by Megan Stith

TW: mention of suicide

In October last year, abortion was decriminalised in Northern Ireland. After decades of campaigning, activism, and solidarity, pregnant people will no longer be criminalised for accessing their basic reproductive health care rights. This was a landmark moment for reproductive rights across the North and for the countless people who have pushed for compassionate treatment and dignity inherent to the human condition.

The Department of Health in Northern Ireland can now commission abortion services in General Practitioners’ clinics, Health and Social Care clinics, and hospitals around Northern Ireland. These health care measures, legal protections, and the recognition of reproductive rights represent a victory for committed human rights defenders and a step towards a more equal society. However, this is not the end of the fight for accessible reproductive health care. In fact, there is a distinct failure on behalf of the Northern Ireland Executive to provide accessible reproductive care for thousands of pregnant people.

The Northern Health Trust has closed its early medical abortion service due to limited resources, leaving pregnant people in the region without access to these services. The Northern Trust is one of the largest Health Trusts in the North, and with the Health Minister failing to fund its services, over a third of Northern Irish residents cannot access the healthcare they need without incurring their own costs to travel miles in order to access services. This “postcode lottery”  disproportionately discriminates against working-class pregnant people who are left to either find their way to another clinic – if there are even appointments available – or to go without their healthcare treatment.

Health Minister Robin Swann has failed to provide funding for abortion services, leaving local clinics without the necessary resources to provide services; 10 out of 26 local areas have had their early medical abortion clinics shut down, and the clinics that are still running do not have the capacity to compensate for the people who need reproductive care. Pregnant people have found themselves back in a pre-legalisation situation, with costly options to travel to England to receive treatment or to find alternative sources without consultation and support. This is all whilst we are in the midst of a global pandemic.

There is also concern that, under current government guidelines, there is no provision for taking both abortion pills at home during the pandemic. An abortion is performed by taking two pills: mifepristone and misoprostol, both of which must be taken in order to end a pregnancy. Current Northern Irish regulations do not permit the use of both pills at home, which severely limits the ability for pregnant people to successfully have an abortion without having to travel to a clinic during this unprecedented Covid-19 crisis, which restricts safe travel and requires potential quarantining and therefore time off for the pregnant person and their families – thereby limiting their earning power and ability to provide for their wellbeing.

Abortion care is a class issue. Denial of access to this service ensures that pregnant working-class people are kept in a cycle of poverty and danger. Without the time or money to access clinical abortion, working-class people are either left to carry a pregnancy that they do not want or cannot afford, or they are forced to turn to unsafe procedures that risk their health and the safety of their families.

The Royal College of Obstetricians and Gynaecologists has criticised Robin Swann for failing to commission abortion services in Northern Ireland, and the failures of the Health Department have pushed pregnant people to seek dangerous alternatives – from back-alley abortions to carrying an unwanted pregnancy, and even suicide. “This harm cannot be overstated”, a letter to The Independent from the College states, “There have already been at least two cases of attempted suicide by women in Northern Ireland unable to access care. We are also aware of a substantial increase (plus 28%) in women turning to unregulated methods of abortion during the pandemic”. Northern Ireland has been experiencing a rise in Covid-19 infection rates, and expecting pregnant people to travel whilst in a vulnerable condition is asking them to place themselves in a position to catch and spread the infection.

Campaigners, activists, and people all across Northern Ireland have fought for their right to accessible abortion care for decades and have seen the current governments in Stormont and Westminster fail to protect these rights in order to restrict health care to the working class. By neglecting to fund these services, neoliberal governments are signalling to working-class pregnant people that their health is not a priority for a system that only cares to hoard their unearned wages. We call for an immediate provision for both abortion pills to be made available for at-home use, and for the release of funding owed to the health services that care for pregnant people.

The Socialist Party believes that there is a need to campaign to ensure decriminalisation of abortion translates into actual access for all who need it, free on the NHS in Northern Ireland. Unions and pro-choice groups must keep up the pressure on the government to secure equal and accessible health care, and resist the anti-choicers who wish to restrict bodily autonomy and subjugate pregnant people to an unwanted situation that will impact them for the rest of their lives.