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How many women in Ireland request abortion pills? How safe are they? Are they illegal?

And how much will they cost if abortion is legalised in Ireland?

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In our Q&A: Eighth Amendment Referendum series, we are answering questions our readers have submitted in relation to the upcoming vote on 25 May.

THE QUESTION 

A number of people have asked a version of these questions. Here are some of those queries:

  • There’s been lots of talk about people in Ireland taking abortion pills every day. Can you tell me how many people really are taking these pills?
  • Please can you give info around helping someone else to procure a pill, if you’re with them when they take it, or even take them to hospital if something seems wrong? Can this person be prosecuted?
  • A lady was interviewed who is an abortion pill vendor in the Netherlands who stated that orders from Ireland have increased by 190%, and that’s just a single vendor. So, please, if possible can you factcheck the 1 in 20 figure currently being used as such a prominent soundbite?
  • Under the Eighth Amendment, it is illegal to have an abortion. If a woman has taken abortion pills but then requires needs medical assistance and presents at a hospital for treatment will she: 1. Be reported by staff to the Gardaí on suspicion of terminating her pregnancy illegally? Or if she mentions it to staff that she has taken medication? 2. Would the state prosecute her and sentence her to 14 years? Will removing the Eighth Amendment decriminalise unregulated abortion if the Eighth is repealed?

THE ANSWER 

It’s currently illegal to take abortion pills in Ireland.

The Eighth Amendment, or Article 40.3.3 of the Constitution, states that the right to life of the unborn is equal to the life of the mother, which prevents abortion in Ireland.

To vindicate and protect that right to life, legislation – the Protection of Life During Pregnancy Act 2013 – outlaws abortion except in very specific, exceptional circumstances.

Section 22 of the Act says it shall be an offence to intentionally destroy unborn human life. The maximum sentence if convicted is 14 years imprisonment.

Subsequent amendments to the Constitution, however, made it legal for Irish women to travel abroad for an abortion or to seek information about the termination of a pregnancy.

If there is a ‘Yes’ vote on Friday, which would repeal the Eighth Amendment, legislators in the Oireachtas would be allowed to change the laws which regulate the termination of pregnancy.

The legislation proposed, if passed, would see abortion without restriction allowed up to 12 weeks of pregnancy. Medical abortions, or terminations of pregnancies through taking abortion pills, would be the main way to terminate pregnancies within that 12-week timeframe.

shutterstock_1059679985 Source: Shutterstock

About the abortion pill

Medical abortion involves taking two pills – mifepristone and misoprostol. The first pill disrupts the pregnancy, and the second causes the uterus to contract and expel its contents in a similar way to a miscarriage.

Stats on use

It’s estimated that around five Irish women request an abortion pill everyday from telemedicine websites; with a further two women from Northern Ireland requesting the same.

Minister for Health Simon Harris said that his department estimates around three women a day in Ireland take abortion pills.

When asked at a briefing last week about what explained the discrepancy in figures, Dr Rebecca Gomperts of telemedicine service Women on Web said that women might request an abortion pill, but could decide at a later stage to continue with the pregnancy.

“The fact that the option of getting an abortion is there for women, helps stop the panic and helps them make a decision,” she said.

What is also interesting is that the data shows quite a lot of women decide not to get an abortion, because actually for them it was such a relief that they had the medicine they could start to really think about whether they wanted to have an abortion or not.

Women on Web can’t say that a woman has had an abortion just because the pills were sent out.

Last week, Renua expressed doubt over the number of abortion pills in Ireland, and asked for “proof of exactly how many pills are coming into the country”.

Because abortion pills are illegal in Ireland, there is no way of getting an exact figure on how many are being taken by women each year. Estimates are based on the number of pills sent out by telemedicine websites like Women on Web, drugs seizures made by Irish authorities, and some studies.

Research by Dr Abigail Aiken (more on this later in the article) showed that requests to Women on Web have tripled between 2010 and 2016. That figure that has been peer-reviewed and published in both the British Journal of Obstetrics and Gynaecology, and the British Medical Journal.

In relation to claims that requests to Women Help Women have increased by 190%, it’s difficult to prove or disprove those exact figures, but it’s widely regarded that requests for abortion pills are increasing.

At the Oireachtas Committee on the Eighth Amendment, Judge Mary Laffoy quoted research from the HSE which shows that there are “increasing numbers of women who are making contact with online abortion pill providers”.

It’s thought that the increase in abortion pill requests is due to increased awareness of them as an option, as it’s also coincided with a drop in the number of women flying abroad to access an abortion.

According to the UK Department of Health’s figures, the number of women giving Irish addresses at abortion clinics has decreased from 6,673 in 2001 to 3,265 in 2016 – a decline of 51%.

In the past 10 years, more 6,000 abortion pills have been seized by Irish authorities, according to the Health Products Regulatory Authority.

original (2) Source: Statista

Dr Abigail Aiken, an Assistant Professor of Public Affairs at the University of Texas at Austin, conducted research into the use of abortion pills through telemedicine websites. During her research, she asked 1,000 women about their experiences, including interviews with 40 Irish women.

Her research indicated that of those who ordered abortion pills, 63% were mothers, and the majority of women were in their 30s.

Some of those women reported going to extreme lengths to end a pregnancy, her research indicated; some try herbal remedies, others “drink alcohol” or “ask to be punched in the stomach”.

Safety

The issue of safety of abortion pills has been raised a number of times during the referendum campaign and before it.

According to Positive Options, the side-effects of abortion tablets may include excessive bleeding, pain, collapse, diarrhoea and shortness of breath.

The site cautions the dangers of ordering abortion pills online: “There is no way of knowing what these products actually contain and what the side effects might be for her.”

Source: TheJournal.ie/YouTube

Dr Gomperts said that millions of women have used this medicine, and misoprostol is listed on the World Health Organisation’s list of Essential Medicines.

“It has exactly the same health effects as a miscarriage, Miscarriages are very common and as with a miscarriage complications are extremely rare,” she said.

If you compare the safety of early abortion to the safety of giving birth, actually an early abortion is much safer for a woman than continuing the pregnancy. The mortality of an early medical abortion is less than one in half a million, and is safer than using viagra or using penicillin. It’s actually safer than driving a car.

She said that in some cases there are conditions which mean that taking abortion pills isn’t safe, but these are extremely rare.

Dr Aiken’s research indicated that almost 95% (947 women) reported that taking a combination of mifepristone and misoprostol ended their pregnancy, 0.7% required a blood transfusion, 2.6% required antibiotics, and overall 9.3% experienced symptoms potentially requiring medical attention. There were no deaths.

Cost

It’s not certain how pregnancy termination services would cost in the event of a ‘Yes’ vote (we had a look at the options in this piece). Dr Ronald Johnson of the World Health Organisation told the  Oireachtas Committee on the Eighth Amendment:

“I cannot answer the question about costs. The cost of an abortion varies across the world from being free to $1,000. Women in New Zealand and the United Kingdom receive a free service. The cost of an illegal abortion can be astronomical.”

He added: “Misoprostol is a generic drug and very inexpensive, the price is cents per tablet. Mifepristone is now also very inexpensive. It can be sourced in bulk for approximately $3.50 per tablet (€2.97).”

It’s free to order abortion pills from not-for-profit websites like Women on Web, but they ask for a donation fee of €70-€90 (or whatever the woman can afford).

Legality

Speaking to TheJournal.ie, the chair of the Referendum Commission Justice Isobel Kennedy answered some of the questions people had around the legality of taking an abortion pill.

“Within the Protection of Life during Pregnancy Act 2013, there is a provision which is Section 22 of that Act, and that says that it is the intentional destruction of unborn human life is a criminal offence.

That particular offence carries a maximum penalty of 14 years imprisonment or a fine or both. The duration of the prison sentence must not exceed 14 years of course a lesser sentence may be imposed by the court.

When asked in the event of a ‘No’ vote could the government decriminalise that Act, Kennedy said that the government currently has an obligation to defend the life of the unborn if taken.

“…And one of the ways of doing that is by way of a criminal sanction. And it is the duty of the State to vindicate and to defend a Constitutional right.

So we the Referendum Commission believe it is unlikely that it will be removed from the Statute Books because of the content of Article 40.3.3.

Kennedy also told Morning Ireland previously that if there’s a ‘No’ vote on Friday, the criminal offence would be for intentionally ending an unborn human life, and is separate to the offence of murder.

“It is not an offence to fail to report someone taking an abortion pill, but it is an offence to intentionally destroy unborn human life. So if a person were charged with that offence, and were convicted of that offence, that person would then have a criminal conviction.”

If you have another question, please send it to referendum@thejournal.ie

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