Ireland vs IPPF

Reform of the Irish abortion laws

 Thank you for your email. [it is a reply, below --- what is replied]

You may be aware that the Labour Party, alone among the political parties has a long-standing commitment to legislate for the X case.

As part of the Programme for Government negotiated in March 2011, we agreed with our partners in government, Fine Gael, to set up an expert group to look into all the complex medical and legal issues around this issue and provide us with recommendations on how best to proceed.  That Expert Group was set up in November 2011.

The report of the Expert Group was published on 27 November 2012 and is available to read on the Department of Health's website.

The Expert Group outlines four  options for the implementation of the European Court of Human Rights judgment in the A, B and C v Ireland case – namely guidelines, secondary legislation (Ministerial regulations), primary legislation (an Act of Parliament), and primary legislation coupled with regulations.

The Government discussed the Report on 27th November, and took a series of decisions on the implementation of the judgment:

1. There will be a full debate on the findings of the Expert Group in the Dail starting this week.
2. Secondly following this discussion, the Government will make a decision by the end of this month.
3. The Joint Committee on health and children will hold public hearings on the implementation of the option chosen for three days before the resumption of the Dail in the middle of January 2013.

The decision taken will be implemented early in the New Year.

It is my personal view that legislation is required to provide legal clarity to women and their doctors, and I believe that the Expert Group report provides us with the roadmap for action in that regard.

Best wishes
Eamon Gilmore TD
Tanaiste and Minister for Foreign Affairs & Trade
taoiseach@taoiseach.gov.ie
cc: enda.kenny@oireachtas.ie, eamon.gilmore@oir.ie

Query 

Honourable Taoiseach,

We are writing to you to express our concern about the recent death of Savita Halappanavar, who was repeatedly denied an abortion in Galway. This tragic case demonstrates once again that the prohibition of abortion in Ireland is not just undermining the autonomy of the women across the country, it is leading to unacceptable suffering and even death.

Savita Halappanavar made repeated requests for an abortion after presenting at University Hospital Galway on 21 October while miscarrying during the 17th week of her pregnancy. Her requests were refused, and she died one week later after several days in agonising pain and distress.

The situation of Savita Halappanavar provides the clearest possible evidence that laws that permit abortion only to save the life of a woman, such as the Irish law, are clinically unworkable and ethically unacceptable. There are numerous clinical situations in which a serious risk posed to a pregnant woman's health may become a risk to her life, and delaying emergency action only increases that risk. There is only one way to know if a woman's life is at risk: wait until she has died. Medical practitioners must be empowered by law to intervene on the grounds of risk to life and health, rather than wait for a situation to deteriorate.

You will be aware that the European Court of Human Rights, as well as a number of United Nations human rights bodies, have called upon the Irish government to bring its abortion law in line with international human rights standards. Had these calls been heeded before now, the death of Savita Halappanavar would have been prevented.

With the death of Savita Halappanavar, Ireland joins the ranks of countries worldwide where abortion is denied to women and leads to their deaths.

We call on your government to take urgent and decisive steps to reform the legislation that led to the death of Savita Halappanavar. Until the Irish legal system is reformed the lives, health and autonomy of women across Ireland are in jeopardy.

Yours,

Vicky Claeys

extra: Poll: Most Irish want new abortion legislation

Is abortion worldwide becoming more restrictive?

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8161 (Published 4 December 2012)

by Sophie Arie, freelance journalist mail@sophiearie.com

Sophie Arie examines the differences in approach to abortion around the world

Abortion has always been a subject for passionate public debate. But recently the temperature has risen, especially in the United States and Ireland. The Republic of Ireland has seen nationwide protests over the death of Savita Halappanavar, who was refused an abortion during a long and painful miscarriage because the fetus was still alive. After the fetus was finally removed she died of septicaemia and organ failure. The debate has also been reopened in the UK, where health minister Jeremy Hunt recently declared a desire to see the limit in England, Wales, and Scotland drop from 24 weeks to 12 and the prime minister expressed an interest in a more modest reduction.

In recent decades, abortion has become legal in all but five countries if a mother’s life is threatened. There has also been a general decline in the numbers of abortions worldwide as contraception has become more widely available. But World Health Organization figures show that the decline has slowed recently. So what’s going on? Is there a general shift towards tighter restrictions? Are people being discouraged from using family planning as populations dwindle? And is that forcing more women to take clandestine routes to terminate unwanted pregnancies?

Ireland

Abortion is illegal under most circumstances in both the Republic of Ireland and Northern Ireland: it is allowed only when a mother’s life is in danger or her long term health seriously at risk. In Northern Ireland, the process for approving an abortion is very strict: two doctors must agree independently that the mother’s health is at risk and the abortion must take place within nine weeks of that decision. The NHS carries out between 30 and 50 abortions a year in Northern Ireland,1 and last year 1007 women travelled to other UK countries for abortions.2 In October, Marie Stopes opened the country’s first private abortion clinic in Belfast. The organisation says it plans to work within Northern Ireland’s legal framework, but anti-abortion groups say it aims to widen access to abortion on mental health grounds.3

In the Republic of Ireland the circumstances in which a woman’s life is deemed to be at risk are not entirely clear, and the recent case of Savita Halappanavar highlighted the fact that even when a woman’s life is threatened some doctors or institutions do not consider abortion an option. At least 4149 Irish women made the journey to the UK for abortions in 2011.2 Ireland is currently revising its guidelines on what constitutes a risk to a woman’s health after three women challenged the country’s constitution in the European Court of Human Rights.4 Anti-abortion groups argue that there are always ways to protect a woman’s health without carrying out an abortion and fear that the new regulations will be the first step towards widening access to abortion.

China

China’s single child policy means that there are an estimated 13 million abortions annually—making it the country with by far the highest number.5 The numbers are thought to have been rising since 2003, after a long period of decline, which has been attributed to increased premarital sex, disruptions in access to contraceptive services because of rapid urbanisation, and a lack of condom culture (six million abortions are in women under 25).6 However, the rapid changes in China have brought growing pressure for a change to the way the one child policy is enforced. Activists monitoring the policy say that instructions have been given to local authorities not to carry out late term forced abortions after one case involving a seven month pregnant woman caused national and international outcry this summer.7 India Abortion is legal in India to protect the mother’s health, after rape, in insane women and underaged girls, or if the fetus has serious malformations. It is not legal as a way to avoid giving birth to a girl. There are hefty fines for those offering sex tests or abortions for sex selection. But India’s 2011 census showed a growing imbalance between the numbers of girls and boys aged 0-6 years, which research suggests is due to an increase in selective abortion of female fetuses.8 The government has so far failed to change or control the culture that prizes boys over girls and contributes to India having an estimated 11 million abortions per year. India’s ministry for Women and Child development reportedly wants to introduce fines and even prison terms for entire families who force a woman to abort a female fetus. And one state, Uttar Pradesh has introduced baby hatches where people can leave their unwanted baby girls.

Russia

Russia was the first country to legalise abortion in all circumstances and has the highest rate of abortion worldwide—54/1000 women aged 15-44 (compared with 24/1000 in China). Over the decades the policy has been changed, and recently it has been restricted by the government of Dmitri Medvedev, which has close ties with the Orthodox church and is facing a low birth rate and shrinking population. In October, parliament voted to limit the period for abortion to 12 weeks of gestation and up to 22 weeks in the case of rape.9 There is no time limit if there is a risk to the mother’s life. Abortion providers are now required to spend 10% of advertising costs on warning of the possible dangers to a woman’s health, and it is illegal to describe abortion as safe. The president’s wife has taken a leading role in anti-abortion campaigns alongside leaders of the Orthodox church.

United States

Abortion has always been a subject of heated debate across the US, but in the past decade there has been a frenzied tightening of restrictions in many states that were previously moderate. Overall, according to the Guttmacher Institute, there were 92 new provisions restricting abortion in 2011, compared with 34 in 2005.10 This year there have been at least 39 new restrictions. In 2000, around a third of American women of reproductive age lived in states that were hostile to abortion rights, a third in states that were supportive, and a third in states that stood somewhere in between. By 2011, over half of American women lived in states that were hostile. States found different ways to obstruct women’s access to the procedure including insisting women must first receive counselling against it, restricting public or private insurance coverage, and making it difficult for physicians to obtain supplies of mifepristone, the FDA approved treatment for medical abortions. Seven largely rural states banned telemedicine for abortion in 2011, meaning a doctor has to be with the patient when prescribing the treatment.

In 2010, Nebraska came up with a new argument for restricting the period in which abortion is permitted. The state ruled to ban abortion after 20 weeks on the basis that the fetus can feel pain at that stage. This theory is not backed up by established science,11 but seven other states (Alabama, Idaho, Indiana, Kansas, Oklahoma, Georgia, and Louisiana) followed with similar rulings. Arizona restricted abortions beyond 18 weeks in March this year using a similar argument.

Critics argue that these laws are unconstitutional because the landmark 1973 Supreme Court ruling in the case of Roe versus Wade held that states could restrict or ban abortion only after fetal viability. It is generally agreed that a fetus could survive outside the womb from 24 weeks at the earliest. Critics also argue that if the concern is for the fetus not to experience pain it would suffice to use anaesthetics. Latin America and Africa

In most of Latin America abortion is either totally banned (Nicaragua, El Salvador) or tightly restricted. Across Africa colonial laws make it legal in only a few situations—usually if a woman’s life is in danger or in the case of fetal abnormality or rape or incest. Social and religious disapproval also contributes to large numbers of women seeking clandestine abortion, which often leads to complications and deaths. WHO estimates that 5.5 million women in Africa have abortions every year, 99% of which are unsafe, and around 36 000 women die from the procedure.12 In Ethiopia, for example, unsafe abortions are thought to account for up to half of maternal deaths. Some 95% of abortions in Latin America are also unsafe.12

In both regions, a few countries have recently decided to relax their laws and make safe abortion services accessible on the basis that criminalising it causes unnecessary deaths. In Kenya, the constitution was changed in 2010 after years of debate over the need to relax the laws and increase provision of safe abortions. Argentina legalised abortion for raped women in March this year and Uruguay legalised abortion up to 12 weeks in October and is providing government funded abortion services. And since 2009, Ethiopia has piloted an apparently successful programme in which trained health workers in one region provide safe medical abortions with misoprostol.

Arab world

Unlike most Muslim countries, Tunisia legalised abortion in the 1970s. The only conditions are that it must be carried out by a qualified practitioner within the first three months of pregnancy. The country’s leaders repressed the population in many ways before the Arab Spring of 2011 but they liberated women by encouraging all sorts of birth control in a bid to control population growth. As a result, the country has the lowest birth rate in the region—2.0 births/1000 women, according to the World Bank’s latest figures.13 It remains to be seen whether the Arab Spring will lead to a relaxing of laws across the Arab world, where abortion is generally available only if a woman’s life is in danger. Data are patchy but according to the International Planned Parenthood Federation, in the five years up to 2000, there were 15 million unwanted pregnancies across the Arab world and over seven million abortions in the same period.14 Clandestine abortions seem to be common, and it is estimated that 5% of maternal deaths are due to unsafe abortions. Because of cultural disapproval, most campaign groups are focusing on promoting better awareness and availability of contraception rather than safe abortions.

Iran

Iran has a relatively low abortion rate compared with other countries, probably because its well educated population makes better use of contraception. But the country’s leaders have begun slashing family planning services and appealing for bigger families in a bid to boost the population. It’s not yet clear how much families are heeding the call to procreate, but the changing government position is likely to produce an increase in the numbers of abortions.


Competing interests: All authors have completed the unified competing interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare no support from any organisation for the submitted work; no financial relationships with any organisation that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Provenance and peer review: Commissioned; not externally peer reviewed.

References

1. Northern Ireland Health Ministry. Statistics on terminations of pregnancy. 
2. Department of Health. Numbers travelling to UK for abortions from the Republic of Ireland and Northern Ireland. Table 12a.  
3. Smyth L. Abortion clinic may exploit and break the law, claims opponent. Belfast Telegraph 2012 Oct 18.  
4. Houston M. Ireland looks at ways to bring its abortion law into line with European judgment. BMJ2012;345:e8165.
5. China has more than 13 million abortions a year. CNN 2009 Jul 30.
6. Guttmacher Institute. Facts on induced abortion worldwide. 
7. Chinese govt may seek end to late term forced abortions. LifeNews 2012 14 Sep.
8. Jha P, Kesler MA, Kumar R, Ram F, Ram U, Aleksandrowicz L, et al. Trends in selective abortions of girls in India: analysis of nationally representative birth histories from 1990 to 2005 and census data from 1991 to 2011. Lancet2011;377:1921-8. 
9. Kishkovsky S. Russia enacts law opposing abortion. New York Times 2011 Jul 15.
10. Benson Gold R, Nash E. Troubling trend: more states hostile to abortion rights as middle ground shrinks.
11. Colghan A. 24-week fetuses cannot feel pain. New Scientist 2010 Jun 25.
12. WHO. Unsafe abortions. 5th ed. 2005. 
13. World Bank. Fertility rate. 
14. International Planned Parenthood Federation. Abortion.

video abortion in Ireland

ought to add: in Russia teens abortions are even less than 1/10th
Source

Council tells Irish Government it must legislate for abortion

The [Irish] Government has been told it must take firm action to legislate for abortion.
It follows last year’s ruling by the European Court of Human Rights, and the Government has been told its actions will be closely supervised until it legislates.

The state has said it will set up an expert group to make recommendations, the third since the Supreme Court ruled on the matter almost two decades ago following the X case.
Ministers representing the 47 countries of the Strasbourg-based Council of Europe, which administers the court, last week reviewed this move by the Government.

The council "underlined the importance of putting in place substantive measures to execute the judgment".

It also invited the Irish authorities to keep it "informed in relation to the steps taken under the timetable set out in the action plan".

The state will be under the court’s enhanced supervision process, which is applied to judgments raising the most serious problems identified by the court and the committee of ministers.

Mark Kelly, the head of the Irish Council of Civil Liberties, welcomed the move. "The mere creation of an ‘expert group’ to look into the matter is not a substantive measure to implement this legally-binding judgment by Europe’s top court. We welcome this clear signal that the committee of ministers will take a firm line on the need for abortion law reform in Ireland."

Niall Behan, head of the Irish Family Planning Association, welcomed what he described as a very strong message to the Government that it can no longer ignore the imperative to legislate for abortion in certain circumstances.

Source: Ann Cahill, Irish Examiner, 20 September 2011

Ireland:State response to European court abortion ruling

The setting up of an expert group to address the implications of an European court ruling on a woman’s right to an abortion in Ireland when her life is at risk is a “wholly inappropriate” response, according to the Irish Family Planning Association.

The European Court of Human Rights ruled last year that the State had violated the human rights of a woman – known as C – because there was no “effective or accessible procedure” open to her to establish her right to a lawful abortion in Ireland. Members of the Council of Europe’s committee of ministers from 47 member states are meeting this week to examine the Government’s measures to implement the court’s ruling. All court judgments are binding on the member state. The Irish Family Planning Association (IFPA) said yesterday the Government’s plan to set up an expert group ignored the central concerns of the court. “The court has already criticised the State for failing to act on recommendations of the three previous government committees that have already considered Ireland’s regulation of abortion,” chief executive of the association Niall Behan said. “The IFPA hopes that the committee of Ministers will . . . request a revised action plan with a concrete commitment to enact legislation to implement the ruling of the court and give legal clarity to women and their doctors on the circumstances in which abortion is lawfully available within the State,” he added. The Irish Council for Civil Liberties also criticised as inadequate plans to establish an expert group which would make recommendations to the Government. In a formal submission to the meeting, it pointed to what it said were shortcomings in the scope, extent and efficiency of the Government’s proposals. Its director Mark Kelly said: “We trust that the committee of Ministers will require the Irish authorities to submit a revised action plan, clearly indicating the precise steps that will be taken to speedily implement this legally binding judgment by Europe’s top court.”

In a case brought in 2009, three women – A, B and C – held that they were subject to indignity, stigmatisation and ill-health as a result of being forced to travel abroad for abortions. The court found the State had violated the rights of C, who had a rare form of cancer and who was forced to travel abroad for an abortion after she became pregnant unintentionally.

 Source: Irish Times, 16 September 2011