Attitudes and practice of gynaecologists towards abortion in Northern Ireland Colin Francome & Wendy Savage Middlesex University Fiapac conference Seville

Abortion law in the British Isles Until 1967 abortion was a crime under the 1861 Offences Against the Person Act punishable by life imprisonment for the person doing the abortion and the woman herself. In 1929 abortion to save the life of a woman was allowed. Following the Bourne case in 1938 Justice MacNaughten ruled that abortion was legal if ‘continuance of the pregnancvy would wreck the woman’s mental or physical health’. Until 1967 abortion was a crime under the 1861 Offences Against the Person Act punishable by life imprisonment for the person doing the abortion and the woman herself. In 1929 abortion to save the life of a woman was allowed. Following the Bourne case in 1938 Justice MacNaughten ruled that abortion was legal if ‘continuance of the pregnancvy would wreck the woman’s mental or physical health’.

The 1967 Abortion Act This allowed an abortion to be performed in GB if two doctors certified in good faith that it was necessary on a number of grounds. This allowed an abortion to be performed in GB if two doctors certified in good faith that it was necessary on a number of grounds. This law did not apply to Northern Ireland which still relies on the 1861 OAPA (which dates back to 1803) as amended in This law did not apply to Northern Ireland which still relies on the 1861 OAPA (which dates back to 1803) as amended in Neither does the 1929 Infant Life Preservation Act apply in Northern Ireland but the 1945 Criminal Justice Act (NI) made same exception Neither does the 1929 Infant Life Preservation Act apply in Northern Ireland but the 1945 Criminal Justice Act (NI) made same exception

NI women travel to GB for abortions At least 50,000 women are known to have travelled to UK since 1968 At least 50,000 women are known to have travelled to UK since 1968 Prenatal screening is carried out but if the woman has a fetal anomaly detected she cannot legally have an abortion in NI –unless she threatens suicide Prenatal screening is carried out but if the woman has a fetal anomaly detected she cannot legally have an abortion in NI –unless she threatens suicide

The study methodology 43 consultants identified by contacting hospitals by phone. One retired by time Q sent out so sample size was consultants identified by contacting hospitals by phone. One retired by time Q sent out so sample size was 42 Questionnaires were sent three times Questionnaires were sent three times 2 refusals 2 refusals 37 (88%) questionnaires received 37 (88%) questionnaires received

Question 1 Research carried out by Marie Stopes International found that 95% of women from Northern Ireland traveling abroad for their abortion would prefer access in Northern Ireland. Do you think that the law in Northern Ireland should be changed to permit abortions to be carried out on a wider range of circumstances, be further restricted or remain the same?’ Research carried out by Marie Stopes International found that 95% of women from Northern Ireland traveling abroad for their abortion would prefer access in Northern Ireland. Do you think that the law in Northern Ireland should be changed to permit abortions to be carried out on a wider range of circumstances, be further restricted or remain the same?’ Abortion law should be liberalised 21 (57%) Stay the same 12 (32%) Restricted 4 (11%)

Question 2 Would you agree that abortion should be legal in Northern Ireland in the following circumstances HIV positive Yes 41% No 49% Unsure 10% Fetal abnormality Yes 76% No 10% Unsure 13% Rape Yes 68% No 22% Unsure 10%

Question 4 If the law was changed would you personally agree to carry out a termination if the woman wanted an abortion in the following circumstances? HIV Would perform 32% would not 65% Fetal anomalyWould perform 70% would not 27% Rape Would perform 49% would not 51% On request in first trimester Would perform 14% Would not perform 85% Would not perform 85%

Question 3 Many countries in Europe including Italy, France, Holland, Germany and Belgium allpw women the right to choose an abortion in the first trimester( up to 12 weeks) Do you think women in Northern Ireland should have unrestricted access to abortion in the first trimester? Yes 13 (35%) No 19 (51%) Don’t know 5 (14%) Younger doctors split 50:50 older against 2:1

Question 5 Would you support the major abortion charities being licensed to carry out abortions in Northern Ireland within the extent of the current law? In favour 19 (51%) Against 14 (38%) Don’t know 4 (11%) Don’t know 4 (11%)

Question 6 If the law remains unchanged do you agree that women should have parity with the rest of the UK and not have to pay for an abortion in England? In favour 29 (78%) Opposed 3 (8%) Unsure 5 (14%)

Question 7 If you were asked to treat a woman experiencing post abortion complications following the use of abortion medication online, would you report the woman to the PSNI (Police Service of Northern Ireland) ? Yes 2 (5%) Depends 1 (3%) No34 (92%)

Policy implications Law should be changed as UK is signatory to CEDAW statement but unlikely to happen Law should be changed as UK is signatory to CEDAW statement but unlikely to happen NHS should agree to pay for abortions for women from Northern Ireland who have to travel to UK. We should lobby for this NHS should agree to pay for abortions for women from Northern Ireland who have to travel to UK. We should lobby for this The charities bpas and MSI should set up a clinic jointly in NI to do legal abortions The charities bpas and MSI should set up a clinic jointly in NI to do legal abortions

Publication This paper Attitudes and practice of gynaecologists towards abortion in Northern Ireland has been accepted by the Journal of Obstetrics and Gynaecology This paper Attitudes and practice of gynaecologists towards abortion in Northern Ireland has been accepted by the Journal of Obstetrics and Gynaecology Colin Francome is Emeritus Professor and Wendy Savage Honorary Professor at Middlesex University Dept of health and Socail Science. She is also coordinator of Doctors for a Woman’s Choice on Abortion (DWCA) and Wendy Savage Honorary Professor at Middlesex University Dept of health and Socail Science. She is also coordinator of Doctors for a Woman’s Choice on Abortion (DWCA)