Uncertainty remains around next steps for the review to ensure legal and policy change
The systematic erosion of women’s rights around the globe particularly in the reproductive healthcare space is the current context for Ireland’s abortion law review. Since the historic repeal of the Eighth Amendment many in Ireland who have not needed to access reproductive care may not have noticed the legal and practical barriers which persist which can be tackled immediately through the review of the legislation.
Background
Section 7 of the Health (Regulation of Termination of Pregnancy) Act 2018 requires that a review by the Minister must take place no later than 3 years after the commencement of the Act, which happened on 1 January 2019. The wording of the review specifically relates to reviewing the operation of the Act. The Programme for Government committed to completing the review in 2021.The review comprised two phases, the first gathered information and evidence on the effectiveness and operation of the Act from service users, health providers and the public. That public consultation phase closed on 1st of April 2022.
Robust research with both service users and service providers was carried out as part of the second phase of the Review. The Review has been led by Independent Chair, Marie O’Shea BL, who has analysed both phases of the Review and submitted a report to the Minister for Health at the end of February. The Minister has committed to publishing the report as soon as possible, however this has not happened yet.
The importance of the review
The Repeal Referendum was one of the defining moments in Irish social and political history and the resounding success for the Yes campaign was a clear statement that no woman should be forced abroad for reproductive healthcare. Yet, we know that several provisions in the Act represent significant and ongoing obstacles to accessing safe and legal abortions in Ireland. The Act provides for unrestricted termination up to 12 weeks’ gestation. Services beyond 12 weeks are only available in very limited circumstances where two medical practitioners must confirm that there is a risk to the life or a risk of serious harm to the health of the pregnant person, or that pregnancy entails a fatal foetal anomaly, which is defined narrowly.
It is not only Irish advocacy groups such as the Abortion Working Group made up of over 20 civil society groups and practitioners and led by the National Women’s Council who are concerned about the barriers to access in the Act. The United Nations Human Rights Committee last July, in their review of Ireland’s implementation of the International Covenant on Civil and Political Rights, called on the State to consider decriminalising service provision, review the arbitrary 3-day waiting period, and the conscientious objection clause, remove all barriers to care for persons seeking terminations due to foetal abnormalities, and to guarantee the universality of and equal access to abortion services for all women and girls, especially for rural women, women living in poverty, women with disabilities, asylum-seekers, victims of domestic violence and women from ethnic or religious minorities. Migrants and asylum-seekers have faced racist discrimination when attempting to access care (See here). Undocumented migrants and asylum seekers who are unable to produce a PPSN are being forced to pay for their procedures. Thus while the Act is supposed to provide free care for all, in practice this is not the case (See here). While some improvements need legal changes to the Act, others will rely on the Government taking concrete steps to tackle the shortage of service providers in rural areas.
The Review provides an opportunity to address barriers and gaps in the Act. If this Review is to be fit for purpose, we need to see a commitment to take forward evidence-led legislative reforms such as decriminalisation and review of the narrow grounds-based access to care post-12 weeks. Unless we tackle these legal barriers to access and enable abortion on request up to viability, women will continue to be forced abroad for healthcare they should receive at home. In the meantime, it is vital that Marie O’Shea’s report to government is published imminently and in full. We have yet to see a commitment to how the findings and recommendations in the report will be addressed. The National Women’s Council has written to the Minister and the Health Committee to suggest the Committee examine the findings and make recommendations to Government by the summer recess. This Review represents a unique opportunity to address the ongoing barriers to abortion access and it is vital that this process leads to meaningful reform.