Abortion was legalised in the Republic of Ireland with the introduction of the 2018 Health Act (réglementation de l’interruption de grossesse). (Termination of Pregnancy Regulation). This law permits the termination of a pregnancy up to 12 weeks gestation with no restrictions imposed. Although it represents long-awaited and significant progress for human rights in the Republic of Ireland, the law comprises several important restrictions.
The law required the Minister responsible to examine the situation three years after it came into force. However, this review has already been rdelayed and will only now take place this year. In addition, the Irish government has stated several times that the review will analyse the functioning of the law which, if narrowly defined, could mean that it fails to look at all the policies affecting access to abortion services. The ICCL, along with other human rights organisations and women’s rights movements, has produced a joint submission on the review, highlighting the significant issues and providing recommendations on how to resolve these.
The Republic of Ireland’s situation was also examined by the UN Human Rights Committee in July 2022 with regard to the International Covenant on Civil and Political Rights (ICCPR). Following submission by the ICCL of an alternative to the State Report including specific comments on the abortion legislation, the UN Human Rights Committee made recommendations to the Irish government, such as removing the criminal sanctions for medical service providers, revising the provisions that could create barriers to abortion and taking the measures necessary to remove existing barriers.
Restrictive and arbitrary time limits
The restrictive limit of 12 weeks gestation does not take into account the complexity of individual circumstances and relevant medical data. New statistics published by the UK government in June 2022 show that 775 Irish residents have been forced to travel to the United Kingdom to access an abortion since the abortion legislation was introduced in the Republic of Ireland. The situation is particularly difficult for people who are marginalised and adolescents who have to face the additional hurdle of a lack of access to information.
Elsewhere, the law provides for access to abortion beyond 12 weeks in the case of fatal foetal anomaly. However, this exception is accompanied by extremely restrictive conditions:access to abortion services is only possible if two doctors consider that a condition exists that is likely to bring about the death of the foetus before birth or within 28 days of birth. This arbitrary limit has led to a significant increase in the number of Irish people travelling abroad to receive abortion care following a diagnosis of foetal anomaly that does not meet the 28-day criterion.
These time limits must be reviewed, as they are depriving many people of access to abortion healthcare in Ireland.
Inequalities in access and discrimination towards certain groups
There is an obligatory three-day wait between the first appointment an individual has who is seeking an abortion and the abortion itself. Despite what the government states in its replies to the list of issues of the UN Human Rights Committee, this represents a major obstacle for many people. More specifically, this provision discriminates against certain groups, such as people with a disability, those living in rural areas and those in financial difficulty, who may not be in a position to travel twice to a medical facility.
Indeed, there are significant regional disparities in the provision of abortion services, as the ten hospitals delivering abortion care are not geographically distributed equally across the country. On the contrary, they are concentrated in the six largest cities and in two other counties. Moreover, the most recent study available shows that 30% of women questioned had travelled between four and six hours to access medical facilities that could provide them with abortion care. This creates important inequalities in accessing abortion, particularly for migrants, asylum seekers, victims of domestic violence and those living in rural areas.
The Abortion Rights Campaign report has also revealed race discrimination faced by migrants seeking abortion care, as well as the financial barrier faced by undocumented people and asylum seekers who are forced to pay for the procedure as they cannot produce a social security number.
Criminalisation, conscientious objection and anti-abortion campaigns
The unequal geographical spread is partly due to anti-choice movements which have a disproportionate impact on access to abortion throughout the country. For doctors, the threat of demonstrations is "potentially the biggest impediment […] in areas which do not yet have adequate provision"->https://www.nwci.ie/learn/publication/accessing_abortion_in_ireland_meeting_the_needs_of_every_woman]} ». A bill presented by the campaigning group Together for Safety, supported by the ICCL and providing for the creation of Safe Access Zones, was adopted by the Senate in April 2022, but was delayed while the government prepared its own legislation. The government bill was published in August. "Safe zones can take different forms but all seek to limit the activities that can be undertaken legally outside a premises where abortion services are provided" and, as the ICCL has stated, "safe zones should be introduced in order to create the safe environment necessary for women to act on their private medical decisions".
Lastly, another major issue for the Irish abortion legislation is the criminalisation of medical practitioners. This continues to apply when an abortion is performed beyond the legal time limit. Criminalisation and a fear of prosecution have the effect of deterring health professionals and "undermine clinical judgement and professional expertise". It is therefore essential to decriminalise abortion entirely.
Moreover, almost one in five pregnant women seeking an abortion find themselves refused treatment and are directed to another doctor as a result of the clause on conscientious objection. This refusal to treat based on conscience must be regulated by provisions obliging rapid referrals in situations where care is not delivered.
This overview of the issues surrounding Irish abortion legislation shows that important questions remain in practice, even after legalisation. States must constantly seek to improve access to abortion in accordance with their obligations under International Human Rights Law.