Ailbhe Smyth has been fighting to repeal the eighth amendment banning abortion since it was inserted into the Irish Constitution in 1983, and has been fighting for women’s liberation and LGBTI rights since the late 1980s. More than any other individual, she has provided the consistent leadership, energy and commitment to alliance-building that resulted in the historic victory of the Repeal movement in 2018. She spoke to Irish Broad Left editor Emma Clancy on Saturday April 20 about the significance of the campaign’s victory; the ongoing problems in implementation; and solidarity with those in the North fighting for their reproductive rights.
When I spoke to Ailbhe Smyth last week, it was just days after the three leaders of the Together for Yes campaign – Ailbhe, Grainne Griffin and Orla O’Connor – had been recognised for their work by Time magazine, who named them as being among the 100 most influential people of the past year.
“This recognition was terrific, of course”, Smyth said, “but not for us as individuals. It was a very important decision made to put the three co-directors of Together for Yes on this list because it put the issue of abortion itself at the very centre of this international and influential agenda.
“The Repeal campaign had a big impact internationally, and this recognition by Time should be viewed as a ‘hooray’ for women, copper-fastening the victory of the Repeal campaign in the international mainstream.
“Consider the international context: There was a specific reason why we were recognised for our successful campaign for women’s rights at a time when these rights are coming under attack around the world. Our victory was a much-needed morale boost for the pro-choice activists fighting for their rights in so many countries, including in Brazil, in Poland, and in the US itself, where there is a massive attempt by the conservatives to roll back hard-won reproductive rights at the state and federal level.
“We also welcome Time’s recognition of our movement because it demonstrates that despite the rapid growth of the far right around the world over the past several years, Ireland was able to buck this trend in 2018, just as we had done with the marriage equality referendum in 2015. So we have proved that people and communities working together can stand up and overcome the far right and the threat they pose.
“That is particularly significant at this precise moment, when we have progressives and socialists fighting to resist the drift to the far right in the crucial European Parliament elections in May. At this particular moment, there is enormous value in our campaign being named, recognised and applauded internationally. It is an affirmation that abortion rights matter, that women’s lives matter.”
A ‘phenomenal moment’
Ailbhe and her fellow pro-choice activists are not sitting on their laurels. At an event held on 13 April 2019, the Coalition to Repeal the 8th met for a working conference with its members, focussing on key topic such as international solidarity, ‘The North is Next’, and implementing the new abortion law and services.
In our interview, Smyth outlined some of the practical problems of implementation of the new law in the southern state, as well as problems with the legislation itself. In a way, she said, the real work is just beginning.
“We were always very clear in our broad campaign, involving 120 organisations, that Repeal was just the first step. We had to remove the obstacle preventing legislation for provision on abortion; we always viewed that goal as the first step in a much longer and more complex process. As soon as the eighth amendment was gone, a huge amount of hard work would have to take place,” Smyth said.
“Stage one was Repeal. Stage two is the very challenging work of making sure that the legislation is implemented properly and that services are provided for everyone who needs them.
“In fact the legislation itself is actually more progressive in certain ways than we had hoped for or anticipated when we started this process after the Protection of Life During Pregnancy Act 2013 was enacted in the Dáil. The broadening of the the legislation came about as a result of hard lobbying and campaigning over years, and were given shape and substance by the recommendations of the Citizens’ Assembly.”
Like most pro-choice campaigners at the time, Smyth viewed the creation of Citizens’ Assembly with scepticism. “We saw it as a delaying tactic by the government and a way for the government to hide behind a smokescreen – regardless of whether the outcome of their deliberations was a ‘yes’ or a ‘no’. But pro-choice activists engaged fully with the Assembly regardless, and ensured that they heard the facts and the evidence, and, most importantly, the real-life stories of what the denial of abortion rights had meant for women in Ireland for decades.
“The Citizens’ Assembly gave genuine consideration to what abortion rights really meant to women’s lives in reality, and in the end, they gave a resounding ‘yes’. They voted firmly in favour of the legalisation of abortion here in Ireland for up to 14 weeks without restriction, and up to viability where there is a risk to a woman’s health. They also voted in favour of abortion in cases of fatal foetal anomaly.”
The Joint Committee in the Dáil then broadly upheld the recommendations of the Citizens’ Assembly, although it did not vote for abortion for socio-economic reasons, and reduced the ‘on request’ time limit from 14 to 12 weeks.
“Ireland took a new direction when we voted to repeal the eighth amendment, and it was a phenomenal moment. We were asking voters to take this major step in a new direction on this, and asking them to affirm that they believed women should be able to make their own reproductive choices,” Smyth said.
“The referendum result indicated that we had indeed undertaken this huge turnaround as a people and as a society, as abortion had previously been considered so taboo, unacceptable, unspeakable.”
On 26 May 2018, the Repeal the Eighth campaign won the referendum with a massive 66.4 per cent of the vote. The new legislation came into effect on 1 January 2019.
Transforming culture in the health sector
Smyth said: “The outcome was better than we hoped, but the reality is that women’s autonomy is still subject to a set of laws in place regulating our bodies. I am opposed to any laws placing restrictions and regulations on women’s bodies and limiting the right to abortion. But that was always going to be the case, especially in Ireland. It means we have further work to do. To my knowledge, Canada is the only country in the world in which abortion is not subject to legislation. ”
Ailbhe went on to say that while the new law is to be welcomed, there are certain specific restrictions causing problems for individuals and groups of people.
“The legal profession, the medical and healthcare professions have all had to undertake a sharp turn on this issue since January; they have had to make a 180-degree turn in their mentality, and transform a culture of prohibition to one of making abortion legal and accessible. It is inevitable that there will be some problems in achieving this transformation, especially as we are only 100 days or so into the process. But it is very important, of course, that these problems should be resolved promptly.”
Training has has already taken place or is ongoing for health professionals, including GPs, midwives and nurses, and training in abortion provision is also taking place in public hospitals. Precise numbers are difficult to estimate but around 1,000 medical professionals have had training since 1 January 2019.
There is a political debate going on between different groups of GPs – one group argues that medical abortions should not take place in a general practice setting. However, a larger group of GPs have responded to this claim by stating that abortion provision is now already established in a GP setting in Ireland, as recommended by the World Health Organisation, and that limiting abortion provision to specialised abortion clinics only would add to the stigma and shame felt by women seeking an abortion.
Smyth believes these debates are inevitable but is already heartened by the strong response in favour of normalised and accessible abortion care from growing numbers in the healthcare profession.
“We need to support this cohort of progressive doctors, nurses, midwives and healthcare providers as they are engaging genuinely with their colleagues in general practice and in hospitals to put abortion services in place to meet people’s real needs.
“All hospitals are now offering some level of service, although only 10 hospitals have full abortion services. But I believe that all hospitals have now realised that they have a legal obligation to provide the services that the people effectively voted for in the referendum. Most hospitals appear to be developing provision and training.
“It is about moving the whole profession along – and the health service as a whole – and the hospitals are very aware of this. There have been complaints made that guidelines have been slow to come into the hospital system, so the process is not complete; it is ongoing and requires further development. Of course, as campaigners and activists we would all like to speed up that time so that everyone who needs an abortion can access it here in Ireland.
“Doctors need to be reassured that the people support them. The people voted overwhelmingly in favour of this. And there are so many people in the medical profession working wholeheartedly right now to make choice a reality. They need and deserve our support.”
Smyth said that abortion rights campaigners are hearing relatively positive feedback about the state-run Health Service Executive (HSE) My Options website and helpline aimed at providing information, including about abortion services, for people experiencing crisis pregnancies. “In general in the HSE I think there is a broad willingness there for people to work together to make this happen,” she said.
“As we always knew, some of the biggest problems are those contained in the legislation itself. The so-called ‘three-day cooling-off period’ is a prime example. The insertion of this patronising provision was a strategy to try to mollify the reluctant politicians, and it is proving to be problematic in all the ways clearly outlined before the referendum by health professionals, lawyers and campaigners,” Smyth explained.
“The ‘cooling off’ period involves three visits by a woman to a GP; the first one where she indicates she wants to have an abortion; the second visit after the three day period; and then typically she will have to go back to the GP a third time for the actual service (i.e., the ‘abortion pill’), provided she is within the nine-week period.
“This is clearly not good for women psychologically or emotionally. But practically it can pose major problems. People from rural areas especially are experiencing problems. There may not be any GP locally willing to provide abortion services, and they will have to travel to another town, or perhaps to to Dublin or Cork to see a GP. This means time off work, travel costs, and childcare costs which may well prove very difficult. Where a woman is unfortunately in an abusive relationship, it may be very difficult for her to ‘explain’ these visits.
“There are specific difficulties which can arise for trans people, for women living in poverty, for women with disabilities, for migrant women and particularly for asylum-seeker women living in Direct Provision, who are appallingly supposed to survive on €19.50 a week.”
Smyth said to make abortion provision genuinely accessible, medical and health services must put supports in place to respond to the needs of specific groups, especially people who are marginalised, who always take the hardest hit where access is restricted.
“We have a lot of work to do to ensure that women who are marginalised have genuine access to these services. We always have to bear in mind that people do not come in one uniform shape and size; we live in a society riven with inequalities and these inequalities come to the fore as barriers that are so important when a person may be in a state of anxiety or turmoil and in need of an abortion.”
“So-called conscientious objectors in the medical profession are causing problems of access for women, particularly in rural areas. But they cannot simply turn a woman away; they are legally obliged to provide her with a referral. A woman who knows or suspects that her local GP is anti-abortion will most likely have to travel to a GP in another town. Rural women are hardly a marginalised group numerically, but given the negative response of some GPs, they may be made to feel that way,” Smyth said.
“We are trying to limit the damage that can be done by a small number of people who are trying to obstruct and thwart women from going about their absolutely legal business. It will take some time to get the new reality into the heads of those who oppose abortion – that providing abortion is the law of the land, and a human right that can no longer be denied. Opponents need to be made aware that they cannot obstruct people from accessing their rights without committing a breach of law, and being sanctioned in response.”
Abortion after the 12-week ‘on request’ period
“Within the first nine weeks of pregnancy, abortion access is straightforward – at least in principle. Medical abortion (the abortion pill) is not administered by GPs in Ireland after the first nine weeks of pregnancy, and in the nine to twelve-week period, women are referred by the GP to a hospital service,” Smyth said.
“After 12 weeks, abortion is available only in restricted circumstances: where there is a risk of ‘serious harm’ to a woman’s health, and where there is a diagnosis of a fatal foetal anomaly, which means that the foetus is affected by a condition which is likely to cause its death before or within one month of birth.
“At this early stage of service provision we do not yet have official data, in the public domain, on how either of these situations is working out for women. But I think it is fair to say that problems may well arise when it comes to ‘serious risk’. ‘Serious’ is a subjective term, not a scientific one, as doctors pointed out to the Joint Oireachtas Committee. It is open to differing interpretation, and dependent on the judgment of the medical professionals. Similarly, there are likely to be difficulties with late diagnoses of fatal foetal anomaly.
“A key point we need to bear in mind, once past the 12-week period, is that the law has not fully decriminalised abortion. As it stands, medical professionals are still liable for prosecution and imprisonment if they perform an abortion outside the strict terms of the law. This obviously has a chilling effect on doctors’ activities.”
The Abortion Support Network, which supports people who need to travel from Ireland (north and south), the Isle of Man, Malta and Gibraltar to have a safe, legal abortion, have told Smyth that travel from the south of Ireland has dropped significantly this year. Ailbhe said this is a very welcome indication that “in general the law is working for the majority of people seeking abortion, but that there are certainly problematic areas which will have to be reviewed and resolved”.
Upcoming review of the legislation
The existing legislation is due to be reviewed within three years. Smyth says abortion rights campaigners will be pushing very hard for full decriminalisation of abortion to resolve the problems with late diagnoses of foetal abnormalities, and to ensure that the abortion should be able to take place without the subjective ‘serious risk’ requirement. The three-day cooling off period also has to go, she said.
“We were also promised safe access zones by the minister of health, but for a variety of reasons, the bill has not yet come before the Dáil and we don’t yet have this legislation in place. It is urgent that we get it into law. There were a few extreme examples of protests, harassment and intimidation of women, especially in January.
“The Taoiseach has said he is seeking advice on this matter from the Attorney General on the conflicting rights at play here. But it should be abundantly clear that in any conflict between the right to free speech and the right to safe access, the fundamental right to security must be paramount. It is absolutely crucial to have safe access – so we need this legislation in place now.”
Solidarity with women in the North
Ailbhe said the coalition of activists and groups who worked together on the Repeal campaign continue to work closely together, with several shared priorities. One of these is to ensure the effective, swift and smooth implementation of the existing legislation in the south to make sure that all women, including those from the most marginalised groups, have access to abortion services if they require them. Another priority is monitoring the problems in the existing legislation, and building a case for reform to be submitted to the government as part of the three-year review process.
Of course, building solidarity with the pro-choice activists in Northern Ireland, where women are still denied basic reproductive rights is a top priority of the all-island campaign networks.
Smyth said: “There is a tremendous sense of solidarity. Last week we held an event where the Coalition to Repeal the Eighth met for a conference where activists sat on a panel themed, ‘The North is Next’, with northern pro-choice activists such as Dawn Purvis taking part.
“There is a tremendous commitment to solidarity ideologically, but there is also huge level of practical solidarity through the close cooperation of organisations such as Abortion Rights Campaign and Alliance for Choice.
“The victory of the Repeal movement undoubtedly had a big impact in the North and gave a huge morale boost to organisations like Alliance for Choice. And that is brilliant. But for me, solidarity is not about telling people how to follow your own campaign, however successful. Each jurisdiction has its own set of unique circumstances and specific context. There is no template to follow.
“What we can do is respond to requests for practical solidarity, respond to questions about certain lessons we learned, and turn ourselves into a resource that can used by the people on the ground who understand their own jurisdiction and its particular challenges best.
“I would hope that we can keep the pressure on politically in the North. What I hope to see in future is unified legislation on unified abortion service provision on the island of Ireland – that’s the kind of solution we have to put on the agenda.”
Defending women’s rights internationally
Smyth concluded by pointing out that women and their reproductive rights have been a permanent target of the far right, meaning vigilance and solidarity in the coming years will be exceptionally important.
“International solidarity on abortion rights is becoming more important than ever in the current political climate where we have an upswing in the far right in Europe, the US and around the world.
“Women’s rights and women’s bodies are always one of the prime targets of the far right – so we have to continue to work together, support each other, and share our resources in order to defend the gains we have won and push for more,” she said.
Photo pictured above: Ailbhe Smyth (centre), with Orla O’Connor, left, and Grainne Griffin, who collectively were named as among Time magazine’s 100 most influential people as the three co-directors of Together for Yes.
Ailbhe Smyth is co-director of Together For Yes and Convenor of Coalition to Repeal the 8th Amendment. Follow her on Twitter @ailbhes. Follow the Coalition to Repeal the Eighth Amendment @repealeight, and Together for Yes @Together4yes. To support the Alliance for Choice in the North, follow @All4Choice.