LAST UPDATE | 25 Apr 2023
CABINET HAS APPROVED the publication of a review of Ireland’s abortion legislation that will make recommendations on the regulation of termination of pregnancies.
The Department of Health is set to publish the review, which was led by an independent chair, tomorrow.
Ahead of its publication, Taoiseach Leo Varadkar said last week he would be “reluctant and uncomfortable” to make any significant legislative changes.
However, pro-choice advocates and some Opposition parties have said that the Government should respect the recommendations of the review and be prepared to enact changes if they are necessary.
A provision was included in the Health (Regulation of Termination of Pregnancy) Act 2018 requiring a review to be subsequently carried out of the legislation, which then-Minister for Health Simon Harris described as a “sensible” measure.
“It seems to me it would be wholly irresponsible for us as legislators to pass legislation on such an important issue to do with women’s health and not keep it under review on the basis that our job is done. It is good practice to keep legislation under review. It is not uncommon,” Harris said.
The review is expected to recommend that there should not be a three-day waiting period required to access a termination, as is currently the case.
The review also identified a lack of sufficient clarity in legislation on how certain sections of the Act should be applied and requested new ministerial guidelines regarding foetal abnormalities, The Journal understands.
In total, it is expected to suggest 10 changes to current legislation and 60 operational changes.
Anti-abortion campaigners have pushed back against the review’s expected recommendations, calling them “extreme”, but others say the changes would ensure that necessary medical treatments can be accessed.
Speaking in Cork on Friday, the Taoiseach said he would be “reluctant and uncomfortable” to make any major changes to the law.
“When I went out and others went out to look for a yes vote, we said that there would be safeguards and that included things like the waiting period,” he said.
“It included things like conscientious objections and I have to say I for one would be reluctant and uncomfortable to make any major legislative changes so soon after that referendum.”
Activist and former Solidarity TD Ruth Coppinger said that there was “great annoyance and anger” over the Taoiseach’s comments.
“Why are we having a review if we can’t actually change anything? We agreed we were having a review of the law to see how it’s operating,” Coppinger said, speaking to The Journal.
She said it was “disappointing” that some senior Government members “haven’t learned the lesson that it’s not about their personal views, it’s about how the law is working and the people that are being left behind by it”.
Social Democrats Leader Holly Cairns criticised the Taoiseach in a statement after his remarks on Friday, calling it “a most inappropriate intervention by Mr Varadkar to publicly state that he is uncomfortable with making any major changes to abortion legislation”.
“This is despite the fact that the review group’s report has yet to be brought to Cabinet. While the removal of the Eighth Amendment in 2018 was welcome, there have been flaws in how the State’s new abortion laws have worked in practice,” Cairns said.
“Once published, the review group’s report should be referred to the Oireachtas Health Committee for analysis, which I believe is the most appropriate forum for advancing any necessary changes to abortion services.”
Speaking to The Journal, Women’s Health Coordinator at the National Women’s Council of Ireland Alana Ryan said it is “really important that there is a follow-through and evidence-led legislative reform”.
She referenced Minister Simon Harris’ comments from 2018 that it would be “irresponsible” for the legislation not to be kept under review, adding: “I think that has to be the starting point for this.”
“The review was commissioned to gather the evidence to see how the service is working in practice and to then make recommendations which will raise quality standards and improve our reproductive health service.”
She said there will need to be a recognition that “some changes are going to be required in order for women to access the care they need at home”.
“I think the changes that are being suggested are based on the evidence and it is important that our politicians and leaders take time to engage with it and are prepared to have follow-through after such a prolonged process.”
Several aspects of the 2018 Act have been flagged repeatedly as causes for concern or barriers to accessing a termination in Ireland.
A person is permitted under the Act to terminate a pregnancy up to 12 weeks. A GP or doctor must first certify that they are no more than 12 weeks pregnant and a three-day waiting period is imposed between being certified and undergoing a procedure or taking medication.
Anyone who assists a pregnant person to obtain an abortion outside of the legislation can face a prison sentence of up to 14 years.
Coppinger described the three-day wait as a “patronising” measure that was introduced to bring reluctant politicians on board with the legislation at the time and said that it has “no basis in health”.
“It is frankly ludicrous that a woman has to make two visits to get a prescription for an abortion pill.”
She said that given not all GPs offer the relevant services, there should not be an additional barrier placed “in the way of somebody who has already probably struggled to get an appointment for a doctor”.
Coppinger called for reform of the 12-week cut-off point and of the “restrictive” wording on allowances for termination on health grounds, saying that there has been a “very conservative operation of the law because the 14-year jail sentence hanging over doctors has acted like a chilling effect”.
“I would welcome the 12 week-issue being raised about if you couldn’t access the scan on time or if the abortion medication didn’t work the first time, people were then forced abroad.
“I think 12 weeks was a huge achievement for the Repeal movement to win in comparison to what was being originally offered. However, other countries, like Argentina, who legislated for abortion after us, made it 14 weeks, because it is difficult for many people to know they’re pregnant until a certain point and it’s quite a strict cut-off.
“The other very important one is people with medical diagnoses and fatal foetal abnormalities,” she said.
“There’s several hundred people a year continuing to travel to the UK – it’s not what people voted for, people voted to give this to women in our own country. I think that has to be locked at.”
Alana Ryan of the National Women’s Council said the group has “long been advocating for the removal of the mandatory 3-day wait and decriminalisation so doctors can provide the care that women need based on clinical evidence and international best practice”.
She also raised the “continued absence of a full service in all of our 19 maternity hospitals” as a concern.
“GPs need to have the backup of the local maternity hospital so if there are any challenges or complications, they have a clear referral pathway and at the moment eight maternity hospitals are not providing the full service in line with the law,” Ryan said.
“It’s important that we see movement on the legal changes because we know that barriers and problems in accessing care are arising from our legal framework. We know, for example, that 775 women have travelled to the UK since our law was introduced and that’s a direct result of things like the 12-week cut-off and the restrictive access to care for fatal foetal anomalies.”
Additional reporting by Christina Finn
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