No Choice in Belfast

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In April, a 21-year-old woman from Northern Ireland was given a three-month jail sentence for committing a crime considered heinous in her country. It was a relatively light sentence—under the law, she could have been condemned to life in prison. Strangely, the punishment was handed down for an action considered legal throughout the rest of the United Kingdom—taking mifepristone and misoprostol pills to induce abortion. The World Health Organization considers these essential medicines, yet it is forbidden to procure them in Northern Ireland. This woman (whose name has been kept confidential for privacy) could not afford to travel to England for an abortion, so she bought the pills online. After her housemates reported her, she was prosecuted.

Ulster laws against abortion are strict: terminating a pregnancy is only permitted if the mother’s life is at risk. Exemptions are provided neither for victims of rape or incest nor for those carrying fetuses with fatal abnormalities. Violators—and those who help them—can face long prison sentences. This policy, according to many, violates women’s rights to control their bodies. At the very least, it certainly has negative public health implications and raises legal concerns given its inconsistency with current U.K. law.

Recently, Belfast’s stance on abortion has come under increased scrutiny by women’s health advocates, bringing hope to many that the country’s abortion laws will take a progressive turn.

A Unique Trajectory

Northern Ireland operates under the United Kingdom’s 1861 Offences Against the Person Act, which makes abortion completely illegal. The rest of the country modified the law with the 1929 Infant Life Act and 1938 Bourne Judgment, establishing lawful abortion when the mother’s mental or physical health is at risk. Although much later, Northern Ireland adopted this provision in 1945 and has since maintained it. But England, Scotland and Wales further modified these laws with the 1967 Abortion Act, allowing for abortion up to 24 weeks into pregnancy—and beyond, under extenuating circumstances—with physician approval and supervision. Yet despite legal access to abortion across the rest of the United Kingdom, this protection was never extended to women in Northern Ireland.

Understanding why Northern Ireland’s restrictive abortion laws contrast with those of the rest of the United Kingdom requires an examination of the region’s complex governmental history. When Britain’s Westminster government passed the 1967 Abortion Act, Northern Ireland was still ruled independently by its own parliament, which passed no similar law. The United Kingdom initiated direct rule over Northern Ireland in 1972, but pro-choice interests never gained traction, and the U.K. government never applied the 1967 act to the newly fully incorporated territory. In 1998, the Belfast Agreement created the Northern Ireland Assembly to share power with the Westminster government. Today, it controls policy areas devolved to it by London, including abortion.

Generally, Northern Ireland has tended toward more conservative social policy than the rest of the United Kingdom. The country only decriminalized homosexuality in 1982 (15 years after England and Wales did so) and is the only area in the United Kingdom to prohibit gay marriage. Abortion policy has proven no exception. Since 2010, when abortion matters were devolved to Belfast, Northern Ireland’s parliament has staunchly maintained its position, allowing abortion only when the mother’s health is imminently threatened.

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A Dangerous Choice

In recent years, pills for early medical abortion prior to week nine of pregnancy have become available online from organizations outside of Northern Ireland such as Women Help Women and Women on Web. Mifepristone and Misoprostol pills are safe options for women looking to terminate their pregnancies, but purchasing them is illegal. Furthermore, women who buy pills online put themselves at risk, because they cannot be sure that the pills they receive are what they ordered. Genevieve Edwards, Head of U.K. Policy and Communications at Marie Stopes United Kingdom—the only charity to offer legal abortion pills in Northern Ireland—told the HPR that “when you buy pills online that aren’t regulated, you don’t know what the content or the quality of that drug is.” Purchasing pills through more reputable sources can alleviate this danger; however, there is still a risk of life-threatening complications when used without the guidance of a doctor.

Though Mifepristone and Misoprostol pills are usually safe and effective, they can cause difficult, but treatable, side effects. In less than 3 percent of cases, complications such as hemorrhage, incomplete abortion, or infection occur, necessitating medical care. However, “if you’ve bought those pills illegally, it may make you reluctant to come forward for further medical attention. [This law] puts women in very, very difficult positions where they are potentially risking their health and also a jail sentence,” according to Edwards.

A Difficult Journey

For the majority of Northern Irish women seeking abortion, the only legal option is to travel abroad. As much of a hardship as travel can be, explained Edwards, “[the women who travel] are the lucky ones. They’re the ones with the money, and the ability, and the means to travel.” Those who cannot travel “face a very stark choice indeed. It’s either being forced to continue with the pregnancy, or risk[ing] their health and liberty by buying illegal pills online.”

In 2015, 16 known legal abortions were performed in Northern Ireland, while 833 women traveled to England or Wales for the procedure. But this number likely underestimates the amount forced to travel abroad for abortion, as many women don’t list a Northern Ireland address when they arrive, and some travel to Scotland or outside the United Kingdom. According to Edwards, “there is definitely a demand that’s not being met. That’s for sure. You can see there is a gulf, a world of difference, between the numbers [of abortions] happening in Northern Ireland and those that are happening in England.”

The costs of travel, accommodation, and medical services for an abortion outside of Northern Ireland can range from $500 to $2,500, an amount prohibitive for many women. Mara Clarke, director at Abortion Support Network, a volunteer led organization dedicated to helping women cover these costs, spoke with the HPR about the drastic measures some clients attempt before finding ASN. “They’ve drunk bleach and floor cleaner. They’ve gotten three packs of birth control pills and taken them with a bottle of gin. There was a woman who said totally matter-of-factly, ‘I’m trying to figure out how to crash my car but not permanently injure myself or die.’” Some women must turn to their abusers to raise the money needed for travel. “There was a girl who sold her car, and cut off her landline, and was then going to ask her rapist for a loan [to travel].” Stories like these underscore the dangers presented by lack of access to legal abortion.

Ultimately, “criminalization doesn’t stop abortion; it just stops safe abortion,” argued Clarke. Even for the women who avoid illegal pills by travelling outside the country, dangers remain. The time it takes to raise money and make travel arrangements may delay abortion until pregnancy reaches the second trimester. At that point, abortion can require surgical procedures and becomes riskier and more expensive. Second trimester abortions are responsible for two-thirds of all abortion-related complications, evidence of the danger of delaying abortion. Department of Health statistics show that only 2 percent of abortions in the United Kingdom occur after 20 weeks, but Clarke estimated that roughly 7 percent of Abortion Support Network’s clients wait over 20 weeks to have an abortion because they’re raising the money to travel outside the reach of Northern Ireland law.

Pushing for a Change

The pro-choice movement in Northern Ireland is growing. In November 2015, Judge Justice Horner of the Belfast High Court concluded that “the Article 8 rights [pertaining to private and family life] of women in Northern Ireland who are pregnant with fatal fetal abnormalities or who are pregnant as a result of sexual crime are breached by [this law].” Public opinion is also building to support a pro-choice viewpoint, with 60 percent of the public supporting abortion in cases of fatal abnormalities and 69 percent in cases of rape and incest. Regardless, in February 2016, Northern Ireland’s assembly voted 59-40 against legalizing abortions in the first case and 64-30 against allowing it in the latter one. This refusal to permit abortion even under extreme circumstances shows that “the Northern Irish Assembly is not working very effectively,” said Sally Sheldon of the University of Kent Law School in an interview with the HPR. She believes that “this is an instance where the politicians are actually a long way behind the public.”

But Northern Irish pro-choice activists are determined to effect change. Hundreds of women assembled to protest after the sentencing of the aforementioned 21-year-old for purchasing abortion pills online. Others have symbolically turned themselves in for violating abortion laws. Last year, 200 people circulated an open letter admitting to having broken abortion laws by using pills or obtaining them for others. When no prosecution emerged, three retired teachers went to the police station to surrender in-person as an act of protest.

But pro-choice voices are not the only ones shouting. Bernadette Lynn of Precious Life, a Northern Irish pro-life group, expressed concern that the “sentencing [of the 21-year-old] was so manifestly lenient in respect of such a serious crime” and “could set a very dangerous precedent for similar cases.” Furthermore, both the Catholic Church and Northern Ireland’s largest protestant group, the Presbyterian Church, have opposed modification of abortion laws. Forty-five percent of Northern Ireland’s population is Catholic or was brought up Catholic, while 48 percent is Protestant or was brought up Protestant.

Yet despite the controversy, women are not backing down. “Views are changing,” according to Edwards. Because no elections are scheduled for the next three years, “there’s an opportunity for people to consider this again and look at it in light of where we are today.” In June 2016, several pro-choice groups announced a collaboration plan to fly abortion pills via drone into Northern Ireland to call attention to the issue. It has been non-profit groups that have come to the aid of Northern Ireland’s women when government has not, and it seems that that trend will continue into the immediate future. But in Edwards’ opinion, “a big important part of change in Northern Ireland will come from women themselves who stand up and tell their stories … about the impact the restrictions and the law have had on them. There are some really amazing, brave women, along with lots and lots of other people [who] are, I think, going to be the change-makers.”

Image Source: Wikimedia/Ardfern // Harvard Political Review/Peter Wright