All You Need to Know About Abortion in Northern Ireland Now

Abortion has been decriminalised in Northern Ireland since October 2019. Despite the decriminalisation, today access to abortion remains tenuous for many. We talked to Emma Campbell, co-convenor of the Alliance for Choice in Belfast to learn about the road towards decriminalisation, the current situation and the ways forward. 

Can you tell us a bit about the Alliance for Choice and your work there?

Alliance for Choice believes everyone who needs an abortion should have free, safe and legal access in their own country, without stigma; set up in 1996, we campaign for free, safe and legal abortion access in Northern Ireland, an end to the criminalisation of women and pregnant people, and an end to the harassment of people using reproductive health services.

Much of our work has been about giving voice to the tens of thousands of women and pregnant people from Northern Ireland who had abortions in Great Britain, or at home alone, with the threat of prosecution and without medical support. We have also just began training a cohort of abortion doulas to meet the needs that fall outside of the current statutory provision.

Abortion was recently decriminalised in Northern Ireland. As an engaged activist, can you tell us a bit the road towards decriminalisation and how it all came to happen?

We always considered the abortion laws that governed Northern Ireland to be about excluding the marginalised and those in financially insecure positions. Northern Irish people have had legal access to abortion in England since 1967, but it involved time, travel, resources and money that many could not afford. In order to ensure everyone is provided for, the most marginalised need to be considered; how do you access abortion if you are in an abusive relationship? If you have a chronic illness or disability? If you have no control over your finances, if you don't speak English in NI, if you have an addiction and or mental health issues, if you have children that would need looked after, if you have a job that would be at risk if you were known to have had an abortion? 

Once the young woman was arrested in 2016, it was a laser focus to remove the British law, enacted during the height of colonialism and with its impacted seen all over the world, but by 2017 we had no local government. The old sectarian arguments were heightened, financial scandal and more, and the coalition was broken. However, with the expertise we have built in collaboration with other organisations, we managed to get it through parliament.

From a grassroots perspective, I think the stories from people's own experiences, the rallies, the underground connections that helped woman and pregnant people across the whole island access the pills even when customs would try and thwart it, grew a movement that was hard to ignore. We were on the tv, radio, in newspapers, in plays, in music, on people's t-shirts and bags, doing quizzes, karaoke, cake baking, craft sales, organising buses to border counties to help with the Irish repeal campaign. We had begun to grasp the popular imagination, and begin to shine light on something kept in the dark for too long. We openly described helping people with pills access, we gave training to activists and students - including medical students, on what the pills were and how to use them. We made stickers that went up across bathroom stalls, public transport and street walls. Northern Ireland has less people in the whole country than the city of Manchester, but by 2018 we were getting thousands of people at Rallies. We learned a lot from our neighbours in the South and we supported each other's campaigns - which was really vital.

What should people know about abortion in Northern Ireland now?

The law is not being met in terms of provision, unlike in the South of Ireland, there is no buy in from the Department of Health, who have an anti-choice minister and a permanent secretary in charge. You're fine up to 9 weeks and 6 days if you can find the information and you can do the first visit in clinic - which many can't as the health service isn't publicly providing it. Many people end up at the biggest rogue clinic - Stanton healthcare who DO NOT provide abortions.

What are the biggest challenges in terms of abortion rights and access in Northern Ireland at the moment?

It is difficult for people to access information. We still need to investigate and advocate for pathways beyond 10 weeks and surgical access at any gestation. The medical staff lacks training and resources for sufficient service provision and this needs to be met. Finally, we still need to combat against abortion stigma. 

How did COVID19 affected abortion rights and access in Northern Ireland?

For a brief period we had worse access that before 1967. Our policy-makers have used COVID to deny people access to essential healthcare and blocked any notion of full telemedicine. We had to make a lot of noise in the press to help the small but dedicated numbers of medical staff who were willing to provide services, without the help of organisations such as Women on Web we would have had some awful circumstances to deal with.

How do you see the future of abortion rights in Northern Ireland? What are the ways forward, what still needs to change?

We need full co-operation of the Department of Health. Doctors and nurses need the reassurance that they can operate fully and be well resourced, properly trained and felt a an integral part of reproductive services

Women and pregnant people need the service to be easy to find, they need to be able to access without fear or shame and they need to be confident that they get the same service in every part of the country.
No-one should still have to travel to England and everyone should be able to access pills online and take them at home safely without fear.

BONUS: People with unintended pregnancies seeking abortion in Northern Ireland, what options they have?

At the moment there are NHS clinics providing funded Early Medical Abortions up to 10 weeks in Northern Ireland - please call the Central Access Point on 028 9031 6100 ICNI if you can attend an in-person appointment, leave a message at any time and you will get a call back. The clinics are multi-use clinics so no-one will know if you are attending for abortion services. This helpline is staffed from 9am to 5pm, Monday to Friday. Translation services can also be arranged. 

What to expect:

ICNI will take your details and provide these to your nearest clinic, the clinic will contact you to arrange an appointment. You will attend an in-clinic assessment. The 1st tablet, mifepristone will be administered in-clinic. If necessary you can call again if you are worried about side effects, need follow-up care or counseling.

If you cannot travel to a clinic due to COVID19 illness, shielding or isolation please contact BPAS below. BPAS is now offering a telemedicine service to any woman or pregnant person in Northern Ireland that qualifies for it below 10 weeks. You can contact to 0300 500 8086 for help. 

What to expect:

Initially you will be put through to a call centre.They will then book you for a phone consultation with a nurse. A call-back is usually scheduled within 24 hours but there can be delays. Once your request is approved, the medical abortion will be sent to you via post with instructions, along with pain medication. If you have any difficulties or need to speak to someone during your home abortion please call 07397 902774 and someone from Alliance for Choice will help you.

At the moment clinics are only providing Early Medical Abortions up to 10 weeks in Northern Ireland (even though this is not the law - it should be up to request to 12 weeks)- please call the Central Access Point on 028 9031 6100 ICNI if you can attend an in-person appointment and are below 9 weeks 6 days only. The clinic in Belfast, Ballymena and Derry are both multi-use clinics so no-one will know if you are attending for abortion services.

You can qualify for an abortion between 12 and 24 weeks if ‘continuance of the pregnancy would involve risk of injury to the physical or mental health of the pregnant woman which is greater than if the pregnancy were terminated.’ In plain speak this can be interpreted as any pregnancy is of greater risk to a person carried to full term than it is to end it early.

12-24 weeks abortion care needs signed off by two healthcare professionals but it DOES NOT NEED TO BE A SERIOUS ILLNESS OR FOETAL ABNORMALITY, it can be for demonstrable mental health or physical health impacts. If a medical professional refuses to offer you care, they are obliged to refer you to someone who will offer care.

Call Informing Choices NI on 028 9031 6100 to book an appointment, unless you need an appointment following a 12 or 20 week scan or a routine pregnancy check-up, then please urge your care team to refer you to the Ob/Gyn team for an abortion consultation.

If you have any difficulties or need to speak to someone during your home abortion please call 07397 902774 and someone from Alliance for Choice will help you.

Abortions in Northern Ireland are permitted after 24 weeks and up to term if:

· the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant person

· the continuance of the pregnancy would involve risk to the life of the pregnant person which is greater than if the pregnancy were terminated.

· Severe foetal impairment or fatal foetal abnormality

This must be signed off by two healthcare professionals and you will likely be referred to a foetal medicine department and the offer of more tests if you get a diagnosis of a severe abnormality. Again if any doctor or medical professional refuses to treat you, they are obliged to refer you to someone who will. Travel should not be necessary, however we know that some families have already been made to travel and the health service is below par and legal obligation.

Please contact us if you need a doula or advocate to attend an appointment with you.

Last Update: 11/09/2020