28, 2019) Available at:
https://www.diputados.gob.ar/prensa/noticias/noticias-podio/noticias_1038.html (in Spanish)
DIY self-managed abortion with pills
D.I.Y.
Self-Managed Abortion
BY SUSAN YANOW, JOANNA ERDMAN AND KINGA JELINSKA / / POSTED SEP 19, 2019
https://consciencemag.org/2019/09/19/d-i-y/
The advent of abortion pills as a health technology has deep personal and political consequences for how, when and where abortions happen. The “discovery” of abortion pills occurred in the 1980s in Brazil, when women noticed that the label for misoprostol, a drug registered to treat gastric ulcers, cautioned against its use by pregnant women because the drug caused uterine cramping. Use of misoprostol alone to end unwanted pregnancy spread quickly in Brazil and across Latin America outside the formal health system, as abortion is criminalized in most of the region. 1
The use of pills for abortion entered formal healthcare systems when the French pharmaceutical company Roussel-Uclaf developed mifepristone for use with a prostaglandin like misoprostol to end a pregnancy (with higher effectiveness than misoprostol alone, although the World Health Organization (WHO) recognizes both misoprostol alone and the combination mifepristone/misoprostol as highly safe and effective).2 Mifepristone was first approved in France in 1988, but almost immediately, Roussel-Uclaf tried to take it off the market and abandon distribution because of social opposition and a threatened boycott.3 The French government intervened and declared the pill the “moral property of women,” but the pharmaceutical company would not seek approval for mifepristone in any other country without government invitation where abortion was lawful.4 These restrictions slowed the global availability of mifepristone, which was approved in the US only in 2000. In most countries, national regulatory agencies adopted unwarranted prescription and dispensing controls for mifepristone, beyond any evidenced need, thereby putting the pills beyond the reach of many. 5
Self-management of the process marks the radical return of abortion to the people: something one does to oneself, something one experiences as their own.
In the US and many other countries where abortion is provided in the health system, mifepristone is given in the clinic, and misoprostol, the pills that provoke uterine contraction and bleeding, are routinely taken at home. In other words, the process of using abortion pills inherently involves the user taking some control of the process. In countries where medical abortion is lawful and available in formal health systems, there are multiple efforts to give users further control in how they engage with and experience abortion within formal healthcare systems, including practice innovations such as telemedicine, reduced follow-up requirements and advanced provision. In the US, as abortion is increasingly restricted, these innovations include developing models of postabortion care to provide medical support for those choosing to access pills outside the formal healthcare system.
Worldwide, the majority of abortion pills are used outside formal systems, particularly where abortion is criminally restricted, but where misoprostol can be self-sourced in a pharmacy, online or through local markets. Even where abortion is lawful, people may not have access to abortion services or prefer to avoid interaction with formal healthcare systems. Some people use the drugs and experience the abortion on their own, whereas others engage the help and support of partners, friends and family members. Self-management of the process marks the radical return of abortion to the people: something one does to oneself, something one experiences as their own. The innovation of abortion pills invites people to think and act positively about their bodies, to use their bodies to protect their health and well–being and to act out their basic human right to decide whether and when to reproduce on their own terms and for themselves, outside formal healthcare systems and sometimes outside the law.
Direct-service activism in self-managed abortion seeks to transform both the patient experience and the social view of self-managed abortion from a last and dangerous resort of risk and vulnerability to an empowered act characterized by feminist care, solidarity with people and even humor.
Over the last decade, a global network of activist groups has emerged to support people in self-management and to make the world outside healthcare and legal systems a safer and more-humane place. Working through a diverse set of practices (e.g., safe abortion hotlines, in–person and online counseling and accompaniment services and community-based distribution of pills), direct-service activists in self-managed abortion have fundamentally changed the abortion black markets and back alleys of today.6 They provide people with confidential, reliable and accurate information on the safest and most-effective ways to buy and use abortion pills; counsel and support people before, during and after their abortions; and help people navigate and access services within formal systems, including follow-up care. There are now more than 20 abortion hotlines worldwide.7 Many activists also help people access quality drugs by bringing medicines into local communities, checking the quality of drugs and driving down prices among other private sellers, and through internet-based services, delivering drugs by postal or courier services. Their direct-service activism not only supports individuals with unwanted pregnancies but also targets the structural conditions that create vulnerability and expose people to risk in self-managed abortion: the information deficits and unregulated drug markets, as well as the social isolation and stigma of abortion. These projects question and force the reimagination of the social norms around abortion through demystification, demedicalization and destigmatization of the practice of self-managed abortion.
Direct-service activism in self-managed abortion seeks to transform both the patient experience and the social view of self-managed abortion from a last and dangerous resort of risk and vulnerability to an empowered act characterized by feminist care, solidarity with people and even humor. Self-managed abortion is not seen as a problem to be solved, or a temporary solution due to a failed healthcare system. Rather, self-managed abortion activism embraces the practice without shame or judgment. It is inspired by a collective conscience of respect, trust and dignity: “I trust you to know and to make good decisions for you.”
Central to self-managed abortion activism is a respect for a person’s needs and choices as expressed and a refusal to subordinate these needs to the interests of any another, including medical and legal authority. There is a commitment to meet people where they are and to strengthen their capacities to manage their abortions safely and effectively on their own terms. Risks such as ectopic pregnancy, inaccurate assessment of gestational age or counter–indications are not ignored or neglected, but instead become normalized and even predictable features of abortion that people can manage should they occur. The rare chance of a complication is not seen as a barrier, but rather as information about the process that should be widely shared, with support for people to access healthcare systems for intervention if needed. When there is community uptake in the use of pills in informal settings, public-health evidence shows that self-managed abortion can be practiced safely, with a decrease in abortion-related death and disability.8
Activism around self-managed abortion is also grounded in the belief that abortion should be easy and convenient, subverting traditional power dynamics of abortion care in recognition that people have a fundamental right to make decisions about their own bodies and to act on these decisions. Gone is the gatekeeper provider role, the policing of the boundaries of the law and the communication of its norms and values through the rationing of abortion care. People help other people to terminate their pregnancies on the collective trust that abortion can be demedicalized.
Official WHO protocols are released into the public domain, with the knowledge that people can and will use them and even innovate around the protocols. Building on the word-of-mouth origins of safe misoprostol use, people today share experiences of self-management and rate the quality of drug sources through online forums. Ordinary people are empowered to create and share knowledge about the process. With people well informed, adequately resourced and openly supported, abortion is treated as a normal life event, perhaps an affirming one. Building up this affirmative social view of abortion is a powerful antidote to the stigmatizing views of abortion in criminal justice and health systems.
The practice of self-managed abortion forces an overdue change in the existing discourse about all abortion. By working in the shadows of unjust abortion laws and the harmful health systems they create, direct–service activists are a powerful voice for removing all abortion practice from criminal law. These activists seek not only to mitigate the harms of these systems, but also to give public testimony to the fact that abortion outside formal systems is often necessary to avoid the abuse and mistreatment within them. They reveal the harms of criminal laws that explicitly ban self-managed abortion and regulatory laws that censor, withhold or otherwise obstruct the provision of safer use information and overregulate abortion medicines, confining them behind the walls of high-level healthcare facilities and out of reach to those who need them. Their activism reveals the hypocrisy of abortion laws and regulations that claim to protect health and life by reaffirming the worth of all those who seek abortion as members of a community whose health and lives matter. As efforts to affirm these most basic public values of respect, trust and dignity, their actions are best described as collective acts of conscience.
Global feminist activism on self-managed abortion supports people in moments of immediate need, while highlighting and resisting the daily injustices of abortion laws. Most importantly, in a spirit of reproductive justice, it offers a vision for health systems in which every person has the right to a safe and dignified abortion informed by the values and needs most important to them, and access to the means of realizing that right. Self-managed abortion highlights the potential of abortion pills to increase access to abortion for millions of people and presents a bold framework for empowering communities and breaking through abortion stigma.
Hist. cienc. saude-Manguinhos. vol.23 no.1. Rio de Janeiro. Jan./Mar. 2016. http://dx.doi.org/10.1590/S0104-59702016000100003 “The Biomedicalisation of Illegal Abortion: The Double Life of Misoprostol in Brazil. A biomedicalização do aborto ilegal: a vida dupla do misoprostol no Brasil.
Medical management of abortion World Health Organization 2018.
Roussel-Uclaf, Press Release, October 25, 1988.
Alan Riding, “Abortion Politics Are Said to Hinder Use of French Pill.” New York Times July 29, 1990.
W.R. Ewart and B. Winikoff, “Toward Safe and Effective Medical Abortion” (1998) 24 Science 520–521.
J.N. Erdman, Kinga Jelinska and Susan Yanow. “Understandings of Self-managed Abortion as Health Inequity, Harm Reduction and Social Change.” Reproductive Health Matters (2018) 26:54, pp. 13–19.
https://womenhelp.org/en/page/regional-resources.
Singh S, Maddow-Zimet I. “Facility-based Treatment for Medical Complications Resulting from Unsafe Pregnancy Termination in the Developing World, 2012: A Review of Evidence from 26 Countries.” Obstet Gynaecol. 2016; 123:1489–1498.
SUSAN YANOW Susan Yanow, MSW is a long-time reproductive rights activist. She was the co-founder and Executive Director of the Abortion Access Project and now works as a consultant to several domestic and international reproductive rights and health organizations. She is cofounder of Women Help Women and spokesperson for SASS (Self-Managed Abortion; Safe and Supported).
JOANNA ERDMAN Joanna N. Erdman is Associate Professor and MacBain Chair in Health Law and Policy at the Schulich School of Law, Dalhousie University, Canada. She is the coeditor of Abortion Law in Transnational Perspective and has acted as an intervener before the European Court of Human Rights and the UN Committee on the Elimination of Discrimination against Women.
KINGA JELINSKA Kinga Jelinska was educated as a cultural anthropologist in Poland and has worked for more than a decade on activist programs to increase knowledge about and access to abortion pills. She is the co-founder and the Executive Director of Women Help Women and works with more than 40 partner groups on community interventions, research and changing the norms and discourse around self-managed abortion.
There's no such thing as a late term abortion - ARTICLE
Here's everything you need to know about abortion later in pregnancy according to doctors, not politicians, including how often it occurs and why it's necessary.
By Emily Shiffer October 01, 2019
What's the correct term for 'late-term abortion'?
"Generally people mean abortion performed after 12 weeks or 3 months, but it's better to specify exactly which period of gestation one is talking about," says Daniel Grossman, M.D., director of Advancing New Standards in Reproductive Health (ANSIRH) at Bixby Center for Global Reproductive Health at the University of California, San Francisco.
Keeping abortion terminology by gestation period is the proper way to define it. "We talk about care as pregnancy progresses in weeks from a person's last menstrual period, or in trimesters (1st: 0-13 weeks, 2nd: 14-26 weeks, 3rd: 27-40 weeks)," says Chelsea Souder, MPH, director of Clinical Services and Communications Manager at AbortionClinics.org.
What about 'partial-birth abortion'?
This term originated from the Partial-Birth Abortion Ban Act of 2003. However, it's not a defined procedure recognized by leading medical groups, including American College of Gynecology (ACOG), according to the Guttmacher Institute.
"'Partial-birth abortion' refers to a procedure known as dilation and extraction, or D&X, which involves attempting to remove the fetus intact through the cervix," explains Dr. Grossman. "The procedure is no longer legal unless medication is used to stop the fetal heartbeat first."
When do most women have abortions?
Since 1973, when abortion was legalized nationally, around 11 percent of abortions have occurred at or after 13 weeks gestation. According to the Guttmacher Institute, here is when women have abortions percentage-wise:
Earlier than 8 weeks: 66%
9-10 weeks: 14.5%
11-12 weeks: 8.3%
13-15 weeks: 6.2%
16-20 weeks: 3.8%
After 21 weeks: 1.3%
When is second or third trimester abortion necessary?
While most abortions occur before 8 weeks, second or third trimester abortions are also options women may have. These are the most common reasons an abortion may occur during the second or third trimester:
Fetal anomalies
"The medical reasons for an abortion in the second trimester include a diagnosis of fetal malformation or genetic anomaly," says Dr. Grossman. These include: anencephaly, the absence of the brain and cranium above the base of the skull, or limb-body wall complex, when the organs develop outside of the body cavity, according to the ACOG.
Mother's medical complications
"Medical complications are the development of a condition in the pregnant woman that necessitates delivery," says Dr. Grossman. "Some examples of these conditions include severe preeclampsia, or high blood pressure of pregnancy, or bleeding from a placenta previa, when the placenta covers the cervical opening of the uterus."
Other medical complications include: premature rupture of membranes and infection, placental abruption, and placenta accreta, which may risk extensive blood loss, stroke, and septic shock that could lead to maternal death, according to the ACOG.
Less access to care
Second and third trimester abortions may also be more common in places with more strict abortion laws.
"Our research in Texas found that the restrictive laws there, which led to the closure of about half of the abortion clinics, were associated with an increase in second trimester abortion," says Dr. Grossman. "The obstacles that women face accessing care ends up pushing them later in pregnancy before they can obtain a wanted abortion."
Adds Souder, "These restrictions have forced many clinics to close, in turn creating waiting lists, sometimes two to three weeks out. Unnecessary waiting periods, gestational bans, and lack of providers in rural areas force people in some states to travel hundreds of miles to get care. Thirty-five states currently ban state Medicaid from covering abortion care, which affects the most marginalized people."
"Nearly 99 percent of abortions happen before a person is 21 weeks pregnant, and those that happen later almost all happen before 24 weeks. In rare and very complex circumstances, abortions may be necessary later on in a pregnancy—such as when there are severe fetal anomalies or serious risks to the pregnant person's health," says Dr. Dean. "These unexpected and potentially life-threatening complications are why it's critical that patients and doctors have the option of abortion later in pregnancy. Ultimately, the decision to end a pregnancy depends on a person's unique circumstances, and should be between them and their doctors."
What is the procedure like for second trimester abortion?
In general, there are two options: "One option involves the use of medications to essentially induce labor to deliver the pregnancy. This may take a day or longer," says Dr. Grossman. "The second option is dilation and evacuation, or D&E, which involves opening the cervix and using instruments to remove the pregnancy. This usually takes less than 30 minutes and can be done under sedation or anesthesia."
Twenty states currently ban the D&E procedure, according to the Guttmacher Institute.
The Bottom Line
"The most precise way to talk about when in pregnancy an abortion takes place is to specify the number of weeks gestation or the range of weeks, like 'abortion at 20-24 weeks'," says Dr. Grossman. "Sometimes people say 'abortion after 12 weeks' or 'second trimester abortion'. It's important to be as specific as possible."
SARAH EWART RETURNS TO COURT ONCE AGAIN
Today Sarah Ewart and her mum Jane Christie will return to the High Court in Belfast where we hope they will finally get the judgement they deserve, that Northern Ireland’s law on abortion has breached Sarah's human rights.
Farewell to a Stalwart
Alliance for Choice are saying farewell to Kellie O’Dowd, our Co-Chair, one of AFC’s longest standing members and all round amazing feminist mover, shaker and influencer. Kellie is moving on to pastures new and whilst we wish her well in her new ventures, we would like to take this opportunity to pay credit to her amazing contributions to the struggle for reproductive justice.
From her time as Women’s Officer at Queen’s University through to all her work across the women’s movement, Kellie has been a friend, an educator, a mentor and a leader. Alliance for Choice would never have been where it is without her persistence and unwavering commitment to reproductive justice.
Long before the struggle for abortion rights became such a public issue, Kellie was an unapologetic activist who worked tirelessly to achieve abortion rights for women and pregnant people. The progress and achievements AFC have made in recent times are in large part, down to the integrity and hard work of women and people like Kellie who have been unafraid to challenge the status quo, shape conversations on abortion rights and encourage and bring others with them.
Wishing our sister love and solidarity and knowing she won’t ever be far away from our continued struggle.
Why I'm Running the Half Marathon for Full Choice!
This law has caused a great deal of harm to pregnant people in Northern Ireland, there are no shortages of horror stories and tragedies in this small province that are a direct result of it.
Join us at the March for Choice in Dublin on 28th September
Now that we are basking in the warm afterglow of the Belfast Rally for Choice - we are gearing up to join our siblings in the Abortion Rights Campaign in Dublin on Saturday 28th September 2019. The bus will pick up at St Anne’s Cathedral Belfast at 8.30am and pick up at Gardens of Remembrance in Dublin at 7pm
Please Pay £5 per person here:
A gig for Choice in South East London!
Now For ToNIght is an evening of music created to raise money and awareness for women all over the UK who are denied abortion rights, access to healthcare and bodily autonomy, specifically in support of the Alliance for Choice and the Abortion Support Network.
The reason for creating it was simple: if you care, and you have the resources to do so, you really must do something. There's no excuse.
I grew up in the suburbs of London but was lucky enough to continue my studies across the pond at Trinity College Dublin. I remember in one of our first lectures - a very lofty "European Thought" class - our lecturer asked us who in the room would consider themselves a feminist. I looked around the room, my arms firmly plastered to my side, wondering who on earth would want to associate themselves with those bra-burning radicals - they certainly won't be getting college boyfriends.
I look back on that moment with a profound sense of disappointment now. Why did I think all the work was done? That because we had voting rights, could go to university, had great job opportunities ahead and could wear what we wanted to - that there was no need for feminism? This was certainly partly my own fault (not probing these points further to reveal their flimsy realities) and a result of my own privilege - coming from a liberal, middle-class family, and attending an a single sex private school - I never really saw how bad it was for us girls back then.
Fast forward a few years, and I'm in Moscow on my year abroad reporting on domestic violence abuses in Russia and the complete lack of legislation on the matter. I'm eventually told by my editor that even though the paper was liberal, we just can't publish things that are that grim and we don't know who we might make angry. Well, I’m angry now and the following year, I return to Trinity and turn that anger into my thesis - an analysis of women's rights to bodily autonomy in post-Soviet Russia and Poland (another European nation with grossly restrictive abortion laws).
It was also in this year - 2016 - that I finally took to the streets for the "March for Choice" - and I'm shocked by the stories I hear. I knew abortion restrictions in the Republic of Ireland were bad, but I hadn't interacted with the reality of the situation until that very day. Again, I'm angry. I turn up to more of these events, and vent all over social media.
Then finally, two years after leaving Dublin in May 2018, the repeal the 8th amendment is passed, voted for by an overwhelming majority. Finally - abortion rights for all women in the UK and Ireland!
WRONG. I discover quickly that women in Northern Ireland are still bound by archaic laws that date back to 1861. WHO LET THIS HAPPEN?! I'm angry again, but I'm 24 and I get swept up by the rat race, I'm trying to pursue a career as a musician and as a broadcast journalist (yes, my back-up career is just as poorly paid as the dream career) - and I don't really do anything for a long time.
I read things, I share things online, but I don't do.
Two months ago, I finally decided it was time. I was conflicted during the Repeal the 8th campaign and felt that it wasn't my battle to fight, and I didn't want to ride off the coattails of my Dublin pals who were doing the real groundwork while I admired from afar in London - but Northern Ireland is different. For better or worse, it is currently part of the UK - and surely one benefit of that should be the adoption of the rest of the UK's policy on abortion. But it isn’t, and this is outrageous and unfair and it boils my blood every time I remember.
Of course, I am delighted to see that in Stormont's absence, the UK parliament has very recently decriminalised abortion in Northern Ireland - and that this will go through by October 21st (pending Stormont power collapse remains), but there is so much work left to do - and many women in Northern Ireland seeking abortions will be subject to even more virulent abuse as they try to access their rights by prolife groups and individuals who do not wish decriminalisation to take place.
On top of this, it's also important to note that women in Malta and Gibraltar face similar draconian restrictions to the women of Northern Ireland - and no-one's talking about them either which this is why money will also be raised for the Abortion Support Network who also help women here.
We can't continue to ignore this blatant abuse of human rights when it is right on our doorstep anymore. We can't continue to police women's bodies and treat them as second-class citizens, as subhuman, as not deserving of their bodily autonomy. To have the body of a woman even with these rights is often enough of a burden to bear. Abortion restrictions target women most in need and abortions will happen whether they are legal and accessible or not. Those who can afford to will endure the emotional trauma of travelling abroad, and those who cannot, will access whatever illegal and unsafe methods are available to them. This is a class issue too.
So, on August 29th, myself and Kalianne Farren – an activist and friend who helped push through repeal the 8th - are organising a gig filled with jazz musicians and dream pop sensations, led by women artists, at DIY Space for London. We'll be joined by my own band - Paige Bea - by the wonderful Bad Honey and by the jam session extraordinaires Higher Ground - who will be running a jazz improv session to round off the night.
Tickets are available through Billetto (https://billetto.co.uk/e/now-for-tonight-tickets-371740) - and if you're a musician who wants to join the jam but money is tight, we can try and sort you out with a sponsored ticket so get in touch via: paigebeamusic@gmail.com for that!
Tickets are £10 online, and £12 on the door - and there will be Alliance for Choice merch on sale for £2 a piece so bring your coins too!
https://www.facebook.com/events/497539244337198/
See you there x
Penny Mordaunt letter to Maria Miller on abortion info in NI
Penny Morduant’s Letter to Maria Miller after the Women and Equalities Inquiry
The British-Irish InterGovernmental Conference
Emma Campbell, Co-Chair of Alliance for Choice said:
“We are horrified that children as young as 12 are still being forced to travel to access medical services. This is indicative of the callousness with which the DUP and others blocking change in the defunct NI Assembly continue to treat us. We have reached a point where the stance of those unwilling to change is not supported by their voters or by any health or human rights bodies. More importantly, the stigma it creates is recognised as harming the physical and mental wellbeing of abortion seekers and their families. ”
Northern Ireland Office leak reveals more than briefing notes
Alliance for Choice have noted that neither the Supreme Court nor CEDAW are satisfied that these arrangements in any way relieve Westminster from their duty to act as noted in the summary of the CEDAW report in February this year.
YES for Ireland
YES! The ringing, resounding, confirming, affirming, positive joy of a yes. “Yes” to a new beginning in Ireland’s relationship with its women and pregnant people. “Yes” to compassion and care and change. “Yes” to the truth of every abortion story and its individual worth. “Yes” to never letting one more woman die because you will no longer say, “This is a Catholic Country”.
Alliance for Choice welcomes the call for better established perinatal care
Alliance for Choice welcomes the call for better established perinatal care for families faced with tragic diagnosis. We believe that all families deserve to be given the option of perinatal care as part of a range of options, as would be offered to our counterparts in England, Scotland and Wales
Alliance for Choice on Secretary of State Northern Ireland's response to parliamentary question on abortion from Stella Creasy MP.
Alliance for Choice were pleased to see the issue of abortion raised in Parliamentary Questions today by Labour MP Stella Creasy. However we were extremely disappointed with the response from Secretary of State for Northern Ireland Karen Bradley.
Co-Chair Emma Campbell said, “We know from a number of opinion polls, and academic research such as the Northern Ireland Life and Times Survey and the Abortion as a Workplace issue report, that the majority of people in Northern Ireland want to see criminal sanctions removed from abortion.”