2nd March 2018

Alliance for Choice have noted that Councillor Kate Nicholl has proposed a motion on the Criminalisation of Abortion. In it she outlines the detrimental impact that criminal sanctions can have on a woman or a pregnant person if they are afraid to access necessary aftercare. We know from research carried out by Women on Web that over 5.5 thousand women on the island of Ireland purchased abortion pills from their website within a 5-year period[1]. They estimate that Northern Irish women make up at least a 1/3 of those purchases, yet these figures only reflect one source where there are easily hundreds more online.

Since 2000, the PSNI has investigated over 30 cases of individuals suspected of procuring an abortion.[2] Between 2006 and 2015, the PSNI made 11 arrests related to illegal abortion.[3] Between 2011 and 2016, five people were questioned and arrested for possession of abortifacients; two were convicted.[4] Alliance for Choice believes this is not a valuable use of PSNI time or indeed that these arrests are in the public interest.

The people accessing clandestine healthcare are your constituents, and they are the sisters, friends, colleagues, daughters, wives, partners and mothers of many more of your constituents. Whilst Alliance for Choice supports the use of these WHO[5] recommended safe medicines, we also believe that the safety of the medicines is compromised if a woman cannot seek the proper medical care required if she develops complications, which can include haemorrhaging (in rare circumstances). Not only do our current laws put the lives of abortion seekers in jeopardy, they also potentially criminalise any medical professional who does not disclose the ingestion of pills if they are aware of such an action.

Alliance for Choice welcome the funding for Northern Irish women to avail of abortion care in England, however the great majority of women who will travel are seeking a termination of up to 12-weeks’ gestation. Most of these women will therefore be accessing an early medical abortion with pills, the same medicines they can get arrested for using in Northern Ireland; if they have no access to documents for travel or no access to childcare or no way to get time off work in precarious employment[6].

Alliance for Choice also recognise that forcing women to travel, due to criminal sanctions, means that women are facing the effects of the abortion pills on their journey home. This is the same experience as a miscarriage, but for women who travel, this induced miscarriage will be on a plane or on a long boat and bus journey, not with a friend or relative. No constituent of yours should ever have to face this experience supported only by air hostesses instead of nurses and midwives simply because we are dragging our feet on legislation that could ensure their safety and legal protection at home.

Alliance for Choice are also eager to point out the findings of the CEDAW[7] Inquiry published last week;

“The finalised 2016 guidance addresses the use of abortifacients purchased from the Internet and states that, “their use to secure a miscarriage in NI is likely to be an offence under the Offences Against the Person Act.”27 The guidance obligates health professionals to provide appropriate treatment to women suspected of having self-administered abortifacients. It further states: “Health and social care professionals working in clinical situations need to be assured that procedures they are involved in are lawful. [They] must balance the need for confidentiality of patients with the obligation to report unlawful terminations of pregnancy to the police and the need to protect others from serious harm. [Emphasis added]”28 The DM received testimony that to avoid having to report women presenting with post-abortion complications to PSNI, the women are neither asked, nor encouraged to reveal, if they had ingested abortifacients. Healthcare professionals stated that the “don’t ask, don’t tell” practice is untenable as it presents a barrier to providing appropriate medical care. “

“The Committee acknowledges the significant health risks associated with ingesting counterfeit abortifacients from unverifiable Internet sources and notes that the only dedicated assistance for women who have self-administered abortifacients is the telephone helpline of the British Pregnancy Advisory Service, an NGO in Great Britain. It is, therefore, concerning that the guidance, in effect, discourages women from seeking care for post-administration complications, fearing criminal sanction.”

In their recommendations they recognise our current legal problems and propose:

“Introduce, as an interim measure, a moratorium on the application of criminal laws concerning abortion, and cease all related arrests, investigations and criminal prosecutions, including of women seeking post-abortion care and healthcare professionals; “

We at Alliance for Choice deal with people who access pills first hand, indeed some of us have taken those medications ourselves[8] yet we are not criminals, we are just citizens who deserve to be treated with equanimity and compassion.

Alliance for Choice recognise that some people believe that an abortion is not something they could choose for themselves and we are fully supportive of the principle that people of all persuasions should be able to choose the reproductive healthcare that is right for them. No-one would ever be forced to have an abortion against their will with the removal of criminal penalties, but we believe that no-one should be forced to be pregnant against their will nor prosecuted and criminalised for choosing to end a pregnancy.
We encourage you to support this motion, even if you cannot countenance an abortion for yourself or for a loved one, do it for those people who do not deserve to be prosecuted for accessing healthcare which is readily available in almost all of Europe and in in the UK.

Yours Sincerely,

Emma Campbell
Co-Chair, Alliance for Choice
07894063965

[1] Aiken ARA, Gomperts R, Trussell J. Experiences and characteristics of women seeking and completing at-home medical termination of pregnancy through online telemedicine in Ireland and Northern Ireland: a population-based analysis. BJOG 2016; DOI: 10.1111/1471- 0528.14401.

Between 1 January 2010 and 31 December 2015, 5650 women requested at-home medical TOP through online telemedicine initiative Women on Web.

[2] F. Bloomer et al., Report, ‘Moving Forward From Judicial Review on Abortion in Situations of Fatal Foetal Abnormality and Sexual Crime: The Experience of Health Professionals’ (July 2016), Reproductive Health Law and Policy Advisory Group (p. 8).

[3] Freedom of Information Request no. F-2015-02701, ‘Charges Relating to Arrests Relating to Abortion’

[4] Freedom of Information Request no. F-2016-01040, ‘Abortion Pills’.

[5] http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf page 13 Box 2 “Recommended Methods for medical abortion” Also see from Box 7 “Laws and policies on abortion should protect women’s health and their human rights. Regulatory, policy and programmatic barriers that hinder access to and timely provision of safe abortion care should be removed. An enabling regulatory and policy environment is needed to ensure that every woman who is legally eligible has ready access to safe abortion care. Policies should be geared to respecting, protecting and fulfilling the human rights of women, to achieving positive health outcomes for women, to providing good-quality contraceptive information and services, and to meeting the particular needs of poor women, adolescents, rape survivors and women living with HIV. “

[6] Our findings strongly suggest that by far the most negative component of women’s experiences with at-home medical Termination Of Pregnancy is the need to maintain secrecy and silence because of the social stigma and a fear of prosecution engendered by its illegal status. Although obtaining mifepristone and misoprostol is not illegal under Irish or Northern Irish laws, using the medications to end a pregnancy outside the extremely limited scope of the law is a criminal offence. In Northern Ireland, two women have recently been charged with unlawfully procuring TOP, one a mother obtaining medications for her daughter and the other a 21-year-old woman obtaining medications for self-use.7 Women in Northern Ireland protested these charges by coming forward to reveal their own use of mifepristone and misoprostol and demanding to be arrested.22

A woman seeking follow-up care after an at-home medical TOP may also risk being reported to the police by a healthcare professional who believes she has broken the law. A recent update to the responsibilities of healthcare providers in Northern Ireland clarifies that medical staff need not ask a woman whether she attempted TOP when providing treatment.23 This clarification frees providers from a potential legal obligation, but does not prevent them from reporting women should they choose to do so. In Ireland, the uncertain interpretation of abortion laws has had fatal consequences, including the death of Savita Halappanavar from septicaemia because clinicians were unable to decide whether TOP could be carried out with- out themselves risking criminal charges. Such incidents prompted the Human Rights Committee of the United Nations to call on Ireland to enact legal reform.24 The few studies that examine clinician attitudes indicate that a majority of obstetricians, gynaecologists and general practi- tioners surveyed in Northern Ireland, and a majority of general practitioners surveyed in Ireland support legal reform.25–28

[7] Report of the inquiry concerning the United Kingdom of Great Britain and Northern Ireland under article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women

[8] https://www.telegraph.co.uk/women/womens-life/11700651/Abortion-Northern-Irish-women-want-arrest-over-illegal-abortion-pills.html