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(en) Red & Black Revolution #7 - Repressing Abortion in Ireland by Mary Favier (Doctors For Choice)

From Worker <a-infos-en@ainfos.ca>
Date Wed, 17 Dec 2003 07:45:45 +0100 (CET)


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The Republic of Ireland has one of the most draconian abortion laws in
the world. At present abortion may only be performed where continuation
of pregnancy poses a 'real and substantial' risk to a pregnant woman's life
- about 5 cases per year of 50,000 pregnancies. In reality a woman must
be dying before a lifesaving abortion can be performed.

The long-standing ban on abortion was strengthened in 1983 by a
constitutional referendum. However in 1995 the Supreme Court ruled that
a minor in the care of the state could travel to England for an abortion
because her life was at risk from suicide. Right wing groups saw this as
a breach of a total ban on abortion and further attempts at restricting
abortion were introduced as a constitutional amendment in March of
2002. This attempted to include in the constitution a specific prohibition
on the provision of an abortion for a woman whose life was at risk by
suicide.

Yet in spite of the ban on abortion and continued attempts to make all
access virtually impossible, approximately 7000 Irish women every year
exercise their right to choose abortion and travel to England to access
legal abortion there, largely through charities provid - ing abortion
services and private clinics. This figure of 7000 includes only those who
are documented in English statistics by the giving of an Irish address. It
does not include those who use UK addresses for reasons of
confidentiality or those who travel to other countries. There has been
about a 10% rise in the figures every year. An interesting statistical fact
is that the majority of Irish women who have had abortions are married
and already have children. It is estimated that about 150,000 Irish women
have had an abortion - this averages about 1:10 of adult Irish women.
Thus for Irish women abortion is common and important.

Unlike previous abortion referenda which had focused on religious issues
(1983), and legal issues (1992), the public debate on the 2002
referendum was largely about medical issues, particularly women's
mental health and foetal abnormality. This was a significant change from
abstract religious and legal arguments as it involved issues people could
themselves identify with. With considerable effort and organisation
across a broad range of groups the referendum was narrowly defeated.
This was significant in a number of ways. It was a defeat of the
conservative forces of the Right that were attempting to further restrict
nonexistent abortion access in this country. Pro-life organisations had
been particularly successful in getting their message heard in political
circles in Ireland in the 1980's and 90's. Successive governments have
buckled under the well-funded pressure and agreed to regressive
referenda. Most recently a minority government relied on the support of
four independents that were actively 'pro-life' and their agreement to
support the government was traded for another referendum to further
restrict access to abortion particularly in the area of suicide risk.
Silence

The referendum was actively supported by the main government party,
Fianna Fail and by the Catholic Church. The significance of the defeat of
these combined forces by the Irish people should not be underestimated.
It marks a turning point in the Irish church/secular divide and in the Irish
urban/rural divide. The considerable ability of the church to influence
national political debate was eroded and exposed as being a waning
force. Furthermore all significant urban areas such as the main cities and
towns defeated the regressive referendum while it was substantially
carried in rural areas. This marks the end of the historic dominance of
rural culture and politics in Ireland - a welcome development for
progressive politics.

A further important result of the referendum debate was the ending of the
silence around abortion. Until now the thousands of women who have had
abortions and returned to their lives and families in Ireland were a silent
group who have had no voice and whose experiences were never heard.
This changed with a number of women making public statements about
their abortion experiences. With an approximate ratio of 1:10 Irish women
having had an abortion, there is someone in everyone's family who has
had an abortion yet nobody knows them, as it is not discussed. For the
first time, abortion as an important public issue was discussed without
the usual 'baby killer' name-calling, (probably a sign of a change of
strategy by pro-life groups rather than evidence that they have gone
away). It is now apparent that one of the positive results of the
referendum for those who support a woman's right to choose, and a huge
setback for those who reject it, is that the genie is out of the bottle as
regards publicly discussing and considering abortion. The ending of the
silence has been slow and is by no means complete, however its
progress is inexorable and is to be celebrated as a coming of age for Irish
political debate.

A further benefit of the referendum was the emergence of organisations
that actively support a woman's right to choose. Some groups also went
on to publicly support the right of Irish women to access abortion
services in Ireland. One such organisation was Doctors for Choice. The
emergence of Doctors for Choice isn't that surprising. While there is a
constitutional ban on abortion in Ireland, women's lives are not any
different to those who live in countries where abortion is legally
available. Wherever they live women need access to comprehensive
reproductive health care, including abortion. For better or worse, women
have always used abortion as a way of controlling their fertility. If it is
not legal, they will, in desperation, seek it illegally. In many developing
and fundamentalist countries doctors see the results of this desperation
every day, in the form of infection, infertility and agonising death from
botched abortions. In Ireland, women are fortunate that they live close to
a country that has legal accessible abortion - England. If this escape
route did not exist we would also see the horrors of back street abortion
here. However, one of the down sides of our proximity to the UK is the
safety valve it has provided to successive right wing governments who
refuse to acknowledge the need for abortion services yet acknowledge
that 7000 Irish women travel to England every year. As one prominent
politician (Mary Harney) who supported the failed amendment, stated in
1992 'if we were an island in the middle of the Atlantic we would have an
abortion service by now in this country...'
Low Pay

In their daily work family doctors see the reality of the failure of the state
to legalise abortion. They see the palpable horror of the woman who
awaits a pregnancy test that she fears is positive. She must face this
situation in the knowledge that she can not have an abortion in Ireland.
Most often, women who have unwanted pregnancies make decisions
about abortion without support and in silence. In spite of this many
women chose abortion as the best option for them. However it is not
always as simple as that. As with so many other health issues, class
issues have a significant impact on any decision that will be made. It
costs approximately 1000 Euro to travel to England from Ireland for an
abortion, covering clinic costs, and travel and accommodation costs. This
amount of money is rarely immediately available to women in poverty or
low-paying jobs or who are raising children alone. Family doctors have
seen women get credit union loans, not pay the mortgage, take the Holy
Communion savings, the holiday money and money from under granny's
mattress. Money lenders have been involved, with the woman eventually
paying several times over - such is the desperation of women to control
their fertility as they see fit. Child-care issues are highly significant for
many women particularly in a silent community where excuses must be
made for why one is away for the weekend. Teenage women are
particularly vulnerable to cost issues and many opt to continue the
pregnancy as the costs become insurmountable.

A direct consequence of the financial issue is that Irish women have
more late abortions that the average English woman. Late abortions after
14 weeks involve more invasive procedures, general rather than local
anaesthetics and a greater risk to health. The delay is contributed to by
difficulties in getting good information about abortion services in the
England, delays in raising the money and the need to arrange the trip in
secret. Airline strikes and bad weather on the ferries take on a new
meaning on Monday mornings when the distraught woman rings the
surgery to see if she still has time to reschedule. Similarly an asylum
seeker must be told that if she travels to the UK for an abortion she is
likely to forfeit her asylum application. The result is she must now face
an enforced pregnancy. These are examples of the silence around women
and abortion in Ireland - their distress is not documented or considered
valid.

Doctors have traditionally expressed a conservative voice on abortion. In
reality many doctors have been dealing with the issues of abortion in
their daily work and have formed opinions not usually expressed publicly.
In the past, public statements have been left to those doctors who have
generally adopted a pro-life position. This has become the safe,
acceptable position on abortion for doctors. With the advent of Doctors
for Choice this has changed. The group developed from an ad hoc group
of pro-choice doctors that felt an alternative medical position needed to
be strongly stated in the debate around the referendum. The organisation
quickly grew from there. Doctors for Choice represents all the
specialities of medicine but particularly general practice, probably
because this is the group of doctors who actually see the female patients
that abortion impacts on. The aims of Doctors for Choice are to give a
voice to doctors who support a woman's right to choose and to work
towards the provision of comprehensive reproductive health care
services including abortion in Ireland. We see this as a basic health
entitlement of women resident in Ireland. To do this there needs to be
provision of quality abortion services that are accessible regardless of
ability to pay. To this end medical education must include abortion
provision training and abortion must not be excluded from public hospitals
by the religious governance of the hospital. Similarly, doctors who
provide care to patients seeking abortion must be protected by law.
Open and public

Doctors for Choice has been considerably more successful than initially
expected. What was thought of as a long haul to encourage doctors to
join a pro-choice organisation was met with many messages of support
and membership subscriptions. It is notable that as doctors we had also
internalised the silence around abortion in Ireland. We had allowed the
agenda to be set by right wing doctors. To do otherwise was to risk being
labeled an abortion doctor and to suffer the subsequent silent
professional discrimination considered inevitable in Catholic Ireland.

As an organisation we plan to ensure that our message is heard amongst
the medical profession so as to provide support to those doctors who
thought they were working alone. We also aim to give support to those
women who thought the medical profession in Ireland did not include
doctors who respected their right to make their own decisions about their
reproductive health. The organisation is small but growing steadily. Our
immediate priority is consolidating our membership. By being open and
public, we will make the subject an easier one for doctors to express a
pro-choice opinion on. This task will be slow, and hasn't been without
difficulties. Not all groups working to defeat the recent referendum
agreed with our unequivocal statements about the right of Irish women to
access abortion in Ireland. It is an unfortunate fact the even those on the
left have internalised the message of silence - that the unmentionable of
abortion in Ireland is too radical to be discussed at this time. It is our
contention that this plays in to the hands of the conservative, Catholic
right wing who have, to date, set the agenda - one where we can't talk
about the right of Irish people to a quality reproductive health care
service, including abortion. As pro-choice advocates we must be
prepared to publicly identify with the 7000 women who access abortion in
England every year - we must state that this service should be available
in Ireland. To do otherwise is defeatist and hypocritical. It is frustrating
and undermining for all the women who travel to England every year, to
see political groups support their right to do so, but not take the next
logical step of publicly supporting abortion provision in Ireland. By shying
away from this statement women's choices are not being fully respected
and validated.
Reality

To change this reticence will be slow, however Doctors for Choice as a
group would argue that only by doing so can we build strength and unity
for what will be a long campaign to achieve abortion provision in Ireland.
However, we don't doubt it will eventually be successful. Ireland is
changing is spite of the efforts of the Catholic Church and the main
political parties. This social and cultural liberalisation will be much faster
in the next twenty years than the last twenty. With hard work and
committed campaigning by pro-choice groups it is likely that in twenty
years time there will be some form of legalised abortion in Ireland. An
important part of this transition will be informing and changing the
opinions of the medical profession, as their participation is intrinsic to
any abortion provision. To date this has been easier than expected but a
lot of work remains, particularly as prolife organisations are likely to
regroup after their recent defeat and may now choose to target specific
influential groups such as doctors. However the medical profession is
also changing and becoming less conservative and isolationist. It is this
momentum for change that Doctors for Choice will work with and
encourage.

It is likely that there is going to be minimal political will to change Irish
abortion laws. Commitments made by political parties to legislate along
the lines of the X case are likely to evaporate as they seek to distance
themselves from this contentious issue. Furthermore, any change to
allow for suicide risk and foetal malformation would involve only a very
small change in the law and would not substantively affect the lives of
Irish women seeking abortion. The Labour Party has supported such a
change in the law, if they were returned to government. They argue that
this is all that can be achieved now and is thus better than nothing. It
serves their private expressions of a pro-choice position while publicly
sitting on the fence. Pro-choice activists need to be cautious about being
drawn in to any broad alliance of support for such a limited legal change.
Doctors for Choice would argue that this is a mistake as it continues to
deny the reality of the 7000 women travelling to England every year. At
all times this issue should remain the focus of any campaign to change
the law. Scarce energy and resources are better spent on creating an
acceptance of abortion as a reality in Ireland. Any campaign should start
with where it means to end - Irish women have a right to access abortion
services in Ireland and the law needs to be changed accordingly.

* More on the struggle for abortion rights in Ireland

Since this article was written, there have been several developments in
the fight for abortion rights, including the formation of the Alliance for
Choice. To get in touch, email: youngbren@eircom.net

---------------------------------------
This page is from Red & Black Revolution
(no 7, Winter 2003)
http://flag.blackened.net/revolt/wsm/rbr/rbr7/index.html
Print out a PDF file of Issue 7
http://flag.blackened.net/revolt/wsm/pdf/rbr/rbr7.html


Most recent Red and Black Revolution
http://flag.blackened.net/revolt/wsm/rbr.html

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