Louise O'Neill: It is still enormously difficult to get an abortion in this country

"Imagine trying to navigate this system as a homeless woman or a migrant woman living in direct provision. Or a woman living with an abusive partner, or a woman from a rural area with little or no services."
Louise O'Neill: It is still enormously difficult to get an abortion in this country

Picture: Miki Barlok

When the exit polls were announced on the evening of the 25th of May, 2018, indicating that the Yes campaign had won the referendum to repeal the eighth amendment by a landslide, I wasn’t elated, as I had been when marriage equality was passed. Instead, I was exhausted – it had been a bitterly fought campaign, and as a woman, it was difficult to feel as if I was begging for the right to make decisions about my own body. 

In the years since, I have sensed a certain fatigue when it comes to talking about abortion rights in this country, an assumption that it’s all ‘sorted’ now because of that referendum. But unfortunately, that is simply not the case. It is still enormously difficult to get an abortion in this country. Let’s look at some figures:

Abortion on request is only available until 12 weeks (and typically, most women might be 6 or 8 weeks pregnant by the time they even realise), and there is a three-day wait. If a woman requests an abortion on a Monday, the earliest they will be able to have the procedure is Thursday. 

Imagine you’re living in Allihies and have to drive to Cork city – you’ll have to make that trip twice. What if you don’t have access to a car? Do you have to take the bus home afterwards? What if you need to arrange childcare, or take time off work? How easy will that be to do twice in one week?

If a woman is over 9 weeks pregnant, she will be referred to a hospital. Only ten out of nineteen maternity hospitals provide abortion – and three of those are in Dublin – and with the hospitals being under-resourced, there is often a narrow time window to get the termination, increasing the pressure on already vulnerable women.

If a woman is over 12 weeks pregnant, the difficulty of accessing abortion increases exponentially. At this point, you need to have it certified by two doctors that your abortion is necessary because of risk to your own health or because of fatal fetal anomalies. 

Many of us were shocked during the referendum to hear stories of people having to travel to the UK for a termination after receiving a diagnosis of FFA – sadly, the numbers today are very similar to those before the eighth was repealed. 

At a time when a 5k travel ban was in place, at least 10 people every week were forced to travel during the pandemic to avail of healthcare.

It must be taken into consideration how much more complicated all of this becomes if you’re already marginalised in society. Imagine trying to navigate this system as a homeless woman or a migrant woman living in direct provision. Or a woman living with an abusive partner, or a woman from a rural area with little or no services. 

As Helen Stonehouse from the Abortion Rights Campaign says, “abortion is still legally and socially interpreted through the shadow of the 8th – even though that landslide vote meant so much to so many, it hasn’t removed the significant barriers that exist to accessing services.” 

As it stands, it seems as if more importance has been placed on protecting the rights of medical providers to refuse care than on protecting women’s right to bodily autonomy. The phrase ‘conscientious objection’ is, to my mind, somewhat misleading; rather, we could easily call it ‘refusal to provide care’. 

The World Health Organisation has explained that all forms of ‘conscientious objection’ act as barriers to safe abortion, and the Abortion Rights Campaign says that “allowing doctors to refuse care on grounds of conscience in the legislation frames abortion as a moral issue rather than a medical one. This will contribute to a culture of stigma among both patients and service providers.” 

ARC has been told of patients who were refused care, sent away with “we don’t do that here” ringing in their ears, but not before paying €60, of course. 

Only 1 in 10 GPs provide abortion – how has it become easier for doctors to refuse care than to provide? It must be acknowledged; an issue too is that there is little support for those doctors who do want to provide the best medical services for their patients. Many who do fear for their own safety due to protestors gathering outside hospitals and GP clinics. (Not to mention how intimidating it is for the women trying to get through.) 

The need for safe access zones was highlighted during the Repeal campaign and again, this is something we’re still waiting for three years later. In 2018, the then Minister for Health, Simon Harris, stated that any issues with the legislation would be fixed when it was reviewed. Harris also said that the review would be “external and independent (and) not be an inside job”. But we’re not over half of the way through 2021, and it is concerning that the promised review of this legislation has not been given sufficient attention. 

Yes, we are in the middle of a global health crisis, but as every week passes and more people have to travel abroad to access life-saving health care, the more people who are putting themselves at risk of contracting Covid, or bringing it back into the country with them. With maternity restrictions still in place despite agreements they should end, it seems as if women and women’s health care is too easily overlooked.

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