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    Early medical abortion care in Ireland: Conscientious provision and the role of law
    (2023-05) Murray , Claire; Donnelly, Mary; Irish Research Council
    Access to sexual and reproductive health is recognised as essential to the United Nations Sustainable Development Goals (in particular SDG3 on health and wellbeing and SDG5 on gender equality) (Kim et al, the Lancet 2022). The WHO Abortion Care Guidelines set out the core elements for quality abortion care to include the availability and accessibility of information; a supportive, universally accessible, affordable, and well-functioning health system; and respect for human rights within a supportive framework of law and policy (2022). Until 2019, abortion in Ireland was banned under all but the most extreme circumstances. This was required because the Eighth Amendment to the Constitution of Ireland provided explicit protection for the ‘right to life of the unborn’. Women1 who needed abortion care often travelled to the UK (and to a much lesser extent the Netherlands or other European countries) or self-administered abortion pills bought online. Following a lengthy campaign of advocacy by a wide range of bodies which included civil society, third sector organisations and human rights bodies, as well as healthcare providers, and a grassroots reform movement (Fletcher, 2018; Taylor et al, 2019), a constitutional referendum was held in May 2018. A decisive majority of Irish citizens (66.4%) voted to replace the Eighth Amendment with the Thirty-Sixth Amendment to the Constitution which states that ‘[p]rovision may be made by law for the regulation of termination of pregnancy’. Notwithstanding the resounding endorsement by the electorate, the 2018 Act remains in essence the same as the draft General Scheme drawn up by a cautious government in advance of the referendum (Donnelly and Murray, 2020). This means the 2018 Act reinforces the law’s ‘extraordinary treatment’ of abortion (Jackson, 2001) and the view that abortion care is fundamentally different from other forms of clinical practice.