Abortion in Ireland will be free, safe, and legal up to 12 weeks into pregnancy starting January 1, a major blow to the Catholic Church and opponents of the country’s abortion rights law, who tried to drag out the legislative process with support from U.S. anti-choice advisers.

To Bríd Smith, People Before Profit member of Irish parliament, the repeal of the Eighth Amendment banning abortion in Ireland was “one of those rare moments in life when you feel such joy, the sheer joy of beating back the Catholic Church’s agenda, really beating it back for once. And pride, because we put a huge amount of effort into it and had witnessed a new generation of young Irish people completely different to what we had known.”

On December 5, Smith and 89 other members of the Dáil Éireann voted to pass the legislation, clearing the way for legal abortions to begin in Ireland in January 2019. And on December 13, the bill passed the Seanad, the upper house of the Irish parliament, meaning that on the president’s signature, abortion care will for the first time be legally available in the Republic of Ireland. Yet Smith notes that as in May after the referendum’s passage, there is still much to be done.

Lynn Boylan, a member of the European Parliament from Sinn Féin and a longtime pro-choice campaigner, told Rewire.News that a “small number of politicians who have disregard for democracy” threw in myriad amendments meant to drag out the process of making abortion care legal in Ireland. Much of the rhetoric and the proposals, she said, would sound familiar to Americans.

There was a proposal to force abortion patients to undergo ultrasounds or watch DVDs describing the procedure; there was a battle over burial of fetal remains, despite, Boylan said, Ireland only recently learning the extent to which babies and children born at infamous “Mother and Baby Homes” for the unmarried were buried in mass graves. “My own brother is buried in a mass grave. He died in childbirth because he wasn’t baptized,” Boylan said. “The hypocrisy of the same people who are saying, ‘You should be burying fetuses … ’—there was disregard given to dead babies for a long time in Ireland.”

Ireland’s abortion services will be based around primary care clinics, and rely mainly on the use of the abortion pill. It will be legal until 12 weeks of pregnancy without restrictions. After that point in a pregnancy, if two doctors certify there is risk to the life or “serious harm to the health of” the pregnant person, or in the case of fatal fetal abnormalities, abortion care may be permitted. The legislation includes a three-day forced waiting period, which Smith opposed, noting that with the 12-week deadline and Ireland’s occasional long wait times for physician appointments, this could push some people over the line, putting abortion out of reach.

Abortion access will be free of charge. Ireland does not have a British-style universal health-care system, but, Smith explains, abortion will be covered under the health service’s Maternity and Infant Care Scheme, which was introduced in the 1950s over the objections of the Catholic church and provides free maternity health care.

There was a struggle over the question of conscientious objection from physicians. In a country where the Catholic Church has long been in control of health care, this was a major point of contention. To get around the issue, the state will institute a 24-hour hotline where pregnant people can get information about where they can find a physician who will perform an abortion. Doctors who don’t want to perform it will be instructed to refer people to another physician or to the hotline.

“It is better really that way because then it is up to the health service, the government health service, to make sure that you get a referral rather than the individual [general practitioner (GP)],” Smith said.

The GP model, Boylan said, minimizes the likelihood of protesting outside of clinics where abortions are performed, though it doesn’t prevent it. There will still be a need for some surgical abortions, and organizations like the Irish Family Planning Association, Smith said, are gearing up to provide abortion care at the clinics already in operation.

“They always have been this source of support for information, for counseling, for getting the appointments in Britain in the past. I think that will seamlessly move over to them being a port of call for getting an abortion here,” she told Rewire.News. While not in the legislation, clinic buffer zones to protect people seeking care from protesters will be a priority for pro-choice activists in 2019.

Mandy La Combre of the Trade Union Campaign to Repeal the Eighth points out that by the time it came to a vote on the legislation, “It was done to death. People knew what they were voting for. Every debate was talked about. Every inch of it.”

The benefit of a referendum, she said, was that everyone in the country had debated the issue thoroughly, and the decisive 66.4 percent victory for Repeal meant that anti-choice members of parliament had little excuse for trying to halt the legislation. Yet there is still much to fight over in the coming months. And while many activists, La Combre said, were thoroughly “burnt out” after the Repeal fight, they are not taking the final vote as an excuse to stop working.

“There is no separation, really, in Ireland of church and state,” Lynn Boylan said, noting the ongoing fight over a new National Maternity Hospital to be built with state funding in Dublin. The site chosen for the hospital is owned by St. Vincent’s Healthcare Group, which is owned by the Sisters of Charity. While the St. Vincent’s hospital is no longer run on a daily basis by the nuns, Smith said, “The board of management still run the hospital, still have their Catholic ethos.”

The concern, Smith told Rewire.News, is that the state is handing over to a Catholic organization control of a major site where pregnant people will likely go for abortion care. In a small country like Ireland, she said, where Dublin is only a couple hours away from any other geographical point, “It is no biggie to have just one major place that would look after these things, but to deliver abortion services, we have to be sure that the Catholic Church have no say in anything to do with that hospital.”

Protests have been held and members of multiple parties have expressed deep concern about religious influence over reproductive health care. St. Vincent’s executives have promised the Sisters are no longer involved, but pro-choice campaigners are not satisfied.

Another coming struggle is over the continued criminalization of abortions outside of the strict guidelines the new legislation puts in place. “There was a 14-year [jail] sentence for abortion put into the Protection of Life During Pregnancy Act, which was brought in after Savita Halappanavar died in Galway,” Smith explains. In the new legislation, that 14-year sentence remains, “not for the woman or the pregnant person, but for the doctor or the midwife or whomever might perform an abortion outside of the parameters of the legislation. We want that gone because, if there is any uncertainty about dates, or it might be three days over 12 weeks or you might be 13 weeks, not 12, this will act as a serious chill factor on the medical services.”

Beyond improvements to abortion care, activists are taking lessons from the campaign to other struggles. The trade union repeal campaign, La Combre said, was important because it introduced the issue of class into the reproductive rights battle. “What we were talking about was the real socioeconomic issues: the working women who can’t afford to travel, who can’t afford to have an abortion, who can’t afford to make those choices.”

Their campaign taught trade union members the importance of broadening their definition of what is and is not a “workplace” issue—and the support from older men within the labor movement was key.

The struggle taught important lessons in solidarity for activists who might not have been directly affected, Boylan agrees. Arguments that abortion rights are “identity politics” don’t wash, but activists had to take into account the intersections. “Gathering that solidarity together and mobilizing around it is what the left should be doing,” she said. “I don’t think we give up identity politics, but we have to instill solidarity and bring class back into the narrative. People in Ireland don’t really want to talk about class.”

The repeal process has changed the major political parties in Ireland. While small parties like People Before Profit took a strong pro-choice position, others had only recently come around, led by grassroots activists like La Combre. “They got on board because it was the political will of the people,” La Combre said. “Fine Gael, for example, they knew the young people wanted this and they needed the young Fine Gael vote,” she continued, naming Ireland’s conservative ruling party.

The referendum changed the left-leaning Sinn Féin, which has its roots in Ireland’s long and at times bloody struggle for independence from England. At the party’s annual gathering in June, Boylan handed out T-shirts printed with the total vote count for Repeal and the slogan “The North is Next,” and the party voted decisively to adopt a pro-choice position—while it had campaigned for a Yes vote on repeal, prominent party members were public about their anti-choice politics during the referendum, making the unambiguous shift significant.

“That has been a long struggle for a lot of us who were pro-choice within the party,” Boylan said. “You join a party, and [you don’t] agree with them 100 percent, but you try and advocate for change within the party. It took longer than I would have liked in Sinn Féin, but we have gotten there. I came away very inspired by those who had been fighting for longer even than me.”

The question of the North—of Northern Ireland, which finds itself at the nexus of geopolitical conflict in the Brexit negotiations but still has no legal abortion despite being a part of the United Kingdom—came up repeatedly. Both Sinn Féin and People Before Profit campaign in both the North and South of Ireland, and both have taken part in major post-repeal actions calling for the North to catch up.

The question of Ireland’s health-care system remains. “We have a crisis in GP service just like we have a crisis in Emergency Medicine. We have a crisis in delivering children’s medicine,” Smith told Rewire.News. “There were years and years of austerity and cutbacks, closures of beds, attacks on the pay of doctors and nurses, and we haven’t got over that yet, despite the growing economy.”

Such a crisis has meant waiting periods to see doctors—something that could make accessing an abortion difficult, particularly if some practitioners opt out of providing abortion care.

To make matters worse, Boylan said, “Any scandals that happen in the Irish health-care system tend to be scandals about women’s health. Whether it is about bodily autonomy when it comes to abortion, or the cervical cancer scandal, and that maternalistic approach that was taken to the women not to tell them and it wasn’t in their interest to let them know that they were having these false negatives.”

It is time, she said, to “radically reform the health service in Ireland.”

The political fights upcoming have been in some ways muddled by the fact that Fine Gael, for years considered Ireland’s most conservative party, has become the face of abortion liberalization. “I see Fine Gael as a really right-wing party. Economically, completely right-wing. But, they use being socially aware to win people over,” La Combre said.

Boylan, too, wonders how the excitement among young people for the Repeal campaign will shake out politically.

“I think it is really important that particularly the left-wing parties go out and try and engage those young people, but I would be that little bit cautious that they are not all going to show up. We are not going to have a #hometovote hashtag for the next general election.” It will be important, she said, to continue reaching out to the networks created by Repeal, because, “We do have a serious problem with how we treat women in this country and that hasn’t gone away just because we voted for repeal. There is still an uphill battle there.”