Liam Farrell: Making abortion legal, accessible and safe

Ahead of Ireland's historic referendum to repeal the 8th amendment, which gives unborn foetuses and pregnant women an equal right to life, Dr Liam Farrell reflects on the impact of restricting access to abortion.

In 1966, Romania, under Nicolai Ceaucescu, decided that the Romanian population should be increased from 23m to 30m inhabitants. Decree 770 was authorised, and abortion and contraception declared illegal. To enforce the decree, contraceptives disappeared from the shelves, any detected pregnancies were closely followed until birth, and the secret police maintained surveillance on procedures in hospitals.

This might sound draconian, but we don’t have to look too far for parallels. The 1967 UK Abortion Act was never extended to Northern Ireland, and abortion remains illegal here.

We also have harsh criminal penalties; in theory life imprisonment for any woman undergoing an unlawful abortion. It’s not just theory; a mother who helped her 15-year-old daughter procure abortion pills online is awaiting trial, and a number of woman have faced prosecution within the last few years.

And when it comes to repudiating women’s rights, we already have a virtual United Ireland. In the Republic of Ireland, the 8th Amendment to the constitution was introduced in 1983, giving equal weight to the life of the mother and that of the foetus. This has resulted in travesties such as the X Case; in 1992 a High Court ruling prevented a 14-year-old rape victim from travelling to England for an abortion.

These restrictive laws don’t prevent abortions, as every year thousands of Irish women, north and south, make the lonely journey across the Irish Sea. According to a report by the Guttmacher Institute abortion rates are similar in countries where abortion is highly restricted and where it is broadly legal.

A more humane and effective approach for real ‘pro-life’ advocates would be to reduce the incidence of abortion by:

  • improving sex education and access to contraception
  • supporting women during pregnancy and child-rearing
  • supporting disabled children and their families. In all my years as a family doctor, I don’t ever recall any ‘pro-life’ advocates helping out in their care and giving exhausted and desperate parents a break.

Restrictions do have the effect of making abortion not only more expensive and distressing, but also more unsafe and less likely to be medically supervised, eroding trust between doctors and patients. Can a woman in crisis approach her doctor for help? Doctors are also placed in an invidious position. How can I ensure my patient is referred to a reputable clinic? How can I provide after-care? How can I record it in my patient’s file? How can I assure the woman that she is not facing this crisis alone?

But in at least one part of the island the times may be changing. On May 25th there will a referendum on repeal of the 8th Amendment, and perhaps at last recognition that you cannot legislate to compel a woman to carry a pregnancy to term, and that abortion must be legal, accessible, safe and free.

At this stage it looks as if the repeal motion is most likely to pass, but after the disasters of Brexit and Trump, there is no room for complacency.

A woman must have the right to choose, and to have control over her own body. As Dr Seuss said, 'The questions are complicated, but the answer is simple.’

This column is dedicated to my fervently pro-repeal daughter @GraceThirteen

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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