Abortion Services in the North of Ireland

Until very recently Northern Ireland was one of the most restrictive regimes in Europe regarding abortion rights. The British 1967 Abortion Act was not extended to Northern Ireland. The Offences Against the Person Act 1861 was still in place which meant that abortion was a criminal offence. Under the Criminal Justice Act (NI) 1945 abortion was only legal if there was a severe and long-term physical or mental risk to the pregnant woman’s health.

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A 2018 inquiry by the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW) found that the UK was guilty of grave and systemic human rights abuses by forcing people to have to travel out of Northern Ireland for abortions, adding that Westminster is ultimately responsible for human rights in the North. The UK Government agreed to change the law that year to cover the cost of abortion for those in N. Ireland availaing of NHS abortion services in Britain in line with the British Abortion Act. According to data published by the UK Department of Health and Social Care: 1,053 women from the North travelled for abortion services to England & Wales in 2018. 1,014 travelled for abortion services to England & Wales in 2019.

On 1 January 2019 the Health (Regulation of Termination of Pregnancy) Act came into law allowing for abortion services in the Rep. of Ireland. Although the service is free to anyone living in the Republic it is only available to anyone living outside of the Republic for a charge, which includes those from the North of Ireland. With costs from €450, plus a required minimum two trips to avail of the services in the South, the availability was limited to those who could afford the expense and the time. However, some 67 terminations were carried out in the Republic on women giving an address in Northern Ireland during 2019. (Annual Report of Termination of Pregnancy Act 2019, Department of Health, published 30 June 2020)

Also in 2019, a ‘Women and Equalities Committee Inquiry on Abortion’ acknowledged the increase in Northern Ireland of the illegal use of abortion pills ordered online. Later in the year a Belfast High Court ruled that Northern Ireland’s abortion law breaches the UK’s human rights commitments. In July 2019, the Westminster parliament intervened on the issue whilst the Northern Ireland regional government was not operating because of a power sharing crisis. A vote to legalise abortion in Northern Ireland and create one of the most liberal abortion regimes in Europe was carried.

New regulations on abortion in Northern Ireland

  • Abortion is decriminalised and criminal charges no longer apply to anyone accessing an abortion or to any healthcare staff providing an abortion or assisting in procuring one.
  • Abortion is legal in all circumstances up to and including 11 weeks + 6 days gestation.
  • If the pregnancy poses a risk to the pregnant woman’s physical or mental health, abortion is allowed up to and including 23 weeks + 6 days gestation.
  • Abortion is permitted up to birth if there is a diagnosis of fatal foetal abnormality or severe mental or physical impairment.
  • Abortion is permitted up to birth if there is a risk to the woman or girl’s life or risk of grave permanent injury.

The services to accommodate the new regulations were to be available in Northern Ireland from 1st April 2020 but have not been fully implemented yet. After the Northern Ireland Government Assembly was restored in January 2020 it debated the abortion legislation and the severe foetal impairment aspect of the regulations. A majority of its elected members agreed on a motion to reject the imposition of the new abortion laws on the region by Westminster, stating that it does not support the provision allowing for abortions in cases of severe foetal impairment without time limit. The vote however was non-binding, and does not alter the regulations. The regional government is resisting implementing the new laws as Assembly politicians remain divided on the issue. The UK government confirmed that the N.I. Assembly could amend the regulations in the future, since abortion was a devolved issue, but that any amendments would need to be “human rights and convention compliant”.

The Department of Health in Northern Ireland is responsible for overseeing the commissioning of abortion services in Northern Ireland, consistent with the regulations. Necessary support is available to the Northern Ireland Minister of Health and the Department of Health, to set up abortion services in line with the new legislative framework. Robin Swann, Northern Ireland Minister for Health, is declining to arrange for the health service to provide for the new abortion services until agreed by the Northern Ireland Government Executive. Minister Swann, Ulster Unionist Party, describes himself as ‘pro-life’. Michelle O’Neill, Northern Ireland Deputy First Minister, Sinn Fein, says the regulations must be implemented by the Health Minster.

The Abortion (Northern Ireland) (No. 2) Regulations 2020’ remain in force yet to date, the NI Department of Health has not commissioned or funded termination services to implement these new regulations across the region. The Department has also failed to issue any guidance to the Health and Social Care Trusts (HSCT) on the provision of new abortion services. The official government website for Northern Ireland citizens still has no information about abortion.  The Department of Health has not provided a statement giving details on where and how women could access abortion services in the North.

Doctors for Choice Northern Ireland have said they are willing to provide the necessary care. Although registered medical professionals in N. Ireland may now terminate pregnancies lawfully on HCST premises some healthcare staff are concerned or unsure about the situation as health trusts have not been given the extra resources, training, or staff necessary.

Doctors for Choice NI

Conscientious Objection is allowed in the regulations stating that no person has a duty to “participate in any treatment authorised”, the only exception being participation if treatment “is necessary to save the life or to prevent grave permanent injury to the physical or mental health of a pregnant woman or girl”. It is not known how many staff avail of this opt-out. Without a public health campaign being provided many people are confused by what is currently legally available and where to access information and services.

719 women had an abortion in the North in the past year (only 8 the previous year). This increase is because Belfast, Northern, and Western HSCTs commenced some of the early medical abortion provisions allowed under the revised law through their already existing sexual and reproductive health services in their areas. This was a short-term measure where resources allowed them to do this as, they were able to transfer staff from other sexual and reproductive services which were paused or reduced because of the Covid.

August 2020, all 5 HSCTs applied for funding to meet the new abortion legislative requirements- but this was not considered by the Health and Social Care Board. Why?

5 October 2020, the Northern HSCT ceased to provide a service for 3months as it had to transfer staff back to other sexual and reproductive health care services and ceased to take any new referrals for termination services.  It restored the service on 4 January 2021 having secured a locum resource. 

Although terminations have been legalised under any circumstances by a registered doctor, nurse, or midwife up to 12 weeks none of the other 4 trusts are providing abortions between 10-12 weeks gestation due to lack of resources.

5 January 2021, the South Eastern HSCT ceased providing abortion service as the only staff member doing the work went on maternity leave and there was no replacement.  It has now restored the service.                                                                                                                

Termination services for medical reasons up to 24 weeks or without a gestational time limit, in line with the Abortion Regulations, are mainly performed by the Belfast HSCT.

There is a continuing struggle for safe abortions more than a year after the procedure was legalised in N.Ireland. The lack of abortion services has left a health care void for many as women are still having to travel outside the country for the essential reproductive healthcare that they are legally entitled to access in their own locality.

30 November 2020 the NI Human Rights Commission decided to initiate legal action against the NI Secretary of State, the NI Executive, and the NI Department of Health for Northern for the failure to commission and fund abortion services in the North. They believe these failures breach the European Convention on Human Rights because there is an existing statutory requirement that the CEDAW recommendations are implemented.

The Commission has produced a fact sheet to outline the extent of failure in the North. 

Fact sheet link: https://www.nihrc.org/uploads/publications/11.01.21_Fact_Sheet_Human_Rights_Commission_Legal_Action_on_Lack_of_Abortion_Services_in_NI_.pdf?utm_source=International+Campaign+for+Women%27s+Right+to+Safe+Abortion+membership+list&utm_campaign=79d5e6e349-&utm_medium=email&utm_term=0_c9f67cdfa6-79d5e6e349-129545565

The CEDAW Report also covered the provision of ‘sexual and reproductive health rights and services’ in Northern Ireland, including sex education and contraception which have not been addressed by the new regulations.

What will happen next is far from clear, but we must continue the fight for our sexual and reproductive health rights and services including free, safe, legal, and local abortion to be accessible in the North.

Accessing Abortion in Northern Ireland                                                  

Please beware of some judgmental crisis pregnancy agencies whose websites, social media, or advertisements you may come across.

For Non-directive Crisis Pregnancy Counselling Contact: informingchoicesni.org or call 028 9031 6100 (Monday – Friday, 9am-5pm)

***Update from Informing Choices Northern Ireland October 2021:

From 1 October 2021 Informing Choices will withdraw their central access point into early medical abortion services. The service has operated outside of a commissioned framework for 18 months. As a small charity with a limited resources, is this placed considerable pressures on the organazation. ICNI previously warned the service could not continue unless interim funding was secured whilst the commissioning of services was underway. Regretfully additional funding has not been provided by the Department of Health. Therefore, it is with deep reluctance that we have no option but to take this action.

ICNI are extremely proud of the role we played to ensure that early medical abortion services were accessible in Northern Ireland and will continue to advocate for the urgent commissioning of local available services. We will also continue to support women through difficult times with our pregnancy counseling service. Early medical abortion services remain suspended within the Western Trust. Services are available in all other Trust areas. From Monday 4th October anyone wishing to access services should contact the British pregnancy advisory service on 03457304030.

Contact: Central Access Point helpline

on 028 9031 6100                                      

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Monday – Friday 9am-5pm.                                                                                       

Leave a message, if necessary, for a return call.                                                    

Staffed by Informing Choices Northern Ireland.

Translation service available

If you can’t travel for an appointment because of Covid-19 restrictions

Free EMA pills are available by post for pregnancies under 10 weeks

Contact: British Pregnancy Advice Service (BPAS) Telemedicine Abortion Service 0300 500 8086                                                                                            

Your suitability will be assessed by a doctor in NI. If eligible, a booking will be made for a telephone consultation and medical assessment. Following your telephone consultation, your treatment pills will be delivered to you. If necessary, the doctor may have to refer you to a local treatment centre in the North instead.

*For Early Medical Abortion (EMA) service for pregnancies 10-12 weeks.

As EMA services for pregnancies of 10-12 weeks are not currently being provided in the North, you will need to contact BPAS if you can travel to England.                    Contact: 0333 2342184 to make an appointment with a funded abortion provider.    To qualify for FREE care/travel: you must reside in N.Ireland with a BT postcode, and be registered with a GP in the North with a BT postcode.

For Abortion services for pregnancies 12 weeks onwards.

Unfortunately as yet there is very little provision of abortion services from 12 weeks of pregnancy onwards in the North. For up-to-date information

Contact: Central Access Point 028 9031 6100 helpline                                  

Monday – Friday, 9am-5pm                                                                                          Staffed by Informing Choices Northern Ireland 

If you are told that you cannot be treated locally there are travel options

Free abortion procedures in Britain

Provided by British registered abortion clinics

Funded by the UK government to cover travel, overnight accommodation if needed, and procedure.

CONTACT:

BPAS Central Booking System 0333 234 2184 

or Marie Stopes UK 0333 234 21.

To qualify for FREE service: you must reside in N.Ireland with a BT postcode, and be registered with a GP in the North with a BT postcode.

Abortion procedures accessible in Ireland

Provided by Health Service Executive (HSE).

CONTACT: myoptions.ie or call 00353 16877044

Costs start from €450.

Health professionals in Northern Ireland can supply information about the above services. Those with a conscientious objection should direct women to where information is available.

For up to date information/details:-                                                            

Informing Choices NI or call 028 9 031 6100                                                                 bpas or call 0300 500 8086 / 0333 234 2184                                                                 Marie Stopes or call 0345 300 8090                                                                            

My Options or call 00353 16877044

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