5 Years of Decrim!

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.

Safe Abortion Day 2023

Thursday September 28th 2023 is the International Day for Safe Abortion, and we have plans!
We will be rallying at Shaftsbury Square from 12:30pm calling for the implementation of abortion services and looking ahead to the introduction of Safe Access Zone. Keep an eye on our socials too as we see how the SOSNI is faring and some other actions.

There will be events taking place all over the world, including in Dublin from our friends in Abortion Rights Campaign on Thursday, in Malta where Voice for Choice will be marching once again on Saturday and Stop Violencies Andorra have activities planned from 26 - 30 September! Check out http://www.september28.org/ to see what all is happening.

We have been told that Safe Access Zones will be in place ‘in a few weeks’ for a few months now, so we are not taking anything for granted, but this is a firm commitment from DOH that SAZs will be live this week. We still do not have commissioned abortion services either, so we’ve plenty to make noise about. Keep reading to learn more about how we got here, and what’s next.

Safe Access Zones

We are pleased to see a statement from the DoH today, 25th September, that they SAZs will be in place by the end of this week, the 29th September.
Earlier this month the NIO confirmed to us that the DoH were ‘on track’ to implement SAZs by the end of the month. This came after a few days of signage outside Causeway Hospital, which was removed as quickly as it was erected.  We are pleased to see a statement from the DoH today, 25th September, that they SAZs will be in place by the end of this week, the 29th September.

However, given the winding road we’ve had to get here we aren’t celebrating just yet.
The Abortion Services (Safe Access Zones) Act (Northern Ireland) 2023 came into force in May after a 6 month lead in period. Despite having time to prepare, 2 months after this The Department said ‘detailed preparation work has been ongoing for a number of months, including mapping and signage arrangements’ however they were still ‘finalising a policy statement on Safe Access Zones as part of the preparations for their introduction.’ Today’s announcement means they will just meet their earlier promise made on 3rd July 2023 to introduce SAZ by the end of September.

This slow movement from the Department means that women and pregnant people accessing health care, and the staff providing it, have continued to be harassed and intimidated despite Safe Access Zone legislation. 

Outstanding commitments

Abortion services are still not commissioned.

While Conscientious Providers are doing their best to rejig resources so that each Trust can provide Early Medical Abortion with pills, this is precarious. Lack of commission means a lack of funding, training, and staff. We’ve seen services collapse before in Trusts as hard working staff take the leave they are entitled to, this is unacceptable for workers and patients alike. 

The Department of Health refuse to provide a central online information point for those needing abortions. While the NIO and some individual Trusts are doing what they can to provide information, some women and pregnant people are still ending up at Stanton Healthcare who continue to provide misinformation, harass and traumatize women; at times deliberately engaging them until past the 9 weeks 6 days cut off. 

Accessing abortion care currently means contacting the Central Booking Line via phone or web form, waiting for them to contact you to arrange an appointment, and then waiting for the appointment. It is a lot of waiting to fit into around 10 weeks! We’ve been contacted by people waiting up to 2 weeks for a call back, and then 5 weeks for an appointment. BPAS are doing what they can to meet demand but are under pressure with resources given that abortions in England have also increased by 17% on this time last year.

The process for surgical abortion or those after 12 weeks is even harder to navigate. Due to a lack of guidelines, and ongoing criminalisation of healthcare providers in the regulations, people are being sent for second opinions or having their request for an abortion assessed by a panel of doctors. Manual Vacuum Aspiration is being progressed in one Trust but we have no specifics on when it will be available, or to what gestation.

We need commissioned and resourced abortion services, managed at a local level, supported by the introduction of telemedicine. 

We need an end to the criminalisation of doctors, midwives and nurses.

We need the 2020 regulations as a minimum. 

No care at home

The UK Government have released figures for January - June 2022.

These figures show that 96 women and pregnant people traveled from NI to England for abortion, 4 a week, 1 every other day.

This includes 3 under 16s, and 3 aged 16 or 17;  6 minors had to travel to England. 

They should have been treated here.
Around a third of those who traveled were under 10 weeks. Were they living in a Trust where services had collapsed? Did they need a surgical abortion due to a medical condition? 

They should have been treated here.
15 were over 20 weeks. Had they found something out at their ‘big scan’, and the doctor was too worried about criminalisation? 

They should have been treated here.

What’s next?

Maybe the Department will have crossed all their Ts and dotted their Is soon, and we will be able to celebrate not too long after International Safe Abortion Day that we have Safe Access Zones that can actually be enforced.

Maybe We’ll have commissioned, resourced, locally available abortion services by the end of 2023.

Maybe then no one else will have to travel.

In any event our Doulas will continue to support people who self manage their abortion, our website will continue to have the most up to date information, and we will continue to advocate for those who need us too - whether they have complex medical needs, are an asylum seeker in contingency accommodation, or have been misled by so called ‘crisis pregnancy centers’.

Department of Health NI figures on abortion

Words are not enough.

Alliance for Choice cautiously welcome the pressure from MPs during this week’s Parliamentary Questions and the announcement of the NIHRC action, led to Robin Walker, Minister for Northern Ireland, advising that the government are ‘considering further legislative action at Westminster’ and ‘stand ready to act’ if the Northern Ireland does not take action to commission services in line with the Regulations passed in April 2020.

However the time for ‘standing’ has long passed and the time for action is now. 

Statements of intent fall short given that despite the decriminalisation of abortion in NI in October 2019, followed by the NI Abortion Regulatory Framework in April 2020, the abortion services we need and require and nowhere near being realised. We need action and we need it now.

Recent figures, including the Department of Health, have shown that alarmingly, too many women and pregnant people are not receiving the local abortion healthcare they are entitled to, with some forced to travel to England to access services. This is compounded by the fact we are in the third wave of a pandemic and risk of contagion from variant strains of the COVID-19 virus has increased significantly.

Figures released this week from a range of sources including the Department of Health show:

• 19 people from the South Eastern Trust area have been denied local early medical abortion provision due to the withdrawal of those services 

• During the suspension of the early medical abortion service in Northern Trust area 88 women called the Central Access Point and requested abortion services with no local services to refer those people two

• One international on-line provider alone has provided abortion pills for 22 women from the South Eastern Trust from beginning to mid January that they should be receiving locally through their Health Trust

• One health professional from one Health Trust has advised that they have had to refer 11 people over a ten week gestation ‘elsewhere’ for the abortion healthcare they require.

• Recent Freedom of Information requests obtained by Alliance for Choice have confirmed that 100s of women and pregnant people from across Northern Ireland are still being forced to travel England and seek abortions on line 

• Statistics released from the Department of Health show that there has been a decrease in the number of people in local health trusts who have received local care in respect of serious foetal anomaly. 

For each day that passes more and more women and pregnant people are being denied the abortion healthcare they require in NI.

The time for the Minister and Secretary of State to act is NOW before any more women are failed, put at risk or pushed down the inhumane road of reproductive coercion.

For #16DAYSNI we need Robin Swann to commission telemedicine... by Amy Merron

Abortion was decriminalised in October 2019 and since then the failure of Robin Swann and the Department of Health to commission services has seen women and pregnant people continuing to travel to seek abortion care that is legal here.

10 out of 26 areas in Northern Ireland have no access to early medical abortion services. The Northern Trust is the largest geographical health trust in NI and is also the most recent to have ceased provision of clinic-based early medical abortion services. Women and pregnant people in this trust now face further barriers to access will have to travel to seek the legal abortion that they could have had at home.

The current situation in Northern Ireland sees early medical abortion services only available up to 10 weeks gestation (9 weeks 6 days) despite the law stating it should be available on request up to 12 weeks gestation and the World Health Organisation recommending 13 weeks. No commissioned services mean that there has been no information published by health trusts on how and when to access services leaving women and pregnant people in the dark when it comes to making healthcare decisions.

The World Health Organisation have recognised that abortion services are essential healthcare and have stated that “abortion provision in a global pandemic should minimise facility visits and provider-client contacts through the use of telemedicine and self-management approaches.” 

During the COVID-19 pandemic the rest of the U.K. has seen improved access to abortion through telemedicine and pills-by-post services. Northern Ireland has yet again been left behind despite being the only part of the U.K. that has fully decriminalised abortion. This is due to the continued obstruction to access by the NI Executive including prominent anti-choice politicians.

Telemedicine is safe and effective and has proven to be a vital service, providing people with safety and reassurance during the ongoing pandemic. Telemedicine would allow a medical practitioner to have a consultation with the pregnant person either over the phone or online. If eligible they will be prescribed mifepristone and misoprostol which can be collected at a pharmacy, alongside instructions for how to take the medication and information on who to contact if additional support is needed.

The Department of Health has advised the public to stay at home, however, women and pregnant people are being forced to travel to a clinic to take a single pill, when they can take the further 4 pills at home 24 hours later. Travelling in a pandemic puts the pregnant person and health professionals at risk of contracting COVID-19.

Beyond the context of the COVID-19 pandemic, telemedicine will provide the modern and compassionate support which is crucial to accommodating women and pregnant people from marginalised groups. Asylum seekers, ethnic minorities, sex workers, the travelling community and LGBTQIA+ people are all disproportionately impacted by barriers to abortion services. Moreover, women and pregnant people may also have caring responsibilities, no access to transport, limited access to finances or are the victims of domestic abuse and coercive control which reduces their ability to access clinic-based care.

Alliance for Choice believes that everyone should have the right to choose, this extends to deciding between clinic-based care and self-managed abortions. Self-managed approaches use the same safe medications that are prescribed in clinics by healthcare professionals. Mifepristone and misoprostol are effective up to 98% of the time and this approach is used by millions of people around the world to safely end pregnancies up to 13 weeks with no long-term effects.

Self-managed approaches will allow us to be our own service providers removing many of the barriers to services that we currently face. Care at home enables us to have more control over our own bodies so we can be supported in ending our pregnancies safely, effectively and privately at home. Alliance for Choice have provided self-managed abortion workshops to empower, educate and inform activists and others in Northern Ireland. These workshops outline where to access the safe and legal online pills, how to take them, what to expect and who to call if there are any complications or worries.

Free, safe, legal and local abortions mean accessible services for everyone who needs them, and the continued obstruction of abortion access and reproductive justice is impacting the lives of women and pregnant people across the North.

Over the next two weeks we will be sharing how telemedicine prevents and ameliorates the impacts of gender-based violence… please link, like and share across our website and social media platforms.

Open Letter to Robin Swann, Health Minister for Northern Ireland

The undersigned call on the Northern Ireland Health Minister, Robin Swann, to implement abortion care recommendations from the World Health Organization (WHO) immediately. This would make provision for abortion telemedicine across Northern Ireland, similar to those commissioned in Ireland, England, Wales and Scotland since March 2020. Since the beginning of the outbreak WHO recommended that services related to reproductive health are considered part of essential services during COVID-19. In June 2020, WHO recommended that abortion provision in the global pandemic should; 

Minimise facility visits and provider–client contacts through the use of telemedicine and self-management approaches, when applicable, ensuring access to a trained provider if needed. (World Health Organization (1 June 2020) 2.1.4 Sexual and reproductive health services, Maintaining essential health services: operational guidance for the COVID-19 context, Interim guidance (pp. 29))

Abortion telemedicine has been available throughout all of the UK and Ireland since the onset of the pandemic yet Northern Ireland remains the only place where a safe, cost effective and practical method of abortion care has been denied to individuals seeking abortions. 

Additionally, the Department of Health has been legally mandated to commission Trust-wide early medical abortion services up to 12 weeks on request and abortions for health and mental health reasons with no conditionality up to 24 weeks gestation from April 1st, yet nothing has been done. In the midst of an unprecedented global pandemic, women and pregnant people who need abortions should not be forced to make unnecessary journeys of any sort, either within Northern Ireland or to England. 

On Monday 5th October 2020, the Northern Health Trust reluctantly advised they are no longer in a position to provide early medical abortions due to lack of resources. This was as a direct result of a failure of the Department of Health to commission or fund ANY services. This is just as the confirmed cases of COVID-19 have surged in that same Trust, with risk of contagion amongst the highest across the UK and Ireland. The blocking of EMA services and a complete lack of telemedicine as a result of the DoH inaction, means those seeking abortions will have to travel to GB, which directly contravenes WHO guidance, placing service users and healthcare workers at increased risk of COVID-19 and adding unnecessary cost and pressure to NHS services.

Since April 2020, over 150 women and pregnant people from Northern Ireland have had to use the Central Booking system of the British Pregnancy Advisory Service (BPAS) and have been forced to travel to GB in order to access the care they require, more have used Women on Web and Women Help Women services when a straightforward pathway was unavailable to them. 

Abortion telemedicine is required in Northern Ireland as a matter of urgency to ensure that those women and pregnant people who require abortion healthcare are placed at no additional risk from being unable to access the services they require or being forced to travel in order to do so. 

We call for the Department of Health, led by the Northern Ireland Health Minister to make this provision without any further delay and to stop blocking resources to abortion services by his refusal to commission services within the Health and Social Care Trusts. 

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Signed by:

1. Abortion Rights UK

2. Abortion Support Network

3. Alliance for Choice Belfast

4. Alliance for Choice Derry

5. Alliance for Choice Mid-Ulster

6. Amnesty International UK (NI)

7. Atlas Womens Centre

8. Belfast Cleaning Society

9. Belfast District Trades Council

10. Belfast Feminist Network

11. Brook Young People

12. Christina Nelson, Actor/Director

13. Colm Eastwood MP & Party Leader SDLP

14. Communist Party of Ireland

15. Common Youth

16. Cllr Connie Egan, Alliance Party Councillor for Bangor West

17. Craigavon & District Trades Council

18. Claire Bailey MLA Green Party

19. DCSDC Cllr Rachael Ferguson (Alliance)

20. DCSDC Cllr Shaun Harkin (PBP)

21. DCSDC Cllr Eamonn McCann (PBP)

22. Dr. Máirtín O'Catháin, University of Central Lancashire

23. Dr Yassin M. Brunger QUB

24. Doctors for Choice NI

25. Doctors for Choice UK

26. Elizabeth Nelson Ulster University

27. Emma Sheerin MLA Sinn Fein

28. End Deportations Belfast

29. Falls Women Centre

30. Gerry Caroll MLA PBP

31. GMB Northern West

32. GMB Irish Region 

33. Here NI

34. Humanists UK

35. ICNI - Informing Choices Northern Ireland

36. International Campaign for Women’s Safe Right to Abortion

37. LadyGeek - Geek Web Design

38. Lawyers for Choice (UK) 

39. London-Irish Abortion Rights Campaign

40. Marie Stopes UK

41. Matthew O'Toole MLA

42. MyBodyMyLife

43. NIC-ICTU - Irish Congress of Trade Unions - Northern Ireland Committee

44. NIC-ICTU Health Committee

45. NIC_ICTU Women’s Committee

46. NIPSA - Northern Ireland Public Service Alliance

47. NIRWN - Northern Ireland Rural Women’s Network

48. Northern Ireland Refugee and Asylum Seekers Women Association (BOMOKO NI)

49. North West Migrants Forum

50. NUS-USI - National Union of Students - Union of Students Ireland

51. Dr Pam Lowe, Senior Lecturer in Sociology, Aston University

52. Paula Bradshaw MLA Alliance Party

53. People Before Profit

54. Project Choice Queen’s University Belfast Students Union

55. Queen’s University Belfast Gender Network

56. Rachel Woods MLA Green Party

57. Rape Crisis NI 

58. RCM - The Royal College of Midwives

59. Reclaim the Night Belfast

60. Sinéad McLaughlin MLA SDLP

61. Sinn Fein

62. Sister Supporter

63. Stephen Farry MP Alliance Party

64. Strabane Pro Choice

65. Trademark

66. TransgenderNI

67. The Belfast and District Trades Union Council

68. The Centre for Gender in Politics

69. The Rainbow Project

70. Unite

71. UNSION ORCHARD BRANCH

72. Ulster University Pro-Choice Society

73. Womens Centre Derry

74. Women's Support Network WSN

75. WRDA - Women’s Resource and Development Agency

76. WPG - Women’s Policy Group

Responding to the MLAs contributions to Matter Abortion Regulations 31/03/2020

Responding to the MLAs contributions to Matter Abortion Regulations 31/03/2020

https://niassembly.tv/matter-of-the-day-abortion-regulations-tuesday-31-march-2020/

Mr Allister

Mr Allister suggested people have abortions on a ‘whim’ this is insulting to people who chose to have an abortion, and does not reflect the reality of certifications being required. Mr Allister said abortion would be uncontrolled ‘up to 12 weeks’ this is untrue, abortions must be certified by one doctor up to 12 weeks and currently the first set of pills must be taken under supervision. Mr Allister then alleged there would be abortion ‘effectively on demand’ up to 24 weeks. Again this is incorrect, after 12 weeks 2 healthcare professionals must certify that the criteria are met, namely that continuing the pregnancy would be a greater risk to the health of the pregnant person than termination.

Mr Allister commented that 79% of responses to the recent consultation were opposed to any change – From the NIOs own report 66% of those responses were linked to a single campaign. None of the professional medical bodies opposed abortion law reform.

Mr Allister then raised that the Assembly was not consulted. MLAs had the same opportunity to respond to the consultation as anyone else. This is a human rights matter, and therefore stays in the remit of Westminster.

Mr Givan

Mr Givan also raised the 79% response figure which we have already addressed. It is worth noting that reposes opposing any change were ruled out of scope.

Mr Givan suggested that abortion up to 24 weeks for any reason, we have already shown this is not the case under the regulations. Mr Givan then stated that abortion to term for disability was permitted. This is incorrect. Abortion after 24 weeks, around 2% of all abortions in worldwide figures, would only be permitted for severe foetal impairment or risk to life and health of the pregnant person. Disability is not a permitted reason.  

Mr Givan suggests’ that a ‘fine’ is not a serious enough penalty for healthcare professionals acting outside the regulations. This is not simply a fine, but a criminal conviction likely to lead to being struck off. It is intended to be a punitive measure, and we oppose any criminalisation of abortion. We would again state that Human Rights are not a solely devolved matter. Westminster had the power and duty to legislate. 

Mr Givan suggests his views are in line with the ‘will of the people’. The NI Life and Times Survey show this is he is mistaken the vast majority support abortion law reform, the 1000s who have travel for abortion also show that this attitude is nothing more than NIMBYism.

Mr Frew

Mr Frew again mentioned the 79% response figure, which we have addressed above, this is mainly from one coordinated anti choice campaign. These responses were not ignored, they simply did not engage with the questions at play.

Mr Frew suggests that he will try and reverse the introduction of regulations. This would be a breach of the Human Rights of those who need abortions. These regulations have been introduced by Westminster legislation, as the body responsible for upholding human rights. It is not in Stormont’s gift to overturn the primary legislation which repealed Section 58 and 58 of the 1981 Offences Against the Person Act.

Mr Frew says he does not want disabled people to fear for their lives – we are not sure why he thinks abortion regulations would make disabled people fear for their lives.

Mr Frew suggests that people were content with NI having a different law than in GB. If this was the case why did 1000 people a year travel to England for abortions they supposedly disagreed with?

Dr Archibald

Dr Archibald spoke broadly in favour of the regulations, saying there is no way to compassionately legislate for access where pregnancy is a result of rape, this is why a 12 week unrestricted period is introduced. We agree with the spirit of this point however we know that many people pregnant as a result of a sex crime, particularly adolescents, are likely to delay seeking an abortion, and are more likely to even be aware that they are pregnant until later term. 12 weeks is not long enough for them.

Mr O’Toole

Mr O’Toole also spoke broadly in favour of the regulations. He said now NI is a place where abortion can be access on par with the Rest of the UK and Ireland. Unfortunately this is incorrect as both jurisdictions have introduced telemedicine and home use of both sets of abortion pills, NI still has not. 

Mr O’Toole said this was a step forward for women and girls, we agree and would add this is a step forward for anyone who can get pregnant.

Mr Butler

Mr Butler says it is important to consider the views of parents, particularly women – we would remind him that the majority of people who have an abortion are already parents. He suggests there needs to be sympathy for instances of fatal foetal abnormality, rape and incest. We agree, the UN CEDAW committee has called for action on specifically these circumstances, but sympathy without material action is pointless in these situations. As previously highlighted there is no way to compassionately, or ‘sympathetically’ legislate for pregnancies resulting from a sexual crime.

Mr Butler says the consultation was not adhered to – we have dealt with this previously, responses demanding no change to the law were not in the scope of the consultation.

Mr Butler, we would argue that denying care is ‘draconian’, not the regulations.
Mr Butler brings up that this is an issue for all sides of the community – it is, there is no significant difference in the number of people seeking an abortion from any one community background. 1 in 3 women worldwide will have an abortion, from all walks of life.    

Again we will remind the MLA that abortion for disability is not a permitted reason for an abortion under the regulations.

Mr Butler mentions Conscientious Objection – the regulations allow for conscientious objection on the same grounds as in GB. 

Mr Muir

Mr Muir spoke broadly in support of the regulations, noting that the Assembly had a chance to make legislation permitting abortion on more limited grounds and didn’t. Mr Muir also highlight the need for home use, which is particularly needed because of the current COVID 19 restrictions. We agree that the inability to travel has already cause real difficulties for people, none more evident that the attempted suicide of someone denied an abortion in NI and unable to travel to England.

Ms Bailey

Ms Bailey spoke broadly in support of the regulations. She noted that while there is access for many up to 12 weeks, there are still many barriers to be addressed. Ms Bailey called for the Health Minister to introduce telemedicine similar to measures in England, noting that abortion pills are on the WHO essential medicines list. She also pointed out that telemedicine protects health workers during this pandemic.

Ms Bailey said the green party ‘do not think it should ever have been a criminal matter, and we believe that any woman should be able to access an abortion as early as possible and as late as necessary.’ And we agree with this position.

Ms Bailey also mentioned the tragic situation brought to light on Monday.

Mr Carroll

Mr Carroll spoke about the reality of denying abortion care, that of the woman who tried to take her own life when unable to travel and refused care locally. We agree with Mr Carroll that  ‘abortion is fundamentally a healthcare issue. It is not a criminal issue’ however we must point out that unfortunately there is still a criminal sanction for healthcare professionals who act outside the regulations, which will likely lead to unnecessary bureaucracy for medical staff to ‘prove’ they were acting in good faith.

Mr Carroll is right that not everyone in served by the new regulations, including people in domestic violence situations and rural areas. He also called for telemedicine and home use of abortion pills, referencing WHO guidance that abortion pills are safe.

Mr Caroll points out that the NI Life and Times survey, previously referred to in our rebuttal, consistently shows support for choice and abortion law reform. 

Mr Lunn

Mr Lunn welcomed the regulations with some reservations. He particularly welcomed the 12 weeks unrestricted period as a way of providing services for people pregnant as a result of rape. Mr Lunn took issue with one element of the regulations, that of abortion for severe foetal impairment saying this was ‘immoral’. In response we would say that this wording allows for healthcare professionals to use their knowledge and expertise in helping people make an informed choice. The wording of fatal foetal abnormality is too restrictive. 

Mr Buckly said this issue transcends party lines. Indeed in there are supporters of change who have spoken publicly in every NIA party, except the DUP and TUV. Likewise the need for abortion care is not restirced to community background.

Mr Buckly rolls out the debunked idea that 100,000 people are alive in NI because of the restrictive abortion law. We ask what about the hundreds of thousands who are documented as having travelled for abortion, and the unknow numbers using abortion pills bought online or more dangerous methods?  Mr Buckly suggests he values life from beginning to end, does he value the life of the person who tried to take their own life on Monday because they were refused an abortion? Does he value the lives of the 1 in 3 women who will have an abortion?

Mr Buckly talks about protection of the most vulnerable, does this include the 12 year old who travelled for an abortion under a police escort pregnant as a result of rape by a family member?

Mr Buckly ends with a threat that the DUP will take action to roll back the regulations.

Regulations published for Northern Ireland Abortion provision amidst COVID-19

Alliance for Choice honour the monumental efforts of women and pregnant people, activist organisations, committed healthcare professionals, civic society and political allies that have brought about the new regulations in Northern Ireland for those who will need abortions. Though we welcome the news, it falls significantly short, especially in a time of a global pandemic. If the COVID19 crisis is to intensify as predicted, the Health Minister has a duty to sanction provision that does not jeopardise the health of women and pregnant people by forcing them to travel to clinics unnecessarily for abortions. 

Naomi Connor, Co Convenor said;

“We should not place women and pregnant people at risk of unsafe abortion when there is a scientific, safe and readily available alternative. At AFC we have heard directly that barriers and lack of access to abortion pills has led many to use dangerous alternatives. This is not a reality we wish to revisit when there is a body of scientific research that supports abortion telemedicine provision.”

Healthcare workers should not be put at risk by needlessly increasing footfall in healthcare premises when proven alternatives are readily available. Telemedicine is not only safe and effective for patients, but also serves to keep our healthcare staff safe and deployed where they are needed at such a critical time.

Emma Campbell Co-Convenor added, 

“We note the NIO has said that arrangements for funded treatment in England will still stand  “until we are confident that service provision in Northern Ireland is available to meet women’s needs”. However we are concerned they have not considered the impact on COVID-19 on both travel and the availability of abortion appointments in England as services shut down.”

The regulations make clear provision for the Health Minister to approve further places where medical abortion can be performed at any point in time. Now is that time and Minister Swann needs to ensure that this pandemic does not place women & healthcare providers at unnecessary risk. The Minister must act now, as is his charge, and as is provided for in the recent abortion guidelines to ensure this service is rolled out to women and pregnant people in NI seeking abortion healthcare

ENDS

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Contact:

Emma Campbell 07894063965  

Naomi Connor 07505096576

Alliance for Choice 

www.alliance4choice.com

@All4Choice

Further Information

‘Where procedures can take place - terminations to be carried out in General Practitioners premises, clinics provided by a Health and Social Care (HSC) trust, and HSC hospitals, operating under the overall Northern Ireland HSC framework and women’s homes where the second stage of early medical terminations may be carried out. The Regulations also provide a power for the Northern Ireland Health Minister to be able to approve further places where medical abortion can be performed, with the power being able to be exercised at any point in time.’

A summary of key points:

- Abortion on request up to 12 weeks, certification from 1 healthcare professional. For medical abortion, home use for second pill will be permitted.

- Abortion 12-24 weeks with ground specificied in the consultation doc and ground C of the Abortion Act 1967. This is expanded upon in the explanatory notes, and in the explanatory notes which state other factors, like well being, which 'may be taken into account'. Certification of 1 doctor and 1 HCP will be needed.

- There will be a criminal, non imprisonable sanction for those HCPs who act outside of the regs, this will carry a 5k fine.

- No time gestational limit where there is a severe or fatal anomaly

- Conscientious objection will mirror Section 4 of the Abortion Act 1967 and will include a duty to refer.

- No action on safe/buffer zones

- CBS funding will continue.

- the explanatory notes can be amendment by the assembly/depts

Please contact us for a copy of the regulations.

BELOW ARE A NUMBER OF POSSIBLE CASE STUDIES

• Someone who has tested positive and whose phase in isolation would push them over 12 weeks by the time they got to a provider. 

• Someone who is in a high risk vulnerable group and does not feel safe to leave the house.  

• Someone who has tried to make travel arrangements to get to England but as clinics are closing cannot get an appointment 

• Someone on a normally low income who has lost their job due the crisis and cannot afford the additional funds that would be needed to travel

• Someone who had an appointment in England whose flight has now been cancelled

• Someone caring for elderly relatives or immuno-suppresed relatives in their own home and cannot risk infection.

• A rise in intimate partner violence was recorded in China during the lockdown, this increases the likelihood of pregnancy as a result of rape and decreases the ability of an abused partner to leave the house safely.

• An Asylum Seeker, who would normally be unable to travel, may be further restricted in access to abortion care by movements of asylum seekers within Ireland being completely restricted going forward, and similarly with visitors not being allowed any access in. If/When asylum seekers are locked down in centres due to COVID-19 they may be hindered in accessing abortion support networks and/or abortion care.

• Someone who is in the country illegally and/ without papers; with tightening of border control internationally due to COVID-19 crisis, it may be structurally impossible for them to access abortion care within or without of Ireland, due to fear of deportation and/or imprisonment 

• Someone who is in a high risk vulnerable group medically and/ disabled, travel may normally be restricted due to physical and financial limitations; however being known to medical and state services as high risk and/ disabled may make a case for someone not being granted exceptional orders to travel for abortion care to delimit potential exposure to COVID-19 (ie ‘for your own good’)

• Someone who is in a high risk vulnerable group medically and/ disabled, particularly for cases over 12 weeks; if risk of threat to life of continuing pregnancy for pregnant person is already high without COVID-19 diagnosis, and if such same person were to be exposed to COVID-19, thus increasing risk to their own life, they then could be considered a major risk to their own health, and travel for abortion care denied  

• Someone in state care, a minor, travel may be restricted on guardianship grounds to be in the best interests of the health of the child going fwd, and the lack of agency of the child in such circumstances  

There's no such thing as a late term abortion - ARTICLE

Here's everything you need to know about abortion later in pregnancy according to doctors, not politicians, including how often it occurs and why it's necessary.

By Emily Shiffer October 01, 2019

https://www.parents.com/pregnancy/my-body/pregnancy-health/theres-no-such-thing-as-late-term-abortion-here-are-the-facts/

What's the correct term for 'late-term abortion'?

"Generally people mean abortion performed after 12 weeks or 3 months, but it's better to specify exactly which period of gestation one is talking about," says  Daniel Grossman, M.D., director of Advancing New Standards in Reproductive Health (ANSIRH) at Bixby Center for Global Reproductive Health at the University of California, San Francisco.

Keeping abortion terminology by gestation period is the proper way to define it. "We talk about care as pregnancy progresses in weeks from a person's last menstrual period, or in trimesters (1st: 0-13 weeks, 2nd: 14-26 weeks, 3rd: 27-40 weeks)," says Chelsea Souder, MPH, director of Clinical Services and Communications Manager at AbortionClinics.org.

• RELATED: Types of Abortion Throughout Pregnancy

What about 'partial-birth abortion'?

This term originated from the Partial-Birth Abortion Ban Act of 2003. However, it's not a defined procedure recognized by leading medical groups, including American College of Gynecology (ACOG), according to the Guttmacher Institute.

"'Partial-birth abortion' refers to a procedure known as dilation and extraction, or D&X, which involves attempting to remove the fetus intact through the cervix," explains Dr. Grossman. "The procedure is no longer legal unless medication is used to stop the fetal heartbeat first."

• RELATED: The Abortion Pill: How Medication Abortions Work

When do most women have abortions?

Since 1973, when abortion was legalized nationally, around 11 percent of abortions have occurred at or after 13 weeks gestation. According to the Guttmacher Institute, here is when women have abortions percentage-wise:

• Earlier than 8 weeks: 66%

• 9-10 weeks: 14.5%

• 11-12 weeks: 8.3%

• 13-15 weeks: 6.2%

• 16-20 weeks: 3.8%

• After 21 weeks: 1.3%

When is second or third trimester abortion necessary?

While most abortions occur before 8 weeks, second or third trimester abortions are also options women may have. These are the most common reasons an abortion may occur during the second or third trimester:

Fetal anomalies

"The medical reasons for an abortion in the second trimester include a diagnosis of fetal malformation or genetic anomaly," says Dr. Grossman. These include: anencephaly, the absence of the brain and cranium above the base of the skull, or limb-body wall complex, when the organs develop outside of the body cavity, according to the ACOG.

Mother's medical complications

"Medical complications are the development of a condition in the pregnant woman that necessitates delivery," says Dr. Grossman. "Some examples of these conditions include severe preeclampsia, or high blood pressure of pregnancy, or bleeding from a placenta previa, when the placenta covers the cervical opening of the uterus."

Other medical complications include: premature rupture of membranes and infection, placental abruption, and placenta accreta, which may risk extensive blood loss, stroke, and septic shock that could lead to maternal death, according to the ACOG.

Less access to care

Second and third trimester abortions may also be more common in places with more strict abortion laws.

"Our research in Texas found that the restrictive laws there, which led to the closure of about half of the abortion clinics, were associated with an increase in second trimester abortion," says Dr. Grossman. "The obstacles that women face accessing care ends up pushing them later in pregnancy before they can obtain a wanted abortion."

Adds Souder, "These restrictions have forced many clinics to close, in turn creating waiting lists, sometimes two to three weeks out. Unnecessary waiting periods, gestational bans, and lack of providers in rural areas force people in some states to travel hundreds of miles to get care. Thirty-five states currently ban state Medicaid from covering abortion care, which affects the most marginalized people."

"Nearly 99 percent of abortions happen before a person is 21 weeks pregnant, and those that happen later almost all happen before 24 weeks. In rare and very complex circumstances, abortions may be necessary later on in a pregnancy—such as when there are severe fetal anomalies or serious risks to the pregnant person's health," says Dr. Dean. "These unexpected and potentially life-threatening complications are why it's critical that patients and doctors have the option of abortion later in pregnancy. Ultimately, the decision to end a pregnancy depends on a person's unique circumstances, and should be between them and their doctors."

• RELATED: What New Abortion Laws Mean for Moms, Pregnant Women, and Women Who Want to Get Pregnant

What is the procedure like for second trimester abortion?

In general, there are two options: "One option involves the use of medications to essentially induce labor to deliver the pregnancy. This may take a day or longer," says Dr. Grossman. "The second option is dilation and evacuation, or D&E, which involves opening the cervix and using instruments to remove the pregnancy. This usually takes less than 30 minutes and can be done under sedation or anesthesia."

Twenty states currently ban the D&E procedure, according to the Guttmacher Institute.

The Bottom Line

"The most precise way to talk about when in pregnancy an abortion takes place is to specify the number of weeks gestation or the range of weeks, like 'abortion at 20-24 weeks'," says Dr. Grossman. "Sometimes people say 'abortion after 12 weeks' or 'second trimester abortion'. It's important to be as specific as possible."

• RELATED: Understanding Abortion Methods and Procedures