How can a state control swallowing? The home use of abortion pills in Ireland

Abstract

Evidence suggests that there is widespread home use of abortion pills in Ireland and that ending a pregnancy in this way is potentially safer than the alternatives available to many women. This paper argues that there is a strong case for women with unwanted pregnancies to be offered truthful and objective information regarding the use of abortion pills by trusted local professionals and, further, that this is possible within existing law. A move in this direction would not, however, negate the need for legal reform to address the fundamental moral incoherence of a law that treats women who terminate pregnancies within Ireland as criminals but those who travel to access services overseas as victims in need of support. In support of these arguments, the paper draws on both library research and a small number of interviews with government officials, service providers and activists.

Empowerment and Privacy? Home Use of Abortion Pills in the Republic of Ireland

“…Sixty consignments of abortion pills impounded by Irish Customs in 2014 clearly originated from other suppliers, as WoW and WHW refuse to ship directly to Ireland, with women generally asked to provide an address elsewhere of someone who can either forward the pills or hold them for the woman to collect. A substantial clinical literature suggests strong grounds for believing that the online services offered by WoW and WHW are very safe and likely to be highly acceptable to women, particularly when compared to the alternatives available (Sheldon 2016). In interviews, this was confirmed by local activists who are in contact with the women who use the pills.…”

“…Nonetheless, they show a trend that is so marked as to suggest real and significant change, coming close to halving over the past fif- (Sheldon 2016). However, the illegal home use of abortion pills has undoubtedly contributed substantially to it.…”

“…Irish law prohibits the mail order supply of pharmaceuticals, and consignments of abortion pills are regularly impounded at the border (Sheldon 2016). While not wishing to be interviewed for this study, the state agency responsible for the regulation of medicines offered a statement about its work.…”

“…Indeed, the CPP advises that women who seek medical aftercare following home use of pills will not be reported to the police, with medical confidentiality protecting them other than in exceptional circumstances (e.g., where there is evidence of abuse; CPP n.d.a, n.d.b). The legal merits of this view are moot (Sheldon 2016), and robust empirical evidence to support it is lacking: the one small relevant study found that 12 percent of hospital doctors would be prepared to report an illegal abortion, with a further 14 percent unsure (Aitken, Patek, and Murphy 2017). However, the advice reflects a more general understanding that, at least with regard to women who have had abortions, the law will remain unenforced.…”

“…However, current official guidance states that offering such information may be considered to be aiding and abetting the criminal offenses committed by a woman who imports and uses abortion pills (CPP 2015, 9.4.2). While the accuracy of this advice is open to debate (Sheldon 2016), this carefully scripted silence-offering detailed advice regarding what counselors may and may not say (CPP 2015)-leaves women who want to know more about abortion pills reliant on negotiating the mass of information of variable quality available from other sources.…”