Following the outcome of the abortion referendum in the Republic of Ireland, women in Northern Ireland now face one of the most restrictive abortion laws in the world. Women are forced to travel for help when faced with an unwanted pregnancy, at a huge personal cost, or use abortion medication purchased online, illegally – and risk up to life imprisonment. The Royal College of Obstetricians and Gynaecologists believes women in Northern Ireland should be able to access abortion care services within their own country – our position on this matter is outlined below.
The Abortion Act 1967 does not extend to Northern Ireland and abortion care is only provided under very limited circumstances – when there is a significant and long term threat to a woman’s physical or mental health or when her life is in danger.
In 2016-17 there were 13 terminations of pregnancy in hospitals in Northern Ireland. During the same period, more than 800 women travelled from Northern Ireland to have an abortion in England, Scotland or Wales. The number of women travelling to other parts of the UK has declined by 24% in the past five years and it is strongly suspected that more women are buying abortion pills online, taking them without medical supervision and risking life imprisonment.
Doctors and other health professionals in Northern Ireland still need to care for women who have had an abortion overseas, or taken abortion pills purchased online. Delivering this post-abortion care presents challenges as health professionals rarely have access to the woman’s relevant medical notes and may not be aware of the exact circumstances. The legal situation also creates unease among the healthcare professionals who provide support to these women due to the threat of criminal prosecution if they fail to report to police their belief that the woman may have committed a crime by taking abortion pills purchased online.
In June 2017, the RCOG signed a letter calling for the removal of the ban on NHS-funded abortion for women travelling from Northern Ireland. Later that month, the Government in Westminster agreed to cover the cost of abortions for women who travel from Northern Ireland to England to have the procedure. Similarly, the Scottish Government has agreed to cover the cost of abortions for women who travel from Northern Ireland to Scotland. The Welsh Government is also proposing to make this policy change.
In September 2017, the Council of the RCOG voted strongly in favour of supporting the removal of criminal sanctions associated with abortion in the UK. Members of the RCOG from across the UK, including those in Northern Ireland, were consulted on this vote and the majority supported the College’s position.
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:
“The RCOG believes that women in Northern Ireland should have the same access to abortion care as women in the rest of the UK.
“The current legal situation means healthcare professionals in Northern Ireland struggle to provide support for women requesting an abortion or safely manage any post-abortion complications. We recognise that this is a highly politicised issue but the current situation is unacceptable and leaves doctors, nurses and midwives working in a precarious legal vacuum in this core part of women’s sexual and reproductive healthcare.
“While the decision by the English and Scottish Governments to fund abortions on the NHS for women from Northern Ireland is an important step forward, it remains unacceptable that these women must travel overseas to access abortion services. The majority of women still have to arrange and cover the costs of travel and accommodation which can be extremely stressful and results in potential delays in obtaining an abortion.
“We are particularly concerned that the barriers to obtaining an abortion in Northern Ireland mean increasing numbers of women are purchasing abortion pills online, taking them without any medical expertise and support, and putting themselves at risk of life in prison.
“Decriminalisation of abortion presents a unique opportunity to address once and for all the inconsistent and unequal access to abortion care in Northern Ireland and we call on the UK government to decriminalise abortion across all UK nations.”
Dr Carolyn Bailie, a consultant obstetrician in Belfast and Chair of the Northern Ireland Committee of the RCOG, said:
“The current situation means that any woman seeking an abortion has to travel to the UK without formal medical referral, and at huge personal cost both emotionally and financially. Whilst funding for abortion in England and Scotland is a welcome temporary step, this is not an acceptable long term solution.
“Members of the Northern Ireland Committee have increasing concerns regarding the purchase of abortion-inducing medications online and the potential complications that can arise when they are not taken under medical supervision. This poses difficulties for healthcare professionals caring for women under such circumstances and places women and professionals at risk of imprisonment.
“We are aware that women, particularly those in vulnerable circumstances, are more likely to attempt to access abortion pills online, despite the recent changes in arrangements for abortion provision in England. It is also more likely that women may delay seeking help should they develop any complications from taking these pills, due to the fear of being discovered and the potential legal consequences.
“The Northern Ireland Committee of the RCOG supports the College’s position on removing criminal sanctions associated with the purchase of abortion pills online. The difficulties women in Northern Ireland face in obtaining an abortion mean they are most at risk of being criminalised if they take the desperate step of buying abortion pills online.
“We welcome the recent publication of the working group report on termination of pregnancies in fatal fetal abnormality cases. Obstetricians in Northern Ireland continue to be in a position where they cannot provide local care and support to parents who have been given the distressing diagnosis of a fetal condition likely to lead to death before or shortly after birth, and who no longer feel able to continue with the pregnancy.
“As doctors, we wish to provide compassionate and appropriate care to these women, according to their individual personal circumstances, and to be able to practise confidently, knowing that this is within the rule of law.
“Members of the Northern Ireland Committee of the RCOG will continue to meet with politicians, members of the legal profession and organisations representing women to help make progress.”
Notes to editors:
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The RCOG is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. Visit our website www.rcog.org.uk and follow us on Twitter @RCObsGyn.