While Ireland continually grapples over the morality of other peoples choices the rest of world has been developing technologies and medicines for safer, quicker more efficient pregnancy terminations and has being doing so for decades now. Sheila Lafferty takes a look at the abortion pill.
Every year 42 million women worldwide choose to have an abortion. This aspect of reality just doesn’t get discussed in Ireland.
Many people residing here on the Isle of Perpetual Judgement don’t realise the different types of abortion that are available. The vast majority of women terminate in their first trimester which is considered up to 13 weeks. When they present to a clinic, options are generally a medical abortion which is brought on using pills or a surgical procedure. Mara Clarke, speaking on behalf of the Abortion Support Network points out, “some women love early medical abortion because they think it’s more natural.”
Misoprostol, a stomach ulcer medication widely used in Brazil back in the 1970s carried the side effect warning “may cause miscarriage” and tens of thousands bright sparks got busy. Reproductive rights researchers noticed that Brazil had extraordinarily less maternal deaths as a result of abortion in comparison to their geographical neighbours. They investigated and discovered it was down to women’s ‘misuse’ of Misoprostol. A clinical study of its use as an abortifacient commenced in Geneva in 1981. By 1985 research was being done into how Mifepristone and Misoprostol worked in conjunction. Terminations were successfully achieved and side effects were minimal on par with that of a natural miscarriage. France and China immediately applied for licenses to begin administering medical abortions over a quarter of a century ago. At this point in time, Ireland was still smuggling condoms in the hems of Grandmother’s skirts across the border.
The World Health Organisation declared the drugs used in medical abortions as safe and effective. Even more so than Viagra which I imagine a clatter of men over fifty and the occasional buzzer uses to no ill effect. As of 2005 the WHO placed Misoprostol and Mifepristone on their essential medicines list.
Whilst other countries in Europe, namely France, update and progress their reproductive laws, Ireland the country closeby but many decades behind has chosen to sink further into repression. The recent Protection of Life Act only benefits those literally knocking on deaths door, and only after numerous doctors and apparently everyone’s auntie decides that thats the case.
For everyone else it’s off to England. There has always been a British solution to this particular Irish problem. Back in the fun-filled days of the laundries England enacted a specific welfare category PFI. Pregnant from Ireland, such was the volume of women fleeing over. Today BPAS the British abortion provider hosts a website dedicated to providing information specifically aimed at the thousands of Irish based women requiring their services annually.
The ever so slight glitch in the system being that there are some people residing in Ireland who cannot afford the human right of reproductive choice. Asylum seekers, women with disabilities, women with low incomes, women who can’t get childcare to cover them for their ‘jaunt’ abroad amongst many others. Many of these women access what is known as an abortion-by-post. Thousands of women do this annually and the truth silently screams as no one talks about it.
The Health Products Regulatory Authority seized 438 doses of abortion pills in 2013 alone. Most of the drugs impounded and subsequently destroyed were caught in batches, suggesting supply networks in operation and a possible blackmarket trade. A cursory internet search reveals multiple online pharmacies supplying termination pills. Cold hard cash being their sole motivator for provision. They sit alongside a plethora of horror stories propagated from the comically self-coined pro-life groups.
Women on Web (WOW) a Dutch based group can be found in the midst of the online muddle. To date they are one of the most prolific suppliers of medical abortion pills to Irish women operating on a donation basis. Intense customs scrutiny meant they had to change their packaging. They now suggest that the pills are sent to Northern Irish addresses where it is not illegal to obtain prescription only medicines online.
The underground nature of accessing the pills makes it difficult to approximate how many women access abortions by post. In 2013 the number of Irish women accessing abortions in England fell to its lowest levels since 1969. For BPAS this may be an indication of more women adopting a self-administering approach to unwanted pregnancies. A spokesperson said ‘It is completely understandable given the desperate situation faced by women in Ireland that some have resorted to buying abortion medication on the internet. It is preferable that they take a safe medication, purchased from a reputable organisation”.
The biggest concern of abortion-by-post is the lack of medical support, interaction and supervision. This definitely something that has been lacking from many previous pill providers. A new group called Women help Women (WHW) launched in Dublin this September. They consist of a dedicated team of experienced reproductive health workers and medical professionals who are “focused on putting reproductive health products, including pills for medical abortion and contraception, directly into women’s hands, where they belong.” WHW intentions clearly stretch far beyond that of an illicit online pharmacy.
Women are legally entitled to physical and mental post-abortive care in Ireland. But as Cathie Doherty spokesperson for the Abortion Rights Campaign points out fear of “ potential legal action or fear of being open with medical providers” can stop women accessing this legal right. You’d hope the fourteen year prison sentence enshrined in the Protection of Life Bill is a bullish exaggerated threat but worries over approaching your local GP can be very real. WHW hope to fill that gap by offering expert medical support in a variety of ways; through hotlines, text advise and email in numerous languages. Technology has caught up with the science and the government still flounders decades behind the rest of Irish society.
The harsh reality remains that while abortion-by-post has given more women in Ireland the ability to choose what happens to their bodies none of us could have predicted the recent horrific case of forced human incubation that devastated a young woman’s life.
The recently published Protection of Life guidelines for medical practitioners upheld her treatment, c-section as termination, continuing to embarrass Ireland on an international scale once more. Thankfully Amnesty International has decided to name and shame Ireland as part of their My body My Rights campaign. Tony Mackee explained “we are researching the effect of criminalisation of abortion on people in Ireland and will be launching the report in late spring, from there we will mount a pressurised international campaign calling for the Irish government to decriminalise abortion.”
Perhaps, Leo Varadkar will don a permed mullet, some acid washed denim and a boombox blaming Wham when explaining internationally why he thinks bad decisions in the eighties still are applicable today.
There is only one solution Repeal the Eighth.
All photos by Andrew Flood.