Abortion in Northern Ireland

There is​ one abortion clinic in Northern Ireland: a Marie Stopes clinic on Great Victoria Street, which joins the two-up two-down red brick terraces of the Lisburn Road, where Ulster banners fly from the lampposts, to the City Hall with its eau-de-nil dome and pale stone statue of Queen Victoria. The clinic isn’t easy to find: the signs beside the door at No 14 are for BioKinetic Europe, which runs clinical trials, MKB Law, and Bupa; next door there’s a Tesco Express and Boojum, a ‘Mexican Burrito bar’. Danielle Roberts, an abortion rights activist with Alliance for Choice, says that on the days the clinic is open – Thursdays and Fridays from 9 a.m. until 6 p.m. – you can’t miss it: members of the pressure group Precious Life are always outside. (‘We are saving babies, mothers, and indeed this country from the silent holocaust that is brutally destroying 50 million lives worldwide every year.’) Danielle acts as an escort for women with appointments on the eighth floor: two activists for every woman, one wearing a ‘body cam, as there have been assaults and harassment’.

Abortion, or assisting abortion, is a crime in the UK: the 1967 Abortion Act that applies in England, Wales and Scotland gets round this with provisos that allow abortion to be lawfully performed: if the pregnancy is still under 24 weeks and two doctors agree that there would be ‘grave permanent injury’ to the ‘physical or mental health of the pregnant woman’, or serious danger to the child. In Northern Ireland, which never adopted the 1967 act, the 1861 Offences against the Person Act – the one that imprisoned Oscar Wilde – substitutes for it. Any pregnant woman ‘with intent to procure her own miscarriage … shall be guilty of felony … and being convicted thereof shall be liable … to be kept in penal servitude for life’ (this remains the maximum penalty). There have been amendments over the years – case law shows that abortion is lawful in Northern Ireland in exceptional circumstances – but nothing to make abortion legal in cases of rape, for instance, has ever been put on the statute book, and successive iterations of medical guidelines haven’t made it clear under what conditions doctors would be acting legally (or illegally) when performing an abortion. And there seems to be no political will to make the situation clear: only the Green Party and the People Before Profit Alliance support decriminalisation; Sinn Fein wants ‘limited reform’; but the Alliance Party claim abortion is a matter of individual conscience and the DUP are openly pro-life. To make things worse, there has been no government in Stormont since March, and the DUP now has a ‘confidence and supply’ arrangement with the Conservative government. Westminster ignored the situation for years before this summer. On 29 June, after Stella Creasy put forward an amendment to the Queen’s Speech, Philip Hammond announced that Northern Irish women who travelled to England for an abortion could for the first time have that abortion paid for by the NHS, like every other citizen and taxpayer of the UK.

Sixteen ‘terminations of pregnancy’ officially took place in Northern Ireland in 2014-15. In 2012, the Department of Health produced a set of guidelines for doctors in Northern Ireland: a psychiatrist had to be consulted if a woman’s mental health was thought grounds for termination, but there was no mention of the required rank of the psychiatrist or the need for a second opinion (the guidelines have since been superseded, but the requirement for a psychiatric opinion remains). It amounted to saying that a woman ‘doesn’t know what she wants’, said Samina Dornan, a consultant obstetrician and gynaecologist at the Royal Maternity Hospital in Belfast, where the abortions took place. Samina was brought up in Pakistan, and has worked in India: she remembers a husband bringing his pregnant wife to see her, and when she advised him that the woman needed a caesarean section, and the cost of it, he turned out his pockets to reveal a fraction of the money – all he had. His wife didn’t get the operation. For Samina, the UK is supposed to be a beacon, so ‘why is there a darkness under the beacon?’ We were sitting on grey velvet sofas in the open-plan living room of the home she shares with her husband, James Dornan, an emeritus professor of Foetal Medicine at Queen’s Belfast. ‘It’s very hard to have grey-haired men telling you you’re a criminal,’ James, grey-haired himself, put it. As a junior doctor, he remembers going to the fathers of women in trouble and telling them that their daughters wanted, indeed needed, their help. Samina said she found her work ‘very very lonely’ at times. It was as if her colleagues were saying to her: ‘Have you not learned yet?’

As well as 16 official abortions 833 women were recorded as having come to England from Northern Ireland in 2015 to have an abortion, and at least 1438 women bought abortion pills online. Women on Web, an international collective of women who’ve had abortions, doctors, researchers and other abortion rights supporters, will send a woman who appeals for help on their website a dose of mifepristone and misoprostol after a consultation with a doctor and a donation of 70 to 90 euros depending on circumstances. (Abortion using pills when less than nine weeks pregnant is safer than taking antibiotics, and the British Pregnancy Advisory Service runs an aftercare line for those who have taken the pills at home.) The pills arrive in the post, and women take them at home over a day or so; Women on Web has instructions in many languages (as well as a simplified version for people who can’t read easily) on how to take them. In April 2016, a 21-year-old woman was given a three-month suspended sentence at Belfast Crown Court for taking abortion pills when she was 19. Her two housemates, both women, had reported her to the police. ‘She called the baby “the pest” and kept saying she just wanted rid of it,’ one of the housemates, who was 38, told the Belfast Telegraph anonymously. ‘She came down carrying a plastic bag. I couldn’t bring myself to ask what she had done with the baby. After my own miscarriage, my mind wasn’t in a good place.’ She found the foetus in the bin: ‘he had fingers, little toes. Even now I have a picture in my mind of it. Its wee foot was perfect.’ When she found she couldn’t put the bin out on collection day, she called the police. ‘This isn’t anything to do with the rights and wrongs of abortion. I’m not anti-abortion. I believe there are circumstances, like rape, where it should be a woman’s choice. This is about her attitude. It was as if she was getting rid of a piece of clothing.’ In another case going through the UK courts a mother is being prosecuted for buying and giving abortion pills to her 15-year-old daughter, who was pregnant by a boyfriend she was scared of. The mother went to their GP after her daughter had had the abortion, worried about her daughter’s emotional wellbeing, and mentioned what had happened. Two months later a doctor at the practice reported them to the police.

If you can’t buy the pills – say, you’re more than nine weeks pregnant, or you have a complicating condition, or you can’t face it – you’ll have to travel. On average, two women from Northern Ireland travel to England every day. Most are married, most are having their first abortion, most are between 20 and 34. Clinics in England have ‘Irish prices’, set slightly lower than private prices, but even so the cheapest available abortion with pills costs £274, and the average costs £410. Then there is a consultation fee of between £65 and £80. Then there are the travel costs: a round trip booked a week in advance on Ryanair in high summer – leaving at 6.55 a.m. and returning at 11.10 p.m. – costs £134.98. Then there’s the journey to the airport: if you are in Belfast, a taxi will cost £16 from the Lisburn Road, but you’d have to spend much more if you need a night in Belfast before flying out. Then there’s travel from the airport to the clinic – a day return on the Gatwick Express is £24.30 – and travel within London. There’s the cost of a visa or a passport, childcare if you have children, and an overnight stay in London should you need it.

‘I keep talking to our clients about planning their unplanned abortions,’ said Mara Clarke of the Abortion Support Network, an independent charity in England that advises women who need an abortion as well as helping them financially and practically with travel and accommodation. Clarke told me of a 14-year-old girl who phoned for help – they sent a volunteer to accompany her from start to finish. ‘We are dealing with human beings,’ she said, and laughed at herself when she found herself saying she provides a ‘bespoke’ service, as if she were a Savile Row tailor. Clarke set up the Abortion Support Network when she moved to the UK from America, where she had put up women who’d come to New York for an abortion in her studio apartment, and found that women from Northern Ireland, the Republic of Ireland, the Isle of Man and the Channel Islands needed the same thing here. ‘There’s no typical client,’ she said. When volunteers have completed their first shift for the helpline they often say to her: ‘I didn’t expect there to be so much laughter.’ She knows that ASN has helped trans men travel for an abortion; she knows there are also women she hadn’t been able to help. One woman rang for advice when she became pregnant despite having an IUD fitted. She couldn’t travel and wanted to take the pills but had to have the IUD removed first, for safety. When she went to her doctor, they couldn’t find the IUD’s strings, so gave her an ultrasound scan to locate the device, and found the pregnancy at the same time. The doctors wouldn’t remove the IUD in case it caused a miscarriage. She couldn’t tell them that’s what she wanted to happen. ‘What can she do?’ Clarke asked.

Financial and practical difficulties can be quantified, but the emotional costs of doing something your culture can’t talk about, won’t legislate for, and thinks is a sin aren’t measurable. In 1971, Simone de Beauvoir, Catherine Deneuve, Delphine Seyrig, Jeanne Moreau and Agnès Varda, among others, signed the Manifeste des 343, declaring they’d had an abortion – who knows if they had or not – in an attempt to break the silence. The stunt was part, and a not insignificant part, of a movement that culminated four years later in the loi Veil (named after Simone Veil, then minister of health) and the decriminalisation of abortion in France. We can make conditions better for women who have to have an abortion – it is and has always been an emergency measure – but how do we change the way it is thought about? Talking about abortion was hard then, and it is hard now: I found no one who would talk to me about it in the time I was preparing this piece. There are, however, many accounts in print, some angry and sad, some regretful and calm and grateful, and women can tell their stories in their own way and in their own words online. Women on Web’s site has many accounts by women of their abortions: the numbers of clots, the pain or lack of it, the seriousness or not of the encounter that led them to that point. The X-ile Project, based in the Republic of Ireland, collects pictures of women who’ve had abortions and posts them online, with no names, no details: a woman with a short black fringe and an off the shoulder top stands in front of a bookcase, a blonde in coral lipstick rests her chin in her hand, a woman kneels in fallen leaves with a dog lead in one hand and her other around her spaniel. On 20 August last year @twowomentravel live-tweeted a trip to London for an abortion, from the ‘chilly’ 6 a.m. flight out, to a blurred grey wall seen from the window of the black cab, to the pistachio green chairs in the clinic waiting room, where they met two women who’d travelled from Munster in the south-west of Ireland. Abortion has been illegal for so long that there are many historical accounts of cases: I found five in a transcript of an international tribunal on abortion held in 1989 to gather evidence in support of the 1967 act being extended to Northern Ireland. Witness C was 22 at the time – ‘I found that everyone had someone with them and I had my knitting’ – and remembers going under while having her hand stroked by a nurse who ‘had her eyes made up fantastically; they were gorgeous.’ Witness D, pregnant at 18 and just about to sit her A Levels, had tried hot baths, soap and throwing herself down the stairs before her mother phoned a minister. A process of consultations with psychiatrists, gynaecologists and ministers to establish her sanity began and nearly ended with a hysterectomy. ‘I don’t think I was being particularly irrational. I didn’t want to have a baby. I hadn’t planned to have a baby and I was asking for the right not to have to bring a child into the world that I didn’t want.’ Hearing these stories I kept thinking of the ones we don’t get to hear: the women who considered, and even wanted an abortion, but who went ahead with their pregnancies after all; the women who took the pills without guilt and who don’t think of their abortion any more because it doesn’t trouble them; the women who died and may still be dying.

I haven’t had an abortion but my mother did, after the 1967 act came into force in England. She has Alzheimer’s now and can’t speak much any longer, so I can’t ask her about it. It’s a silence I can’t break, and I’m not even sure my mother would speak to me about it if I could break it. The arguments in favour of a humane abortion law don’t require you to love someone who has had one: the idea that women should have control over their own bodies by having access to a safe abortion; that you don’t eliminate abortion by making it harder to get, you just make it more dangerous; that a woman with friends and parents and a job and a life, is worth more to the world than a foetus that can’t yet survive outside the womb, seems so logical, so kind, so practical and honest that it shouldn’t be necessary for women to unfold their sexual and emotional history to get one. On the other hand, it does seem that changes in abortion law have historically been a result of the details of individual cases becoming known. The 1967 act was preceded by the Bourne case of 1938, when a gynaecologist turned himself in having performed an abortion at St Mary’s Paddington on a 14-year-old girl who had been raped by several soldiers. (She had been turned away by St Thomas’s on the grounds she might be carrying a future prime minister.) I only know about my mother’s abortion because my father told me how she had told him: he remembers that they were travelling on the Tube together not long after they met and he had a sense that there was something she wasn’t telling him. He pushed her to say; she wouldn’t. My father grew up in the Home Counties in the late 1950s and early 1960s – ‘sheltered’, as he might put it – and my mother knew he was against abortion on principle. That time on the Tube, he kept asking her, and she gave in. And on hearing her story, he changed his mind.

In 2012, Savita Halappanavar died in Galway after being repeatedly refused an abortion even though she was miscarrying and in danger of developing sepsis. There were protests across the Republic. ‘How many, many generations of women have to be punished in this way?’ Ailbhe Smyth, the convenor of the Coalition to Repeal the Eighth, asked me as we sat in Buswells Hotel, opposite Leinster House in Dublin where the Irish Parliament sits. The Eighth Amendment to the Irish Constitution gives equal value to the lives of the foetus and the woman, and makes abortion under virtually any circumstances impossible. Following the successful referendum on marriage equality in 2015, activists across the South have been campaigning to strike that amendment from the constitution. An opinion poll last year showed that there is around 87 per cent support in the Republic for access to abortion to be expanded, and a referendum on the issue is due next year. Smyth has been campaigning for women’s and LGBTQ rights for more than thirty years, and has seen referendums succeed and fail. ‘The country is ready for it,’ she says now. The prohibition on abortion in the Republic seems to make reform in Ulster more urgent, and it seemed to me that some of the activists in Northern Ireland were jealous of what’s happening in the South as change seems more likely to happen there. Smyth hoped that Northern Ireland would leapfrog the 1967 act and be the first place in the UK to have a modern abortion law. (In most of Europe – Malta, Poland and Ireland excluded – abortion is available on request: that is, without the need for two doctors to ok it.) While we were talking, an American acquaintance came over to say hello to Smyth, a Repeal the Eighth badge attached to her necklace. While we debated which of our countries was in the worst state, the American pressed her to take her bundle of blue 20 euro notes – she was about to fly back to the US – for the cause.

What will happen next? It is not yet clear how the abortions of women who have to travel over to England from Northern Ireland will be paid for, and whether travel costs will be reimbursed. Northern Irish feminists can’t rely on Westminster: many people reminded me of the moment in 2008 when Harriet Harman blocked a move to extend the 1967 act to Northern Ireland in order to gain votes from the DUP for 42-day detention of terrorism suspects. If it makes travel to England harder, Brexit will make access to abortion harder too. Irish customs routinely confiscate abortion pills, so women from the South often have them sent to the North, but then they have to go there to pick them up. Although opinion poll after opinion poll shows that there is support in Northern Ireland for a better law on abortion, people there, I was told, vote according to affiliation, and for ever more extreme parties, as they know any measure will get watered down under the power-sharing arrangement put in place following the Good Friday Agreement. Even so, there is energy around the various campaigns. In 1967 Britain was one of the first countries in Europe to improve access to abortion, and although the law serves, I could still go to jail if I bought pills for a friend and gave them to her. I don’t know quite how a modern abortion law would go – perhaps it would start by ditching the 1861 act, having no time limit and allowing abortion at a woman’s request – but I know that the threat of jail shouldn’t be part of it.