5 years ago we gathered to celebrate the a monumental law change which saw the decriminalisation of abortion and the introduction of equal marriage in Northern Ireland. This was the outworking of decades of campaigning, lobbying and legal challenges alongside practical support under one of the most draconian abortion laws in the world. Let’s reflect on where we are in 2024.

No more prosecutions for self managed abortions.

Since the law changes, no one can be criminalised for self managing their abortion with safe pills from Women on Web or Women Help Women. This is huge and put us ahead of Britain, Ireland and most of Europe!

Abortion access in all 5 health trusts

All 5 health trusts have provision for Early Medical Abortion, that is abortion with pills. However this is only one location in some Trusts meaning long journeys for some for example from Enniskillen to Altnagalven instead of a closer NHS site.

Surgical abortion is less accessible. Only one site provides surgical abortion, meaning every Trust must refer there. Currently surgical abortion is only offered up to 20 weeks, which falls short of the 24 weeks provided for in the regulations.

Later term abortion can be even more complicated to access. Alliance for Choice have had to advocate for people who clearly met the requirements, sometimes helping them access care here others supporting them to travel for treatment they should have had at home.

The current level of provision, low levels of trained providers and lack of awareness amongst the medical profession is unacceptable 5 years on.

Relationship and Sexuality Education

The 2019 legislation states there should be
‘“age-appropriate, comprehensive and scientifically accurate education on sexual and reproductive health and rights, covering prevention of early pregnancy and access to abortion”

Instead we’ve had delays, consultations which focus on parents opting out, and an ongoing ‘mini inquiry’.

Our young people deserve, and had the right to, better.

What else?

Outside of the Regulations Safe Access Zones have been implemented and enforced at all sites providing abortion care! Again we were far ahead of elsewhere in these Islands on delivering this, with the Republic of Ireland and Scotland implanting similar legislation recently and England and Wales expected to in the near future.

Safe Access Zones have had varying success depending on the location, and they must be reviewed to ensure people accessing treatment or their workplace are protected from harassment.

Despite the regulations allowing the NI Health Minister to adopt telemedicine, and this measure being introduced by our neighbours during the pandemic and then retained due to it efficiency, we do not have telemedicine abortion in Northern Ireland. We need telemedicine abortion to address many of the barriers faced by women and pregnant people who need to access abortion be that travelling from a rural area, fitting appointments around work or caring, or being in an abusive or controlling home environment.

We called for telemedicine when the regulations were drawn up, and 5 years on we continue to repeat this call.

So where are we now?

Sometimes it’s hard to see how far we’ve come when our day to day is supporting those who fall through the cracks, and pushing for delivery and improvement of services.

Thousands of women and pregnant people have been able to access abortion care a lot closer to home than 5 years ago. While the latest figures show around 3 a week are still travelling to England, which needs to change, this is a vast reduction from 28 a week before the law change.

Unknown numbers are safely self managing their abortion without fear of prosecution with pills from Women on Web or Women Help Women.

However the lack of implementation of the regulations, limited sites providing abortion, and no telemedicine are shortcomings.

On paper we have one of the best abortion laws in Europe, but not in practice. We incorporated CEDAW recommendations into domestic legislation, but those recommendations have not been delivered. We’ve some amazing conscientious providers committed to working in what continue to be pretty difficult circumstances, we need a health service and department that supports them.

The best abortion law is no abortion law, where abortion is treated as other healthcare. Removing criminalisation was a big step along that road.