This article analyses abortion health activism (AHA) in the Irish context. AHA is a form of activism focused on enabling abortion access where it is restricted. Historically, AHA has involved facilitating the movement of abortion seekers along ‘abortion trails’ (Rossiter, 2009). Organisations operate transnationally, enabling access to abortion care across borders. Such AHA is a form of feminist anarchism, resisting prohibitions on abortion through direct action. However, AHA work has changed over time. Existing scholarship relates this to advancements in medical technology, particularly the emergence of telemedicine and the increased use of early medical abortion. This article goes beyond those explanations to explore how else AHA has changed by comparing the work of AHA before and after the Republic of Ireland’s referendum on abortion in May 2018. Based on this, I argue that there is a visible shift in the politics of AHA. Drawing on qualitative data from research on AHA organisations along the Liverpool–Ireland Abortion Corridor, specifically those based outside Ireland, the article argues that in the aftermath of the referendum, Irish AHA has increasingly moved towards decolonising feminist activism, thus drawing attention to the relationship between abortion health activists (AHAs) and broader political discourses entangled with abortion law reform.