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Northern Ireland Barriers to Accessing Abortion Services

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Northern Ireland Barriers to Accessing Abortion Services NORTHERN IRELAND BARRIERS TO ACCESSING ABORTION SERVICES Amnesty International Publications First published in 2015 by Amnesty International Publications International Secretariat Peter Benenson House 1 Easton Street London WC1X 0DW United Kingdom www.amnesty.org © Amnesty International Publications 2015 Index: EUR 45/0157/2015 Original Language: English Printed by Amnesty International, International Secretariat, United Kingdom All rights reserved. This publication is copyright, but may be reproduced by any method without fee for advocacy, campaigning and teaching purposes, but not for resale. The copyright holders request that all such use be registered with them for impact assessment purposes. For copying in any other circumstances, or for reuse in other publications, or for translation or adaptation, prior written permission must be obtained from the publishers, and a fee may be payable. To request permission, or for any other inquiries, please contact [email protected] Amnesty International is a global movement of more than 3 million supporters, members and activists in more than 150 countries and territories who campaign to end grave abuses of human rights. Our vision is for every person to enjoy all the rights enshrined in the Universal Declaration of Human Rights and other international human rights standards. We are independent of any government, political ideology, economic interest or religion and are funded mainly by our membership and public donations. CONTENTS Executive summary ....................................................................................................... 5 Methodology ................................................................................................................. 7 A hostile terrain for reproductive rights ............................................................................ 8 The law regulating abortion ......................................................................................... 8 Limited political will to legislate for change .................................................................. 9 Abortion rights activism over the decades ................................................................... 10 Impact of ‘the Troubles’ ........................................................................................... 11 Polling data ...................................................................................................... 12 Changes in public opinion ........................................................................................ 12 The international law framework on access to abortion .......................................... 13 International right to life protections do not apply prenatally .................................. 14 Travel to access abortion services ................................................................................. 15 Statistics .......................................................................................................... 16 Financial costs of travelling for abortion services .................................................. 17 Marginalized communities and groups ....................................................................... 19 International human rights criticism of requiring women to travel abroad to access abortion services ............................................................................................... 19 Stigma and stereotyping .............................................................................................. 20 The moral standing of physicians............................................................................... 20 Comprehensive sexuality education ............................................................................ 21 International human rights obligations to address gender stereotypes and to ensure access to comprehensive sexuality education ....................................................... 22 Harassment ............................................................................................................. 23 Intimidation of health care providers ...................................................................... 23 Intimidation of women seeking clinic services ......................................................... 25 Police investigations ............................................................................................. 26 Consultation on legislative reform by the Department of Justice....................................... 27 Abortion in cases of fatal foetal impairment ............................................................... 28 The international law and standards on foetal impairment ..................................... 30 Pregnancies resulting from sexual crime .................................................................... 30 The international human rights and health standards on sexual crime and abortion . 33 Conscientious objection ........................................................................................... 34 Lack of abortion guidance to healthcare providers: the chilling effect ............................... 35 The Family Planning Association case ....................................................................... 35 WHO recommendations on implementing national standards and guidelines on safe abortion care .................................................................................................... 36 Uncertainty arising from 2009 and 2013 draft guidance documents ............................ 37 A postcode lottery? .................................................................................................. 39 Conclusion ................................................................................................................. 40 Recommendations ...................................................................................................... 41 Northern Ireland 5 Barriers to accessing abortion services “My guilt and shame was not about my decision to have an abortion; it was because society had made me feel like I was a fallen woman, dirty and criminal. That shame, that stigma was the most damaging part of my experience. Not being able to say a word in case I outed myself as some sort of perceived murderer. My silence was suffocating.” Aoife, from County Down, who had an abortion in England when she was 17 years old “Abortion in Northern Ireland is a criminal offence which is punishable by a maximum sentence of life imprisonment […].” John Larkin QC, Attorney General for Northern Ireland, in a letter to the Chairman of the Northern Ireland Assembly’s Committee for Justice, 16 October 2012 EXECUTIVE SUMMARY In recent months, the Department of Justice (DOJ) for Northern Ireland has embarked on a process of legislative consultation on the possible decriminalization and legalization of abortion in cases of “lethal foetal abnormality and sexual crime.” While this initiative is, in principle, a positive move towards removing criminal sanction for accessing reproductive health care, the underlying stigma around abortion and the lack of legal clarity on the circumstances in which abortion is permitted in Northern Ireland, continues to have a damaging impact on women and girls’ human rights. Women and girls in Northern Ireland who need to access abortion services, for the most part, have to travel to another jurisdiction. Healthcare providers providing abortion information or services in Northern Ireland face harassment. The abortion regulation in Northern Ireland is underpinned by 19th century legislation, the Offences against the Person Act 1861, which predates all the relevant international human rights treaties by a century. The Abortion Act 1967 and subsequent legislative developments which regulate abortion in Great Britain do not extend to Northern Ireland. Responsibility for healthcare and criminal justice matters has been devolved, since 1999 and 2010 respectively, to regional authorities in Northern Ireland. Index: EUR 45/1057/2015 Amnesty International February 2015 6 Northern Ireland Barriers to accessing abortion services The law governing abortion in Northern Ireland is one of the most restrictive in Europe both in law and in practice; only Ireland and Malta are more restrictive.1 It also carries the harshest criminal penalty in abortion regulation in Europe—life imprisonment for the woman undergoing the abortion and for anyone assisting her. Abortions are only lawful in extremely restricted circumstances, namely where there is a risk to a woman’s or girl’s life or a real and serious long-term or permanent damage to the physical or mental health of the pregnant woman. Abortions procured for other reasons carry a risk and threat of life imprisonment, including abortions sought because the pregnancy is a result of a sexual crime, such as rape and incest, and in cases of fatal foetal impairment. Although that criminal sanction is not applied in practice, the risk and threat of possible severe criminal sanction continue to exert a chilling effect on women and healthcare providers alike. In practice, the law is even more restrictive. For many women, demonstrating a long-term risk to health, particularly mental health, and overcoming barriers to access to abortion in Northern Ireland is often an insurmountable challenge. Women’s access to and experience with health services also varies depending on the attitude of and availability of services within each of Northern Ireland’s National Health Service (NHS) health trusts
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