Why 12 weeks? (And other things you need to know)

With the referendum fast approaching, the race to win over undecided voters has intensified. In order to secure enough Yes votes, we need to ensure facts triumph over fiction. So here's a comprehensive guide to everything you need to know ahead of May 25th. 

What are we being asked?

The question on the ballot paper is a wordy one, (you can read the wording of the present article and proposed one here) but in its essence, you're being asked whether you want the Eighth Amendment - which places the life of the mother, equal to that of the foetus - to be removed from the Constitution. 

If you vote yes: There will still be abortion laws in Ireland, but they will be decided upon and regulated by the Oireachtas, rather than enshrined in the Constitution. 

If you vote no: Nothing will change. Abortion will still be illegal in most cases in Ireland. 

How will abortions work in Ireland if the Eighth is removed?

The policy paper on the proposed legislation can be found here and the general scheme (a more detailed version) can be found here

  • It recommends making abortion legal, without restrictions as to reason up to 12 weeks. Those who seek abortion will have a time period after their initial consultation to make a final decision. 
  • After 12 weeks, abortions will only be carried out on the grounds of a serious risk to the health or the life of the mother.
  • In cases of a foetal condition likely to lead to death before or shortly after birth, a termination can be carried out upon the assessment of two doctors.
  • After the point of viability (when the foetus could survive outside the womb - currently about 24 weeks) abortion will be illegal. In the case of a risk to the health or the life of the mother, the baby will be delivered, and treated by neonatal doctors. 
  • Medical and nursing staff will be permitted the right to conscientious objection - meaning they won't have to carry out terminations if they don't want to.  

Why 12 weeks?

The 12-week limit was recommended by the Joint Oireachtas Committee and the Citizens’ Assembly after hearing legal and medical experts from both sides of the abortion debate over the course of several months. You can read them here.

One of the main arguments made in favour of the 12 week limit, was the growing use of abortion pills in early pregnancy. Around 2,000 women* in Ireland ordered pills online in 2016. They took them at home without any medical supervision and put themselves at risk of prosecution.

Speaking about why he decided to support the 12 week limit, Committee member Billy Kelleher said: “It became clear abortions are happening in houses across the country and that we, as legislators, are turning a blind eye to this reality.”

A 12 week limit would also bring Ireland in line with European norms. Italy, Greece, Luxembourg, Switzerland, Germany, France, Denmark, and Belgium along with many others have unrestricted abortion access up to 12 weeks. 

In Britain, abortions are available until 24 weeks, in Netherlands it's 22 weeks, Sweden, 18 weeks, and Spain, 14 weeks. 

The majority of women find out they're pregnant between four and six weeks. A 12 week access period would give them time to confirm their pregnancy, consider their options and access care if required. Women should not feel rushed. 

I don't like the idea of women accessing abortion 'on demand'

Women have unwanted pregnancies for all sorts of reasons. And no woman takes the decision to have an abortion lightly. 

In Britain, 54% of women who have abortions are already mothers. In Ireland, 70% of those who travel for an abortion are married or have a partner, and almost half are already mothers

We need to change the stereotype of women in crises pregnancies as 'flippant' or 'silly', and instead trust them to make the best decisions for themselves and their families. 

A lot of people I speak to would like to see some restrictions

The prospect of introducing abortion in limited circumstances, such as rape and incest, was discussed by the Oireachtas Committee.

But concerns were raised about how this would be legislated for. Verifying sexual crimes is a complex process and could result in further trauma to the pregnant woman.

The committee agreed terminations on these grounds would be “unworkable in practice”.

So what happens after 12 weeks?

After the 12-week limit has been reached, abortion will only be available in exceptional circumstances, where a woman has been told her baby will not survive outside the womb, or if her health or life is at serious risk.

If an abortion is requested after 12 weeks on medical grounds, the law will require an obstetrician and another doctor to agree that a termination is necessary to avert any risk to the woman’s health.  In the case of an emergency situation, when the mother's life is at immediate risk, this assessment can be made by one doctor.  

No campaigners say they they’re concerned “serious harm” is not defined in the bill. But psychiatrist Dr Eoghan Ryan told us that doctors must be free to assess patients individually and make decisions based on their expertise rather than legal definitions.

“Two trained specialists would assess the patient. They could suggest to her the most appropriate treatment options. That decision would then be made by her and not a legal team,” he added.

Just 8% of abortions in England and Wales take place after 12 weeks and are usually for medical reasons.

This figure rises to 15% for Irish women who present at British clinics, undoubtedly because it takes time to finance their procedure and arrange travel. By removing this requirement, Irish residents would be able to access terminations at a much earlier stage of pregnancy.

There are posters on my street saying we'll have abortion up to six months

What these posters fail to provide is context. Terminations will be performed up to viablity at 24 weeks, but only if two doctors agree the woman’s health or life is in danger. Based on the recommendations of the Citizens’ Assembly and the Oireachtas Committee, there’s no distinction between mental or physical health.

This is something the No campaign has latched upon, claiming “abortion on mental health grounds is abortion on demand”.

As a psychiatrist this alarms Dr Ryan.  "There is an idea here that mental health issues are not a legitimate concern," he said. 

“We’ve spent 50 years trying to shift public attitudes towards mental health – and certainly in the way Eighth Amendment debate has been framed to date, it is a push backwards.

“As medical professionals we spend a lot of time trying to get our head around the reality of healthcare issues. The idea that you can explain complex medical situations using a couple of words on a poster, is absurd."

This Irish Times fact check agrees. 

In Britain, just 0.1% of abortions are carried out at 24 weeks

Women can go to England if they really want an abortion. We shouldn't make it too easy. 

Travelling abroad for a termination is expensive and arduous. The Abortion Support Networka charity which supports Irish women in need of a termination, takes thousands of calls a year from people who cannot afford the trip, are not well enough, don't have the relevant travel documents or are trapped in a violent relationship

ASN director, Mara Clarke says the charity does its best, but can't always help. As a result some women resort to dangerous methods.

 “I drank floor cleaner. I took all the pills in the medicine cabinet...I’ve asked my boyfriend to punch me in the stomach.

"People say, oh, you’re just making stuff up. No, I wish I was," she told the Guardian

There’s already long A&E queues and waiting lists in hospitals, won’t legalising abortion make it worse?

The vast majority of abortions will be GP-led, that means they will be done medically with abortion pills taken at home with GP supervision.

The rest are largely cases which would involve a hospital visit even now, foetal abnormalities or a threat to the health of the mother. 

Currently we are simply exporting these procedures to Britain. By removing the Eighth Amendment, Irish women will be able to access abortions earlier, and they will be less likely to have complications post-termination. 

What about the current law? Doesn’t it protect women’s lives?

The Protection of Life During Pregnancy Act was enacted in 2013 in response the death of Savita Halappanavar.

It permits abortion only in cases where the woman’s life is at risk, meaning medics cannot intervene until the last minute. 

Dr Rebecca Headon told us about one case she knew of, in which a foetus was not viable for life, but a heartbeat was still detected.

"The woman had to wait for three days in partial labour, for the heart to stop before the doctors could proceed. That is just an infection waiting to happen. That’s another tragedy waiting to happen."

Abortions can also be performed if there’s a risk of suicide, but three physicians must agree this is the case. There have been several instances of girls and women being denied terminations, because one of the medics has objected.  

One such case in 2016 saw a pregnant child detained under the mental health act after seeking an abortion.

“We know from our day to day work in psychiatry, that suicidality isn’t straight forward,” said Dr Eoghan Ryan.

“This is an area where decisions need to be made quickly, clearly and appropriately."

“This can only be done if the Eighth Amendment is removed and considered legislation is enacted.”

How will the legislation compare to England’s abortion laws?

Abortion in England, Wales and Scotland is legal up to 24 weeks of pregnancy, if there's a risk to the physical or mental health of the mother or any of her existing children. Two doctors must sign off before a termination is permitted.

After 24 weeks, abortions can be carried out in certain circumstances, such as if there is a risk to the life of the mother or the child will be born with a serious disability. As the majority of Irish women travel to Britain for terminations, our current abortion access is determined by Westminster. 

If the Eighth is removed and the Irish government is free to legislate, abortion will only be permitted up to 12 weeks. After that it will be only available in the case of a serious risk to the health or life of the mother, or a foetal condition likely to lead to death before or shortly after birth. Two specialist doctors will assess the patient and consult her on her options. 

Dr Ryan said: "Various obstetricians are very clear that if there’s any potential viability for the pregnancy (ie after 24 weeks) the goal will be to deliver and provide care, rather than a termination of pregnancy."

The proposed legislation is closer in line with European norms than the laws in Britain - you can see a full country by country breakdown here

Are the 1 in 5 posters accurate? 

No, both The Journal and the Irish Times fact checks concluded that this figure could not be confirmed. 

This figure does not include miscarriages which are estimated to account for up to 25% of all pregnancies

The figure also includes the 3,200 Irish residents who have abortions in Britain every year.

If women in Ireland no longer have to travel, British abortion figures would be lowered, and those who seek abortion in Ireland can do so earlier and more safely. 

What will legalising abortion mean for Pregnancies with a Down Syndrome Diagnosis?

The amniocentesis test for Down Syndrome and other conditions is conducted between 15 to 20 weeks of pregnancy. As Down Syndrome can't be diagnosed by 12 weeks, the proposed legislation will have no impact on the number of babies born with Down Syndrome.  

The proposed legislation does not allow for terminations when a non-fatal foetal abnormality is identified after 12 weeks. 

Comprehensive abortion legislation would also protect adults with Down Syndrome in crises pregnancy situations. 

What happens if we don’t remove the Eighth?

Abortions will continue to happen. The Eighth has never and will never prevent Irish women from seeking terminations.

More than 170,000 pregnant people have travelled to Britain for abortions since 1983. That’s around 10 a day. A growing number are accessing pills online.

By keeping our abortion laws enshrined in our constitution, we can't legislate for women in cases of rape, incest or fatal foetal conditions

A Yes vote will ensure these women receive safe and legal care at home. A No vote means they’ll continue to import pills, or leave Ireland in search of care and compassion on foreign shores.

If you still have questions about what's being proposed or you need advice on how to talk to friends or family members about the referendum, please get in touch with us at londonirisharc@gmail.com. 

*Including trans-man and non-binary individuals





 

Hannah Little