Section 7 provides an excellent opportunity for a candid and comprehensive examination of problems that have emerged since 2019, and possible steps to address them.
Regrettably, rather than taking this opportunity, the framers of the review have, to date, narrowly blinkered its scope by an obstinate focus on making abortion yet more widely available – to the detriment of the most basic protections for unborn babies and their mothers.
Stakeholder groups meeting
In June 2021, the minister held a private meeting with 'stakeholder groups', at their request, consisting of an abortion-supporting Oireachtas group and several campaigning groups, including the National Women's Council, the Coalition to Repeal the Eighth Amendment, the Southern Taskgroup on Abortion and Reproductive Topics, the Irish Family Planning Association, and the Abortion Rights Campaign.
If one wants an example of groupthink, this meeting surely qualifies. Unfortunately though, this one-sided meeting has profoundly influenced the review process. In stark contrast, the minister ignored repeated requests for a meeting, including from pro-life organizations and even from parliamentary colleagues in the All-Party Oireachtas Life and Dignity Group.
At a meeting of the Oireachtas Health Committee in December 2021, the minister set out a series of issues he would like to see addressed as part of the review.
He narrowly focused on questions such as why a small number of Irish women still had abortions in England and Wales. The implied solution would be to bring the law more in line with Britain - despite voters being assured in 2018 that Irish law would not be as extreme as British law.
Although stating he did not want to prejudge the findings of the review, the minister clearly indicated by these comments the direction in which it was heading.
At this Health Committee meeting, the minister also committed to tendering on the Government's eTenders site to recruit an independent chair for the review. He quickly broke this commitment and, instead of an open and transparent tendering process, he invited six hand-picked candidates to apply for the role, and then chose one from this group.
UnPAC espouses radical change
The review is also influenced by the Unplanned Pregnancy and Abortion Care Study (UnPAC), commissioned by the HSE and released in July. This study, which interviewed a narrow pool of 58 participants, espouses a radical change to the present law, which would erode its basic protections and, most probably, produce a further spike in abortion numbers.
None of this instils confidence that the review would be fair, transparent, or objective. Yet section 7 of the act does not indicate that the scales of a review of the abortion legislation should be tilted in favor of more abortion. Moreover, only 25% of voters favor more access to abortion, according to a recent Irish Times/Ipsos poll.
Major changes being sought by abortion campaigners are in direct breach of promises made repeatedly by Government members and others to Irish voters during the referendum campaign in order to secure a 'yes' vote.
For example, promises that abortion would only be legal up to 12 weeks (apart from particular specified circumstances thereafter); and that abortion in Ireland would be rare. The latter promise very quickly proved to be untrue
In 2018, there were 2,879 abortions performed in England and Wales on women resident in the Republic. The then Government and abortion campaigners made claims that around 1,000 women a year were having an illegal abortion in Ireland using pills.
Even assuming those claims were accurate, that means an increase of thousands of abortions each year, because the official records show 6,666 abortions under the act in 2019, and similar numbers in the following years.
Three-day waiting period
This increase would be even worse were it not for the life-saving, three-day waiting period. In 2020 alone, 1,480 women initiated the process of obtaining an abortion, but did not go through with it after the waiting period.
This means fewer lives taken and fewer women hurt by abortion than would otherwise be the case under this legislation. In this way, the three-day wait fulfills, to some extent, the purpose for which it was promised to voters before the referendum. Unfortunately, that is another promise that abortion campaigners wish to see broken, if they seek the abolition of the three-day wait.
In our 2021 report Ireland's Abortion Law: End the Silence, the Pro Life Campaign recommended important changes that should be supported by a large majority of people, whatever their views on the wider issue of abortion.
These changes sought to rectify some of the problems with the act, including steps to address the huge increase in the number of abortions, with an emphasis on alternatives, and measures to ensure truly informed consent.
Our report also calls for amendments to prohibit some particularly barbaric practices in the current operation of the act, and for more comprehensive conscience protection for healthcare workers.
The tragic case in 2019 of Baby Christopher, a healthy unborn child who was aborted under section 11 (titled 'Condition likely to lead to death of fetus') following a misdiagnosis, received considerable public interest.
The Pro Life Campaign report argues that cases such as this illustrate the urgent need to ensure that a robust system exists to investigate and address adverse incidents occurring under the act.
Inadequate data collection
The minister's annual report for 2021 indicated that 4,577 abortion notifications were received for the year 2021. However, HSE data showed that the true figure for 2021 was approximately 6,700 abortions.
The minister blamed this drastic undercounting of abortions on the impact of COVID-19 and the 2021 cyber-attack. However, it also forms part of a wider and ongoing problem of inadequate data collection under the act.
In the interests of best-practice healthcare for women in pregnancy, to avoid healthcare inequalities and inform public policy, section 20 of the act should be amended to incorporate the data required on abortion notification forms in England and Wales.
This enables a detailed annual release of abortion data, while ensuring that privacy is protected. As recommended in our report, the data collected in Ireland should not continue to fall below that standard.
Of course, we would advocate much more extensive changes to the act than just the reforms recommended in our report. However, it is difficult to have confidence that the review will endorse even those limited reforms, given the issues with the fairness and objectivity of the review process.
Clearly the review must broaden its horizons of investigation and engage meaningfully with a range of perspectives if it is intended to have any legitimacy.
Eilís Mulroy is a solicitor and Chief Executive Officer of the Pro Life Campaign. (For more information on this topic, visit www.prolifecampaign.ie)
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