Abortion Care for Northern Irish Citizens: What Comes Next?

13 April 2018

When the news broke on 29 June 2017 that the newly elected Conservative government would allocate funding for pregnant women and people from Northern Ireland (NI) to access abortion in mainland Britain, this was met with a very positive response from feminists and campaigners in NI. I remember this day well, as I was attending a conference at the University of Kent about doctors and abortion law in practice, and the atmosphere in the room was boosted massively after this news was delivered. This positive and exciting response was then mixed with confusion as to how this was going to be implemented practically.

The British Pregnancy Advisory Service (bpas) and Marie Stopes International (MSI) began to waive charges for Northern Irish residents, meaning they could access services in independent clinics free of charge. However, clarity was needed on pathways of referral; could Northern Irish women and people seeking terminations of pregnancy (TOPs) be referred from general practitioners in NI, and would they be able to access this care in National Health Service (NHS) hospitals free of charge, where necessary?

Scotland’s devolved parliament had discussed the idea of removing charges for Northern Irish residents in Scotland before, when the issue was raised by Scottish Green Member of the Scottish Parliament (MSP) Patrick Harvie, and on 6 November 2017 the Scottish Parliament approved this move. Currently in Scotland, access is possible through individual NHS Boards.

In March 2018, Northern Irish referrals were added to the central booking system run by BPAS. Through the central booking system, abortion seekers from NI can access TOPs through BPAS, MSI, National Unplanned Pregnancy Advisory Service (NUPAS) and other appropriate providers in England. The Welsh assembly have discussed widening access through the Welsh NHS, however nothing has been announced about delivering this so far.

All of these moves are positive developments in ensuring access to safe, free abortion care for Northern Irish residents. However, it is not a long-term solution, and this move is also leaving many behind: those with disabilities and unable to travel, those in abusive relationships, those who are homeless, and asylum seekers and refugees who may not have travel documents. Added barriers to accessing care overseas are travel and accommodation expenses, and for many it is difficult to access child care, or take time off work. In fact, research conducted by Ulster University on ‘Abortion as a Workplace Issue’, showed that 20% of survey respondents had direct experience of abortion, as a workplace issue, whether they were accessing abortion care themselves, or their partners were. Another issue is that while abortion and access to abortion care is already stigmatised, even where it is legal, needing to travel for this care, rather than accessing it locally at home, further compounds the stigma experienced by women and pregnant people in NI.

There has been a lack of response from the NI Department of Health in issuing updated guidance to healthcare staff on advice for patients. This inadequate response has left healthcare staff without the information they need and patients without support in their care.

The lack of a devolved NI Assembly is becoming another pressing issue, and one for which Westminster has been dodging responsibility. There is a very serious and urgent need for free, safe and legal abortion in NI, allowing pregnant women and people to access healthcare at home. Something which has been largely ignored by the mainstream media in mainland Britain is the ongoing criminalisation of women and activists in NI for accessing abortion pills. The silence from Westminster on this treatment of pregnant people in NI is deafening.

Recent developments such as the publication of the CEDAW (Committee on the Elimination of Discrimination Against Women) Report in February 2018, which condemned NI abortion laws for violating the human rights of women and girls, makes this lack of progress all the more shameful, and the responsibility lies at Westminster’s feet. Campaigning groups such as Alliance for Choice have been working hard to push for interventions, as Westminster is responsible for upholding the human rights of UK citizens, and this responsibility is accentuated in the absence of a devolved government at Stormont.

However, the likelihood of a Conservative government overruling devolved issues appears to be low; only recently a Ten Minute Rule Bill on marriage equality, with support from many parties, passed its first reading. However, Theresa May refuses to intervene on this matter through Parliament, in order to appease the Democratic Unionist Party (DUP), whom the Conservative party rely on for votes.

Consistent pressure from lobbying and campaigning groups, and developments to ensure some access, are positive; however, a bigger question for the future of campaigning is: Will a Conservative government step in over abortion law reform, or will they acquiesce to the DUP over their staunch anti-abortion stance?

Jill McManus, Third-year Medical Student, Queen’s University Belfast, Belfast, Northern Ireland; jmcmanus27@qub.ac.uk

Note on the Author

Jill McManus is president of the QUB chapter of Medical Students for Choice, and is an activist with Alliance for Choice, a pro-choice activist and advocacy group based in Northern Ireland. She also has a blog, where she writes about current events and information on abortion.