Let’s talk about…The abortion review

Abortion review highlights major issues in current system

 Back in 2018, the Irish people voted in favour of repealing the eighth amendment, a major victory for reproductive rights that saw our population being granted access to safe, legal services for the first time in this country’s history.

In 2018, I was still shy of the voting age and so wasn’t able to participate in the referendum, but that’s not to say it was a topic I wasn’t aware of or didn’t have an opinion on at the time. In fact, I don’t think it would’ve been possible to avoid being made aware of the entire debate and eventually forming some sort of opinion on it; discussions on the topic permeated the news cycle for months and months in the lead-up to the referendum. I held the same opinion then as I do now – that everyone has a fundamental right to bodily autonomy, and this includes the right to access safe, legal abortion services.

When it was announced, I welcomed the repeal result with a degree of relief; prior to the referendum, I was still apprehensive about which way the vote would go. I worried our country’s reputation for (and indeed long and fraught history with) failing those dealing with unwanted pregnancies could tip the vote in favour of keeping reproductive rights restricted. Fortunately however, this was not the case.

Five years on, and you might think that the topic would’ve faded from public consciousness, and that by now, Ireland would have established a fairly smooth system for abortion provision, in line with what the Irish people voted for. Yet this, it seems, is far from reality.

In the last couple of weeks in particular, the topic has been back in the public consciousness off the back of a recent review into Ireland’s abortion system. The findings of the review, which were discussed by the Cabinet on Tuesday, reveal that there is uneven geographical coverage when it comes to abortion access, many patients are experiencing delays and obstruction, most GPs are not performing abortion care, and conscientious objection guidelines are being abused “with impunity”. The review also calls for the three-day waiting period to no longer be mandatory, and for the criminal sanction to be removed from healthcare workers providing abortion services.

The waiting period recommendation in particular is one of the more contentious issues in the review. Currently, it is a statutory requirement that three days must elapse after a patient’s first consultation before informed consent to access a termination can be given, with a mandatory obligation on the GP to inform the patient they’re entitled to a reflection period. The review recommends this wait be made voluntary – and I can see why.

The wait period directly and unfairly limits abortion access in many cases – for example, those who only realise they’re pregnant later in the first trimester, or who are seeking services at a later stage in their pregnancy following a previous failed termination. It also doesn’t account for how uneven geographical coverage and people’s local healthcare providers not performing abortions – both things that were identified as significant problems in the review – raises practical obstacles to care.

But even if you sidestep how the mandatory waiting period unfairly restricts access to certain people, I feel there still remains an issue. The sheer existence of a mandatory three-day wait to access a termination feels, frankly, infantilising. I do not doubt that for many people, taking time after a consultation to go through their options is the right choice for them. For some people, they may be unsure whether ending or continuing their pregnancy is the best option, and they would benefit from a period of reflection. But I think it is ludicrous to suggest that everyone is unsure, that everyone requires that period, or that no one could be certain about not wanting to endure a pregnancy before going into the consultation. And to insist on a waiting period for everyone is to suggest just that.

The waiting period is unnecessarily infantilising at best, and an obstacle to people’s right to termination at worst. It also seems to exist as mandatory just to placate those on the fence about abortion provision – take Fine Gael’s comments about being reluctant to remove the wait because in their Yes campaign, they gave constituents a commitment that there would be safeguards in place, and they feel the wait’s removal would be “reneging” on that commitment. To them, the waiting period is a bargaining chip to keep the faith of 2018’s on-the-fence voters, but to too many unexpectedly pregnant people, it could be the very thing that stops them from accessing the care they should be entitled to.

But even if it is rectified, the three-day waiting period is but one of many examples of the systemic obstacles to abortion access. If the recent review is anything to go by, it’s clear that in order to adequately accommodate and provide care to everyone in need, a number of legislative and operational changes need to be made.

Hopefully the review’s findings have been able to shed some light on the failings in the current system, and maybe the review itself could be the catalyst we need to see these failings addressed. It’s been five years since our country voted to make abortion safely, legally, and practically accessible to everyone – it’s unacceptable that with the current system, this still isn’t the case.