London-Irish Rights Campaign - British Irish Parliamentary Assembly Committee D

4 December 2017

Submission to British Irish Parliamentary Assembly (BIPA) Committee D (Environmental and Social) Review of cross-jurisdictional implications of abortion policy in the BIPA jurisdictions

Email: [email protected] ​ Twitter: @LdnIrishARC ​ Website: https://londonirisharc.com/ ​ Facebook: https://www.facebook.com/londonirishARC/ ​

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INTRODUCTION 4 AND POLICY IN NORTHERN IRELAND AND IRELAND 5 Committee Question b: How would you summarise the different abortion regulatory regimes across the BIPA jurisdictions? What is the political, logistical, statistical and societal impact and interaction of the different regimes? 5 Northern Ireland 5 Ireland 7 COMMITTEE QUESTIONS 10 Committee Question a: The Committee is investigating the cross-jurisdictional implications of abortion policy in the BIPA jurisdictions. What would you identify as the key issues that we should be aware of? 10 Travel for abortion services causes harm 10 The Effect of Criminalisation 12 Violence Against Women and Girls 14 Ireland 17 Committee Question c: How would you respond to arguments that the comparatively restrictive nature of the abortion regimes in Northern Ireland and Ireland has meant that the issue is, in effect, exported to Britain for a solution? 22 Ireland 22 Committee Question d: How would you respond to arguments that the issues surrounding abortion are best dealt with not through liberalisation of the law, but by other means, such as more effective support for women? 24 Increased sex education and contraception 24 Adoption 24 Increased social care/amelioration of poverty 25 Quality of life 25 Autonomy and dignity 25 Putting the positive case for abortion 26 Committee Question e: How would you summarise and respond to recent developments in relation to abortion in Northern Ireland, including the Northern Ireland Court of Appeal ruling on the Northern Ireland abortion law, and the UK

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Government’s decision (since echoed by the Scottish and Welsh Governments) to fund abortion services in England for women from Northern Ireland? 27 Committee Question f: Following the announcement by the Taoiseach that a referendum on the Eighth Amendment to the Constitution will be held in May or June next year, how would you assess the current state of the debate as regards abortion policy in the ? 29 Committee Question g: To what extent is the increased availability and proliferation of online abortion pills affecting the level of demand for access to abortion services in Great Britain from women in Ireland, North and South? Are there sufficient safeguards in place to support and ensure the health and safety of women who choose to take this medication? 34 APPENDIX 1 – Notable court cases & legislative developments in Ireland 37

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INTRODUCTION 1. The London-Irish Abortion Rights Campaign is a grassroots organisation of over 1,000 members based in and around London, founded in November 2016. We campaign for free, safe, legal abortion in Ireland and Northern Ireland. We are actively involved in advocacy, media, legal, fund-raising, awareness-raising and direct action activities in London. We work closely with a number of key stakeholder groups in Great Britain, Ireland and Northern Ireland. We are not affiliated to any political party.

2. The BIPA jurisdictions are Ireland, Northern Ireland, England & Wales, Scotland, Jersey, Guernsey and the Isle of Man. These submissions relate principally to abortion law and policy in and between Northern Ireland, Ireland and England and Wales.

3. Abortion rights in Northern Ireland and Ireland have been and continue to be affected by a range of intersecting factors, many with a cross-jurisdictional flavour. These include legal, political, religious, social, economic, geographic, historical and cultural factors, the most important of 1 which we set out in this submission. As a result of these factors, in relation to abortion, women in Ireland and Northern Ireland face on a daily basis discrimination, harm to their health, levels of hardship, discrimination and breaches of their human rights almost unique in the developed world.

4. We set out below our responses to the seven specific questions provided in advance by the Committee D Secretariat. To aid the flow of our evidence and by way of scene-setting, we set out our response to the Committee’s question b, a summary of abortion law and policy in Ireland and Northern Ireland, in our initial substantive section (paragraphs 5 - 32). We then turn to the Committee’s specific questions in subsequent sections.

1 While we use “woman” and “women” throughout this paper, the London-Irish Abortion Rights Campaign supports access to abortion for everyone who needs it, whether they be cis, trans, non-binary or gender fluid.

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ABORTION LAW AND POLICY IN NORTHERN IRELAND AND IRELAND Committee Question b: How would you summarise the different abortion regulatory regimes ​ across the BIPA jurisdictions? What is the political, logistical, statistical and societal impact and interaction of the different regimes? 5. We set out below a summary of the laws and policy governing abortion in Northern Ireland and Ireland. This is the first part of the Assembly’s Question b. Referring to the second part of Question b, our submissions regarding “the political, logistical, statistical and societal impact and ​ interaction of the different regimes” are contained in some detail in the paper as a whole. ​

Northern Ireland

6. The law governing abortion in Northern Ireland is one of the most restrictive in both the 2 European Union and the Council of Europe , and the maximum criminal penalty imposed – life imprisonment for both the woman undergoing the abortion, and for an individual who assists 3 4 her – is the harshest in Europe and amongst the harshest in the world . ​ ​

7. Attempting to procure an abortion, having an abortion, and performing an abortion are criminal offences in Northern Ireland under ss.58 and 59 Offences Against the Person Act 1861 (OAPA) as is the “destruction” of a child then capable of being born alive, under s.25(1) Criminal Justice Act ​ ​ (Northern Ireland) 1945. Both offences carry sentences of up to life imprisonment.

8. Abortion is illegal in Northern Ireland unless the continuance of a threatens the life of the pregnant woman, or would adversely affect her mental or physical health. The adverse effect on her mental or physical health must be “real and serious” and must also be “permanent 5 ​ ​ ​ or long term” . ​

9. Section 5 of the Criminal Law Act (Northern Ireland) 1967 places a duty and legal obligation on medical professionals to report to the police an ‘arrestable offence’. These penal provisions ​ ​ ​ ​ contained within the legislation relate to a medical procedure and health risk only experienced by women.

10. The Abortion Act 1967 (the Abortion Act) which allows women in England and Wales to access abortion legally under certain circumstances did not apply to Northern Ireland when passed for 6 the rest of Great Britain and was never extended to Northern Ireland.

11. The general prohibition on abortion applies to all forms of abortion; there is no distinction

2 Amnesty International, Northern Ireland: Barriers to Accessing Abortion Services (February 2015), p. 6; see also D. Petrova and J. Clifford, Religion and Healthcare in the European Union: Policy issues and trends (2009, Network of European Foundations), Appendix D: National policy on abortion in some EU states.

3 See further Amnesty International, Northern Ireland: Barriers to Accessing Abortion Services (February 2015), p. 6.

4 Center for , Abortion Laws Worldwide, http://worldabortionlaws.com/map/ ​ 5 Family Planning Association of Northern Ireland v Minister for Health and Social Services and Public Safety [2004] NICA 37, at §12

6 Section 7(3) Abortion Act 1967

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between surgical and medical abortion (the latter being known as the “abortion pill”).

12. There is no exception to the general prohibition on abortion in Northern Ireland in cases of fatal foetal abnormality or where are a consequence of rape or incest. In December 2015, failure to provide exceptions in these specific cases was found to be incompatible with Article 8 of the European Convention on Human Rights (ECHR) by the Belfast High Court, following a claim brought by the Northern Ireland Human Rights Commission (NIHRC). This judgment was overturned by the Northern Ireland Court of Appeal in June 2017. An appeal to the Supreme Court was heard on 24 – 26 October 2017. Judgment is awaited.

13. In 2015/2016 only 16 legal were carried out in Northern Ireland, the same number as 7 in 2014/2015 .

14. Abortion policy was devolved to the Northern Ireland Assembly (NIA) in 2010 as part of wider policing and justice powers under the Hillsborough Castle Agreement. The reform of abortion policy in Northern Ireland has been a major area of political debate.

15. Lengthy legal challenges by the Family Planning Association for Northern Ireland to address the lack of clarity in the law for medical professionals resulted in the publication of guidance by the Department of Health, Social Services and Public Safety in 2016.

16. Of the parties represented in the NIA, the Democratic Unionist Party (DUP), the Social Democratic and Labour Party (SDLP), and Traditional Unionist Voice (TUV) oppose any change to the law on abortion in Northern Ireland. Sinn Féin passed a motion at its most recent Ard Fheis (annual party conference) in November 2017 extending the party’s support for abortion to when a woman or girl’s physical or mental health is at risk. The Alliance Party and Ulster Unionist Party offer their members a 'vote of conscience' on abortion. Only the Green Party and the People 8 Before Profit Alliance are in favour of the full decriminalisation of abortion . These two parties represent a tiny minority of the NIA, with 3 seats between them, compared to 28 for the DUP.

17. There is strong evidence that the general public in Northern Ireland supports reform of the abortion laws. In June 2017, the Northern Ireland Life and Times Survey reported that over 80% of the Northern Irish public believe abortion should be legal when a woman has become pregnant as a result of rape or incest, and 73% believe that abortion should be legal in local 9 hospitals in cases of fatal foetal abnormalities .

18. The NIA collapsed in January 2017 and at the time of writing, there is no immediate prospect of it reforming.

7 Department of Health, Northern Ireland Termination of Pregnancy Statistics, 2015/2016, page 1, at https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-termination-of-pregnancy-stats-15-16.pdf

8 Alliance for Choice, ‘MLA candidates stance on abortion’, http://www.alliance4choice.com/news/2017/2/mla-candidates-stance-on-abortion-ae17

9 Grey Ann Marie, Northern Ireland Life & Times, Attitudes to Abortion in Northern Ireland http://www.ark.ac.uk/publications/updates/update115.pdf

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19. As a result of the restrictive abortion laws in Northern Ireland, the majority of women and girls who do not wish to continue with their pregnancy, and who have the means to do so, access abortion either by travelling outside the jurisdiction (usually to England) or by illegally accessing the abortion pill for the purposes of a medical abortion.

20. Official figures state that in 2016, 724 women travelled from Northern Ireland to England to 10 have an abortion .

Ireland

21. Abortion is illegal in Ireland except under very limited circumstances. The overriding provision governing abortion law in Ireland is Article 40.3.3 of the Irish Constitution, known as the Eighth Amendment, voted into the Constitution in 1983. The Eighth Amendment states: “The State ​ acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its law to defend and vindicate that right.”

22. The Eighth Amendment effectively equates the right to life of a pregnant woman with that of an embryo or foetus.

23. The law in Ireland was governed by the OAPA offences until they were replaced by the Protection of Life During Pregnancy Act 2013 (PLDPA). The provisions of the PDLPA govern the practical operation of the law on abortion in Ireland. The PDLPA replaced the offence under the OAPA of “unlawfully procuring a miscarriage” which was punishable by life imprisonment, with a ​ ​ 11 new offence of “destruction of unborn human life,” punishable by up to 14 years’ ​ ​ imprisonment.

24. Under the PLDPA, abortion is legal only when there is a “real and substantial risk of loss of the ​ woman’s life”, rather than to her health, which can only be averted by termination of the ​ pregnancy, and the unborn life is not yet viable (Attorney General v X [1992] I IR 1). This places a ​ ​ difficult burden on doctors to determine where a risk to a woman’s health ends and a risk to her life begins.

25. There is no exception in Ireland to the general prohibition on abortion in the cases of fatal foetal abnormality or of pregnancies which are a consequence of sexual crime. No distinction is made between surgical and medical abortion.

26. The constitutional right to access abortion does not distinguish between different sources of risk 12 to the life of the pregnant woman (for example, risk of suicide or risk of death from disease) .

10 Department of Health, Abortion Statistics, England and Wales: 2016, June 2017, Revised October 2017, at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/652083/Abortion_stats_England_Wales_2016.pdf

11 Section 22 PLDPA 2013

12 Attorney General v X [1992] I IR 1 ​ ​ 8

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However, the PLDPA differentiates between the two and imposes additional procedural 13 requirements where a woman claims her life is in danger because of a risk of suicide ​ compared 14 to a risk from physical illness .

27. All pregnant women in Ireland have a constitutional right to travel outside of the state to access 15 abortion and a constitutional right to information relating to abortion . The latter provisions are governed by the Access to Information (Services outside the State for Termination of Pregnancy) Act 1995. Under this Act, medical practitioners are not permitted to refer a woman for abortion 16 services in another jurisdiction

28. Following the 1983 referendum, there followed a number of high-profile legal cases involving ​ 17 18 19 the Eighth Amendment, including Ms X , ,​ the death of Savita Halappanavar , and the 20 case of P.P. w​ ho was kept on life support after she died.

21 29. In 2016 25 abortions were carried out in Ireland under the PLDPA legislation .

30. As is the case for women in Northern Ireland, Irish women who do not wish to continue their pregnancies must travel, if they can, outside the jurisdiction, or order abortion pills illegally online. Official figures state that in 2016, 3265 women travelled from Ireland to England to have 22 an abortion .

31. Ireland’s abortion laws have been repeatedly criticised by numerous international human rights 23 bodies . Two recent cases, in June 2016 and June 2017, brought by Irish women have found 24 Irish abortion laws to be in breach of UN Human Rights Law . The UN Human Rights Committee 25 in 2016 called them “cruel, inhuman or degrading treatment” .

13 Section 9 PLDPA

14 Section 7 PLDPA

15 Article 40.3.3 Irish Constitution

16 Section 8 Access to Information (Services outside the State for Termination of Pregnancy) Act 1995 ​ 17 Attorney General v X, [1992] IESC 1; [1992] 1 IR 1

18 Holland, Kitty, (2014), ‘Timeline of Ms Y Case’, Irish Times, [online], 4 October, 2014, at https://www.irishtimes.com/news/social-affairs/timeline-of-ms-y-case-1.1951699

19 Holland, Kitty, (2012), ‘Woman ‘denied a termination’ dies in hospital’, Irish Times, [online], 14 November, 2012, at https://www.irishtimes.com/news/woman-denied-a-termination-dies-in-hospital-1.551412

20 Carolan, Mary, (2014), ‘Court clears way for clinically dead pregnant woman to be taken off life support’, Irish Times, [online], 26 December, 2014, at https://www.irishtimes.com/news/crime-and-law/courts/high-court/court-clears-way-for-clinically-dead-pregnant-woman-to-be-taken-off -life-support-1.2048616

21 Department of Health, Notifications in Accordance with Section 20 of the Protection of Life During Pregnancy Act 2013, published June 2017, at http://health.gov.ie/wp-content/uploads/2017/06/PLDP-Annual-Report-2016.pdf ​ 22 Department of Health, Abortion Statistics, England and Wales: 2016, June 2017, Revised October 2017, at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/652083/Abortion_stats_England_Wales_2016.pdf

23 https://www.ifpa.ie/Hot-Topics/Abortion/International-Human-Rights-Observations-on-Abortion-in-Ireland ​ 24 https://www.ifpa.ie/Hot-Topics/Abortion/Abortion-in-Ireland-Timeline ​ 25 http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20077 ​ 9

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32. The United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, has expressed concern regarding the “severe physical and mental ​ anguish and distress experienced by women and girls regarding termination of pregnancy due to 26 the State policies”. ​

26 List of issues prior to the submission of the second periodic report of Ireland, December 2013 ​ 10

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COMMITTEE QUESTIONS 33. We set out our response to each of the Committee’s questions below (with the exception of the first part of Question b, our response to which comprises the preceding sections of this paper.)

Committee Question a: The Committee is investigating the cross-jurisdictional implications of ​ abortion policy in the BIPA jurisdictions. What would you identify as the key issues that we should be aware of? 34. We consider the following issues to be of particular concern for both Northern Ireland and Ireland: (i) The harm caused to women and girls by the need to travel for abortion services. (ii) The effect of criminalisation. (iii) Forced pregnancy as an internationally-recognised form of violence against women and girls.

Travel for abortion services causes harm

35. Women have travelled from Northern Ireland and Ireland to another jurisdiction to access 27 abortion services since the late 1930s. By far the most common destination is England .

36. In 2016, a total of 724 women from Northern Ireland, 3,265 women from Ireland travelled to the 28 UK for abortion services , the vast majority to England.

37. These figures do not include women who travelled to other jurisdictions, women who travelled from Northern Ireland or Ireland but gave addresses from other parts of the UK, or women who procured abortion pills online.

38. The economic cost of travelling to obtain an abortion, whether from Northern Ireland or Ireland, can be high. The need to travel therefore impacts poorer women in particular. Recent announcements regarding funding for women from Northern Ireland to travel elsewhere in the UK for an abortion are dealt with more fully under our responses to the Committee’s Question e below. Such measures, while undoubtedly helpful to hundreds of women in Northern Ireland in the short term, cause only partial alleviation of hardship, are not applicable to many women, and are in any event not a permanent solution to the lack of safe, legal abortion services in a woman’s home country.

39. The economic hardship caused by travel for abortion services has a wider context in parts of Northern Ireland and Ireland. Official statistics indicate that a high percentage of the population

27 Diarmaid Ferriter, “Occasion of Sin: Sex & Society in Modern Ireland”, pg 253

28 UK Department of Health, ‘Abortion Statistics, England and Wales: 2016’, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/652083/Abortion_stats_England_Wales_2016.pdf

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29 in Northern Ireland lives in relative deprivation (up to 20%) and that household incomes and poverty rates have worsened in Northern Ireland since 2009, with the deterioration being markedly greater than in Great Britain. The same study found that 15% of the population in 30 Ireland was experiencing poverty .

40. Obtaining an abortion in England costs around £330 - £410 if the woman is under 14 weeks pregnant, rising to around £2,000 if the pregnancy is further advanced. If accompanied by a ​ ​ 31 friend, relative, or partner, the cost can increase by around £200 to cover additional expenses .

41. Some women have been driven to drastic steps in order to afford to travel. These have included: selling their children’s Christmas presents, rationing food for the family, asking the man who raped them for a loan, selling their car, failing to pay the rent, going to disreputable 32 money-lenders, and avoiding paying utility bills .

42. Economic inequality is thus at the heart of forcing women to travel for abortion in both Northern Ireland and Ireland. In 2017, the Irish College of General Practitioners said in its submission to the Citizens’ Assembly on the 8th Amendment: “Poorer women accept pregnancy because they ​ can’t get together 1000 to fund a termination abroad. Women from less deprived backgrounds € are more likely to undertake a termination, because they and their partners can afford it. .” …

43. The cost of travelling away from home for an abortion is not merely economic. There is undoubtedly an additional psychological impact upon women who must travel to obtain an 33 abortion rather than being “in the security of their own medical system”, close to home . ​ … ​

44. The potential for delays before the procedure can take place, due to the need to raise the requisite funds, may also be a source of deep distress and may result in the termination being more physically demanding and invasive than would have been the case had the woman been able to access the service earlier.

29 Department for Social Development, Northern Ireland, Poverty Bulletin. ​ ​ 30 th Joseph Rowntree Foundation, New Policy Institute, Monitoring Poverty and Social Exclusion in Northern Ireland, 2014 (25 ​ March 2014) ​ ​ ​ & https://www.irishtimes.com/news/ireland/irish-news/poverty-levels-in-north-higher-than-in-republic-1.1736881 ​ 31 http://www.bbc.co.uk/newsbeat/article/37854308/this-is-what-it-costs-a-woman-in-northern-ireland-to-get-an-abortion ​ 32 submission to Citizens’ Assembly “The true cost of Ireland’s abortion laws” https://www.citizensassembly.ie/WebServices/Submission.asmx/GetFile?json=300_6073

33 A, B, C v. Ireland (2011) 53 EHRR 13, at [126]. A recent case is a particularly stark example of the added distress resulting from the need ​ ​ to travel to access abortion services: Independent, “Northern Irish couple told to carry remains from English abortion clinic in picnic cooler ​ ​ ​ th bag,” 14 ​ September 2016, at ​ http://www.independent.co.uk/news/uk/home-news/northern-irish-couple-told-to-take-remains-home-from-english-abortion-clinic-in-pi cnic-cooler-bag-a7292336.html

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45. Marginalised populations suffer particularly as a result of the abortion laws in Northern Ireland and Ireland. Traveller women, women in abusive relationships, women with insecure immigration status and trans women are just some of the groups most negatively impacted.

46. Women in abusive relationships may struggle to find an opportunity even to book an appointment at a clinic, let alone organise travel and childcare. Abusive partners often use pregnancy as a way of controlling women, and also maintain financial control of their partner, for example, by denying access to bank accounts. Women who need to keep their pregnancy and abortion secret from an abusive partner therefore face greater practical difficulties and suffer additional trauma and stress.

47. Adolescent girls are also particularly at risk. Official statistics record that in 2016, 24 girls under the age of 18 travelled from Northern Ireland and 66 from Ireland to obtain an abortion in 34 England .

48. Girls who fall pregnant and wish to end the pregnancy face even greater hurdles than adult women in the same situation. They will often have difficulty accessing the funds to travel to England, even if the procedure itself is free. They may have difficulty accessing their passport and booking flights if they do not have a credit card. They will also have to miss school. They may not wish to tell their parents. Indeed, they may be in a situation at home where they would be at risk if they do tell their parents. Girls in care are particularly vulnerable.

49. It is likely that these factors lead to more adolescent girls making the decision to buy abortion pills, illegally, risking arrest, prosecution and conviction, and a criminal record, rather than trying to travel to England.

50. The above hardships are experienced by those who are able to travel. This option is simply not open to some women. Such women include young girls whose parents will not allow them overseas, women who have children but cannot find appropriate childcare to cover the time they need to be in England, asylum-seekers who do not have the necessary travel documents, and women with abusive partners who control access to travel documents.

The Effect of Criminalisation

51. The abortion laws in Northern Ireland and Ireland mean that women of child-bearing age risk criminalisation if they do not wish to continue with an unwanted pregnancy.

52. The threat of criminal prosecution in Northern Ireland for abortion-related offences is not a

34 UK Department of Health, ‘Abortion Statistics, England and Wales: 2016’, page 77, at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/652083/Abortion_stats_England_Wales_2016.pdf

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theoretical one. Women and girls in Northern Ireland have been arrested for buying abortion pills. Between 2010 and 2017, there have been 9 prosecutions under the OAPA or for alternative offences related to procuring an abortion.

53. In 2016, a 21-year old woman was given a 3-month prison sentence, suspended for 12 months, 35 after pleading guilty to purchasing abortion pills online in order to induce an abortion .

54. A judicial review challenge is currently underway into the decision to prosecute a woman ​ ​ charged with helping her teenage daughter to access abortion pills in order to perform a 36 termination . The prosecution arose as a result of the mother seeking medical attention when the daughter had abnormal bleeding. The message some will take from this prosecution is that medical attention should not be sought in these circumstances – or that teenage girls should not tell their parents and seek their help for fear of dragging them into the criminal justice system.

55. This threat of criminalisation is not, as some voices in the anti-abortion lobby claim, an empty threat, nor are the sanctions mentioned above negligible. A criminal record can have a profoundly deleterious effect on a person’s life, including her employment and educational opportunities, her ability to travel and to obtain work permits, and her ability to apply for a mortgage or insurance.

56. A criminal record, no matter how apparently lenient and no matter when obtained, can result in lingering feelings of shame and stigmatisation.

57. The criminal laws governing abortion remain on the statute books in both Northern Ireland and Ireland. There is no stated policy not to enforce them; on the contrary, in the case of Northern Ireland, there has clearly been an express intention on the part of the Police Service of Northern Ireland to enforce the criminal law in this regard. It is irrelevant if the laws have not been enforced for a period of time, for whatever reason: women who become pregnant in jurisdictions where criminal laws are in force are at risk of being directly affected by them and are, therefore, victims of those laws (see Norris v Ireland (1991) 13 EHRR 186). ​ ​

58. Moreover, the threat of criminalisation may prevent medical practitioners from acting in the best interests of their patients.

58.1. In the case of A, B and C v Ireland, the European Court of Human Rights stated: “[T]he ​ ​ ​ Court considered it evidence that the serious criminal penalties for having or assisting in an unlawful abortion would constitute a significant “chilling factor” for both women and their 37 doctors, regardless of whether or not prosecutions have been pursued under the Act.”

35 BBC, [online] ‘Woman who bought drugs online to terminate pregnancy given suspended sentence’, 4 April 2016, at http://www.bbc.co.uk/news/uk-northern-ireland-35962134

36 BBC [online], ‘Appeal right granted in abortion pills case’, 26 January 2017, at http://www.bbc.co.uk/news/uk-northern-ireland-38759822

37 Paragraph 254, page 70, https://www.dfa.ie/media/dfa/alldfawebsitemedia/ourrolesandpolicies/internationallaw/echr-a-b-and-c-vs-ireland-2010.pdf

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58.2. In giving evidence to the Joint Oireachtas Committee on the Eighth Amendment, 38 Professor Fergal Malone, Master of the Rotunda Hospital, Dublin said : “There is a lack of ​ clarity currently amongst some doctors as to whether they may have a vulnerability to ..a … conviction [under Section 22 of the Protection of Life During Pregnancy Act 2013] if they are involved in any way with the management of a patient who has a pregnancy termination in another jurisdiction There is a lack of clarity currently as to whether a hospital’s ……​ ​ assistance to its patients in seeking a pregnancy termination for fetal abnormalities in another jurisdiction might be seen as “consent or connivance” [under Section 23 of the Act]“

Violence Against Women and Girls

59. International human rights bodies have repeatedly made clear that criminalisation of health services which only women and girls require, including abortion, is a form of discrimination . against women. ​ The UN Committee on the Rights of the Child has also highlighted the ​ importance of adolescent girls’ reproductive rights.

60. Pregnancies resulting from violent sexual crime, such as rape and incest, raise particular human rights concerns. Forced pregnancy is defined as a crime against humanity in Article 7 of the Rome Statute of the International Criminal Court and is a form of gender-based violence against women that constitutes a serious violation of the human rights and dignity of women and girls. Denial of sexual and reproductive health and rights services, including safe and legal abortion, is now recognised by both the Committee on the Elimination of Discrimination Against Women (CEDAW) and the European Parliament as a form of violence against women and girls.

61. The term ‘gender-based violence’ applies to the sexual or physical abuse of groups targeted because of their gender or gender roles and relegated to a lower position of social status or power. The United Nations’ Committee on the Elimination of Discrimination against Women in its General Recommendation 19 (GR19) defined gender-based violence as: “violence that is ​ directed against a woman because she is a woman or that affects women disproportionately.” In ​ its recently adopted General Recommendation 35 (GR35), updating GR19, the Committee stated: “17. The Committee endorses the view of other human rights treaty bodies and special ​ procedures mandate-holders that in making the determination of when acts of gender-based violence against women amount to torture or cruel, inhuman or degrading treatment, a gender sensitive approach is required to understand the level of pain and suffering experienced by women, and that the purpose and intent requirement of torture are satisfied when acts or omissions are gender specific or perpetrated against a person on the basis of sex.” ​

62. The Istanbul Convention acknowledges that violence against women and girls is gender-based discrimination necessitating positive action by State bodies to address the adverse effects of such violence (which include the subordination of women and the obstruction of female equality

38 http://www.oireachtas.ie/parliament/media/committees/eighthamendmentoftheconstitution/Opening-Statement-by-Professor-Fergal-M alone,-Master-of-the-Rotunda-Hospital-Dublin.pdf

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39 and the advancement of women). T​ his recognition reflects the statistical understanding, which indicate that the prevalence, impact and consequence of violence against women, including sexual violence, is very different to that against men. Women and girls are much more likely than 40. men to be the victim of multiple incidents of abuse, and in particular of sexual violence T​ hey are also significantly more at risk of serious sexual assault (1 in 20 women compared to 1 in 331 41 men ).

63. The Istanbul Convention came into force in 2014 and the United Kingdom government is now committed to ratifying it following the passing in June 2017 of the Preventing and Combating Violence Against Women and Domestic Violence (Ratification of Convention) Act 2017 (the 2017 Act). Although not yet ratified, s. 1 provides for a timetable for ratification, with in-built urgency as the Secretary of State is required to take certain steps “as soon as reasonably practicable” (s. 1(2)).

64. The purposes of the Istanbul Convention are set out in Article 1 and include not only to prevent, prosecute and eliminate violence against women but importantly, too, to “design a ​ comprehensive framework, policies and measures for the protection of and assistance to all 42 victims of violence against women and domestic violence .​ ” Article 6 places obligations upon the parties to develop gender-sensitive policies and specifically, “to promote and effectively ​ implement policies of... the empowerment of women”. Article 18 sets out the general obligations ​ upon the parties including that measures to protect and support victims shall “be based on an integrated approach which takes into account the relationship between the victims, perpetrators, children and their wider social environment” and “address the specific needs of vulnerable persons, including child victims, and be made available to them.”

65. Gender-based sexual violence includes child sexual abuse; sexual assault outside an intimate relationship; teenage physical dating violence; and intimate partner violence. The latter two categories encompass abusive unions, and it is now well established that abusive partners may try to manipulate reproductive outcomes as part of their efforts at control – from sabotaging contraception to physically assaulting pregnant women with the aim of inducing miscarriage. Adolescents are especially at risk, and US studies indicate that more than half of teenage and young adult women experience partner interference with and access to reproductive services43.

39 See the Preamble which acknowledges that violence against women is a manifestation of historically unequal power relations between women and men, which have led to domination over, and discrimination against, women by men and to the prevention of the full advancement of women.

40 Walby and Allen, Domestic Violence, Sexual Assault and Stalking: Findings from the British Crime Survey (Home Office RDS Directorate) ​ (2004).

41 Equality and Human Rights Commission, Consultation Response, Ending violence against women, domestic abuse and sexual violence (Wales) Bill (February 2013).

42 At [1c].

43 Laura A. McCloskey, ‘The Effects of Gender-Based Violence on Women’s Unwanted Pregnancy and Abortion,’ Yale J. Biol. Med. 2016 Jun; 89(2): 153-159, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918882/. ​ ​ 16

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66. Under 18 year olds are particularly vulnerable, with the victim profile for reported sexual 44 offences in 2012/13 showing 56% were children . This also chimes with international statistics which indicate that young women are especially vulnerable with 54% of rapes occurring before 45 the age of 21 . The concomitant risk for victimisation and unwanted pregnancy highlights the need to understand and acknowledge the role gender-based violence may have in abortion.

67. There is also increasing recognition that forced pregnancy or restrictions preventing women who are victims of sexual violence from accessing abortion is in itself a form of gender based violence and gender based discrimination. GR3546 states, for example: “18. Violations of women’s sexual ​ and reproductive health and rights, such as forced sterilizations, , forced pregnancy, criminalisation of abortion, denial or delay of safe abortion and post-abortion care, forced continuation of pregnancy, abuse and mistreatment of women and girls seeking sexual and reproductive health information, goods and services, are forms of gender-based violence that, depending on the circumstances, may amount to torture or cruel, inhuman or degrading treatment.” ​

68. At EU level, gender-based violence is acknowledged, as is the need for additional support, services and protection: for example, in Directive 2012/29/EU, [17]. A recent European Parliament motion, concerning the Istanbul Convention, included the following passages:

“The European Parliament . ​ …

4. Strongly affirms that the denial of sexual and reproductive health and rights services, including safe and legal abortion, is a form of violence against women and girls; reiterates that women and girls must have control over their bodies and sexualities; calls on all the Member States to guarantee comprehensive sexuality education, ready access for women to family planning, and the full range of reproductive and sexual health services, including modern contraceptive methods and safe and legal abortion";

5. Stresses that forced pregnancy is defined as a crime against humanity in Article 7 of the Rome Statute of the International Criminal Court of 17 July 1998 and is a form of gender-based violence against women that constitutes a serious violation of the human rights and dignity of women 47 and girls...”

Ireland

44 Northern Ireland Department of Justice Consultation on Amending the Criminal Law on Abortion, published on 8 October 2014, page 65: https://www.justice-ni.gov.uk/sites/default/files/consultations/doj/the-criminal-law-on-abortion-lethal-foetal-abnormality-and-sexual-cri me.pdf

45 Centers for Disease Control. Sexual violence data source, 2015, available at http://www.cdc.gov/violenceprevention/ ​ sexualviolence/datasources.html and cited by McCloskey, ibid, fn 45.

46

47 European Parliament, Interim Report on the proposal for a Council decision on the conclusion, by the EU, of the Istanbul Convention, 19 July 2017: http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//NONSGML+REPORT+A8-2017-0266+0+DOC+PDF+V0//EN . ​ ​ 17

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69. We consider the following issues to be additionally of particular concern for residents of Ireland: (i) The potential impact of ‘Brexit’ (ii) The dependence of Ireland on NHS-commissioned abortion service providers

The impact of Brexit Note: Subsequent to the BIPA Committee D meeting of 4 December 2017 where London-Irish ARC gave evidence on this point, the UK Foreign Office stated on 22 December 2017 that the current rights enjoyed by British and Irish citizens under the Common Travel Area are 48 protected after the UK leaves the EU . There is still uncertainty regarding the potential impact of Brexit on the rights of foreign nationals living in Ireland to travel to Britain in future.

70. Any changes to the existing travel arrangements between Ireland and Great Britain as a result of Brexit are likely to have a serious effect on the women who have to travel every day from Ireland to access abortion services in Britain. In particular, we are concerned about any changes to the bi-lateral arrangements that form the Common Travel Area (CTA).

71. The current CTA arrangements, in place since the foundation of the Irish State in 1922, allow British and Irish citizens to travel freely between Ireland, Northern Ireland and the rest of the UK without being subject to passport controls.

72. The UK Government has listed the maintenance of a Common Travel Area as a priority for Brexit 49 negotiations . Brexit Secretary David Davis has described the continuation of the CTA after 50 Brexit as “non-negotiable” . The Irish government has stated its commitment to preserving the 51 benefits of the CTA .

73. Despite this rhetoric, independent sources indicate that it is likely that although it may be 52 nominally retained, substantive changes to the CTA are likely to occur . The likelihood of change has been expressly acknowledged by UK parliamentarians. A Special Report of the House of Commons Northern Ireland Affairs Committee states: “The Government has been clear that ​

48 https://www.gov.uk/government/publications/citizens-rights-uk-and-irish-nationals-in-the-common-travel-area/citizens-rights-uk-and-iris h-nationals-in-the-common-travel-area

49 HM Government, ‘The United Kingdom’s exit from and new partnership with the European Union’ Cm 9417 (February 2017), https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/589191/The_United_Kingdoms_ex it_from_and_partnership_with_the_EU_Web.pdf

50 BBC, ‘Brexit: What would 'no deal' look like?’ (24 March 2017), http://www.bbc.co.uk/news/ukpolitics-39294904 ​ 51 https://merrionstreet.ie/MerrionStreet/en/EU-UK/FAQs/Your_questions_answered.html#What%20will happen to the Common Travel Area?

52 A January 2017 analysis, “The Common Travel Area: Prospects After Brexit” published by the research project “Constitutional ​ ​ Conundrums: Northern Ireland, the EU, and Human Rights”

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53 there will be no immediate changes to our practices surrounding the CTA (our emphasis)” ​ ​ ​

74. House of Commons Briefing Paper Number 7661, dated 9 June 2017, states: “The future of the ​ CTA post-Brexit is uncertain expert evidence received by Parliamentary select committees … warned that Brexit poses “a real and substantive threat to the very existence” of the CTA and 54 cautioned that the maintenance of current arrangements should not be taken for granted.” ​

75. Furthermore, we have as yet seen no evidence that policy-makers in Ireland, Northern Ireland or Great Britain in this area have given any consideration to the very particular circumstances in which women have to travel in the context of accessing abortion services.

76. We see this as a very real concern, given the following:

76.1. Any increase in document or identity control will cause further hardship or act as a barrier to women travelling for abortion. The stigma that attaches to abortion in Ireland means that many women who travel wish to do so anonymously. It is widely known that 55 many provide a UK address to clinics, rather than an Irish one, or provide a false address .

76.2. Additional hurdles of any kind result in additional trauma. The accounts of women who travelled to Britain for abortion services in recent decades provide a vivid illustration of the heightened distress caused by the need to travel covertly in a time when it was not uncommon for those travelling from Ireland to be stopped and detained for questioning at airports and seaports. The women in question will have had sleepless nights worrying over the information gleaned during their encounter with the security services. They will have agonised over the fact that such details will have been entered on the Police National Computer as a matter of routine, available at the click of a computer mouse to their 56 own police force … The reason for those interventions by the police and immigration authorities originated in the then political situation in Northern Ireland. In the current climate regarding heightened immigration controls throughout Europe, it is a reasonable expectation that similar forms of interventions post-Brexit would apply to women who are perceived to be undesirable or suspect.

76.3. Even if there is no material change to the future ability of Irish and Northern Irish citizens to travel freely to Britain, the same will not necessarily hold true for foreign nationals living on the island of Ireland whose reproductive rights are subject to the same restrictions as Irish and Northern Irish citizens. Little clarity has been provided by any

53 House of Commons, Northern Ireland Affairs Committee, ‘Northern Ireland and the EU Referendum: Government Response to the Committee’s First Report”, First Report of Session 2016-17, 16 January 2017, at https://publications.parliament.uk/pa/cm201617/cmselect/cmniaf/924/924.pdf

54House of Commons, ‘The Common Travel Area, and the special status of Irish nationals in UK law’, Briefing Paper Number 7661, 9 June 2017, at http://researchbriefings.files.parliament.uk/documents/CBP-7661/CBP-7661.pdf ​ 55 Factsheet: Abortion, FPA, Department of Health, Social Services and Public Safety, and HSC Public Health Agency (October 2012). ​ ​ ​ 56 Rossiter, A, ‘Ireland’s Hidden Diaspora: the ‘abortion trail’ and the Making of a London-Irish Underground, 1980-2000’, p. 35

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government about the rights of other EU citizens. According to the most recent census 57 reports, there are over 500,000 non-Irish nationals living in Ireland (2016) and over 80,000 58 non-UK/Irish nationals living in Northern Ireland (2011) .

76.4. The most negative potential impact of Brexit on access to abortion for residents of Ireland is on the most vulnerable. This was highlighted by Prof Fergal Malone, Master of the Rotunda Hospital in his evidence to the Joint Oireachtas Committee on the Eighth Amendment of the Constitution of Ireland: “I am concerned about the impact of Brexit. If ​ there are further practical impediments to patients travelling freely between Ireland and the United Kingdom, I would see some significant added traumas and challenges for our patients. It must be remembered that those who are most vulnerable to being traumatised are those who are non-English speaking. They are perhaps refugees who do not have the wherewithal or the common sense to be able to find other avenues for their care. It is a 59 potential significant problem for us.”

Dependence of Ireland on NHS-commissioned services 77. Exporting women to Britain for abortions creates an implicit reliance on the British healthcare system and the reproductive healthcare providers operating within that system.

78. Since the early 1980s, there has been a change in NHS commissioning practices which has led to the NHS-funded independent sector – effectively BPAS and Marie Stopes – accounting for two-thirds of NHS-funded abortion services, with the remainder being provided by private healthcare and NHS hospitals. Women with complications or requiring late-term abortions may 60 need to be referred to NHS acute hospitals .

79. Residents of Ireland are dependent on access to the same abortion service providers as British residents.

80. In the independent sector, BPAS and Marie Stopes have both been meeting the needs of Irish 61 women for over 40 years, with dedicated websites providing information on reduced prices, free taxis, and advice with booking flights to meet the needs of Irish women who must travel for abortion.

81. NHS hospitals meet the very particular needs of Irish women who require a later-term abortion, such as following a diagnosis of fatal foetal abnormality. Irish hospitals have pre-existing working relationships with NHS hospitals in Britain which allows them to provide patient contact

57 https://www.rte.ie/news/2017/0921/906465-census-migration/ ​

58 http://www.migrationobservatory.ox.ac.uk/resources/briefings/northern-ireland-census-profile/ ​ 59 http://oireachtasdebates.oireachtas.ie/debates%20authoring/DebatesWebPack.nsf/committeetakes/EAJ2017101100002?opendocument #W00050

60 https://www.theguardian.com/world/2017/oct/24/women-abortion-rights-service-crisis-nhs-no-specialist-doctors ​ 61 www.bpas.ie & www.mariestopes.org.uk/overseas-clients-abortion/irish ​ ​ ​ 20

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62 details, together with all relevant medical records . Patients must make their own appointments with the NHS hospital, make their own travel arrangements, and cover all expenses which may run into thousands of euros.

82. For a British resident accessing an abortion on the NHS, the waiting time should be less than two weeks from the patient’s initial appointment to having an abortion. However, demand management pressures on NHS system capacity overall also impact access to abortion services, 63 leading to longer waiting times in some cases .

83. The need to prioritise service provision for NHS commissioners and British health populations has a consequent impact on the ability of Irish women to access abortions:

83.1. In February 2017, Marie Stopes announced that it was forced to prioritise NHS patients due to a surge in demand. Irish patients could not make bookings with Marie Stopes during that time and were instead referred to BPAS. BPAS was simultaneously reporting that its services were under strain and that it would be necessary to redirect some Irish women to 64 different clinic locations in Britain .

83.2. In relation to later-term abortions which must be carried out in NHS hospitals, Professor Fergal Malone (Master of the Rotunda Hospital, Dublin) made the following statement in his 65 evidence to the Joint Oireachtas Committee on the Eighth Amendment: “Recently, we ​ have been faced with a number of cases of patients with fatal or complex fetal abnormalities not being able to make an appointment with a centre in the UK for pregnancy termination because that centre has been too busy or because the patient has been at a later gestational age. This can add significantly to patient distress, but additionally, it also adds to the complexity of the pregnancy termination procedure when performed at later gestational ages. Additionally, we are unsure as to what the impact of Brexit will be on the ease of access, or potentially lack of access, for our patients to pregnancy termination in the UK”

83.3. A personal account of this type of situation was reported in on 21 Nov 66 2017 : “I started to ring around places in the UK and initially had no luck at all. Liverpool ​ women’s hospital was recommended to me, but they said they had too many Irish couples booked in at that time so couldn’t take any more as they needed to look after their own local patients as well. I also rang a place in London and was told they could give me

62 http://www.oireachtas.ie/parliament/media/committees/eighthamendmentoftheconstitution/Opening-Statement-by-Professor-Fergal-M alone,-Master-of-the-Rotunda-Hospital-Dublin.pdf

63 http://www.contraceptionjournal.org/article/S0010-7824(17)30435-3/fulltext ​ 64 http://www.independent.co.uk/news/uk/home-news/abortion-irish-women-uk-british-clinics-turn-away-marie-stopes-a7567046.html ​ 65 http://www.oireachtas.ie/parliament/media/committees/eighthamendmentoftheconstitution/Opening-Statement-by-Professor-Fergal-M alone,-Master-of-the-Rotunda-Hospital-Dublin.pdf

66 www.irishtimes.com/life-and-style/health-family/my-baby-s-ashes-arrived-by-courier-along-with-a-shopping-delivery-for-my-neighbour-1. 3289138

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medicine to bring on the labour, but then I would have to go home to give birth – this of course was also not possible as I couldn’t do it on my own – so I rang another place, this time in Birmingham, but they were so cold on the phone that I didn’t even bother asking them and just hung up. Then as a last resort, I rang Liverpool again and I don’t know if someone had intervened on my behalf, but they told me that they could book me in for St Patrick’s Day 2014.”

84. Please refer to Committee Question c paragraphs 90-92 for further evidence of the degree to which healthcare services in Ireland have an explicit reliance on the provision of abortion services in England.

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Committee Question c: How would you respond to arguments that the comparatively restrictive ​ nature of the abortion regimes in Northern Ireland and Ireland has meant that the issue is, in effect, exported to Britain for a solution?

85. Like women in every country in the world, women in Ireland and Northern Ireland have abortions. Their reasons for doing so vary. For some it is a difficult and sometimes painful decision, while for others it is straightforward and a relief to end an unplanned pregnancy.

86. The only difference is that the vast majority of Irish and Northern Irish abortions do not take place on the island of Ireland. It is clear that criminalisation of abortion is ineffective in preventing women from having abortions.

87. Between 1970 and 2015, at least 61,311 women travelled from Northern Ireland and 180,797 67 from Ireland to England for abortion services .

88. Please refer to Committee Question a, paragraphs 78 – 85 for further evidence of the consequences of exporting the demand for abortion services from Ireland to NHS-commissioned services in England which are already under capacity pressures.

89. Please refer to Committee Question e regarding the limitations of the system now in place for women from Northern Ireland to access abortion services in Britain.

Ireland

90. The HSE Sexual Health & Crisis Pregnancy Programme is a national programme situated within the Health and Wellbeing Division of the Health Service Executive (HSE) in Ireland. It is mandated by a statutory instrument to reduce the number of crisis pregnancies and to provide support to those who have a crisis pregnancy.

91. The evidence presented to the Joint Oireachtas Committee on the Eighth Amendment by the 68 HSE Sexual Health and Crisis Pregnancy Programme makes it clear the degree to which Irish reproductive health services are deliberately structured around the presumed ability of Irish women to access abortions through NHS providers: “Crisis pregnancy counsellors and healthcare practitioners can, on request, provide Irish women ​ with information on how to access abortion services including names and addresses of clinics. Post abortion counselling is provided by the same funded services which provide crisis pregnancy counselling. Information on the availability of free post abortion counselling in Ireland is also provided by abortion clinics in the UK and the Netherlands. The HSE Programme links with abortion providers

67 https://www.theguardian.com/world/2016/oct/17/home-abortion-kits-women-ireland-study ​ 68 http://www.oireachtas.ie/parliament/media/committees/eighthamendmentoftheconstitution/Opening-Statement-by-Ms.-Janice-Donlon,- HSE-Sexual-Health-and-Crisis-Pregnancy-Programme.pdf

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to ensure the information is made available to women who have travelled from Ireland. A post abortion medical check-up is available for women to ensure they have fully recovered from their procedure”

92. Until there is constitutional and legislative change in Ireland, the Irish healthcare system has a critical dependency on the British healthcare system to meet the needs of Irish women for access to abortion services. This point was emphatically made by Dr. , Chairman of Institute of Obstetricians and Gynaecologists of Ireland in his presentation to the Joint Oireachtas Committee on the Eighth Amendment: “Without access to abortion in the UK, it is ​ inevitable that Ireland would have an epidemic of illegal abortions and a massive increase in maternal mortality.”

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Committee Question d: How would you respond to arguments that the issues surrounding ​ abortion are best dealt with not through liberalisation of the law, but by other means, such as more effective support for women?

93. Many people argue in favour of finding a ‘middle ground’ in the that would marginalise the ‘extreme’ positions on each side. However, the methods suggested are not satisfactory. We believe that “more effective support for women”, as the question phrases it, ​ ​ should mean support for women and their healthcare needs at all stages of their life, including their decision to have an abortion.

94. Women have the right to full participation in society on equal terms with men and control of their fertility is a pre-requisite for this. We believe that women who want an abortion should be supported in that decision and that there is no safe or effective immediate alternative to preventing or reducing the number of unwanted pregnancies.

95. Denying legal abortions does not stop women from having abortions. The right to a safe medical procedure for terminating pregnancy if a woman is psychologically, physically, socially or economically in a position not to wish to continue a pregnancy to term is recognised in almost all mature jurisdictions. The principle lying behind this is that it is a social good that dangerous and illegal abortions should not occur, and that hence it should be a matter for a woman herself to decide whether to continue a pregnancy to term, knowing her own circumstances better than anyone else does.

Increased sex education and contraception 96. One suggestion that is often put forward as an alternative to liberalisation of the law on abortion is better sex education and use of contraception. There is evidence to suggest that improved sex education does lessen the need for abortion but the debate is not black-and-white: sex is messy and complicated and contraception, of all types, is fallible. It is irrelevant for the purposes of this debate whether failures in contraception are a result of an inherent fault in the method or because people use it poorly or irresponsibly; the point is it does fail and so abortion is therefore needed as a back-up.

97. What’s more, in many developed countries – including the USA - contraception is not provided by the State, and so it is only the privileged who are able to access it. Cultural norms also exist within certain cultures whereby men are reluctant to use condoms, and hormone-based methods of contraception are not suitable for all women. It is therefore all-the-more important for women to have access to free, safe and legal abortion, because contraception is not always available or reliable.

Adoption 98. Adoption is not a substitute for abortion: women who want an abortion want not to be pregnant, not simply to not have a child. It is a myth that adoption is a ‘win-win’ solution to

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unwanted pregnancy; it is a convenient, political proposal that gives the impression of benefitting all parties involved but in fact privileges the foetus and the would-be adopters over the pregnant woman. What is often forgotten by proponents of adoption in place of abortion is that the burden of pregnancy qua pregnancy, regardless of how much help and support is provided by a woman’s partner, the State or others, is on the woman and the woman alone. The emotional turmoil that a woman must endure in carrying a pregnancy to term and then giving up a newborn baby is not an alternative to abortion.

99. A further problem with proposing adoption as an alternative to abortion is the impact on a woman’s career. Pregnancy is not a neutral state of being. At best, pregnancy is demanding; at worst, it is debilitating; and it is always disruptive. Trades unions, human rights organisations and equality groups that campaign for women’s rights at work are all too aware of the “pregnancy penalty” experienced by women via loss or reduction of earnings, stigma and/or lessening promotion opportunities.

100. Crucially, adoption is rejected by the key stakeholders: the reality is that pregnant women faced with unwanted pregnancies tend not to choose adoption. In Britain, while there are almost 200,000 abortions every year, fewer than 200 newborn babies are offered for adoption.

Increased social care/amelioration of poverty 101. While many pro-life organisations recognise that often women seeking abortions are poor and cannot afford to have another child, changing this is a major, long-term project that does not reflect current and recent government policies on austerity and swingeing welfare cuts. This is therefore not a realistic or viable alternative to abortion in the short-term.

Quality of life 102. The quality of life of the woman and particular nature of her suffering under compulsion to continue a pregnancy against her will, forcing her into parenthood, is also relevant. Pregnancy is an all-consuming physical experience, affecting how a woman breathes, moves, sleeps, toilets. It is an unfair burden to place upon a woman to force her to carry an unwanted pregnancy to term, and provide whatever may be needed to sustain the life of the foetus. The woman’s life may be altered irrevocably for the worse: dreams shattered, education foregone, opportunities closed off, with an indefinite sentence of despair and poverty offered instead. An unwanted child will also need care which the mother may be unable to give. Its life prospects will typically be poorer than those of others, generating social problems and costs.

Autonomy and dignity 103. A principal argument in support of a woman’s right to choose to terminate an unwanted pregnancy relates to the self-determination that she is entitled to exercise over her own body. A woman has a right to choose to whom and in what circumstances she gives access to her body, and what happens to it or within it, in intimate personal relations. This same right is engaged in the case of pregnancy. Pregnancy as a physical sequence of events happens to her and her 26

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alone, and it is an unconscionable violation of a woman’s right to privacy and self-determination to be commanded and constrained to accept this sequence of events and all it entails, to be denied choice in the matter, and to be subjected to an external third-party general view about pregnancy as such, without regard to her personal circumstances, needs and interests. Women should therefore be supported by the State to access free, safe and legal abortion if that is what they choose.

Putting the positive case for abortion 104. It is important to remember that women who want to be able to choose to have a free, safe and legal abortion are not anti-life or anti-child; they simply want to be able to take control of their own futures. Many women who choose to have an abortion do want children and look forward to that experience, or already have children and cherish those existing children. The fundamental fact is that they want to be able to have children at a time of their own choosing.

105. It is a social good that unwanted children should not be brought into the world, that a mother unable to support more children than she already has should not take an unwelcome further pregnancy to term, that the opportunity for women to further their education and to have careers uninterrupted by unwanted parenthood is a plus to society.

106. The right to a safe, legal abortion is therefore not only a matter of privacy and self-determination, but also a matter of equality for women: unless women can control if, when and in what conditions to have a child, through contraception and when necessary through safe and legal abortion, they are denied this equality. It has been estimated that improved fertility control for women between 1970 and 1990 contributed to 75% of the growth in numbers of doctors and lawyers in that period.

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Committee Question e: How would you summarise and respond to recent developments in ​ relation to abortion in Northern Ireland, including the Northern Ireland Court of Appeal ruling on the Northern Ireland abortion law, and the UK Government’s decision (since echoed by the Scottish and Welsh Governments) to fund abortion services in England for women from Northern Ireland?

107. On 29 June 2017 the UK government announced that it would fund abortions in England for women travelling from Northern Ireland. This change in policy came as a result of a proposed amendment to the Queen’s Speech by Stella Creasy MP. When it became clear that MPs were likely to back Creasy's amendment, the government announced that the Equalities Office would fund terminations for women from Northern Ireland.

108. Further details of the scheme were announced on 23 October 2017. Whilst the London-Irish Abortion Rights Campaign views this as a potentially positive interim measure that will improve the condition of hundreds of women with immediate effect, it is not a solution to the continued criminalisation of abortion in Northern Ireland.

109. In particular, the following issues remain of grave concern:

109.1. Travel will be refunded but only for the very poorest of the population. Finding the money upfront for flights and accommodation will remain a barrier for many women.

109.2. Abortions in clinics are not suitable for all. Northern Ireland women continue to be barred from accessing abortions on the NHS. Whilst clinics can and do treat the majority of women and girls who require an abortion, treatment in a clinical setting is not appropriate for everyone. Women with even relatively minor health conditions, such as high BMI, anemia or high blood pressure, need to have abortions in a hospital. Regulation 3 of the NHS (Functions of Strategic Health Authorities and Primary Care Trusts and Administrative Arrangements) (England) Regulations 2002 bars Northern Ireland women from accessing this service. This bar applies only to Northern Ireland women: women resident outside the UK and who do not fall under the responsibility of any other Primary Care Trust (including women travelling from Ireland) may in theory receive abortion services on the NHS and be charged for those services.

109.3. Women who wish to organise cremation or burial of the foetal remains, or want a post-mortem examination to be carried out, experience particular hardship. Transportation of foetal remains to Northern Ireland can be carried out by couriers like DHL, which can be expensive, or the woman must carry the remains herself. There is inevitably, therefore, not only an additional financial and practical burden to be borne, but a further emotional burden. One of only two paediatric pathologists resigned in September 2016, stating that the final straw was having to advise a couple to use a picnic cooler bag to return their baby's remains to NI following a late-term abortion in England. Dr Gannon stated that: “Had the couple been in Northern Ireland, there would have been midwives present and ​ 28

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hospital processes in place so they could sit with their baby...Somebody else would be responsible for bringing their baby down to the mortuary to ensure the post mortem is carried out..But they had to organise that themselves and transport their own baby's body 69 back in a picnic cooler, in the boot of the car, on the overnight ferry.

110. We note that at the time of submission, Justine Greening has resigned from her post. Crucial aspects of the scheme have not yet been implemented, including putting in place a system for women to access the promised funding, make an appointment for treatment with the appropriate provider, and access the means-tested travel bursary. It has also not been decided what process will be established for the transport of foetal remains.

111. Women are thus at the mercy of a highly-volatile political process and promises made by an unstable government benighted by unfavourable parliamentary arithmetic. Whilst we are confident that the government will honour former Minister Greening’s promises, and we will continue to lobby it in this regard, it is clear that rights conferred under such circumstances are ​ at best unstable, to say the least. 112.

69 https://www.belfasttelegraph.co.uk/news/uk/doc-who-told-ni-parents-to-put-dead-baby-in-picnic-cooler-bag-quits-over-abortion-interve ntions-35048334.html

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Committee Question f: Following the announcement by the Taoiseach that a referendum on the ​ Eighth Amendment to the Constitution will be held in May or June next year, how would you assess the current state of the debate as regards abortion policy in the Republic of Ireland? Note: Subsequent to the BIPA Committee D meeting of 4 December 2017 where London-Irish ARC gave evidence on this point, the final report of the Joint Oireachtas Committee on the 70 Eighth Amendment of the Constitution was published on 20 December 2017 .

113. The issue of access to abortion in Ireland has been the subject of review by a Joint Committee of the two houses of the Oireachtas (the national Parliament of Ireland): Dáil Éireann (House of Representatives) and Seanad Éireann (the Senate). The Joint Oireachtas Committee (JOC) was established to consider the report and recommendations of the Citizens’ Assembly on the Eighth Amendment of the Constitution.

114. The Citizens' Assembly is intended to be an exercise in deliberative democracy which aims to place the citizen at the heart of important legal and policy issues facing Irish society, including 71 abortion . It is a body comprising a Chairperson and 99 Irish citizens, randomly selected to be broadly representative of the Irish electorate.

115. The Citizens’ Assembly considered the Eighth Amendment between November 2016 and April 2017, during which time it received and heard detailed written and oral testimony from 25 experts, 17 advocacy groups and representative organisations both in support of and opposed to the availability of abortion as part of women’s healthcare. Citizens debated in private and public sessions various aspects of the abortion issue in Ireland including: crisis pregnancy; termination of pregnancy; suicide in pregnancy; rape and sexual assault; foetal abnormalities; provision for abortion access in other countries; sex education; ethics, morals and freedom of choice; and regulation of the medical profession.

116. On the final weekend of the Assembly in April 2017, the members voted in a series of 72 ballots. The key recommendations of the Assembly report were as follows: - to remove the Eighth Amendment from the Constitution and, for the avoidance of doubt, replace it with a provision which makes it clear this is solely a matter for the Oireachtas to decide how to legislate on these issues; - that the termination of pregnancy without restriction should be lawful; - that termination should be lawful in multiple circumstances where there is: real and substantial physical risk to the life of the woman; risk to the life of the woman due to suicide; serious risk or risk to the physical health, mental health, or health of the woman; pregnancy as a result of rape; there is a fetal abnormality that is likely to result in death before or shortly after birth; there is a

70 https://data.oireachtas.ie/ie/oireachtas/committee/dail/32/joint_committee_on_the_eighth_amendment_of_the_constitution/reports/2 017/2017-12-20_report-of-the-joint-committee-on-the-eighth-amendment-of-the-constitution_en.pdf

71 https://www.citizensassembly.ie/en/About-the-Citizens-Assembly/ ​ 72 Report and Recommendations of the Citizens’ Assembly on the Eighth Amendment 29 June 2017 https://www.citizensassembly.ie/en/The-Eighth-Amendment-of-the-Constitution/Final-Report-on-the-Eighth-Amendment-of-the-Constitu tion/Final-Report-incl-Appendix-A-D.pdf

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significant fetal abnormality that is not likely to result in death before or shortly after birth; and for socio-economic reasons.

117. There was widespread surprise in the Irish media and political parties in response to these progressive recommendations which went far beyond what had been assumed to be the likely outcome of the Citizens’ Assembly process.

118. Commentary by the National Women’s Council of Ireland (NWCI) puts this outcome in context, both in relation to how the Eighth Amendment was in itself a 1983 manifestation of Ireland’s past and why the Citizens’ Assembly voted as they did in 2017: “The Eighth Amendment ​ is reflective of Irish society at the time of its enactment to the Constitution in 1983: an Ireland in which women were incarcerated in workhouses for bearing children out of wedlock or leaving abusive husbands; in which contraceptives could only be dispensed by a pharmacist on the presentation of a valid medical prescription from a practising doctor; and in which divorce and homosexuality were illegal, but marital rape was not. It reflects a society which didn’t trust 73 women to make choices about their own lives :.” ​

119. NWCI response to the Citizens’ Assembly recommendations stated: “ fully armed with the …​ relevant facts and when they have had the opportunity to consider them, the Irish public recognises that the Eighth Amendment does not work and is reflective of an Ireland that we wish 74 to put behind us” . ​

120. In order to understand the recommendations of the Citizens’ Assembly, it is necessary to see them in the context of a decades-long backdrop of court, clinical case reviews and radical wider social and cultural change in Irish society, which eventually led to the current legislative and regulatory landscape. A list of some of the most notable court cases and legislative developments can be found in Appendix 1 to this paper.

121. The Citizens’ Assembly recommendations are reflective of more general changes in Irish society as a whole since 1983 as demonstrated by the following factors:

121.1. The evolution of Irish legislation relating to sexuality, reproductive health and gender 75 issues , most notably: 1990 – the recognition of rape in marriage as a crime; 1992 - the sale of condoms without a prescription; 1993 - decriminalisation of consensual homosexual acts between adults; 2003 - licensing of the emergency contraceptive pill for use in Ireland; 2011 - regulation of the emergency contraceptive pill for over the counter purchase without a prescription; and 2015 - legalisation of same-sex marriage, the first country to do so by popular vote in a referendum.

76 121.2. The decline in religious practice In Ireland. As of 2016 , the percentage of the

73 https://www.citizensassembly.ie/en/Meetings/NWCI-s-Paper.pdf ​ 74 https://www.irishtimes.com/news/ireland/irish-news/citizens-assembly-reaction-from-both-sides-of-abortion-debate-1.3058645 ​

75 https://www.ifpa.ie/Media-Info/History-of-Sexual-Health-in-Ireland ​ 76 http://www.cso.ie/en/media/csoie/releasespublications/documents/population/2017/Chapter_8_Religion.pdf ​ 31

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population who identified as Catholic fell sharply from 84.2% in 2011 to 78.3% in 2016. There has been a corresponding rise in the number with no religion which grew by 73.6 per cent to 468,400, accounting for just under 10% of the population. In addition, there has been a significant decline in Catholic practice in Ireland with the majority no longer attending Mass regularly and significant numbers not believing in key tenets of the church’s 77 teaching .

121.3. The recent acceleration in the decline of Catholic practice is generally considered to be a consequence in part of the cumulative impact of the publication of a series of reports on abuse in the church (Ferns in 2005; Ryan in 2009; Murphy in 2009; Cloyne in 2011.)

121.4. Earlier this year, the UN Committee Against Torture sharply criticised the Irish State’s 78 approach to the issues of abuse of women in the Magdalen Laundries , despite the apology issued in 2014 to 10,000 women held in Magdalen Laundries by the then Taoiseach Enda 79 Kenny .

121.5. At the time of writing, a further Commission of Investigation is currently underway in 80 relation to the operation of mother and baby homes . There has been a global spotlight placed on the work of this Commission of Investigation in light of ongoing investigations 81 surrounding the disposal of children’s bodies at the Tuam mother & baby home .

122. From the outset, it had been reported that members of the Oireachtas were of the view that the JOC must “water down” the recommendations of the Citizens’ Assembly on the basis that 82 they were too liberal for middle Ireland to accept .

123. Some members of the Oireachtas and JOC had accordingly been positioning an exclusions-based model - that is, abortion could be made available solely in cases of fatal foetal abnormality and rape or incest - as a more acceptable ‘middle ground’ than the recommendations of the Citizens’ Assembly. However, presentations to and discussions within 83 the JOC on 11 Oct 2017 highlighted that fatal foetal abnormality and rape are cited as the reason for abortion in only ~4% and 2% of cases, respectively. An exclusions-based model of this type would therefore ignore the other 94% of the 168,703 women who have travelled from Ireland to Britain since 1980 to access abortion services. Furthermore, multiple presentations to both the Citizens’ Assembly and JOC demonstrated that an exclusions-based model for rape and

77 https://www.irishtimes.com/news/many-catholics-do-not-believe-church-teachings-1.1063895 ​ 78 https://www.irishtimes.com/news/social-affairs/state-walking-back-from-apology-to-magdalene-survivors-says-un-1.3168714 ​ 79 https://www.independent.ie/irish-news/taoiseach-delivers-state-apology-to-magdalene-women-29081636.html ​ 80 http://www.mbhcoi.ie/MBH.nsf/page/index-en ​ 81 https://www.nytimes.com/interactive/2017/10/28/world/europe/tuam-ireland-babies-children.html ​ 82 https://www.irishtimes.com/news/politics/abortion-referendum-wording-should-ensure-it-passes-1.3237637 ​ 83 http://oireachtasdebates.oireachtas.ie/Debates%20Authoring/DebatesWebPack.nsf/committeetakes/EAJ2017101100002?opendocument #W00050

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incest is unworkable in practice.

124. Notable developments over the course of the JOC review included the following:

84 124.1. The majority vote of the JOC on 18 Oct 2017 not to retain the Eighth Amendment of the Constitution in its current form was broadly welcomed.

124.2. Sustained and deliberate attempts by a small minority of JOC members to undermine the work of the Committee, by allegations of bias both in relation to the workings of the 85 JOC as a whole and the chairing of the JOC by Senator Catherine Noone .

86 124.3. It was encouraging to see in the meeting of 15 Nov 2017 a series of rebuttals of these allegations by multiple members of the JOC, in relation to the workings of the JOC and their roles as JOC members, as well as strong statements of support for the fair and even-handed chairing of the proceedings by Senator Noone.

125. These meetings of the JOC took place against a backdrop of three recent party conferences where the issue was the subject of significant debate. ● Fine Gael and Fianna Fail are allowing their members of the Oireachtas a free vote. ● Sinn Fein policy supports repeal of the Eighth Amendment and legislation for terminations in the cases of rape, incest, fatal foetal abnormalities and when a mother’s life, heath or mental health is at risk. ● Labour Party policy supports repeal the Eighth Amendment and legislation for terminations on the grounds of rape, incest, fatal foetal abnormalities, and to protect the life and health of the mother. ● Smaller parties and Independents in the main support repeal of the Eighth Amendment, but with a mix of view on circumstances. A minority are vehemently opposed to any change.

87 126. The final JOC report published on 20 December 2017 recommended that Article 40.3.3 should be removed from the Constitution and politicians should be allowed to legislate for abortion. The report concluded that legislating to allow for abortions in the cases of rape and incest would have presented significant challenges. These difficulties and the availability of abortion pills led the members to agree abortions should be allowed up to 12 weeks of gestation without restriction. The JOC also concluded that abortions should be allowed when a mother’s life or health is at risk, and that terminations should be provided when requested when the unborn child has a fatal abnormality that is likely to result in death before or shortly after birth.

127. There remains a serious concern that, given the historically divisive nature of the issue, certain Irish politicians and sections of the media remain reluctant to reflect the reality of

84 https://www.irishtimes.com/news/politics/committee-votes-not-to-retain-eighth-amendment-in-full-1.3260573 ​ 85 https://www.irishtimes.com/news/politics/chair-of-oireachtas-committee-defends-abortion-witness-list-1.3268384 ​

86 https://beta.oireachtas.ie/en/committees/32/eighth-amendment-constitution/ ​

87 https://www.irishtimes.com/news/politics/committee-wants-legislation-to-permit-abortion-up-to-12-weeks-1.3334472 ​ 33

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contemporary Irish attitudes to abortion as evidenced by the latest polling released 1 Nov 2017 88 by Amnesty International :

● 60% believe women should have access to abortion on request, either outright or within gestational limits.

● Access to abortion is supported by o 89% when women and girls’ health is at risk o 85% when pregnant as a result of rape o 81% where there is a diagnosis of a fatal foetal abnormality o 64% where there is a diagnosis of a serious but non-fatal foetal abnormality o 72% based on a woman’s socio-economic circumstances

89 128. At the time of writing, it has been reported that Irish Government officials are working to ensure that there is no delay between the JOC’s report being published in December 2017 and a possible referendum in May or June 2018. Minister for Health Simon Harris has set a deadline of February 14 2018 for the new law to be published, in advance of a referendum on the future of the Eighth Amendment being put to the vote.

129. When speaking to the recent Fine Gael party conference, Minister Harris said this: "I’ve sat ​ in far too many rooms with women who have found this country to be cold, neglectful, lonely and isolating. That’s the truth, abortion is a reality for many, it just takes place with a pill from the internet, or a trip to another country. As the Irish minister for health I have to accept the reality that Irish women are having dangerous abortions" ​

88 https://www.amnesty.ie/amnesty-internationalred-c-poll-reveals-60-support-access-abortion-request/ ​

89 https://www.thetimes.co.uk/article/no-test-for-rape-victims-under-new-abortion-law-7c0lpw8sd ​ 34

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Committee Question g: To what extent is the increased availability and proliferation of online ​ abortion pills affecting the level of demand for access to abortion services in Great Britain from women in Ireland, North and South? Are there sufficient safeguards in place to support and ensure the health and safety of women who choose to take this medication?

130. The availability of the abortion pill, also known as medical abortion, has changed dramatically the landscape of abortion access throughout the UK, Ireland and the other BIPA jurisdictions.

131. and are the pills typically used by women and healthcare advisors within the first 120m weeks of pregnancy. They are widely known to be the safest method of 90 abortion and are included in the World Health Organisation’s list of essential medicines and 91 have been since 2005 .

132. As stated above, there is no distinction made regarding medical and surgical abortion in the laws of Ireland and Northern Ireland. In Ireland, women who order and take abortion pills and anyone who procures abortion pills for them, risk up to 14 years’ imprisonment under the PLDPA 2013. In Northern Ireland, the maximum sanction for taking or procuring abortion pills is life imprisonment under the OAPA 1861.

133. Yet the number of women ordering and taking abortion pills in Ireland and Northern Ireland is increasing every year. In 2014, 1017 abortion pills were seized by Irish Customs, more than ​ 92 double the amount seized in 2013 .

134. Evidence given to the Joint Oireachtas Committee on the Eighth Amendment by Dr Abigail Aitken, Assistant Professor LBJ School of Public Affairs, University of Texas at Austin highlighted how the number of Irish and Northern Irish women travelling abroad to England and Wales had fallen by almost 50% between 2002 and 2016, the while the number accessing telemedicine has 93 increased .

90 WHO Model List of Essential Medicines, 20th List, March 2017 (Amended August 2017) http://www.who.int/medicines/publications/essentialmedicines/20th_EML2017_FINAL_amendedAug2017.pdf?ua=1 page 46) ​ ​ 91 Gibson, Liza, WHO puts on its essential drug list’, British Medical Journal, 2005 Jul 9; 331(7508): 68. ​ ​ 92 http://www.irishexaminer.com/ireland/seizures-of-illegal-abortion-pills-lead-to-fears-353462.html ​ 93 http://oireachtasdebates.oireachtas.ie/Debates%20Authoring/DebatesWebPack.nsf/committeetakes/EAJ2017101100002?opendocument #J00100

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EXHIBITS TO ACCOMPANY WRITTEN STATEMENT TO THE JOINT OIREACHTAS COMMITTEE ON 94 THE EIGHTH AMENDMENT

135. Evidence given to the Joint Oireachtas Committee on the Eighth Amendment by Janice Donlon, funding manager at the HSE Sexual Health and Crisis Pregnancy Programme highlighted that “[T]he reasons women may be accessing abortion pills online are cost and access. For ​ women who have made the decision to terminate a pregnancy, the cost associated with travelling from Ireland to another country for a medically supervised termination is high. Research finds that higher earning women are more likely to travel to other countries for abortions over their lower earning counterparts. Until recently it was difficult to make an assessment of the level to which this practice is occurring as limited information was available.

94 http://www.oireachtas.ie/parliament/media/committees/eighthamendmentoftheconstitution/Professor-Abigail-Aiken,-Briefing-Documen t-1-of-2---Exhibits-Brief.pdf

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Recently published research suggests that more women are contacting online providers of 95 abortion pills annually and becoming more aware about the availability of these drugs online.”

136. Janice Donlon’s evidence to the Joint Oireachtas Committee also highlighted key findings 96 from a 2017 study by Dr Abigail Aitken of self-reported outcomes after medical abortion through online telemedicine use in Ireland and Northern Ireland: “while the vast majority of ​ women did not need to contact medical services following taking the abortion pill at home, approximately one in ten - 9.3% - reported to the online provider that they were experiencing a symptom for which they were advised to seek medical advice and the vast majority of these women sought medical advice as advised

137. There were extensive discussions in multiple sessions of the Joint Oireachtas Committee on the Eighth Amendment regarding the question of safeguards to support and ensure the health and safety of women who choose to take this medication. The consistent theme running through these discussions have been the efforts being made on the part of the HSE, Family Planning Association, GPs and hospital consultants to encourage the minority of women with complications following the taking of the abortion pill to seek medical advice, while recognizing that the risk of prosecution is a real deterrent to accessing health care.

95 http://oireachtasdebates.oireachtas.ie/Debates%20Authoring/DebatesWebPack.nsf/committeetakes/EAJ2017111500002?opendocument #S00100

96 Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2011 (Published 16 May 2017) ​ ​

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APPENDIX 1 – Notable court cases & legislative developments in Ireland ● 1992 – the “X Case”: The Irish Attorney General determines that a 14-year old girl (X) pregnant as a result of rape, faces a real and substantial risk to her life due to threat of suicide and is entitled to an abortion in Ireland

● 1992 - three possible amendments to the Constitution are put to the vote in a referendum: o freedom to travel outside the State for an abortion - PASSED o freedom to obtain or make available information on abortion services outside the State, subject to conditions - PASSED o roll back the X Case judgment in order to remove suicide as a ground for abortion in Ireland – REJECTED

● 1995- regulation of Information (Services outside the State for the Termination of Pregnancies) Act allows doctors, advisory agencies and individual counsellors to give information on abortion services abroad should a woman request it.

● 1997 - the Irish Supreme Court rules that a 13 year old girl (Miss C), pregnant as a result of rape, was likely to take her own life if forced to continue with the pregnancy and so was entitled to an abortion in Ireland.

● 2002 - Irish voters reject an Amendment of the Constitution which would remove threat of suicide as a ground for abortion and increase the penalties for helping a woman have an abortion.

● 2005 - three Irish women (A, B, C) in the European Court of Human Rights (ECHR) challenge Ireland’s abortion ban under Articles 2 (protection of the right to life), 3 (freedom from inhuman and degrading treatment), 8 (protection of the right to family life) and 14 (protection for equal enjoyment of convention rights) of the Convention.

● 2006 - an Irish woman (D) in the ECHR argues that Ireland's ban on abortion in the case of fatal foetal abnormalities violated Articles 1, 3, 8, 20, 13 and 14 of the European Convention on Human Rights.

● 2007 - the Irish High Court rules that a 17-year-old woman (Miss D) with an anencephalic pregnancy had a right to travel for an abortion.

● 2010 - in the case of ABC v Ireland, the ECHR unanimously rules that Ireland's failure to implement the existing constitutional right to a lawful abortion in Ireland when a woman's life is at risk violates Article 8 of the European Convention on Human Rights.

● 2012 - Savita Halappanavar dies of septicaemia in her 17th week of pregnancy at Galway University Hospital.

● 2013 - the review into the death of Savita Halappanavar commissioned by the Health

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Service Executive highlights that “The interpretation of the law related to lawful ​ termination in Ireland, and particularly the lack of clear clinical guidelines and training, is considered to have been a material contributory factor in this regard”. ​

● 2013 - the Protection of Life During Pregnancy Act 2013 comes into effect.

● 2014 - an asylum seeker (Ms Y) pregnant as a result of rape and suicidal is denied access to abortion under the Protection of Life During Pregnancy Act 2013, and is subject to a court order for force-feeding and forcible hydration before a caesarean section.

● 2014 - the Irish High Court rules that a young pregnant woman (PP) who had been declared clinically brain dead for more than three weeks can be taken off life support because there is no genuine prospect of her baby being born alive.

● 2016 - the Irish government awards Amanda Mellet 30,000 compensation following a € ruling by UN Human Rights Committee that Ireland’s abortion laws subjected her to cruel, inhuman and degrading treatment after a diagnosis of fatal foetal abnormality.

● 2017 - an Irish teenager who requests an abortion is instead sectioned and held in a mental health unit against her will.

● 2017 - the Irish government awards Siobhan Whelan 30,000 compensation following a € ruling by UN Human Rights Committee that Ireland’s abortion laws subjected her to cruel, inhuman and degrading treatment after a diagnosis of fatal foetal abnormality.

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