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A Health and Rights Approach to Abortion in Ireland Irish Family Planning Association

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A Health and Rights Approach to Abortion in Ireland Irish Family Planning Association Submission to the Citizens’ Assembly A health and rights approach to abortion in Ireland Irish Family Planning Association 16.12.16 Contents IFPA position on the Eighth Amendment .................................................................................... 4 Glossary of terms ............................................................................................................................... 6 About the IFPA .................................................................................................................................. 10 A leading provider of sexual and reproductive health services ...................................... 10 Vision .............................................................................................................................................. 10 Mission ............................................................................................................................................ 10 An advocate for the right to reproductive health ................................................................ 11 1. Introduction ................................................................................................................................... 12 1.1 Why does the IFPA believe the Eighth Amendment should be repealed? ............ 12 1.2 Why the IFPA is not in favour of reform that allows abortion only in exceptional cases ............................................................................................................................................... 13 1.3 How could we value prenatal life if the Eighth Amendment is repealed? .............. 14 1.4 How have states achieved low abortion rates?............................................................. 15 2. Irish women and abortion.......................................................................................................... 16 2.1 Why do women have abortions? ....................................................................................... 16 2.2 Who are the women who have abortions? ..................................................................... 16 2.3 How do women in Ireland access abortion? .................................................................. 16 2.4 Why do women attend pregnancy counselling? ........................................................... 17 3. Legal framework .......................................................................................................................... 18 3.1 Protection of Life During Pregnancy Act 2013 .............................................................. 18 Case study 1: “Mary” .............................................................................................................. 20 4. The harms of Ireland’s abortion laws ..................................................................................... 21 4.1 Access to information .......................................................................................................... 21 4.2 The requirement to travel .................................................................................................... 22 Case study 2: “Róisín” ........................................................................................................... 23 4.3 Inability to travel .................................................................................................................... 23 4.4 Impact of criminalisation of abortion ............................................................................... 24 Case study 3: “Cecile” ............................................................................................................ 24 4.5 Gender inequality .................................................................................................................. 25 5. Women’s health ........................................................................................................................... 27 5.1 Abortion when there is a risk to the woman’s health .................................................. 27 5.2 What happens in other countries? ................................................................................... 27 5.3 What happens in Ireland? ................................................................................................... 28 Case study 4: “Jana” .............................................................................................................. 29 5.4 Abortion in cases of severe or fatal foetal anomaly .................................................... 29 2 5.5 Use of the abortion pill in Ireland ...................................................................................... 30 Case study 5: “Miriam” ........................................................................................................... 31 5.6 Post-abortion care ................................................................................................................. 31 Recommendations ........................................................................................................................... 33 Appendices ........................................................................................................................................ 34 Appendix 1: Abortion in Ireland: Legal timeline .................................................................. 34 Appendix 2: Abortion in Ireland: Statistics ........................................................................... 36 UK ................................................................................................................................................. 36 Other countries ......................................................................................................................... 36 Appendix 3: Recommendations to Ireland by United Nations (UN) treaty monitoring bodies and the Universal Periodic Review (UPR) ............................................................... 38 Appendix 4: IFPA Multimedia .................................................................................................... 42 Appendix 5: Supporting best medical practice in Ireland’s abortion laws: Expert views ................................................................................................................................................ 44 Appendix 6: Rebecca Cook address to the IFPA Winter Seminar 2016 ........................ 47 Appendix 7: Abortion access in other European countries ............................................. 55 Guidance from the World Health Organization (WHO) ....................................................... 57 Appendix 9: Additional barriers to access to the highest standard of reproductive health ............................................................................................................................................... 60 Further reading ................................................................................................................................. 62 References ......................................................................................................................................... 63 3 IFPA position on the Eighth Amendment The Irish Family Planning Association (IFPA) believes that Article 40.3.3, the Eighth Amendment of the Constitution, is irreconcilable with the State’s obligation to its citizens to guarantee the highest standard of reproductive health. The problem is not its legal ambiguity: It is the fact that its impacts, including the denial of abortion services to women in Ireland, are harmful to women’s health. It is the firm view of the IFPA that the Eighth Amendment must be repealed, and replaced with a regulatory framework to guarantee that women in Ireland have the right to legal abortion services and that these services are accessible, affordable, of high quality and respect women’s dignity and right to confidentiality and privacy. International evidence is unambiguous: Countries that have lowered the abortion rate have not achieved this through criminalising abortion. They have achieved it through a combination of primary prevention-including high-quality comprehensive sexuality education and the provision of access to reliable and affordable contraception, the provision of safe abortion services—secondary prevention, post-abortion contraception counselling and services, and the provision of abortion services.1 Constitutional declarations such as the Eighth Amendment prevent the development of the kind of practical policy solutions that a complex issue such as abortion requires. Repeal of the Eighth Amendment will free the Government to draw on the wealth of technical, ethical, legal and medical guidance that has been developed by international standard setting bodies to assist states with the development of a practical and appropriate health system and regulatory approach to abortion. The World Health Organization has drawn on the research and technical knowledge of medical, legal and health policy experts from across the world to develop best practice guidelines on the provision of abortion services. The International Federation of Gynecology and Obstetrics (FIGO) and the Royal College of Obstetrics and Gynaecology in the UK have also developed ethical and technical guidelines on all aspects of abortion. In addition, the issue of abortion is settled in virtually all other European states. The Irish Government, therefore, can draw on the regulatory models of other countries that have found
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