A tale of two abortions in Ireland: One legal, one criminal

Jane had two different experiences: one when terminations were still illegal, another this year

The HSE’s MyOptions helpline was a cornerstone of the Government’s post-referendum plan. Photograph: Getty
The HSE’s MyOptions helpline was a cornerstone of the Government’s post-referendum plan. Photograph: Getty

“Jane” had two terminations in Ireland: one before the Eighth Amendment was repealed, and one afterwards. The difference between her two experiences is stark.

The first time, she bought the pills online and they were shipped to a friend in the North. “I was legally classified as a criminal, I could face up to 14 years in prison for making personal decisions about my health.”

She says the secrecy, stigma and illegality surrounding this procedure was traumatising. “Having to access healthcare without the guidance of a doctor made me feel scared, discarded and alone.”

After the law changed in January, Jane found herself in a very different position. “The second time, I was afforded the human right to healthcare. From the office administrator who helped me make my doctor’s appointment to the GP who prescribed me the pills, all individuals I interacted with during my abortion treated me, and my decision, with dignity and respect. I wasn’t scared.”

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Her decision both times was based on several factors: her desire to finish her education, a need to achieve financial stability, and a decision to protect her mental health.

“The ability to access these services saved my mental health, and protected my future.”

Failed contraception

When “Niamh” found out she was pregnant at four weeks and four days, it was a shock. She had been using contraception diligently for 11 years.

“I had never had even a scare in the past. I never expected I would experience failed contraception and end up in this situation.”

She was excited to have children, but received medical advice that for her own health she should not get pregnant until the end of the year. Her first port of call was the HSE MyOptions helpline. She recalls that this experience was positive.

“The process was easy from the very start. The doctor referred to me by the HSE helpline was beyond caring.

“He explained everything to me in clear language, and he helped me understand how the medication would work. I’m so grateful my experience was positive with him.”

Throughout, she could remain in her own home. She says she felt safe, but that the experience itself was a “horrible ordeal”. “The pain was so bad, for hours on end, horrendous cramping and contractions. My partner supported me throughout.”

While she cried and hoped the pain relief would kick in, she thought of campaigners who had warned that women would use the new laws to “abuse the system”. She believes no woman would take such a decision without thinking it through.It took her more than two weeks to recover.

“I’m so proud of our country for supporting women ... I cannot imagine what it must have been like for my fellow country women who had to travel, or who had to travel after a procedure or medicine.”

4,000 calls

Niamh is just one of thousands of women who have turned to the MyOptions helpline since it was established just over 100 days ago. Since January 1st, the helpline has received over 4,000 calls. The average numbers of calls per day is between 45-50, with most occuring in daytime hours

It was a cornerstone of the Government’s post-referendum plan: a confidential helpline that would give women access to all the information they need whether it be the name of a GP who was providing the service or post-procedure counselling.

Minister for Health Simon Harris has a similarly positive outlook about how the first 100 days of the new system have panned out. He says that more than 300 GPs have now signed up, though some counties still have none signed up.

“I am satisfied that access is in place, that the helpline is working very well. The general feedback that I am getting from the HSE is that the system is operating as expected.”

He says after the first full year of the legislation being in effect, early next year, he will report to the Oireachtas about the service. “That will be the first opportunity for all of us to have a conversation.”

Before then, his focus is on legislating for so-called buffer zones to prevent the kind of protests that have popped up outside healthcare centres around the country.

Three-day wait

Privately, some TDs have expressed disappointment that the legislation was not on the priority list for this term.

“I expect to have a general scheme before Cabinet this summer, as early as possible. This is a priority for me,” says Harris. “Unfortunately Brexit and other things have dominated a lot of time for a lot of our drafters . . . I think we should aim to pass, and I believe we will, that legislation this year.”

The first opportunity to potentially change the law won’t come until 2022, as a three-year review mechanism is built in to the legislation.

Yet within weeks of the new law coming into effect, it was already clear which areas campaigners are turning their attention to, and this includes the three-day wait to access abortion medication once it has been requested.

Fianna Fáil TD Billy Kelleher previously said this measure was introduced only to allay the concerns of Tánaiste Simon Coveney, who had a very public struggle with supporting the abortion legislation.

Campaigners such as Ailbhe Smith and Solidarity TD Ruth Coppinger say the provision must be removed from the law.

Fine Gael TD Kate O’Connell says the evidence will have to be weighed up. She says “it could be got rid of” if it is found that it is of no benefit to women. “But if there is evidence that it leads to more holistic and comprehensive care, that will have to be considered too.”

O’Connell points out that there has been some debate over complex foetal abnormalities and fatal foetal abnormalities – one woman’s case was raised on the floor of the Dáil earlier this year. She says this is unsurprising and there is value in having a public conversation on the difference between complex abnormalities and fatal abnormalities.

Coppinger says: “The ban on severe fatal abnormality is causing problems. It is very hard to get an abortion after 12 weeks on any grounds.”

O’Connell counters: “The Government was very clear on this, it would not legislate for disability as a grounds for abortion.”

The Fine Gael TD also wants to see progress made on the issue of providing free contraception. A working group is due to begin considering the issue this month.

Some names have been changed