Northern Ireland Is Proof of How F*cked Abortion Access in the UK Really Is

feature image of First Minister Nicola Sturgeon via Shutterstock

I’ll be blunt: the UK’s abortion laws are a disaster, and nowhere worse than in Northern Ireland. Internationally, people generally know that the Republic of Ireland’s abortion laws are terrible, but for the most part their neighbours to the North and West are overlooked. If people don’t forget that the North is still a part of the UK rather than the Republic (which, considering the history involved, is a bizarrely common mistake) they assume that everything is fine. After all, in the United Kingdom abortion is free on the NHS and available up to twenty four weeks — which is around when people stop listening and fail to notice the small print.

The Abortion Act 1967 on medical termination of pregnancy:

(1) Subject to the provisions of this section, a person shall not be guilty of an offence under the law relating to abortion when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith—
[F1(a) that the pregnancy has not exceeded its twenty-fourth week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family; or
(b) that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman; or
(c) that the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated; or
(d) that there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.]

Technically, abortion in the UK is actually illegal, with certain medical exemptions. To access abortion on the mainland then you need to convince not one, but two – two! – doctors that you need one. That you really need one. And only with the consent of those two doctors can you move forward and access one. The penalty for accessing abortion outside of those channels is up to life imprisonment. I wish I was joking.

I can’t speak firsthand as to how difficult getting an abortion is in practise, but it seems to vary wildly by doctor and by region. Some doctors have actively obstructed patients access to abortion care for any number of reasons ranging from personal religious belief to apparent ignorance of the law itself to petty moralising. There are also doctors who find this entire thing farcical and consider any person asking for an abortion to be at risk of psychological injury if forced to continue the pregnancy, granting abortions to anyone who applies within the legal limits. Some doctors have even got into legal trouble for pre-signing forms to speed up the process, making it very clear that the law is about forcing women to jump through hoops to access reproductive healthcare and not about anything else. (Incidentally if you too find this obscene and would like to change it there’s a campaign you can involve yourself in here).

But all of this is irrelevant if you live in Northern Ireland, because the 1967 Abortion Act doesn’t apply there. Instead, their devolved parliament chose to keep in place the literal Victorian legislation that predated it, with small updates permitting abortion in cases where the mother’s life was in imminent danger and the fetus not yet viable. More recently, the law has again been updated to allow for abortion in cases where giving birth will cause both serious and long term or permanent harm to the gestational parent. But even if you meet the criteria, you still have to realise that you’re pregnant and navigate your way through the system before you make it to nine weeks, and good luck finding a doctor willing to help you out with that. Northern Ireland is small and extremely religious, and running an abortion clinic there is really quite a lot like doing the same thing in Texas.

So while abortion isn’t technically entirely illegal in Northern Ireland, it may as well be. The unwillingly pregnant have resorted to ordering the abortion pill online and carrying out DIY abortions at home, something which is obviously dangerous and also exactly what every pro-choice organisation told us would happen. So far no one’s been handed that potential life sentence, but prosecutions are still going ahead for patients who get caught.

Of course, because there’s always one rule for the rich and another for everyone else, there is a loophole available for anyone with the money to do it. It’s illegal to procure an abortion outside of official channels while in Northern Ireland, but there’s no law stopping pregnant people from leaving the country and getting one elsewhere. Dozens of Irish women from both sides of the border come to England every year for abortion care. In addition to the time off work and the travel and accommodation costs they also have to pay for the abortion out of pocket, because despite being National Insurance paying citizens the Northern Irish women still aren’t entitled to NHS abortion care on the mainland.

Except maybe not for much longer. Scotland’s First Minister and her cabinet have a history of progressive policies — from trialling basic income to protecting the rights of our unemployed and disabled citizens — and now they’ve turned their attention to the plight of Northern Ireland’s abortion patients. Last week a member of the Green party raised the issue in parliament and, though it was something of a politician’s answer, Nicola Sturgeon’s response was promising:

“I am happy to explore with the NHS what the situation is now in terms of the ability of women from Northern Ireland to access safe and legal abortion in NHS Scotland and whether any improvements can be made.

Like Patrick Harvie, I believe that women should have the right to choose, within the limits that are currently set down in law, and that that right should be defended. When a woman opts to have an abortion – I stress that that is never, ever an easy decision for any woman – the procedure should be available in a safe and legal way”

“I certainly agree that no woman should ever be stigmatised for having an abortion. No woman ever wants to have an abortion; there will be a variety of circumstances in which a woman finds herself in that position, and I absolutely agree that safe abortion is of paramount importance. I also agree that abortion should never be seen in isolation—it is a part of healthcare, and delivering abortion safely is a fundamental part of healthcare.”

This isn’t a guarantee of anything, of course, and even if she does come through and open NHS abortions to Northern Irish patients they’ll still have to find the money to come over here and find ways to explain their sudden absence to family and employers. It’s also disappointing that she’s defending the current laws as they stand and pushing the line that abortion should be, is always, an inherently difficult choice. But to make the sort of changes she’s being asked to make often requires that sort of appeasing language, at least at first, whether or not it’s in line with her own beliefs. Importantly, whether or not this leads directly to expanding abortion services for patients in Northern Ireland, it’s reopened the conversation around abortion rights and services and may provide a launching point for us to push for reform.