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Please enter the message. Please verify that you are not a robot. Would you also like to submit a review for this item? Human Rights Watch found that many medical practitioners do not know what services they may lawfully provide to women and what the standard of medical care should be when an abortion is performed in Ireland. Service providers also do not know when they can advise their clients to request an abortion. The Medical Council, a statutory body established in to regulate the medical profession and protect the interest of the public in Ireland, is supposed to provide guidance on ethics and is responsible for disciplining those doctors who breach the required standards of conduct and behavior.
The relevant portion of the submission is reprinted in the guide. The submission fails to refer to the risk of suicide as a ground to legally terminate a pregnancy. The failure of the Irish government to ensure that women have access to information about when legal abortions may be obtained in Ireland clearly violates their right to health. The UN Committee on Economic, Cultural and Social Rights has articulated the positive obligation on the part of the state to disseminate information about sexual and reproductive health, including through information and education campaigns.
The failure of the Irish government to ensure that women have access to abortion-related information means that many women struggle to access timely, accurate, and complete information about legal abortion services abroad. As a result, they experience delays in accessing care, which heightens the possibility of health complications from the intervention.
Aoife C was living in a rural part of Ireland when she got pregnant. As a result of the delay, she was almost 28 weeks pregnant when she finally had an abortion. The Irish government has failed to take steps to inform women of their right to travel. The European Court of Human Rights at the time found Ireland to be in violation of its human rights obligations regarding access to information. The European Court of Human Rights noted that limiting access to information created a health risk to those women who, due to inadequate counseling, sought abortions at a later stage in their pregnancy, or who were not seeking post-abortion care.
The legislation, ostensibly enacted to give effect to the constitutional amendments guaranteeing the right to travel and information and to bring the law more in line with the Open Door ruling, in fact places far-reaching curbs on the manner in which information can be given and almost inevitably delays access to services.
For example, information may only be given during a face to face meeting. Service providers are required to prioritize the prescripts of the law over caring for their patients. A researcher and activist described how legal constraints on the provision of information, as provided for in the Information Act, negatively impact the provision of care:.
Although the internet now means that many women can access information about abortion services abroad without having to meet with a service provider, and in some ways the Act has become obsolete, it continues to discriminate against marginalized, resource-poor, or rural women who do not have ready access to the resources provided by the internet. Since information may not be provided telephonically, access for those women and for anyone else without access to transport, is further limited.
For some women, these forms of information may be the only way in which they are able to find out about available services. Barriers to information are higher in non-Irish and in resource-poor communities. A service provider who assists African immigrant women indicated that her clients encountered particular problems in securing information about abortion services. I give them information in a way that they can give it to others. The law requires that information about abortion be provided without any advocacy or promotion of abortion. We have to send them away with a list of clinics to call.
A community organizer who has spoken to many women in need of services added: The difficulty in accessing full and accurate information about abortion, and the strict regulation imposed on bodies that provide what limited information on legal abortion services they can, is further exacerbated by the existence of unregulated agencies that actively provide misleading or inaccurate information about abortion and related services in their efforts to delay or prevent abortions. These agencies misrepresent their services as neutral sources of information about crisis pregnancies and all available options, luring in women seeking information about a full set of options.
The act regulating the provision of abortion-related information does not apply to service providers who do not give abortion-related information. As a result, women who seek accurate information about all their options are at risk of receiving inaccurate, untruthful and misleading information, or in many cases, are denied information about abortion services altogether. Claire C was under the impression that the agency she sought advice from would give her information and counseling about all her options.
A state of isolation : access to abortion for women in Ireland.
Instead, she was given misleading information, similar to that given to Sinead Ahern. I stopped answering [calls with] withheld numbers. Have you killed it yet? Jane H and her boyfriend were also misled by an advertisement. Interpretations of international law unequivocally support the conclusion that decisions about abortion should be made by pregnant women, and them alone.
The UN Committee on Economic, Cultural and Social Rights has explicitly recognized the obligation of the state to ensure that third parties do not limit access to information. Women who find out that they are carrying a fetus with severe genetic abnormalities face additional challenges, including the stress of unexpected emotional, physical, financial, and other consequences of dealing with a special needs pregnancy. In Ireland, they do so without any support from the state. Not only does Irish law prevent women with severe fetal abnormality pregnancies from accessing legal abortion services at home should they so choose, it also does not facilitate screening for fetal abnormalities for pregnant women in the first place.
The lack of consistent access to screening is of particular concern as fetal abnormality pregnancies can have a detrimental effect on the physical health of the pregnant woman, especially as the pregnancy progresses, in addition to the emotional stress that comes with dealing with a difficult pregnancy without support. These medical facts, while uncontested in Ireland, have not translated into policies and practices that ensure that all pregnant women have routine access to antenatal care that includes screening for fetal abnormalities, or that they may choose to terminate a pregnancy that can severely endanger their health.
The general stigmatization of abortion exacerbates a situation that is already painful. A clinical midwife specialist at the largest maternity hospital in Dublin who has dealt with fetal abnormality pregnancies for more than a decade, recalled the distress of the family members of a year-old daughter carrying an anencephalic pregnancy: But now I am in a society that expects my daughter to have this pregnancy! There is no national protocol that regulates antenatal screening, although the Royal College of Gynaecologists recommended in that ultrasound screening for abnormalities be offered to all pregnant women.
A survey of maternity units in Ireland found wide variations in practice, and recommended that a standard national protocol be developed. It also indicated that a national debate on ultrasound screening for fetal abnormality was urgently needed. If a woman wishes to terminate a pregnancy with fetal abnormalities, early detection is preferable, both for the safety of the procedure itself, and to minimize the physical and emotional health consequences for the pregnant woman.
Moreover, an early termination allows those women who wish to do so, to attempt having a healthy pregnancy sooner, with potentially mitigating effects on their emotional health. In the UK, the terminations are earlier. Aisling J encountered several obstacles in accessing diagnostic tests throughout the early part of her pregnancy, and therefore discovered relatively late that the fetus she was carrying had spina bifida [81] and hydrocephalus [82] and could not survive.
She explained the problems she had met with:. I was not referred to anyone else either. She elected to terminate the pregnancy. She told Human Rights Watch: I felt let down, maltreated. A medical practitioner interviewed by Human Rights Watch, who did not want to be identified, inadvertently illustrated the cruelty of a system that, because abortion is illegal, fails to provide sensitive support and care:. There is little, if any, support and assistance provided to women who are grappling with complex and traumatic decisions.
For pregnant women and their partners, the discovery that the fetus may not survive, may only live a short time after birth, or may be severely disabled, is devastating. All the women interviewed for this report identified the costs associated with traveling as their most immediate and urgent concern once they had decided to have an abortion. Sarah B was 24 years old when she traveled to the UK for an abortion. She was a student and working part-time as a waitress. I was just, how am I going to do this?
Claire A was also a student when she had an abortion. He had to involve his brother, who was appalled and even now These costs do not include other direct costs, such as travel and accommodation, or indirect costs, including childcare, loss of income and the costs of a traveling companion. Service providers interviewed by Human Rights Watch confirmed how difficult it is for many women to raise the money to travel and the lengths that some must go to to ensure their access to safe and legal abortions.
A community activist described the situation of the women she works with: There are circumstances where they have been violently beaten because they cannot afford to repay. For women who are in the asylum seeking process in Ireland, money is even more difficult to borrow, earn or find. The costs of traveling to obtain an abortion are plainly out of reach for them, unless they are willing to take drastic action.
Asylum seekers are in a particularly vulnerable position. Often isolated, without family and other social support, they fear the consequences of seeking permission to leave the country to have an abortion. They also face additional costs as they have no travel documents, and must therefore apply and pay for emergency temporary travel documents, which are issued by the Department of Justice, Equality and Law Reform.
A service provider, who spoke to Human Rights Watch on condition of anonymity, described the situation of a young female asylum seeker she had worked with:. Mary E, a young woman from an African country, had already applied for asylum when she became pregnant and decided to terminate her pregnancy. Another service provider confirmed that their clients had experienced particular difficulties on getting entry visas to the UK due to a lack of information about how to apply for the visa and what documents are required.
However, she concluded that the Department of Justice was unwilling to come up with a policy to cover all women and persisted in treating each application as a new and separate case. The position of Traveller women is equally difficult. One service provider Human Rights Watch spoke to had assisted eight women with unwanted pregnancies over a period of four years: The Covenant on Economic, Social, and Cultural Rights prohibits discrimination in the enjoyment of the rights protected by the covenant, including specifically on the ground of property.
Women interviewed for this report described a profound and pervasive sense of shame and guilt caused by the stigma attached to abortion in Ireland. Being forced to leave their homes to have an abortion reinforced these feelings. The distress the women we interviewed felt was profound and in many cases linked to the reluctance on the part of the Irish government to address the issue of abortion. Having to travel abroad for a procedure at a time when many women are already in distress because of an unwanted or unhealthy pregnancy was a major source of anxiety.
It is still so traumatic even if you can afford it. I felt completely abandoned. Siobhan G described an equally harrowing experience. Siobhan was pregnant with twins when she discovered that both had fatal birth defects:. Megan H also described the trauma of terminating her pregnancy in the UK.
Antenatal tests indicated that the fetus had Edwards syndrome, which leads to severe physical and mental disabilities: Then [after an initial visit to an Irish clinic] I was on my own, I had to contact the place, make my own travel arrangements, hotel arrangements. Women who cannot travel are faced with a bleak and lonely choice—continue with an unwanted pregnancy or have an illegal and potentially unsafe abortion. This group of women is difficult to access, with few willing to expose themselves to the risk of criminal prosecution or admit that they contemplated terminating a pregnancy, once their child has been born.
Interviews conducted by Human Rights Watch suggest that many women have no choice but to continue with unwanted pregnancies. It is almost impossible to find accurate information about the prevalence and extent of illegal abortions in Ireland. The legal restrictions on abortion, stigma, fear of prosecution and attitudes of healthcare workers all prevent those women who have had illegal abortions in Ireland from seeking post-abortion care and disclosing information to healthcare providers and others.
Irish service providers interviewed by Human Rights Watch all expressed concern that women were resorting to unsafe backstreet abortions: We had deep concerns about how the woman had been treated. The community worker told Human Rights Watch about the experience of one young woman who continued with her pregnancy:. Advances in both medicine and technology have provided potentially safer options to women who are unable to travel in that they might purchase abortifacient drugs over the internet, though this would still constitute a crime under current Irish law, punishable by prison.
Access also still depends on the resources available to the individual woman—both financially and in terms of her access to information. Even these newer options come with considerable delays and no medical review and safeguards. A medical practitioner who, for research purposes, bought abortifacient drugs over the internet to test when and how they arrived, told Human Rights Watch:. Service providers also expressed confusion about whether acquiring an abortifacient over the internet contravened the provisions of the Offences Against the Person Act, leading women who obtained medication in this way to be more reluctant to seek post-abortion care and counseling.
However, the mandate and structure of the CPA are mired with weaknesses that prevent it from adequately addressing the many abortion-related issues set out in this report, including that the CPA is a planning and coordination body with no regulatory authority, and the government is not obliged to follow its recommendations. Another serious problem is that the agency, by its mandate, is geared towards limiting the autonomous reproductive decision-making that women have a human right to exercise, rather than supporting it.
A state of isolation : access to abortion for women in Ireland in SearchWorks catalog
As a result of its limited mandate, the CPA has focused much of its attention and resources on funding counseling services and post-abortion care. The CPA claims that it has increased the provision of crisis pregnancy counseling by 55 percent since The current legislation, while regulating the provision of abortion-related information, does not regulate the provision of any other information. It acknowledged that it had received 67 complaints in a nine month period from women who had been victims of these agencies.
The Irish government has done little to mitigate the effects of a condemnatory public discourse on abortion on the sexual and reproductive health of its population. In fact, it has contributed to it by failing to provide and regulate the provision of accurate information by refusing to collect reliable information about the need for abortion in Ireland and by, on the one hand paying for some women to travel to the UK for abortions, [] while, on the other, going to court to prevent others from leaving the country to do so.
Dr Mary Favier summed up the often duplicitous public dialogue:. None of the women interviewed for this report were willing to be identified, even though all had told friends and family about the abortion and had received support and understanding from them. The women interviewed by Human Rights Watch described their feelings of isolation and shame, not related to the abortion, but to their fears of public disapproval.
Women were particularly concerned about how they would be treated by the medical profession. Both British and Irish service providers interviewed by Human Rights Watch indicated that the uptake of post-abortion care, which is free in Ireland, is low.
The numbers are even lower for post-abortion counseling. Since the mids, the UN treaty bodies that monitor the implementation of the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights, the Convention on the Elimination of All Forms of Discrimination against Women, the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, and the Convention of the Rights of the Child have produced a significant body of jurisprudence regarding abortion in over concluding observations concerning at least ninety-three countries.
They have repeatedly recommended the review or amendment of punitive and restrictive abortion laws and have urged states parties on multiple occasions to legalize abortion, in particular when a pregnancy is life or health threatening or the result of rape or incest. International human rights law and relevant jurisprudence support the conclusion that decisions about abortion belong to a pregnant woman alone, without interference by the state or third parties. UN bodies and conferences have recognized that firmly established human rights are jeopardized and prejudiced by restrictive and punitive abortion laws and practices.
Human Rights Watch has previously published detailed legal analysis of the relationship between international human rights law and abortion, equally relevant for Ireland. In the following, we lay out additional analysis, not previously published, on the right to information and the right to be free from cruel, inhuman, and degrading treatment. Particularly noteworthy to the violations exposed in this report are the circumstances in which Irish law on abortion violates the right to be free from cruel, inhuman or degrading treatment.
This right is protected by international customary law as well as by several international and regional human rights treaties. In May , the United Nations Committee against Torture CAT described the criminalization of abortion under any circumstances as a violation of human rights. Obstacles in access to abortion-related information may also violate the right to be free from cruel, inhuman, or degrading treatment. For example, this right is arguably violated where the government, as in the case of Ireland, actively contributes to or fails to mitigate the stigmatization and misinformation that is directly related to a heightened emotional distress and anxiety among women who seek abortion services abroad.
The clarity of the status and scope of state obligations with regard to the intersection of the rights to information and health also has particular relevance to Irish law.
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Entities authorized to interpret international law have made clear that governments have essential responsibilities in providing this information and in countering misinformation in the public sphere. In , the Committee on Economic, Social and Cultural Rights recognized that the right to health includes the right of access to information and health-related education.
The particular needs of women in relation to access to health-related information has also been highlighted by the Committee on the Elimination of Discrimination against Women the CEDAW Committee and the UN Special Rapporteur on Health who stated that one of the factors that make women more vulnerable to ill health is a lack of access to information.
The right to information, as it relates to the right to health, includes both the negative obligation for a state to refrain from interference with the provision of information by private parties and a positive responsibility to provide complete and accurate information necessary for the protection and promotion of reproductive health and rights, including information about abortion. Human rights law recognizes the right to nondiscrimination in access to information and health services, as in all other services.
Ireland has been repeatedly criticized by international treaty bodies for its failure to provide women with access to safe and legal abortions. We are grateful to the women who agreed to share their stories with us and we salute their courage and their resilience. Human Rights Watch thanks the many individuals and organizations that contributed to this report with their time, expertise and information.
Human Rights Watch is particularly grateful for the information, support, expertise and feedback provided by many staff members of the Irish Family Planning Association. Human Rights Watch takes full responsibility for any errors and omissions in the report. Skip to main content. Summary Every day, women all over the world face the decision of whether to terminate crisis pregnancies they did not plan, did not want, or cannot continue.
Recommendations To the Irish Government Take immediate steps toward decriminalizing all abortion for women living in Ireland. In the interim period, take urgent steps to: Ensure that a national regulatory framework is effectively implemented to clarify the circumstances in which abortion is currently legally available in Ireland. Develop a national framework to guarantee access to legal abortion according to international standards. To the Department of Justice, Equality and Law Reform Develop a uniform policy, including a streamlined process, for obtaining emergency travel documents for asylum seekers.
Ensure that female asylum seekers are informed that, should they need to leave the country in order to obtain an abortion, this information will be kept confidential, and will in no way affect their asylum claim. Develop binding guidelines to guarantee equitable access to abortion as currently permitted under Irish law, and to set out the duties of healthcare professionals and institutions in facilitating such access. Ensure that such guidelines specify: Develop guidelines on the right of individual healthcare workers who decline to provide abortions on the grounds of conscientious objection, including clear standards on: The right of all women to receive full and accurate information about their health options as well as emergency health care; The obligation of doctors to make a timely referral to a known practitioner who will perform an abortion; The obligation of all publicly funded health institutions to ensure that they have on their staff healthcare workers who will perform abortions; and The limitation of conscientious objection to individual medical staff, excluding institutions and administrative staff.
To the Medical Council Disseminate clinical guidelines that explain: When doctors may lawfully perform abortions; and The complete standards of clinical care required for women having abortions in accordance with international medical norms and scientific development, including criteria and standards for access to both surgical and medical abortion. The duty to provide emergency medical care; The duty to make a timely good faith referral to a known practitioner who will perform an abortion.
To the Crisis Pregnancy Agency Conduct a detailed evaluation of effective access to information about abortion and post-abortion care in Ireland, with particular focus on marginalized communities, with a view to developing targeted awareness-raising campaigns on these issues to close any information gaps.
Develop and disseminate guidelines regulating the provision of information relating to abortion, including requirements that all information be accurate and based on medical and scientific principles. Publicly challenge incorrect medical information on abortion, such as, for example, claims of links between abortion and breast cancer. Ensure that the positive options campaign differentiates clearly between two-option agencies and three-option agencies, with particular guidance to women on where to obtain information on abortion services abroad.
Assess the need for abortion services for women living in Ireland: Conduct a detailed survey of legal and illegal abortions carried out in Ireland; Conduct a detailed survey of the level of involuntary pregnancies in Ireland; and Conduct research on the reproductive health needs of those who cannot travel for abortion services such as immigrant and asylum-seeking women, minors, and those under state custody.
Withdraw funding from agencies that provide misleading or inaccurate information to women. Ensure that agencies funded to provide post-abortion care services provide full and accurate health information to patients, and that services are compassionate, humane, and respectful toward patient decisions, including the decision to terminate a pregnancy. Provide legal aid and support for women to make complaints where inaccurate information is being provided, and publicly announce that this support is offered. Conduct research on the reproductive health needs of immigrant and asylum-seeking women and advocate for the removal of travel barriers for women who travel for abortions.
Background and the Need for Services In their daily work family doctors see the reality of the failure of the state to legalise abortion. They see the palpable horror of the woman who awaits a pregnancy test that she fears is positive. She must face this situation in the knowledge that she cannot have an abortion in Ireland. Legal Framework Ireland has held 5 seperate [sic] referenda on the seperate [sic] occasions on this issue.
I am not aware of any proposal to put this before the people again. One of the main reasons that abortion remains illegal is because they can export their problem, because women can travel. A researcher and activist described how legal constraints on the provision of information, as provided for in the Information Act, negatively impact the provision of care: Claire A, a year-old woman, described her experience to Human Rights Watch: I checked in the Golden Pages [an Irish directory of products and services], and there was the first advert, called British Alternatives. I was very devastated that I was in this situation and I was afraid of getting a doctor who was unsympathetic.
I called them and told them I wanted an abortion and I needed to know how far along I was. They made an appointment for Saturday