Abortion in Ireland. Warning….LONG

Looks like there’s a debate on abortion in Ireland again, and it looks as if it’ll be as messy and unpleasant as all the previous times.

Now abortion can’t be taken as a “pleasant” subject at the best of times,  but we could at least talk about it calmly and logically and discuss what the goals of policy ought to be. But we won’t .

As for me? I find abortion a difficult and unpleasant subject but that doesn’t give me a free pass from trying to have an opinion on it. Some women might say that I shouldn’t have an opinion. Whatever about the philosophical angles of that discussion, I’ll have a vote in any referendum so it seems important that I try.

Angkor Wat Abortion AD 1150

Bas-relief of an abortion in Ankgor Wat, from 1150AD

Anyway, all I’d like to do is touch on what policy ought to aim for, and then very briefly on one of the more awkward discussions, i.e. Down Syndrome, on why that discussion is largely a distraction from the main issues and therefore why Down Syndrome  need not and should not be brought into the discussion at all.

I might even come to a personal conclusion, like it or not. You might like my reasoning, or at least tell me where you think I’m wrong. Politely, please, on twitter.

First off, I think most people would agree that policy should not aim to have “more abortions”. For instance, probably everyone would agree that contraception is a better way of avoiding unwanted children than abortion. So fewer abortions is probably better, as a general principle.

However, we know that Irish resident women have abortions all the time, they just have the abortions in England. So we DO have abortion in Ireland, we just outsource it. And we only outsource it if you have the money and ability to travel to England in the first place, which doesn’t seem too equitable.

Now the only effective way of preventing these abortions would be a travel ban on pregnant women, or even all women, which are both terrible ideas for more reasons than anyone could list. So these abortions will continue to happen unless there’s a better option. For some women, a better option could include better support for adoption, better childcare and support for potentially handicapped children, etc.   And Ireland’s record isn’t great on either of these topics, but that’s a discussion for another day.

For other women there may not be a better option so those abortions will happen anyway, at least for those women with the money and the ability to travel (and, thinking of the sad Savita Halappanavar case, she was in hospital and unable to travel).

In addition, the abortion pill is now widely available and can be sent untraceably in the post. So if you’re quick enough you don’t even have to go to England to have an abortion, you can do it at home. You just have to have a credit card and you can’t do it with any medical support, which seems a bad idea too.

So, we have abortion in Ireland, but about as badly provided as we can manage – although we are (AFAIK) spared the horrors of back-street abortions. One small mercy at least.

That makes our choice smaller in scope.

Are we going to allow Irish resident women to get abortions in Ireland, with medical support here, instead of forcing them to take the abortion pill with no support or having to go to England for an abortion with minimal after-care?

Personally I’d say “Yes”, although there certainly are arguments for and against allowing abortion in Ireland.

Many of the arguments for are probably pretty clear already, and I’ll get to some more of those in a minute. The argument against is mostly two fold; one is that, by banning abortion in Ireland we’re at least taking a clear moral strand against it and not facilitating “the murder of children”, and the other is that the number of abortions might increase if getting one in Ireland was easier. On the first part, I disagree. Taking a moral stand against something without doing anything practical about it is meaningless. On the second case, there’s certainly an argument. If the total number of abortions were to increase, most people would probably agree that was – at least – an apparently undesirable element of any change.

For a moment I need to take a segue into some specific cases where I believe our current law has some terrible, unfair, and immoral consequences. In my view they’re grounds for repealing the 8th Amendment on their own and obviously some would have to form some part of a replacement policy on abortion, though they don’t and won’t drive a fully coherent policy on their own.

  1. Fatal Fetal Abnormality
    • I find the idea that a woman be forced to remain pregnant with a child that she KNOWS will never live to be beyond cruel. Her situation, and that of the baby, is horrible and sad and forcing her to remain pregnant for months and then to give birth to an essentially dead baby is an appalling thing to do. On its own, grounds to repeal the 8th Amendment
  2. Rape
    • While some women can and do love children that are the result of rape, others do not. And that’s perfectly understandable. To force a woman to remain pregnant after being raped is, IMHO, also cruel and unreasonable. Again, on its own it’s grounds to repeal the 8th Amendment, and particularly in the case of underage sex/rape.
  3. Incest
    • I think you see where I’m going with this. And again, particularly in the case of underage women.
  4. People unable to travel
    • If you hold a strong moral position against abortion in all and any case then you may feel that the 8th Amendment is ok, even for women unable to travel. I don’t, though I see the validity of the view even while disagreeing with it. In my view it’s unreasonable for a state to – essentially – sneakily allow abortion unless you’re a women in direct provision and unable to travel, or a woman in hospital and unable to travel, or a poor woman and unable to travel.  That brings “sneaky” too far, IMHO. Whatever, as a country, we decide on as our policy towards abortion should not exclude the poor or the refugee or the sick just because they’re poor, or refugees, or sick.  That’s NOT ok.

So, on balance I think the 8th Amendment needs to go. And my argument so far hasn’t really gotten into the politically and often sexist territory of “Choice” or “Life” beyond what I feel are pretty solid cases where abortion should be possible. Unwanted, unpleasant, but possible. And supported IN IRELAND.

So, does any of this get to a stage where I have a wider view on what abortion in Ireland should look like? If we replace the 8th with either law or a new constitutional amendment? And which should we do?

First up I think Ireland should aim to prevent unwanted pregnancies better in the first place. Our sex education compared to – say – The Netherlands is pretty poor. Better  sex education, better contraception, fewer abortions. And fewer STDs too, hopefully. But that’s largely a separate discussion too.

On abortion,  it has to be legal in Ireland at least in the cases above but I think most Irish people – even those who support abortion in general – get increasingly unhappy the later an abortion takes place. At some point the embryo becomes a fetus and that becomes, essentially, a child. Then, for most people, it’s not just the woman’s body any more. What’s “late stage”? A good discussion, but let’s at least agree that the issue is a real thing. You can’t just abort an 8 month baby as if it’s nothing. ‘Cos it’s not. So, in the absence of some huge reason in each specific case (e.g. fatal fetal abnormality, threat to the mother’s health requiring either delivery or abortion, but perhaps not on grounds of rape any more), there have to be limits on how late abortion can happen. Let’s say approx three months for now and mark both the timing and the specific possible cases as “To be discussed”. The committee looking into it in Ireland suggested 12 weeks.

But this does mean that there will have to be very strict limits on abortion after this stage. Whatever your view on abortion earlier, in my view there cannot be an open-ended possibility. At some point, it’s a baby or at least close enough to one that it’s not one person’s choice any more. Some may argue that the same is true before that stage, but let’s at least agree about after that stage. Easier if we find agreement rather than disagreement, I hope.

So, conclusion so far is to allow abortion in some specific cases, and a general “No” after some stage in pregnancy. That narrows the problem/discussion down a little.

But before that stage, what?

Well, in the case of rape or incest or Fatal Fetal Abnormality my view is already pretty clear. But what if the reason for abortion is “It doesn’t suit me for economic/personal/relationship/whatever reasons” or “The baby is going to be a girl” or “The baby is going to be handicapped“? Then what?

So, we’re back to the fact that people can still get on the boat or place to England and/or get the abortion pill, and so we’re back to trying to equalize things for those who can and who cannot travel. Or at least that’s a factor that needs to be taken into account. Alongside trying to make sure that women who DO use the abortion pill can get medical support without risk of arrest…so I’d argue that a possibility of some kind needs to exist to get an abortion in Ireland before the pregnancy becomes “late stage”. And yeah, I’m talking myself into allowing abortion fairly widely here….whether I like it or not. Again, doesn’t matter whether I like it….we’re talking about legislation here.

Now, first off, I think there’s good grounds for saying “Abortion on grounds of sex is wrong” and doing whatever’s possible NOT to support that. So if we, for instance, made it illegal to say if a pregnancy is male or female until at least “late stage”, I’d be fine with that. I’m not aware of any medical reason to need it normally.

As for “Abortion on grounds of handicap”, that’s difficult and dangerous ground. Here’s where the Down Syndrome people come in. The reasons they shouldn’t be specifically pulled into the discussion are multiple. One is that abortions of handicapped babies will be a minority among all abortions, and abortions specifically of DS babies a subset of that, so there’s simply no need to use their specific circumstance. The majority of “aborted babies” will be nominally healthy. And people shouldn’t use Down Syndrome as a specific example because using their specific circumstance is uncomfortable for the many DS people who live happily among us. But, assuming there are pregnancies where the baby is known to have some congenital, chromosomal or developmental problem, should the parent/s be able to make the awful decision?  If it’s early enough, yes. How early is early? “To be discussed”. If the discovery is late in the pregnancy then this is a difficult legislative issue. If early, as you’ll see below, I think it’s a personal decision for the parent/s.

With which handicaps SHOULD parent/s make that decision? Hard to say. Many handicapped people live happy and productive lives and both they and their parents are happy they’re alive. Many, sadly, lead miserable lives full of pain and they and their parents’ lives are potentially worse off than if they didn’t exist. Where’s the line? I have no idea and certainly have no idea how you’d put that into law.

And as for “Abortion on convenience”?  Here’s the really hard one. First, I really doubt that many women use abortion as a “convenience”. It’s certainly a lot harder than getting contraception right, and I expect that many of the women who DON’T get contraception right and who then want abortions are in the kind of circumstances where they’re least suitable/prepared to be parents, e.g. drug/alcohol problems, abusive relationships, precarious economic situations, etc. So the state should be doing everything it can to support women and families in those situations so that they’re NOT in those situations, ensuring that all men and women are well educated on contraception, and offering pregnant women more support ONCE they’re in that situation and ultimately, if all else fails, offering them the option of abortion (early) in Ireland rather than throwing them on the boat.

So, where does that leave me? Well, the logic might be very different if there was no abortion in England, but there is. All sorts of moral quandaries might arise. But they don’t….we have a much simpler problem.

Abortion is a reality in Ireland and we’re managing it really badly.

Summary? In my view abortion should be extremely difficult after again (say) 3 months. Only possible in the event of serious medical problems, which will have to be carefully defined in legislation, leaving enough flexibility for doctors to address cases that’ll never be the same twice. And yeah, if the pregnancy is the result of rape this might well mean having to stay pregnant, awful though that is.

And before or after 3 months we should not support any attempt to abort on grounds of sex. Why? Well, apart from the fact that it’s morally awful there are valid grounds for states not to want skewed sex ratios. So that’s that one. No sex tests, or results, to be given to the parent/s before “late stage” and no abortion on those grounds afterwards.

But in general we should allow abortion up to (say) 3 months on the sole decision of the parent/s and do as much as possible to make sure that parent/s always say “No, let’s keep the baby”.

And I still don’t like abortion. But sticking your fingers in your ears and shouting “La la la” doesn’t make England go away. I suspect Ireland tried that before.

And, since the whole thing is going to remain a horrid moral, legal and practical grey zone, I believe that the 8th Amendment should be repealed and then replaced with legislation rather than another constitutional amendment. For instance if, some day, it’s possible to take a 4 week embryo and put it in an artificial womb then all sorts of other possibilities and issues arise. Just one example might be that a father might get to say “But I want the baby”, even if the mother didn’t. Easier to deal with in legislation rather than another cocked-up constitutional amendment.

Phew, that was long. But I’m ok with that. And it’s not a neat conclusion, and I’m ok with that too. And I might be wrong, but someone’s going to have to tell me why.

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