Abortion and the referendum in Ireland  Siobhán Silke, Communications Officer, IFPA For me the most important aspect of the campaign was the storytelling. There was a time in the very recent past where you could count on one hand the number of women in Ireland who had publicly told their stories of abortion. In 2000, the Irish Family Planning Association published a book called The Irish Journey which was a collection of personal stories gathered from clients of our counselling service telling stories of their journeys, but it was still anonymous. Then a few years ago, members of Terminations for Medical Reasons - a campaign group involving women and couples who had diagnoses of a fatal fetal anomaly and had been forced to travel elsewhere for terminations - went on Irish TV with their faces showing, with their real names and told their stories. That emboldened and gave courage to others with different tales to come forward too. So, by 2018, there was a flood of women telling their stories. And it was it was really one of the most important parts of the campaign. I would say that no woman owes anybody her story. But their bravery was just incredible. Part of my job during the campaign was supporting the women and ensuring that they had a level of protection. I was conscious they had to tell their own story directly, so they’re not filtered. But it it's a delicate thing, because you're asking somebody who is already vulnerable put themselves in a position that could potentially make them more so. I would certainly say when a woman has told her story three or four times to three or four different journalists, that’s enough and it’s time to find someone else. It is also important as a campaigner to have good relationships with journalists. Be ready to respond. Because the other side always will be.

Abortion and the referendum in Ireland  Ivana Bacik, Labour Party Senator, Dublin My personal reproductive rights journey began when I was President of the Student Union at Trinity College, Dublin in 1989 and I was threatened with prison. A pro-life group called The Society for the Protection of the Unborn Child (SPUC) started to take legal cases against student’s unions and women's counselling centres to stop us from providing phone numbers and addresses of abortion clinics in England. Irish women had been travelling in large numbers to England over many years since abortion was legalized in England in 1967, so student unions helped them by providing information. In 1983 the people voted for the eighth amendment, a text inserted into the Irish constitution to guarantee the unborn an equal right to life to that of the mother. There was nothing in the eighth amendment about information, but it was used by SPUC. They won a legal case that if you give information to a woman in crisis pregnancy that might enable her to access abortion, therefore that's endangering the life of the unborn and therefore it's in breach of the Constitution. It was a big legal jump of interpretation to suggest that the eighth amendment should stop women from accessing information but that's what happened. The Students Union was taken to court and we were threatened with prison just for giving out information to women in crisis pregnancy. Our case generated huge outcry. We didn't get sent to jail because our legal counsel Mary Robinson (who went on to be first female President of Ireland) made a series of very important arguments based on European law and our case was sent to the European Court of Justice in Luxembourg. After that there was a series of referenda in 1992, and one of those guaranteed freedom of information. Since 1992 women can be given information on where to access abortion but it's subject to certain restrictions. For example, doctors and counsellors cannot refer a woman to a clinic in England. They can only give the information and she must make the appointment herself. This created more obstacles for women. It was particularly difficult for women with diagnoses of fatal fetal abnormality, where they're in a hospital in Ireland and yet their doctors can't refer them to a doctor in England to terminate their pregnancy. They can only just give them the phone number.

Abortion and the referendum in Ireland Niall Behan, Chief Executive, IFPA   The Irish Family Planning Association has a long track record of opposing restrictions on abortion in Ireland. It felt risky when we first started calling ourselves a pro-choice organization in a country where abortion was criminalized. But our view is good reproductive health services and rights for women must include abortion care. It’s a human rights approach. We knew the harmful impact the law had on women. We looked at what the best medical practice is. We had our own analysis and evidence based on what women told us in counselling. And then we applied that analysis to the abortion situation, and we felt that we had to go on the offensive and push back because we felt if we didn’t do it no one else would. We knew that to bring about that change we needed to have a mass movement. We needed to get a whole range of other civil society organizations involved, but that proved very difficult to do. We looked at the instruments we could use to push the argument forward - Human Rights Institutions such as the UN and European Court of Human Rights. We started making submissions to them. We were very conscious that women's voices were important, so we made them central to our litigation. Abortion was stigmatized and only a handful of women had ever spoken about their abortion experiences in Ireland. And there were very strong well-funded anti-choice groups who picketed clinics, targeted people or politicians who spoke out. They had a very strong voice within the mainstream media. As an organization we had a reputation as the voice of reason and that formed our communications strategy. We needed to start talking about the harms that Ireland’s abortion laws were having on women.  

When the exit polls late on 25 May predicted a massive landslide victory for the Yes campaign to repeal the 8th amendment of the Irish constitution, activists and campaigners barely dared to hope. But when the counting began the following morning, and Yes votes started trickling in from constituencies all over the country, it quickly became clear that a seismic change in public opinion on abortion had taken place. Young and old, female and male, urban and rural – the Irish people had decided that compassion and care must be the values governing women’s reproductive health and rights – replacing the decades-long Roman Catholic stranglehold characterized by coercion and abuse of women. With the 8th amendment now repealed, Ireland’s Prime Minister Leo Varadkar has committed to delivering legislation which legalizes abortion care on a woman’s own indication in the first trimester of pregnancy before the end of this year, bringing it in line with the majority of European countries. Women’s lives will be changed for the better, and as an Irishwoman I have never been so proud of my country. But the Yes vote has repercussions outside of Ireland, bringing into even sharper focus Europe’s outliers – those remaining countries that still refuse to end forced pregnancy, restricting access to safe and legal abortion care to the extent that it is virtually inaccessible to most women. In Northern Ireland, women and girls are denied abortion care even if they’ve been raped, been a victim of incest, or had a diagnosis of fetal abnormality. As the celebrations kicked off in Ireland this weekend, UK campaigners rightly stepped up their calls on the government and the Northern Ireland executive to recognize that this is no longer tenable and follow Ireland’s lead in placing compassion at the heart of women’s health care. In Poland, the legislation on abortion care is among the most restrictive in Europe. The Polish government has been making constant, fanatical efforts to further limit access in order to coerce women into moving through pregnancies against their will. We hope that the Irish example sends a strong signal to the Polish authorities that people’s care and compassion will triumph over absolutism and bullying. Just two weeks ago, Malta was reconfirmed and feted as Europe’s top champion of rights for LGBTI people. And yet it refuses to allow abortion care, even if the life of the pregnant woman is at stake, abandoning couples and families to fend for themselves when faced with a crisis pregnancy. It is hard to imagine a more selective application of compassionate values, and a more incoherent approach to the upholding of human rights. In the light of Ireland’s vote, the Maltese position looks even less credible, its inhumanity starker. And while Italy has required abortion care to be available to all women since it was legalized in 1978, the reality in 2018 is that widespread and growing denial of care by many doctors and other medical professionals (over 90% of gynecologists refuse to provide abortion care in some Italian regions) means that unsafe and illegal abortions are on the rise, with sometimes lethal consequences. This cruel and degrading treatment of the country’s women and girls is perpetrated on spurious grounds of individual conscience – a tactic that we see used systematically in countries around the world that do not believe in free and safe reproductive lives. The Italian government is complicit in its failure to act. These are some of the battles ahead, in a Europe where retrograde conservative forces work with right-wing governments to deny women control over their own bodies. Grassroots campaigners, NGOs and individual citizens will be buoyed by Ireland’s historic shift. There could be no clearer signal that Europeans are aligned in supporting abortion care based on the values of gender equality and solidarity. The EU institutions should be emboldened to take concrete actions to defend reproductive freedom in Europe. In this moment of optimism, we dare to hope that such an unequivocal triumph of compassion over coercion will bring us closer to making abortion care safe, legal and accessible for all women, everywhere. By Caroline Hickson, IPPF EN Regional Director This blog was originally published by Euractiv: Ireland’s Yes vote ushers in a new era for women’s rights in Europe

IPPF is overjoyed at the Irish people’s decision to remove the harmful ‘8th Amendment’ from Ireland’s constitution with today’s referendum result. IPPF’s Director General, Dr Alvaro Bermejo, said: “We wholeheartedly welcome this vote for change, which makes it possible for the Irish Parliament to legalise abortion care on a woman’s own indication in the first trimester of pregnancy, in line with the many other countries around the world which ensure women can access safe and legal abortion care when they need it.” Caroline Hickson, IPPF’s European Network Regional Director, said: “As an Irishwoman I know the 8th Amendment has harmed countless women physically, emotionally and psychologically for more than 30 years. The vote to remove it paves the way for a more compassionate and caring environment for women in Ireland. They will no longer be forced to access abortion outside the state or resort to unsafe and unregulated use of abortion pills obtained online and outside the law. Instead, women and girls who experience crisis pregnancies will be able to make personal, private decisions about their health care with the support of their doctors and loved ones. They will be able to receive proper care, in their country, when they are at their most vulnerable.” Dr Alvaro Bermejo added: “Ireland’s decision sends a signal around Europe and the world that people’s care and compassion can triumph over absolutism and coercion. We hope that it also gives courage to women and all those who support their fight against reproductive coercion in so many other places, and to all those countries where the Global Gag Rule is having devastating impact on access to sexual and reproductive health care. For all women everywhere, it’s time to end forced full pregnancy and make abortion care safe, legal and accessible. Today Ireland has shown us that positive change is possible.”

By Alison Spillane, Irish Family Planning Association. Ireland has taken important steps in recent years in the fight to end female genital mutilation (FGM). At the domestic level, the Criminal Justice (Female Genital Mutilation) Act was introduced in 2012 to prohibit FGM and, as part of its Overseas Development Assistance, Ireland has contributed towards the UNFPA-UNICEF Joint Programme on FGM, which is the largest global initiative to accelerate the elimination of FGM. Since 2014, the Irish Family Planning Association (IFPA) has provided comprehensive medical and psychological care to women and girls in Ireland who have experienced FGM. The FGM Treatment Service is publicly funded which enables the IFPA to provide care to affected women and girls free of charge. Although the practice is mostly concentrated in Africa and the Middle East, the phenomenon of global migration means women and girls affected by FGM live across the globe, including in Western Europe. It is estimated that more than 5,000 women and girls living in Ireland have experienced FGM. IFPA Medical Director Caitriona Henchion says, “FGM is recognised internationally as a violation of the human rights of women and girls. It causes harm and has no health benefits. In fact, it can result in short- and long-term health complications, such as pain, infection, menstrual problems, urinary tract problems and sexual difficulties.” The IFPA engages in outreach activities to promote awareness of the FGM Treatment Service amongst those who have experienced FGM. Dr Henchion explains, “A key challenge for us as a healthcare provider is raising awareness about this free service amongst affected communities. FGM can be difficult for women to talk about – it’s a very stigmatised topic. We want women to know our staff provide completely confidential, non-judgmental care. Our doors are open.” In our outreach work, the IFPA frames FGM as one of a range of sexual and reproductive healthcare issues impacting ethnic minority women and we provide information about cervical and breast screening, contraception, menopause and screening for sexually transmitted infections (STIs) alongside information about the FGM Treatment Service. This is in recognition of the fact that the issue of FGM is part of a wider set of issues in healthcare provision for women from minority ethnic backgrounds, particularly asylum seekers and refugees. The IFPA also educates frontline service providers, such as healthcare professionals, about FGM and its harms. Dr Henchion says, “FGM is not yet fully integrated into medical education in Ireland. As a result, healthcare providers may not understand what FGM is or how many women and girls are affected globally. We want to equip them with the knowledge to recognise FGM and refer women to existing services if needed.” While the provision of financial support for the FGM Treatment Service is an important aspect of efforts to address FGM, the State must take more ownership over the issue in order to effectively combat FGM. Legislation alone is insufficient to ensure the abandonment of the practice. The IFPA believes a government-led interagency committee, with representation from key government departments and other state and non-governmental bodies, is required to comprehensively tackle FGM. Such a committee could take responsibility for the development of a national action plan across the key areas of prevention, protection, provision (for women and girls who have experienced FGM) prosecution and promotion (of efforts to eradicate FGM).  *** Read more about the work of IPPF Member Associations supporting survivors of FGM.

Today marks the fourth anniversary of the senseless death of Savita Halappanavar, who died at Galway University Clinic in Ireland after she was denied a life-saving abortion during her miscarriage. Although she begged doctors to terminate her pregnancy, the hospital refused, citing Ireland’s restrictive abortion laws, under which doctors can be prevented from making clinical decisions in the best interests of pregnant women’s health. Savita died of septicaemia a week after she was admitted to hospital at just 31-years of age. The flagrant disregard for Savita’s life and health is indicative of a society where rights of pregnant women are violated on a daily basis. Tragically, just 12 days before the anniversary of Savita’s death, a similar case was reported, this time in Italy. Valentina Milluzzo was 19 weeks pregnant with twins when she was hospitalised in Sicily after one of the foetuses became distressed. She was told that the doctor, a conscientious objector, would not operate while there was a foetal heartbeat. Valentina miscarried both foetuses before she died of septicaemia on October 16, 2016. She was 32-years old. What is especially outrageous about this case is that abortion is legal in Italy, yet health care providers continually side-step the law by invoking the “conscience clause”, even though objecting doctors are not legally permitted to deny care when the life of a pregnant woman is in danger, under any circumstances. Restrictions on access to abortion, wherever they exist, do not reduce the need for abortion. Women either suffer harm to their health or where possible they seek services outside of their own healthcare system. This is costly, delays access and creates social inequities – and it is likely to increase the number of women seeking illegal and unsafe abortions. Since 1980, at least 167,000 women and girls have travelled from Ireland to access abortion services in another country; with around 10 women travelling each day from Ireland to the UK. Irish abortion laws are so extreme that if a woman is pregnant with a foetus that is unlikely to survive birth, she must still carry that pregnancy to term or travel to another State for a termination. In June of this year, the U.N. Human Rights Committee called for reform of Irish abortion laws after it found that a woman carrying a foetus with a fatal abnormality was subjected to discrimination and cruel, inhuman or degrading treatment due to Ireland’s abortion laws. The lessons from Italy and Ireland must be that access to abortion care is vital for women.

In 1983, religious conservative groups, fearing the Irish Supreme Court might infer a right to abortion into the Constitutional right to privacy, managed to insert an amendment in the Irish Constitution. This amendment equates the right to life of a woman with the right to life of the “unborn”. This amendment has caused untold damage to the health and well-being of women and girls in Ireland. It has also led to a succession of court cases and consistent condemnation from international human rights monitoring bodies. The amendment was intended to prevent abortion. It hasn’t achieved this aim. Instead it has forced thousands of women and girls to seek abortion services in another countries. Since 1983, at least 150,000 women and girls from Ireland have made that journey. Many others have been unable to travel due to a lack of resources. Almost immediately after its insertion, the amendment caused a legal battle over the right to receive information about abortion services in the UK. Newspapers carrying advertisements for UK abortion clinics were stopped at Dublin airport. Services providing abortion information were closed down. Legal challenges were brought to Irish courts, the European Court of Human Rights and the European Court of Justice.   Then in 1992, a 14 year old rape victim, known as X, was denied the right to travel to the UK for an abortion. This decision was overturned by the Supreme Court, which ruled that abortion is allowed if there is a real and substantial risk to a woman’s life including from a threat of suicide. Referenda on the right to receive information on and travel for abortion services in another country followed, both of which were passed with significant majorities. A third referendum to remove suicide risk as a ground for abortion, which was put to the people for a second time in 2002, was defeated. Despite the Supreme Court’s ruling in the X case, no legislation was enacted to implement its judgment. The following years saw more court cases against the State by girls and women in extremely vulnerable situations who were denied access to abortion services. In the 1997 Miss C case, the High Court ruled that Miss C, a 13 year old rape victim, was entitled to an abortion in Ireland. In the 2007 Miss D case, the High Court ruled that a 17 year old girl in the care of the State with an anencephalic pregnancy, who was refused permission to travel to the UK for an abortion, had a right to travel. Other women took their case to Europe. In 2010, in the case of A, B and C v Ireland, the European Court of Human Rights unanimously ruled that Ireland's failure to implement the existing constitutional right to abortion when a woman's life is at risk violated rights under the European Convention on Human Rights. All seventeen judges acknowledged that travelling for an abortion constituted a significant psychological, physical and financial burden. The Court was also clear that its door is open for another challenge to Irish abortion law, particularly in a case where a woman was unable to travel for abortion services. Following this ruling, the Protection of Life During Pregnancy Act 2013 was enacted to regulate the existing right to abortion when a woman’s life is at risk. However the Act poses new legal barriers to accessing an abortion even in such situations, particularly for women with mental health problems. The Act has also done nothing to diminish continued criticism from international human rights bodies. Only last July, the UN Human Rights Committee strongly criticised the discriminatory and harmful impact of Irish abortion law during its fourth periodic review of Ireland. Chair of the UN Human Rights Committee and former Special Rapporteur on Torture Nigel Rodley described women in Ireland raped and denied an abortion as being "treated as vessels and nothing more”, highlighting that “recognition of the primary right to life of the woman, an existent human being” has to prevail over prenatal life. The amendment inserted into the Irish Constitution in 1983 has led to the enactment of bad laws and the violation of human rights. It stands in the way of women and girls exercising their considered and conscientious choices about their pregnancy. It also stands in the way of service providers like the Irish Family Planning Association by limiting what support we can give to women seeking abortion services. But bad law can be changed. Irish opinion polls have consistently shown increased support for access to abortion. Only in September, a poll in the Sunday Independent newspaper showed that, of those who expressed an opinion, over 75% of people were in favour of holding a referendum to repeal the constitutional amendment on abortion. Despite the wishes of its own people and the condemnation of almost every human rights institution, the Irish State has continued to defend this shambles - a shambles entirely of its own making.   Denise Ryan is Communications Officer of the Irish Family Planning Association www.ifpa.ie