Letter to the editor, Belfast Telegraph

Dear Editor,

I write in response to the Belfast Telegraph article of 19th May 2022 entitled ‘Abortion service plans unjust and a continued assault on the preciousness of life, say ‘concerned’ Church leaders’. Whilst the Presbyterian church leaders quoted in the article are entitled to hold and express their views on the morality of abortion, it is important to highlight that they do not represent the views of all Christians. As Faith Voices for Reproductive Justice (FVRJ) (1) we represent people from all religious communities in Northern Ireland whose faith has led us to support safe abortion access as a necessary part of society.

There has never been complete consensus on the morality of ending a pregnancy and the approach taken by Christian denominations has changed over time. The Bible contains no direct teaching on abortion and many Christians the world over consider it an issue of individual conscience. For us at FVRJ, we believe that the moral consequences of denying women and pregnant people access to abortion services deserve more consideration by the Church. We all want to build communities where every family feels supported to have and raise children in safety and with dignity. But we cannot achieve that by denying women the right to make their own decisions about their own bodies. Research (2) demonstrates that religious women have abortions at roughly the same rate as those with no faith and we know many Christian women right here in Northern Ireland who have made this decision faithfully, prayerfully and with a sense of responsibility for their own lives and those they already care for. Public statements from church leaders condemning abortion serve to force those women into silence, burdened with stigma and fear of alienation from their church community. We want them to know that they are not alone and in fact churches are full of people who understand the complexity of pregnancy and difficult reproductive decisions, just as we believe God understands.

Grace and peace,

Kellie Turtle on behalf of Faith Voices for Reproductive Justice

Alliance for Choice undeterred by Billboard damage and abuse

PRESS RELEASE Monday 27th September 2021

On the eve of International Safe Abortion Day Alliance for Choice have two messages;
"Abortion is Normal."
and
"All sorts of people need abortions."

These messages were displayed on billboards in 11 sites across Northern Ireland alongside beautiful artwork by local artist, Nichola Irvine. Within days many billboards were damaged or destroyed completely. Within a week the campaign was reluctantly withdrawn by the company hosting the billboards, due to abuse of their staff and criminal damage to the billboards. The company wishes to identify those involved and are seeking legal advice on further action they can take. 

Naomi Connor, Co Convenor said;"Our billboard locations were carefully selected to be visible by women and pregnant people accessing abortion care. It is unsurprising that anti choice people have resorted to harassment in an attempt to silence us, after all it is the kind of activity they engage in weekly outside clinics. We will not be silenced. They may be able to tear down a poster but they cannot tear down the pro choice majority. We had an incredibly positive reaction to our pro-choice message from members of the public and across social media."

Anti-choice online abuse and on-street harassment of women and pregnant people accessing abortion care must stop. 

Emma Campbell, Co-Convenor added, “The billboards were funded by our amazing supporters chipping in to show they care about abortion seekers. Everyone loves someone who has had an abortion. Alliance for Choice will continue to ensure that there is free safe legal local abortion access for everyone who wants or needs one, regardless of the aggression anti-choice protesters show to healthcare staff and patients.”

In the coming days, we will continue with our campaign, albeit differently. We will not be deterred. Such despicable actions strengthen our resolve to normalise abortion healthcare in Northern Ireland.

We will not be bullied into silence.

ENDS

-----------

Contact:

Emma Campbell 07894063965  

Naomi Connor 07505096576

Alliance for Choice 

www.alliance4choice.com

@All4Choice

Further Information

The billboard images are stills from our series of short films ‘Who gets to choose?’ created by Alliance for choice with feminist artist Nichola Irvine.
Available at - https://www.alliance4choice.com/who-gets-to-choose

Dear Texas,

Dear Texas,

We have heard that you are facing a serious push back on abortion rights from legislators; we are writing from Northern Ireland to offer you our solidarity. Having battled an abortion ban here, we believe it is incredibly important to receive local and international support when people are denied their fundamental rights. 

Alliance for Choice will donate to, and share Texan abortion funds amongst our sibling organisations across the UK and Ireland. We hope this bolsters the funds required to cover additional costs abortion seekers will face when it comes to forced interstate travel.

We also support strong relationships with online abortion pill providers, such as Women on Web and Women Help Women who are a safe way to provide for those who fall through the cracks and cannot travel up to 13 weeks; those in coercive control relationships, with disabilities, with precarious jobs without leave, unsure immigration status, lack of access to finance, and more. 

You will need to fight even harder to dismantle the harmful stigma that accompanies such extreme misogyny, abortion bans are not healthy to live through either physically or mentally for all those who need abortion healthcare, those involved in providing it and those advocating for it. You may have to become the people – instead of clinicians, that offer advice and help to women and pregnant people who need abortions, you will have to find ways of sharing the information that helps the most people without getting yourselves into trouble.

We know what it is like to be criminalised for helping people. You and those you help might actually get arrested, you might have your homes searched and your workplaces raided as we did. Those intent on denying women and pregnant people access to abortion healthcare may inform the police of what they think is ‘illegal behaviour’,… either way you really have to know who you can trust with the information about your medical procedure, if you access pills at home.

We spent decades pleading with politicians in Northern Ireland and the UK to address these human rights abuses. We don’t have full access yet, but our persistence and the determination of those intent on seeing abortion rights, access and justice a reality, delivered decriminalisation and safety. 

We don’t stand behind you, we stand shoulder to shoulder alongside you, don’t give up hope! 

In solidarity, 

Alliance for Choice

Self-Managed Abortions do not put anyone at any greater risk...

Or, what we actually responded to the Newsletter’s Adam Kula:

Today the Newsletter once against posted a scaremongering article this time about abortion access; https://donotlink.it/LP6lVy

So Alliance for Choice would like to publish our conversation with the writer in question, in full, as we believe some of the article is misleading and harmful.

”Good evening,

This is Adam Kula at the News Letter, I hope you are well. I am getting in touch because I had seen your upcoming class on 'self-managed abortion' and wanted to run this past you.

The Department of Health says the following: "Women are at risk if they access unregulated abortion services – the Department’s view is that that services should be properly delivered through direct medical supervision within the Health and Social Care system."

In short, I wondered if you wanted to have your say on that. If so, please email me here by noon tomorrow if you can.

Regards,

Adam Kula”

---

Hi Adam, 

Thanks for your email and your interest in our Pills class - are you going to attend the class?
I am drafting a response to the question for you now.

Many thanks

Emma Campbell, Co-Convenor

---

Hello,

Thanks for that. I'll not be attending, though. It's just that, when I read about the class, it brought to mind conversations I've had with the RCM in the past, where they've told me they were opposed to the idea of DIY abortions, on the grounds that terminations are best performed in a supervised clinical environment.

Adam Kula

---

Dear Adam, 

Many thanks for enquiring about our online class explaining how to use abortion pills at home safely. This is part of the joint activities with our partner the Abortion Rights Campaign to commemorate International Day of Safe Abortion. The theme this year is 'I manage my abortion' and our local theme is 'care at home'. The home use of abortion pills following consultation with a medical professional is safe and it is healthcare that should be commissioned by the Department of Health in NI following the regulations. People should not be forced to travel to GB to access abortion care, which the NIO and DoH suggest as an acceptable pathway. Currently across GB there are measures for telemedicine and home use of pills in place, NI once again stands as a place apart failing to offer those who need abortions care even though there is now a legal obligation for these services to be provided.Our session on abortion pills, details the drugs used for early medical abortion, the methods of taking the pills for the most effective outcomes, the safety measures for afterwards, how to look out for complications and what to do if they arise. Alliance for Choice have been running similar workshops for almost 7 years and the medical advice and evidence we use is based both on the recommendations of the World Health Organisation and the advice of providers such as BPAS, Women on Web and Women Help Women, all of whom follow strict clinical guidelines and ask patients to go through either an online or telephone consultation before accessing the pills.

The World Health Organisation released a report in 2018 outlining the safest methods of delivery for medical abortion, based on global evidence, they concluded,

 “Given the nature of the medical abortion process, it is also possible for individuals to play a role in managing some of the components by themselves, outside of a health-care facility. Another existing WHO guideline, Health worker roles in providing safe abortion and post-abortion contraception (2015), recommends that in specific circumstances, individuals may self-manage their mifepristone and/or misoprostol medication without direct supervision of a health-care provider, as well as self-assess the success of the abortion process using pregnancy tests and checklists.”

For women and pregnant people in Northern Ireland, currently the main method of delivery of abortion up to 10 weeks gestation, is with the pills mifepristone and misoprostol, with the 1st pill being taken at a clinic and the second set of pills at home. Despite the law saying abortion should be on request up to 12 weeks and pills being recommended up to 13 weeks by the World Health Organisation, our health service stops at 10 weeks as it has not been properly commissioned by the Department of Health due to political prevarication. This has meant many people are not able to properly access abortion with pills via the Northern Ireland Health Service, even though legally they should.

For some in NI, if they qualify, they can order the pills to be delivered by post from BPAS https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/remote-treatment/ and others continue to use the services of Women on Web and Women Help Women,  which is currently not a criminal offence. If you look online, information on how to access abortion in Northern Ireland has not been published by any of our Health Trusts, again, due to a failure of the Depart of Health to provide information and services. Informing Choices NI do sterling work in supporting people with access up to 10 weeks but again are not supported to do this by our Health Department and have to rely on charity funding.

Once England pressed ahead with self-managed telemedicine abortion due to Covid-19, Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said:

“Giving women the option of taking both abortion pills at home following a video consultation is safe and effective and has rightly been judged as a vital and necessary step if we are to limit the spread of COVID-19. Many women will no longer be forced to make the difficult decision between leaving their home and continuing with an unwanted pregnancy. This change in practice will reduce pressure on the health system while limiting the unnecessary risk of infection for women, their families and health workers. We now urge Scotland, Wales and Northern Ireland to introduce similar measures to help protect frontline staff."

Equally on 24th March 2020 when the UK government were failing to allow for home use during covid, the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) stated,

“We are disappointed by the Government’s decision not to allow home-use of mifepristone, the first drug used for early medical abortion. This change in practice which the Government announced and later revoked would have enabled women to access care remotely through video and teleconference, with treatment sent by post. This would have reduced pressure on an already overwhelmed health system, limited risk of coronavirus infection for women, their families and healthcare professionals, while ensuring safe and timely access to abortion care.”

We appreciate your concern for the safety of women and pregnant people needing abortions. We want everyone to have access to free, safe, legal, and local abortion care should they want or need it. Therefore we have asked both the NIO and DoH for all services, as mandated by law, to be provided to people in NI through our Health Service. These services should include home use, as recommended by the World Health Organisation, and telemedicine as in place across GB. We urgently need the DoH to commission services in line with the regulations, fulfilling their legal duty, as well as a public awareness campaign and training for healthcare professionals. Until the government does their job, Alliance for Choice will continue to share international best practice guidance and support those who need to access abortion.

Kind Regards
Emma Campbell & Naomi Connor

---

Wow - quite a reply! Received, many thanks.
Adam Kula

---

Access to safe abortion is very important to us, as is up to date and accurate reporting on the issue.

thanks Adam

Emma

---

Adam, we also have a statement from Women on Web:

In the last thirty years since unsafe abortion was defined, evidence has evolved and new technologies such as vacuum aspiration and medical abortion, have changed the terms and conditions of abortion care provision. Today, the World Health Organization affirms that individuals can self manage their abortions up until 13 weeks and recommends telemedicine abortion services to be expanded to ensure access to abortion. WHO suggests that self-management of medical abortion is non-invasive, cost-effective, acceptable and improves autonomy. The international community, including WHO, as a result has actually moved away from a dichotomous division of safety when it comes to abortion care, to a more three-tiered classification (safe, less safe, and least safe) to better capture the spectrum of varying situations and experiences individuals face on the ground.
The 15 years of service and experience of Women on Web epitomizes this progress and testifies that individuals can self manage their abortions safely when provided with accurate instructions and information, and supported in case of complications. - Hazal Atay, Women on Web
Emma Campbell

---

Good stuff - it's good to get comment to balance things out where possible, but this is a whopping lot of text! I'll include what space allows. Best,
Adam Kula

---

well then at least you have plenty of medical evidence-based quotes to choose from!
Emma

Also thought it would be significant for you to know that Pakistan offers the services our Health Department won't. 

PAKISTAN – Training in telehealth

 by International Campaign for Women's Right to Safe Abortion |  posted in: Asia, News, Newsletter, Pakistan, Uncategorised |  0

With physical access to health facilities in Pakistan severely limited by the country’s rapidly growing number of Covid-19 cases, providing women and girls an alternative way to get reproductive health counseling and information “is the need of the hour,” says Ghulam Shabbir Awan, director of Ipas Pakistan.

A new telehealth initiative is helping meet that need. The project is a joint effort by Ipas Pakistan, provincial departments of health and  Sehat Kahani Pakistan, a non-governmental organization working to improve low-income people’s access to quality health care. To date, 22 private- and public-sector health professionals have received three days of online training that has equipped them to provide telehealth consultations with women and girls in need of medical abortion, abortion self-care or post-abortion contraception.

In addition, Ipas-trained lady health workers (LHWs) are reaching out to women and girls to make them aware that telehealth consultations are available and free of charge during the COVID-19 crisis. Seventy-eight lady health workers have been trained on how to access the telehealth services and they, in turn, are helping women and girls access the services by smartphones.

SOURCE: Ipas, 22 July 2020

Emma Campbell

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

-----------

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