Women in Northern Ireland still being denied abortions due to lack of services - despite law change

Abortion was decriminalised in Northern Ireland in 2020 but women still don’t have access to comprehensive, state-run support

Pro-choice supporters gathered at Stormont in Belfast in October 2019, as the liberalisation of abortion laws came into force. The commissioning of abortion services has been sporadic and strained since the decriminalisation. (Picture: Getty Images)

The BBC’s compelling drama, Three Families, outlined the issues that were faced by women and girls in Northern Ireland (NI) prior to abortion being decriminalised in 2020.

The drama was based on the true stories of three women living in Northern Ireland, whose lives were altered by the country’s strict abortion laws.

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While in theory, a new legal framework for abortion services that took effect from 31 March 2020 was a meaningful step towards greater choice for women, in practice women are still unable to access state-funded services.

Amnesty UK has highlighted how hundreds of women have continued to travel to other parts of the UK to have abortions during the Covid pandemic, despite pregnancy terminations now being legal in Northern Ireland.

The current law allows women to have an abortion up until 12 weeks gestation, with no time limit if there is a case of fatal foetal abnormality.

‘A breach of human rights’

According to Amnesty UK, the Northern Ireland health minister refuses to fund termination clinics and resources, citing a lack of support from the Northern Irish Executive as the reason for this.

Given that abortion is now legal in Northern Ireland, Amnesty UK argues that not providing sufficient services is a “breach of human rights”.

Patrick Corrigan, Amnesty International Northern Ireland Director said: “Abortion has now been granted as a woman’s right, therefore they should have access to the abortion services.”

Amnesty UK is calling on the UK’s Secretary of State for Northern Ireland, Brandon Lewis, to use powers granted to him in March 2021 to overrule the NI Health department, and commission funding for abortion clinics.

Upon receiving the powers, Mr Lewis said the UK Government had “used every opportunity and avenue to encourage progress,” adding, “Our strong preference remains for the Northern Ireland Executive to take responsibility itself for upholding these rights.”

He said: "It has always been our expectation and preference that the Department of Health would drive forward the commissioning of abortion services.”

‘Shameful denial of healthcare’

Mr Corrigan of Amnesty International, told NationalWorld the charity is urging the UK government to call time on attempting to concede with the NI government, and press on.

He said: “Last month, parliament voted to give him [Mr Lewis] the power to commission these services directly, over the head of the local health minister. He should do so without further delay and bring this shameful denial of healthcare to an end.”

On the other hand, NI Health Minister Robin Swann insists he needs the support of the NI Executive to progress with funding abortion services, a stance which has been contested by pro-choice ministers, Amnesty UK, and other pro-choice charities, as well as the NI Human Rights commission.

Mr Swann told the NI Assembly on 22 March that he tabled proposals around the commissioning of services in April and May last year and followed these up with a letter in November, adding: “As the Executive has not agreed to this proposal, no further work has been taken forward by my department.”

The support of the executive would require approval from the DUP and Sinn Fein, which Mr Swann knows is unlikely.

In response to Mr Swann’s comments, the DUP’s Pam Cameron said: “The DUP is a pro-life party focused on saving lives, not on taking them.”

And so while women in Northern Ireland can no longer be criminalised for accessing termination services, they still aren’t offered the comprehensive, state-run support that they need.

‘Postcode lottery of services’

Furthermore, the Northern Ireland Department of Health’s failure to commission services means that health trusts have been left to absorb the costs and resource abortion care themselves, whilst battling through a pandemic.

The support and resources these trusts can offer is volatile, underfunded and women have often only been offered medication to initiate an abortion up until 10 weeks gestation.

Because of the pressure they have been under, three of just five health trusts in Northern Ireland have temporarily suspended services.

Western Health and Social Care Trust’s services collapsed due to pressure on resources and, with no referral services to allow women to go elsewhere, many women and girls had to approach charities for help or travel to England for abortions.

Amnesty has repeatedly called on the NI Health Department to commission services to ensure they are sustainable and accessible, but to date the Department has failed, the charity says.

Mr Corrigan said: “The Minister has created a postcode lottery for healthcare by forcing women to travel in the midst of a pandemic. At the very time when the government has been telling people not to travel. This is nothing less than a scandal.

“Abortion is legal and women must not be refused this service. The Secretary of State Brandon Lewis must now intervene to commission these services for those who need this healthcare.”

And the charity isn’t the only organisation calling for change.

The Northern Ireland Human Rights Commission has taken legal action against the Secretary of State, NI Health Department and NI Executive, and will take them to court for failing to commission and fund abortion services in Northern Ireland.

Amnesty UK argues that Mr Swann has been given 15 months to use his own powers, to no avail. Meanwhile, hundreds of women and girls have travelled miles to London or Liverpool, to terminate their pregnancies.

The UK government has attempted to soften the blow by reimbursing the travel expenses, but Amnesty UK argues that travel should not be necessary in the first place as women in Northern Ireland should have access to proper support in their home communities.

When asked for a response to Amnesty’s claims, a spokesperson for the NI Department for Health told NationalWorld: “The Department is not required to commission the relevant services, however the Department has advised Trusts that the Regulations require such terminations to be carried out on Health and Social Care premises.

“In relation to the full commissioning of abortion services, the Department of Health is finalising an updated paper for consideration by the Executive.

“Under the Ministerial Code any matter which is significant or controversial and clearly outside the scope of the Programme for Government must be brought to the Executive for consideration and agreement.

“It is not possible at present to give a timescale for the introduction of a fully commissioned abortion service. The Regulations allow access to abortions up to 12 weeks gestation without conditionality. Abortions beyond 12 weeks gestation are lawful in specified instances, including when severe fetal impairment and fatal fetal abnormalities are detected.”

The department stated there is access to “early medical abortion services” in Northern Ireland, with the exception of Western Trust which paused its EMA service on 23 April 2021.

The spokesperson added: “We are advised by the Western HSC Trust that this is a temporary pause and that efforts are ongoing to restore provision as soon as possible and with minimum disruption.”

Therefore, the health department acknowledges that women should have access to comprehensive services, while failing to commission these or recognise that the sparse services in place only partially meet the legal requirements.

Commenting on the lack of support available, Mr Corrigan said: “The repeated collapse of abortion services in parts of Northern Ireland is a direct consequence of the Health Minister’s failure to commission and fund these health services.

“[Northern Ireland] is a progressive, predominantly pro-choice country, Yet women are being left with very little choice.

“For those without services in their area, either they travel for an abortion or carry their pregnancy to full term. This is the reality women continue to face in Northern Ireland.”

The UK Secretary for NI has been approached for comment.