Ireland: Yes vote would give hope to millions across the globe

I am an international human rights lawyer with two decades experience working on sexual and reproductive rights globally, including as a consultant for the World Health Organisation and other UN agencies. I tend to work in countries with restrictive abortion laws, like Ireland. I have found Ireland’s almost total abortion ban amongst the worst. Only if a woman’s pregnancy might kill her can it be terminated, because of the Eighth Amendment inserted into the Constitution in 1983.

In 2014 I talked to women about their experiences, and doctors about their frustrations. I still cry recalling what women shared

Christina Zampas

In 2014 I was back in Ireland, conducting research for Amnesty International. Talking to women about their experiences, and doctors about their frustrations, it was the first time I delved deeply into understanding the Eighth Amendment’s harshness and cruelty. I still cry recalling what women shared.

In my report for Amnesty, ‘She is not a criminal’, published in June 2015, I found that women’s human rights are gravely violated in multiple ways. Addressing the Oireachtas Joint Committee on Health in June 2015 on Amnesty’s report, I could see growing political intolerance of this suffering.

I commend this Government for taking decisive action. The Citizens’ Assembly made excellent proposals last year. When that process moved to the Joint Oireachtas Committee on the Eighth Amendment last autumn, I was invited as an expert witness. I could see first-hand its members’ care and compassion for women, and their attention to fact and evidence. The women members were especially critical in this, and holding the ground on equality.  

I was in Dublin again recently, to speak at a conference on ‘Human Rights During Childbirth’ (as it happens, another area of reproduction where women’s rights are limited by the Eighth Amendment.) It was amazing seeing the referendum posters up: A feeling of justice on the brink. Now, women’s rights are finally back in the people’s hands. I worry though that voters lack the facts the Citizens’ Assembly and Oireachtas Committee had. So I would like to offer some from my experience.

When I was conducting my research, the Protection of Life During Pregnancy Act 2013 had just come into law, despite fierce resistance by anti-choice groups. still seems to escape media and public attention today, that this law does not allow terminations even where pregnancies pose serious, irreparable or long-term damage to women’s health. This is because the Eighth Amendment has no regard whatsoever for a woman’s health (or indeed if she has been raped, or received a diagnosis of a severe foetal impairment).

The reality is that remaining pregnant – not just some other health condition – can harm a woman’s health. Abortion care can be the medical treatment needed to save her health. It is standard medical practice across Europe that termination is amongst the options available to doctors in managing high-risk pregnancies. But in Ireland, because of the Eighth Amendment, it is not only prohibited in this situation, it is also a criminal offence for woman and doctor, carrying a possible 14-year prison sentence.

So women are forced to travel to other countries for health-saving abortions. For some with serious or complex health conditions, travel is impossible or too frightening, and taking abortion medication (illegally) too precarious. So some women face the terrifying prospect of knowing they have no option but to continue a pregnancy, no matter how devastating the impact on their health and their families.

One of the many tragedies leading to this referendum was Savita Halappanavar’s death in October 2012. It sent shock waves around the world. Few outside Ireland had realised just how dangerous the Eighth Amendment was for pregnant women. But Savita’s husband made sure her story was told. Ultimately, the HSE’s independently chaired inquiry concluded that the Eighth Amendment was one of the reasons for her death.

The simple, awful truth is, had a risk to health ground been in Irish abortion law then and applied, Savita would not have died. At the point when she was miscarrying and her health was clearly at risk, when she had requested an abortion she would have got it.

This is what anti-choice groups try to paint over with their referendum posters of six-month old foetuses. The Government’s proposed availability of abortion up to “viability” would apply only where women’s health is at risk of “serious harm” (or the foetus has a “fatal condition”). Also, abortions in these circumstances are generally of very much wanted pregnancies, and everything is done to save the woman’s health and pregnancy. In fact, this is a very narrow health ground compared to most other countries in Europe, including England.

For people in Ireland truly concerned about women’s health, the Government’s proposed access to abortion ‘on request’ in early pregnancy is very important; not only in itself to respect women’s autonomy, but also to complement the health ground. Within this proposed 12-week period some possible health risks related to the pregnancy could be averted early, without reaching the “serious harm” threshold.

In conclusion, surely the measure of success for healthcare is how well it protects women’s health?   Healthcare aimed only at preventing their death suggests women’s bodies matter only in relation to their reproductive function, at any cost. This is not the Ireland I know.

A Yes vote would send a powerful message to women in Ireland that their health, equality and human rights are valued

Christina Zampas

On the other hand, placing women’s health and rights at the centre of their healthcare does not require ignoring foetal interests. Prenatal life can be safeguarded by ensuring safety in childbirth, reducing stillbirths of wanted pregnancies, and promoting healthy birth outcomes, and preventing crisis pregnancies. But prenatal life may also be protected by regulating abortion, so long as that regulation is evidence-based and consistent with women’s rights. This is what the model of law reform on the table in Ireland would achieve: respecting women’s rights and protecting foetal welfare.

A Yes vote on Friday would send a powerful message to women in Ireland that their health, equality and human rights are valued. It would also give hope to millions of women across the globe that change is possible in their countries too.

This article first appeared in the Irish Examiner here

Christina Zampas – a former Senior Legal Adviser at Amnesty International – is an independent consultant and Sexual Health Law Fellow in the International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto.