The struggle to give Northern Irish women access to abortions on the NHS in mainland Britain may finally have been won this summer, but for those women and others from the Republic of Ireland where abortion is illegal, there are still many obstacles to overcome.
Research led by Dr Deirdre Duffy of Manchester Metropolitan University found that many Irish Women seeking an abortion are not receiving good enough pre and post abortion care. Other findings are that:
- the cost of the trip to England means there is still a financial prohibition on abortion for many women
- there is no systematic, centralised management of the care women receive
- there is limited evaluation of the care women receive
- women could still face opposition, censure and lack of support at home.
Dr Duffy's study will be the focus of an event as part of the ESRC's annual Festival of Social Science. The research, funded by Wellcome, explores care workers' perceptions and perspectives about the care for Irish women travelling for abortions.
The study found that stigma surrounding abortion and the lack of clarity on the legality issue, meant that some women were not seeking help back in Ireland when it was needed.
Dr Duffy, senior lecturer in the Faculty of Health, Psychology and Social Care at MMU, said: "Women must undertake the long and expensive journey for this medical procedure when they are emotionally and physically vulnerable.
"What we have found is that women have to navigate abortion care with little support. This may mean that women go to centres without appropriate care or that they are not fully clear on the process. The fact that women are not part of a single care pathway also means that they can fall through gaps between services.
"These women have very distinct needs, they are travelling from somewhere where abortion is stigmatised and illegal and some women really believe they are breaking the law. They may not tell anyone back home what they are doing. Participants in our research also felt like there was no continuity of care and that it was a broken circuit where they had to abandon women."
One of the healthcare professionals from the Republic of Ireland says in the report: "I see women who would come in after having had abortions in the UK... Women are delaying their access to medical care because they don't know if they are in a legally OK place. I've had a woman come in… bleeding so much and she had delayed coming into see us and she was asking me 'am I going to get in trouble?'"
Although UK abortion clinics provide their patients with documentation about the procedures to give to healthcare workers at home, the study found that some women would not keep this as they feared the reaction if somebody saw it. One clinic manager told the researchers that they thought some women even left their discharge letter, which contains details of the procedure, gestation and haemoglobin levels, in bins at the clinic before they left, as they did not want to risk travelling with that information on them.
Dr Duffy said that there needed to be better awareness of the practical problems that the requirement to travel creates.
Although women from Northern Ireland may now access free abortions in the UK, they still have to pay travel costs. Those from the Republic of Ireland will still have to pay privately for the abortion as well as the journey to the clinic. The study found that this could cost between £500 and £2,000.
The report says: "Having to access services abroad and pay for them plus travel costs means that women from Ireland are unable to access services quickly. During our research, it was reported that women often have to wait for flight prices to be affordable by which time their gestational limit has increased and the procedure may cost more. In addition, because of the illegality of abortion and the stigma associated with it, women may wait longer to confirm a pregnancy test or may travel to England without having a scan to determine their length of pregnancy in Ireland. This puts them at risk of being turned away by clinics (for being too early or too late) and having to make a repeat journey."
Dr Duffy hopes that the research, in the longer term, could influence policymakers to review abortion care and, eventually, support a change in legislation. It has already been picked up by the Irish Family Planning Association.