NI Abortion Laws 'Have Negative Impact on Women's Health'

Nicky Broyd

October 19, 2018

Despite a policy change which allows women from Northern Ireland to have a funded abortion in other parts of the UK a new study has found there are still multiple barriers to accessing that care, and women are still turning to abortion medication bought online.

The new research, 'The impact of Northern Ireland’s abortion laws on women’s abortion decision-making and experiences' has been published in the BMJ Sexual and Reproductive Health. It involved anonymous in-depth interviews with 30 women living in Northern Ireland who had either travelled to England to obtain an abortion or who self-managed a medical abortion at home using pills bought online.

Negative Impact on Women's Health 

Abortion is a devolved matter, which means the law on abortion in Northern Ireland is decided by the Northern Ireland Assembly. It adheres to the 1861 Offences Against the Person Act (OAPA), which means women face imprisonment if they have an abortion that is deemed illegal and health professionals are breaking the law if they carry out the procedure.

Dr Abigail Aiken, an assistant professor at the LBJ School of Public Affairs, University of Texas, US, who conducted the interviews, found that NI's restrictive abortion laws had a negative effect on women's health and well-being and led women to mistrust the health care system. She said: "The recent policy change to provide free abortions for women travelling from Northern Ireland to clinics in Great Britain has not been sufficient to create a reliable and accessible pathway to care.

"In addition to the physical toll and emotional stress of travelling overseas, many women … need to keep their abortions secret from their families or communities."

The report found that women who chose to manage their abortions at home with medication bought online experienced severe anxiety, isolation, and feared the pills would be seized by the Northern Irish Customs.

Lack of clarity surrounding the duties of healthcare providers to report self-managed abortion also led women in the study to mistrust the health care system and they felt compelled to either lie to their doctors or avoid seeing a health care professional altogether.

Public Health

The authors of the report say their "findings provide important evidence of the negative impact of the current law on the quality and safety of women’s healthcare in Northern Ireland and offer a public health rationale for ending the criminalisation of abortion".

Commenting on the study, Mara Clarke, founder and director of the Abortion Support Network, said: "This research backs up what we have found to be the case in practice. We continue to receive several calls each month from women in Northern Ireland who are either unaware of their right to access free care in England, or who, even with this knowledge, do not wish or are not able to travel.

Clare Murphy, director of external affairs at the charity bpas (British Pregnancy Advisory Service) said: "Abortion is a healthcare issue, not a criminal matter. Decriminalising abortion would mean it could be regulated in the same way as other women’s healthcare procedures and ensure no woman is deterred from seeking the medical help and advice she needs for fear of prosecution and prison."

Next week a bill will be presented in the House of Commons seeking to decriminalise abortion up to 24 weeks in England, Wales and Northern Ireland by reform of the OAPA. However, it may prove controversial as it would be Westminster legislating for Northern Ireland, and by-passing Stormont.

The research was supported by funding from a Junior Investigator grant from the Society of Family Planning, a grant from the European Society of Contraception and Reproductive Health, and a grant from the HRA Pharma Foundation. The study was also supported in part by an infrastructure grant awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Aiken ARA, Padron E, Broussard K, et al. BMJ Sex Reprod Health Published Online First 19th October 2018. doi:10.1136/bmjsrh-2018-200198