Faith Voices for Reproductive Justice

Alliance for Choice is pleased to support a letter published today from Faith Voices for Reproductive Justice calling for the immediate commissioning of abortion services. We have been supporting the development of this network over the past year through a joint project with Ulster University funded by Joseph Rowntree Charitable Trust. It is important people are more aware of the range of religious approaches to reproductive rights as people of all faiths and none have abortions.

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Dear Minister Swann,

We are writing to you as people from faith communities in Northern Ireland to ask you to take action on the commissioning of abortion services. Faith Voices for Reproductive Justice is an initiative started by people from Christian denominations and as a growing network, we are open to members of all religious communities whose faith has led them to support safe abortion access as a necessary part of society. We have observed with concern the delay in the commissioning process which has led to a recent intervention by the Secretary of State. Our shared position as faithful members of religious congregations is that full reproductive healthcare services should be commissioned without further delay. This is a position we have come to through reflecting on  scripture, our own life experiences, the stories of women and girls still having to travel for abortion related care, the burden of stigma and shame unfairly placed on those in our communities who have had abortions, and the values that underpin our beliefs and faith practice.

We believe in the inherent dignity of every person, including the sacred gift of sexuality. We recognise that the dignity of women has not been equally valued in society and that religious doctrine and power has been misused to harm women and girls over many generations. We believe that it is time for faith communities to reject entrenched patterns of sexism and patriarchy, listen to the stories of women and minority genders that have often been silenced, and be led by their voices. We therefore call on you as health minister, and on all legislators and policy makers, to fulfill your obligations to women under the United Nations human rights convention and ensure that reproductive healthcare is made accessible for everyone who needs it. These human rights standards serve the same purpose as our calling as people of faith; to uphold the dignity and rights of all people and to work for justice in an unequal world.

We treasure the freedom to live according to our own religious beliefs and values and the liberty to exercise our conscience in communion with God and each other.  We celebrate the diversity of views on abortion within and across our many faiths and denominations. We acknowledge that people of all faiths and none have abortions. There are few things more sacred than the choices we make about our bodies and families. We are, we know and we love women who have exercised their right to conscience and made these important moral decisions in the context of their own life circumstances. It is not in keeping with our values of religious liberty and conscience to deny others access to abortion services. We do not support the use of religious ideology by legislators who claim to have the authority to make pregnancy decisions on behalf of others.

 As people of faith we seek to practice compassion and care for everyone facing complex pregnancy decisions and challenges. We are called to provide support and understanding for women, pregnant people and their families as they make the decisions that are right for them. We are distressed by the stories of those from Northern Ireland who still have to travel for abortion services. A compassionate society does not turn its face away from people whose lives have led them to a crossroads, whose struggles we might never fully understand and who do not need the additional burden of travelling to access care. We want local services fully commissioned to provide people with the reproductive healthcare they deserve and which is in line with agreed international healthcare rights.

 We believe in the moral vision of Reproductive Justice as it calls us to address all systems of oppression still at work in the world. We want everyone from every background to be able to choose if and when to have children. We want to build safe and sustainable communities where every family can raise their children with dignity and free from poverty, discrimination and violence. Removing barriers to reproductive healthcare is an important part of that wider vision. For too long accessing abortion in Northern Ireland has been an issue of inequality. Those without the resources, freedom and safety to travel have felt the greatest impact of the criminalisation of abortion and the absence of local services. Our NHS is a testament to this society’s commitment to the health of all people and as health minister we remind you of your duty to ensure that this vision of equal access is fulfilled in practice. Safe, free, legal and local abortion services without barriers are long overdue.

 We therefore urge you to join us in acknowledging the importance of reproductive healthcare and exercising the power you hold to make it accessible to the people who need it. The report by the Northern Ireland Abortion and Contraception Taskgroup sets out a practical vision for achieving best practice in this area of healthcare which is in keeping with the regulations that are already in place. We hope you will embrace the advice of these experienced healthcare providers, many of whom have courageously delivered services over the past year with no support while  often facing public harassment at their workplaces. We want to highlight our support as people of faith, for their recommendations. 

We pray for wisdom and courage for you as you undertake this important work, 

Faith Voices for Reproductive Justice

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.

Abortion in Contemporary Literature

Abortion rights and reading have long been my “hobbies”. Since lockdown and not going out to talk to strangers about abortion, I’ve been reading a lot. Abortion doesn’t appear as a plot point that often, but when it does it can completely change how I feel about a novel. None of the novels below are about abortion and I’m fixating on minor plot points really, but do be aware if you don’t want spoilers then please don’t read ahead. If you can think of more please get in touch. I won’t be going outside, so I can read!

Daisy Jones and the Six by Taylor Jenkins Reid is one of the best depictions of abortion in fiction. I would have enjoyed more of Camilla and Karen’s friendship overall but Camilla going with Karen for her abortion and supporting her when her partner won’t shows the need for female friendships. It showed the male entitlement: he wanted a baby, why would she deny him this? And it is one of the few novels that addresses that pregnancy is not just you get a bit bigger and then there’s a baby. Karen points out that it will impact her work: how can she be in a touring band while pregnant? 

Abortion is a sin and leads to punishment in Discomfort of Evening. This is a Dutch novel and I think that changes the tone than say an Irish novel coming out with the same idea. The abortion is barely noticeable in this novel of a family dealing with grief following the death of their eldest son. The incest, peadophilia and animal abuse are much more prominent. That the mother feels she is being punished is derided by the child narrator. The word abortion never used but her mother’s religious beliefs are not to be trusted. 

I read Oh My God What A Complete Aisling last year because it was 99p on Kindle and I thought it was a light read. It was not. I got one of the best depictions of living under the eighth amendment and why the Repeal campaign was so important. It looked at how long the fight was going on for, how the conversations in rural areas were so important and that the access involved more than just getting on a plane to England. It covered who it impacted, why it needed to change and showed various ways to campaign. The two authors were both vocal about getting the law changed and I think continue to support ARC as the fight isn’t yet over. 

Another recent Irish novel with a abortion and the lack of it: Lisa McInerney’s The Glorious Heresies. The story is one of a large cast of characters and how their lives are all entwined. Travelling to England for an abortion is just one small sub plot but was just matter of fact. 

Marian Keyes has a long history of Irish women “getting the boat”. Her novels are a great way to look at how abortion was treated in Ireland. Her 2018 novel The Break had every interview for its promotion talking about the abortion because of the year of release. But Keyes wasn’t just jumping on the bandwagon trying to make the novel relevant. There are lines in earlier books about women travelling, it’s plot points and character reveals. 

Maggie O’Farrell deals with abortion regret with great nuance and subtlety inInstructions for a Heatwave. It uses the same language as Expectation (“my baby would be three”) but it doesn’t just leave her crying and then moving on. We go back to her as a person who doesn’t want children. We get that the abortion changed her relationship with her husband and her sister. The regret isn’t the abortion, it’s how it changed those relationships. O’Farrell is described as British-Irish and her characters in Instructions are second generation Irish in England. I think that the Irish and Northern Irish experience of abortion meant this was more sympathetic than Expectation. 

I was so disappointed in Expectation. I can’t say if it is abortion regret or if it is reflection. Sometimes that sort of ambiguity is a strength in a novel and it’s good that we don’t know, but as we know the other two main characters' feelings about having a baby it felt like it was unclear. Maybe I’m being unfair and it is good literature because women don’t always have clear feelings about their abortions but when a novel has so much about pregnancy, yearning for pregnancy, a shot gun wedding for a pregnant character; the feelings on abortion should either be clearer or written better. I thought this was an English novel for an English audience and when I look at how abortion is presented through that lens it angers me less. That it was an option to be accessed readily and easily. To not require more than a couple of sentences. To be a throwaway line. 

Abortion in Irish literature has almost become a tick box for a modern novel. Sally Rooney discusses the Eighth Amendment in both Conversations with Friends and Normal People. In neither novel is it a pivotal plot point but is to give insight into the characters minds and politics. Naoise Dolan’s Exciting Times is much the same: her abortion fund pays for her to move to Hong Kong. Thankfully the character did not have a crisis pregnancy as an abortion in Hong Kong costs a lot. 

As I stare at my bookshelves I see many memoirs where people talk about abortion as a relief. I see American novels that talk about supporting Planned Parenthood without a crisis pregnancy in the story. I look forward to the days when abortion in Ireland is a thing for historical fiction. I can’t wait for abortion to be so normal in Northern Ireland that I don’t fixate on two lines in a novel. But until then, I will keep complaining and keep campaigning. 

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