Abortion

Ireland’s Repeal of the Eighth in Retrospect: Evidence and Empathy Won the Day

We talked about "compassion in a crisis." But did pro-repeal campaigners miss opportunities to talk about autonomy, the right to abortion, and medication abortion's safety when we fought the country's draconian abortion ban?

[PHOTO: Red mural of smiling South Asian woman and a woman with small children kneeling.]
A woman and children stop at a Dublin mural remembering Savita Halappanavar, a 31-year-old dentist who died in 2012 due to the miscarriage complications that went untreated due to Ireland's abortion ban. Her death galvanized pro-choice activists in this year's successful repeal. Barry Cronin/Getty Images

In May, a two-thirds majority of Irish voters cast ballots to repeal the Eighth Amendment, a constitutional ban on abortion.

Having moved away from Ireland for work, I wasn’t directly involved in this most recent phase of the referendum campaign. But I had been an active member of the Abortion Rights Campaign in the three years leading up to the vote and was heavily invested in the result. Several exit polls made me optimistic, but cautiously so, not wanting to count unhatched chickens or uncounted votes.

When the official result came in, I hugged friends and fellow campaigners a street chockablock with stark REPEAL sweaters and colorful Together for Yes T-shirts. We repeated, like a happily bewildered broken record, “We did it, we did it!” But overwhelmingly, the mood in Dublin city center that night wasn’t celebration, but relief that we were going to alleviate women’s suffering.

A Yes voter waited anxiously at Dublin Castle for results in the Irish referendum on the Eighth Amendment concerning the country’s abortion laws on May 26. (Charles McQuillan/Getty Images)

Irish society has changed profoundly since the Eighth Amendment debuted in 1983, particularly in the Catholic Church’s diminishing dominance and the increased visibility of women. Together, a combination of cultural change and evidence also won the day. Campaigners worked hard to make sure that information about how Irish women need abortion and how many were accessing it regardless of the ban took center stage.

Waking Up to the Realities

Educating the public was no small task. Ireland’s law said the only grounds for a legal abortion was an immediate, unambiguous danger to the pregnant person’s life. It also made it illegal to share or receive abortion information.

By 2015, this legally imposed silence had done decades of damage. In that year, Amnesty International released the results of the RedC poll, which reported only 9 percent of people knew that the sentence for having an abortion in Ireland was up to 14 years imprisonment.

Still, several legal cases began chipping away at the secrecy and censorship. In 1992, a suicidal child, pregnant by rape, was prevented from leaving the country for an abortion. The resulting X case eventually decided that suicide risk would also be grounds for an abortion, and that Irish women could legally go abroad.

But until recently, few people were aware of the difficulties involved with either concession. A suicidal woman had to go before a panel of six doctors, who judge whether she is “suicidal enough” to qualify—a cruel burden to put on someone struggling with their mental health. Traveling for an abortion, usually to the United Kingdom, was the more common legal option, but not any easier. Such travel requires more than $1,000 in immediately available cash for a first-trimester surgical abortion; navigating at least a full day’s absence from normal life; and a visa for migrant or refugee women. A system that forces a person to sneak away from home and later get back on an airplane following a medical procedure, still bleeding and cramping, callously denies that person any comfort or dignity.

Years of slow and steady work educated the public on the grim realities of the Eighth, but the single biggest event to wake people up to its full horror was the 2012 death of Savita Halappanavar after she was denied a life-saving pregnancy termination. A 31-year-old dentist, she was experiencing a weeklong miscarriage and requested an abortion to end the process. Her doctors denied it because a fetal heartbeat was still detected and, under the ban, treating her miscarriage would have been considered an abortion. The delay cost Savita—known mostly by her first name—her life due to an infection.

Theoretically, the abortion law had a provision that meant women wouldn’t die because of being denied an abortion. No one thought that a woman would be allowed to die surrounded by people and medical inventions that could very easily save her.

Savita became the subject of an international controversy and a symbol. Every year, a vigil is held in her honor in conjunction with her remaining family and friends in Galway. During the Repeal the Eighth campaign, her father called for us to “Remember Savita” by voting yes. After the referendum, people left flowers, notes, and their Together for Yes badges at a mural of her.

In life, Savita was an inspiring woman. For many of us, her death felt like terrifying evidence of how little the Irish state cared about women. Our horror and shame at how Savita had been treated—and our fear—galvanized the campaign to repeal the Eighth Amendment.

Not Politics as Usual

Over time, opinion polls showed strong support to liberalize the country’s abortion law, and the pro-choice movement was gathering momentum and becoming mainstream. But as the ban was constitutional, no reforms could be made without a referendum, and political processes had to take place before the government called one.

In 2016, a “Citizens’ Assembly” was convened by the then-government. About 100 citizens with no strong feelings on abortion were invited to examine arguments, submissions from citizens and groups, and finally make a recommendation to government on the Eighth Amendment.

I wrote an individual submission and collaborated on the Abortion Rights Campaign submission. I loaded them with evidence about the safety of abortion generally and the danger of clandestine terminations, especially in places where women can’t safely access the abortion pills or seek medical advice in the rare event that complications do occur. I included information about how making abortion illegal doesn’t even reduce it. In my individual filing, I discussed how my friends and I earned low salaries and paid high rents; we couldn’t afford to travel and in a crisis would have to take pills at home and risk prison.

A newspaper story at the time described the Citizens’ Assembly being unimpressed with the quality of many of the submissions, describing them as polarizing, based on emotion, and lacking complexity. One group unanimously agreed that “pro-life submissions offered no solutions and they did not analyse or address the complexity of the situation.”

Based on evidence—statistics about Irish women were accessing abortion anyway and personal stories—the assembly took a pro-choice position, voting overwhelmingly to recommend access to abortion. The government then convened the Joint Oireachtas Committee, made up of members of both houses of the Irish legislature, to consider the recommendations of the Citizens’ Assembly. They examined evidence and heard from a number of national and international medical and legal experts.

People in the street were beginning to say that there didn’t seem to be many—or any—credible experts speaking out in favour of the status quo.

The Complex Case of Abortion by Pill

Medication abortion—the combined misoprostol-mifepristone regimen—was a game-changer.

More than 170,000 Irish women are known to have accessed abortion in the United Kingdom between 1980 and 2017, with a small number of Irish women also traveling to the Netherlands. These numbers are probably underestimates; I’ve heard from women who, out of fear, gave false U.K. addresses at these clinics.

But the number of women traveling declined as more women accessed medication abortion. A single provider, Women on Web, sent abortion pills to 1,636 women from 2010 to 2012 both here and to Northern Ireland, and 5,650 women in the two countries requested abortion pills from 2010 through 2015.

To policymakers, the increasing availability of the abortion pills made the ban unworkable. OB-GYN professor and former International Federation of Gynecology and Obstetrics President Sabaratnam Arulkumaran led the inquiry into Savita’s death and told the Joint Oireachtas Committee that making abortion illegal only serves to promote illegal abortions and disadvantage poor women. And when estimated numbers of medication abortions in the country were reported in the media, it blew the illusion that Ireland is “abortion-free” right out of the water.

Ironically, popular misconceptions about the abortion pills swayed many votes. The abortion pills are safe, but with no regulation or official guidance on how and where to safely access them, many Irish voters worried medication purchased online couldn’t be trusted as much as a pill acquired from a doctor or pharmacist.

“They’d say things like ‘Sure, that’s so dangerous, you wouldn’t know what these poor girls are taking over the internet,’” recalled Gearóidín McEvoy. She canvassed in my home area of County Laois, where there had been no visible pro-choice presence until months before the referendum.

In the case of medication abortion, evidence took a back seat. Empathy came to the fore.

Evidence Versus Messaging

Yes campaign posters didn’t display facts or statistics. “Sometimes a private matter deserves public support” reminded some posters, while others promised a yes vote was for “compassion in a crisis.”

[PHOTO: A cyclist passes a billboard saying "A woman you love needs your Yes" on a street.]

While some activists used “choice” rhetoric in the fight against Ireland’s abortion ban, many preferred to talk about compassion and worked to make the vote a more personal issue, as did this mobile billboard in Dublin. (Barry Cronin/AFP/Getty Images)

Elaine O’Neill, who also canvassed for the Yes side, said, “I spoke to people that I would never have thought would be ‘yes’ voters and they said, ‘Sure, it’s not my business what other people do. I don’t know other people’s situations.’”

As popular ideas about the safety of medication abortion went against evidence that shows women can take it with few complications, even without a doctor’s monitoring, neither was there much mention of the right to choose or bodily autonomy in much of the mainstream messaging.

That troubles some Irish feminists who feel that messages of free, safe, and legal abortion and a woman’s fundamental right to bodily autonomy were compromised too much.

Did we win by avoiding those issues?

The “soft” messaging that focused on privacy and protecting women suited Ireland, in some ways. The campaign to keep abortion illegal backfired most when it placed graphic and distressing images outside maternity hospitals and schools. Still, it is possible that the repeal movement overestimated the conservatism of the Irish majority. It is also possible that more people would have responded to choice messaging.

We felt we had to play it safe because we needed people who were unsure to side with the repeal: people who were pro-choice in some situations but not in favor of abortion without restriction, people wary of how quickly Ireland seemed to be moving away from its religious past, or people who feared “abortion as contraception.”

There’s an interesting contradiction here. We had to speak directly to people and stayed away from the kind of strident language that could make them feel they were merely watching a debate. But there’s also the fact that talking about a person’s “right to choose” makes it very private and personal. The risk then is that people, especially those unlikely to face a crisis pregnancy themselves, decide it’s not their concern. Reminding voters that “sometimes a private matter deserves public support” almost certainly got more of this group out to vote yes than “my body, my choice” would have done.

I want abortion to be free, safe, and legal, and I want a society that respects a woman’s decision. But if we hadn’t got this vote through, there would be terrifyingly little hope of change. Compromising on messages of choice and bodily autonomy and focusing on more general messages of care and compassion probably won the day.

Armed with this victory, we can now fight those battles and false narratives that disguise anti-abortion messages as care.

I had worried that the No side would try to put a pro-woman spin on their propaganda. I’ve previously had to fact-check misinformation about links between breast cancer and abortion. Despite both international and Irish evidence that the majority of women don’t regret their abortions (and I would argue that a society where abortion is not stigmatized would provide better care for the minority who do), unsound arguments that women are physically and psychologically torn apart by terminations can gain traction. Ireland has had problems with fake “crisis pregnancy” agencies before.

Media campaigns that questioned false narratives helped. Influential news websites ran “fact-check” columns. “In Her Shoes” publicized stories of women who had, in various ways, been affected by the Eighth Amendment. People were very actively looking up their own information and getting the facts for themselves.

In contrast, women didn’t feature very much in the No campaign. It was primarily about “the unborn.” Graphic posters, aggressive canvassing, and hardline tactics on the No side seem, if anything, to have alienated many voters.

[PHOTO: A plane flies across a gray backdrop, towing a banner that says "Save Babies. Save Both. Vote No."]

The day before the referendum vote, a plane towed this anti-choice message across the Dublin sky. In keeping with the No campaign’s focus, it put “babies” first. (Barry Cronin/AFP/Getty Images)

When Evidence Didn’t Matter

It’s not a surprise that many anti-abortion people refused to engage with research or be moved by personal stories.

As evidence mounted that Ireland was ready to change, the No campaign pivoted to a new strategy.

In 2017, a pro-choice activist investigated the false claim that, due to abortion, there have been almost no babies with Down syndrome born in Iceland for a number of years. This myth made the rounds on social media, but in early 2018, Down syndrome advocacy groups requested that no group use the condition in the campaign.

We respected that, even as the No campaign put adorable babies and children with Down syndrome on posters claiming that “abortion discriminates.” The right of a person with Down syndrome to bodily autonomy in the event of their facing an unintended pregnancy wasn’t discussed. Distorted statistics from the United Kingdom and Iceland implied that repeal would wipe people with disabilities out.

To my knowledge, none of the groups who used Down syndrome in their fight to keep abortion illegal have ever provided practical support, donated money or time, or advocated on behalf of this community.

One of the most important pieces I’ve read this year was the op-ed of a father to a young child with Down syndrome who wrote “the idea of her being exposed to voices on the radio and posters on the street declaring that she is only alive because her parents were forbidden from terminating her is heartbreaking.”

‘Home’

I had hoped for a close, knife’s-edge victory at best.

In London’s Heathrow Airport before the vote, everywhere I looked I could see someone wearing a pro-repeal sweater, T-shirt, or badge. It was a huge shift from just a few years ago to see a pro-choice movement so visible. The #HomeToVote hashtag made international news. There was something deeply meaningful about openly crossing the Irish Sea east to west in the hope that no more women should have to secretly journey in the other direction.

Pictures of women with suitcases have been a theme in Irish pro-choice messaging for a long time. On May 26, the group Parents Together for Yes posted a photo of a young woman pulling a suitcase behind her. And in large letters over the picture, a simple message: “She is finally home.”

Although the referendum repealed the Eighth, the government has yet to legislate and organize services. Women are still traveling and will be for months; the minister for health is pressing ahead and hopes to have services in place for January 2019, but service providers are unsure this is realistic.

So she’s not quite home yet, and neither are we.