Abortion exported: the women travelling for terminations

Graphic by Chris Scott

Graphic by Chris Scott

WOMEN from Northern Ireland and the Irish Republic had almost 25,000 abortions in England and Wales over the last five years – an average of close to 100 terminations every week.

New data obtained by Detail Data from the Department of Health in London reveals the individual clinics the women attended, with the map above illustrating the journeys they undertook to bypass strict abortion laws at home.

Another key finding from an analysis of the abortion figures for 2010-14 is that almost half (45%) of all the abortions involving women from Northern Ireland and the Republic of Ireland took place in Manchester clinics.

Women boarded planes or ships to travel to this city in the north west of England to terminate over 11,000 pregnancies. Thirty percent of all of the abortions recorded (7,182) took place in one clinic there - Marie Stopes International Manchester.

Those who had terminations outside of the Republic of Ireland and Northern Ireland in the last five years include hundreds of children under the age of 16 – 152 from the south and 69 from the north.

The findings are being published as the issue of access to abortion continues to be hotly debated on both sides of the Irish border.

Abortions are only available in Northern Ireland if a woman’s life is at risk or where there is a risk of a serious and adverse effect on her physical or mental health which is either long term or permanent. The punishment is life imprisonment for anyone who unlawfully performs a termination.

Abortion is also illegal in the Republic of Ireland, except where the pregnancy presents a real and substantial risk to the mother's life.

Northern Ireland Amnesty campaigner Grainne Teggart said: “The Northern Ireland and Irish governments don’t mind women having abortions just as long as they’re not here in Ireland.

“Abortions not being lawful doesn’t mean that women don’t have abortions, it means that they either resort to desperate measures or they seek those services elsewhere.”

However, pro-life campaigners disagree with making abortion more accessible and instead argue that there should be better support services put in place for women dealing with a pregnancy crisis.

THE COST OF TRAVELLING

The cost of abortions for women travelling to England and Wales ranges from £400 to £1,500 for the treatment alone, with travel and potential accommodation costs on top of this.

An abortion provider told us about women travelling for late term abortions (after 20 weeks gestation) in cases involving fatal foetal abnormalities who decide to carry their baby’s remains on flights for burial at home. Some sought official permission from airlines for this – others just hoped the remains wouldn’t be found in their luggage.

Belfast woman Sarah Ewart was one of the more than 4,480 women who travelled for an abortion in 2013. She had been devastated to learn at her 20 week scan that her baby girl was likely to die shortly after birth.

Writing for Detail Data today, Sarah said: “It was terrible going to a place I didn’t know, to people I didn’t know and not having the full support of my consultant, medical staff and my full family around me. It made a terrible situation so much worse.”

To read the article written by Sarah, click here.

Commentator Susan McKay has also written for Detail Data and calls for "compassion, respect, dignity and support" for all women. To read her comment piece, click here.

The Abortion Act 1967 covers England, Scotland and Wales but not Northern Ireland. It states that two doctors must agree that a termination would cause less damage to a woman’s physical or mental health than continuing with the pregnancy. There are rare occasions when an abortion can take place after 24 weeks.

Last month, Belfast’s High Court ruled that Northern Ireland’s current abortion law is incompatible with human rights law in case of pregnancies resulting from rape or incest or where there are fatal foetal abnormalities.

Mr Justice Horner is currently considering whether existing legislation can be interpreted to allow abortions in these limited cases or whether new legislation needs to come from the Assembly. The decision may also be subject to appeal.

Meanwhile, Executive Ministers are considering new abortion guidelines which were compiled before the high court ruling.

The death of Savita Halappanavar (31), an Indian-born dentist, in 2012 in Galway when she was 17 weeks pregnant sparked a major debate on Ireland’s abortion laws. Momentum is growing there for a referendum on repealing the eighth amendment which gives equal status to the right to life of the unborn and the mother in the Irish constitution.

THE CLINICS

Using Freedom of Information legislation, we requested and received a breakdown by clinic of five years of abortions involving women from Northern Ireland and the Republic of Ireland.

This is the first time this data relating to individual clinics in England and Wales has been released into the public domain.

The figures show that women travelled from the north and south of Ireland to England or Wales to have 24,599 terminations over the last five years (2010-14).

In total, 4,652 terminations for women from the north and 19,947 from the south were officially recorded. Some individual women may have had more than one abortion over the time period covered by our request.

However, this is not the true total as not all women give their home addresses to clinics, others may travel to other countries for treatment and some resort to ending their pregnancies by sourcing abortion pills online, which has raised some health concerns among experts.

In contrast, just 23 legal terminations of pregnancy were carried out in Northern Ireland’s hospitals and clinics during the 2013/14 financial year, the most recent year for which figures are available.

Our interactive map published today shows the number of terminations for women from Ireland north and south carried out at each English and Welsh clinic.

In total, 11,116 abortions involving women from Northern Ireland and the Republic of Ireland took place across three clinics in Manchester with almost a third of all the recorded cases at one Manchester clinic – Marie Stopes International. It is open six days a week and offers medical and surgical procedures.

In Liverpool 4,462 abortions involving women from Ireland – north and south - were recorded.

London was the third most popular city with 3,267 terminations across 10 clinics.

The location was not provided for 143 terminations due to ‘data protection protocol’. This means that the number of abortions at these clinics totalled under five.

Karen Lannon has worked for Marie Stopes for 11 years and is a health care worker in its main Manchester clinic.

In an interview with Detail Data, she said: “Making the journey over can be really difficult. Some Irish women arrive at our clinic with just a jacket on and not even enough money to buy a sandwich. If they haven’t had a consultation already, they can be distraught and fearful. Some even ask if they are going to die because that’s what they’ve been told at home.

“We have drivers from a local taxi company who can pick them up at the airport and leave them back again. It is a huge weight off the ladies’ minds to know they are being looked after.

“There isn’t a typical client from Ireland or Northern Ireland. We have seen girls aged 13 and happily married women in their mid 40s. They come from all walks of life.

“English girls want to know how painful it will be. Many Irish girls also ask ‘What is God going to think?’”

Genevieve Edwards, director of policy at Marie Stopes UK, said: “It is not surprising that many opt for Manchester, as it’s geographically close and can be quicker and cheaper to get to than some other cities in England.

“We give the women as much support as we can. For example, some women need to have a chaperone with them after a procedure but can’t afford to bring someone with them so there are volunteers in Manchester who will look after them and put them up for the night.

“We believe that all women in the UK should have equal access to legal abortion services, regardless of which country within the UK they live in.”

Graphic by Chris Scott

Graphic by Chris Scott

WOMEN’S AGE AND STAGE OF PREGNANCY

Department of Health data published annually gives a breakdown of the pregnancy gestation and age of women travelling to England and Wales for abortion treatment. We examined the figures for the years 2010 to 2014 to tally with the individual clinic breakdown we requested.

For terminations involving women from Northern Ireland, 72% (3,351) took place at 3–9 weeks gestation and less than 2% (82) were late term abortions at 20 weeks or later.

For women from the Republic, 13,601 terminations (68%) took place at 3–9 weeks gestation and 3% (557) were late term.

Half of all of the abortions were performed on women aged in their 20s. However, 69 terminations were recorded for girls aged under 16 from the north and 152 under 16s from the south.

The age of consent for sex is 16-years-old in Northern Ireland and 17 in the Irish Republic.

The British Pregnancy Advisory Service (BPAS) confirmed that thirteen 14-year-olds and forty-nine 15-year-olds were among the women having abortions in their clinics during the five year period we are examining. The oldest BPAS patient from Northern Ireland was 47 and 49 from the Republic of Ireland.

Marie Stopes and BPAS offer reduced fees for women travelling from Northern Ireland or the Republic of Ireland because of the travel costs they face.

Only a very small number of women travel to Scotland for terminations.

We requested data from NHS National Services Scotland and this shows in the last four years (2011-14) only 10 cases were notified to the Chief Medical Officer for Scotland.

A spokeswoman added: “Some women from NI or the ROI may prefer not to provide their home address, instead preferring to give a residence in Scotland. This may result in some under-reporting.”

Graphic by Chris Scott

Graphic by Chris Scott

CAMPAIGNING FOR CHANGE

International human rights organisation Amnesty International has been campaigning for a change in the law in Northern Ireland.

Amnesty campaigner Grainne Teggart said: “The Northern Ireland and Irish governments don’t mind women having abortions just as long as they’re not here in Ireland.

“Abortions not being lawful doesn’t mean that women don’t have abortions, it means that they either resort to desperate measures or they seek those services elsewhere.

“If we think of it from a socio-economic perspective it is only those women who can access the funds to travel who can afford to. Those who don’t have the financial means to travel will resort to other more desperate measures and that’s really where women are putting their health and their life at risk.”

Ms Teggart said that politicians here need to “wake up” to what she described as the danger the current law could effectively pose to women.

“Amnesty has been advocating for change here in very exceptional circumstances where there are fatal foetal diagnoses and in cases of rape and incest. Women in those most distressing of circumstances deserve access to this form of healthcare.

“We know that that the majority of people in Northern Ireland support change in these circumstances so it is about time that our politicians reflected public opinion on this matter as well as upheld their obligations to these women.”

View Abortion data in a full screen map

SUPPORT FOR THOSE IN PREGNANCY CRISIS

David Smyth is public policy officer at the Evangelical Alliance Northern Ireland. He argues that the current law in Northern Ireland carefully balances the rights of both the woman and unborn child.

“There is no doubt that the numbers of women travelling to England and Wales for abortions is concerning,” he said. “However this is in the context of our concern about abortion statistics generally; like the fact that last year there were 190,000 abortions in England and Wales and 37% of these were repeat abortions.

“The statistics do raise questions for our politicians and our culture about how we treat women with a pregnancy crisis, although Northern Ireland’s ratio of live births to abortions is still much lower than other parts of the UK, with a ratio of 28:1 instead of 4:1.

"The really difficult cases of fatal foetal abnormality, or life limiting disability as I prefer to talk about, or rape and incest, sexual crime, are heartbreaking. I suppose we dare to believe that in every human life there is dignity and that the premature ending of an unborn child’s life does not actually solve the horrendous crime or the awful situation that they face.

“We feel there needs to be better perinatal hospice care for the woman and unborn child in this moment.

“We want to see better support services for any women who find themselves in pregnancy crisis.”

Lynn McKenzie is centre coordinator at The Pregnancy Resource Centre in Carrickfergus which was set up by a group of churches but states that it does not have a pro-choice or pro-life stance.

As well as advising women dealing with a pregnancy crisis it also gives personal development classes to school children including teaching about self-esteem and identity, relationships, sexually transmitted diseases, contraception, sex and consent.

The centre presents three options to women – parenting, adoption and abortion.

Mrs McKenzie said: “We take time and get them to look at their circumstances and talk about what is going on in their head. For example they may say they don’t have any money or they are still at school. Some feel they have no other way out.

“We try to get them to think if their circumstances will change. We also ask what they think about abortion and that will vary from person to person. Putting all their responses alongside each other can be helpful as they can see a fuller picture. It is so awful to speak to women years later who wish they could turn back the clock because their circumstances have changed.

“If the women decide they do want to have an abortion, we would refer them back to their GP or the Family Planning Clinic where they can ask for phone numbers. We can also tell them about the Marie Stopes Centre in Belfast if they enquire about it.

“Abortions outside of Northern Ireland cost money so we also get women contacting us to ask how they could cause a miscarriage and do it themselves and that is very worrying.”

The centre’s first post-abortion client was aged in her 80s and had had an abortion in her teens.

“Abortion was very much shrouded in secrecy then. Other people we have seen have been in their 60s and 70s but can range from 16 upwards.

“People often come to us further down the line when they have gone through anniversaries and due dates. It can affect them just like any other kind of loss.”

Mrs McKenzie said: “Unfortunately the pro-life lobby is associated with the image of people standing with placards showing pictures of aborted babies. We believe it isn’t right to tell anyone what to choose.

“We don’t give an opinion or judgement or advice. We just present the facts and encourage women to take their time to make a decision.”

THE STORIES OF THOSE WHO TRAVEL

Donagh Stenson, associate director of marketing at BPAS, said there isn’t a typical client from Ireland north or south that seeks their care.

“We see women from teenage years all the way up to women and their late 40s and their late 50s. They are from all sorts of backgrounds, all sorts of religions and the only thing they really have in common is that they feel that they have a pregnancy they can no longer continue with.”

She said that the experience for such women, when they seek abortion care in England, is quite different from their English counterparts.

“They have to sort the logistics out, they have to find the money which in some circumstances can run into thousands of pounds and they have to leave their family, friends and loved ones at a time when they are very emotionally in difficulty.

“With the Irish women that we see in our clinics, often a lot of them will talk to us about how they are going to be accepted back in society and we even have religious conversations with them about being asked whether they’re going to go to hell because of a decision they’ve taken to end the pregnancy.

“That can be quite difficult for our staff to hear a woman saying that. Even though they know that the decision they have taken is the right decision for them.”

Ms Stenson acknowledges that women seeking a termination because of a fatal foetal abnormality are often ending a much wanted pregnancy after problems discovered during the routine 20 week scan.

She said: “Often women with a foetal abnormality will choose a medical procedure because there is an option for them to hold their babies at the end. Then we have to have a very delicate and sensitive conversation with them about whether they have any specific wishes about their baby’s remains.

“It can be fairly tortuous to watch them go through the realisation actually that they are going to have to leave their baby here unless they are prepared to do something to get those remains home.

“Having to then think about do they want their baby cremated or do they want to bring the baby back themselves. That is possible and we can help facilitate that but I can’t imagine what that does to somebody knowing that they are carrying their baby’s remains home with them.

“BPAS is very proud to be looking after women from Northern Ireland and we will continue to do so until the Northern Ireland government does something about it.”

To read Sarah Ewart's article, click here.

To read Susan McKay's comment piece, click here.

  • The data used for this project is available here.
  • Detail Data is a partnership project between The Detail and NICVA, the representative body for the voluntary and community sector.

Image title

WOMEN from Northern Ireland and the Irish Republic had almost 25,000 abortions in England and Wales over the last five years – an average of close to 100 terminations every week.

New data obtained by Detail Data from the Department of Health in London reveals the individual clinics the women attended, with the map above illustrating the journeys they undertook to bypass strict abortion laws at home.

Another key finding from an analysis of the abortion figures for 2010-14 is that almost half (45%) of all the abortions involving women from Northern Ireland and the Republic of Ireland took place in Manchester clinics.

Women boarded planes or ships to travel to this city in the north west of England to terminate over 11,000 pregnancies. Thirty percent of all of the abortions recorded (7,182) took place in one clinic there - Marie Stopes International Manchester.

Those who had terminations outside of the Republic of Ireland and Northern Ireland in the last five years include hundreds of children under the age of 16 – 152 from the south and 69 from the north.

The findings are being published as the issue of access to abortion continues to be hotly debated on both sides of the Irish border.

Abortions are only available in Northern Ireland if a woman’s life is at risk or where there is a risk of a serious and adverse effect on her physical or mental health which is either long term or permanent. The punishment is life imprisonment for anyone who unlawfully performs a termination.

Abortion is also illegal in the Republic of Ireland, except where the pregnancy presents a real and substantial risk to the mother's life.

Northern Ireland Amnesty campaigner Grainne Teggart said: “The Northern Ireland and Irish governments don’t mind women having abortions just as long as they’re not here in Ireland.

“Abortions not being lawful doesn’t mean that women don’t have abortions, it means that they either resort to desperate measures or they seek those services elsewhere.”

However, pro-life campaigners disagree with making abortion more accessible and instead argue that there should be better support services put in place for women dealing with a pregnancy crisis.