21.According to information before the Committee, in response to the decision of the European Court of Human Rights in 2010 in the case of A, B and C v. Ireland, the State party adopted the Protection of Life during Pregnancy Act of 2013, which limits access to abortion to instances in which there is a “real and substantial risk”, including of suicide, to the life of the pregnant woman. Please provide information on the framework that regulates the determination of risk to the life of the pregnant woman in deciding whether to allow her to procure an abortion. Please also explain in detail the specific steps that a woman has to follow in order to legally procure an abortion on those grounds. Please provide information on legislative measures envisaged to revise the law in order to provide for abortion on other grounds, including threat to the health of the pregnant woman, rape, incest and severe fetal impairment, and to remove punitive measures for women who undergo abortions. Please provide detailed information regarding the demand for abortion services by women and girls, including those who procure them abroad, and the cost to women for travel and abortion services and care in those countries.
22.Please also provide information on the extent of the problem of clandestine abortions in the State party, and whether medical personnel can provide post-abortion care in those circumstances without being prosecuted. Please provide information on measures to revise the Regulation of Information Act of 1995, which criminalizes the provision of information by health-care providers and pregnancy counsellors that advocates or promotes the option of abortion. Please state the programmes that are in place to increase the accessibility, availability and affordability of modern contraceptive methods and family planning services, as well as to facilitate access by women and girls to health services, in particular reproductive health services. Please provide an update on the implementation of the recommendations made by the Law Reform Commission in 2011 with regard to taking into account the views of minors in the context of contraception. Please also provide information on the prevalence of breast and cervical cancer and the measures taken to prevent those and other chronic non-communicable diseases that predominantly affect women, as well as on the percentage of the national budget allocated to combating those diseases. Please also provide information on the health situation of Traveller, Roma and older women, women migrant workers, women with disabilities and women in detention.
State Party Report (2016)
Demand for and cost of abortion services
212.The HSE Crisis Pregnancy Programme (CPP), formerly the Crisis Pregnancy Agency, was established in 2001 to work closely with Government Departments and Agencies to reduce the incidence of crisis pregnancy, including abortion, among women living in Ireland. The CPP strategically invests in research as a means of understanding the context in which crisis pregnancy is happening. Over 35 research reports have been published to date on a wide range of topics related to crisis pregnancy and sexual health and behaviour, including research with young migrant women on sex, fertility and motherhood.
213.The monitoring system developed by the CPP to examine the number of women giving Irish addresses at abortion clinics in other jurisdictions has shown a 40 per cent reduction, from 6,673 in 2001 to 3,982 in 2012, in the women travelling from Ireland to the UK for abortion services. The Irish Contraception and Crisis Pregnancy Study published in 2012 found that 94 per cent of all women living in Ireland who have experienced an abortion had travelled to the UK for the procedure.
Reply No. 22
Free abortion aftercare
214.Abortion aftercare services, including post-abortion medical check-ups and post-abortion counselling, are available free of charge to all women living in Ireland. The Abortion Aftercare campaign, developed by the CPP, aims to raise awareness of the availability of free State-funded post-abortion medical check-up and counselling services, promoted at www.abortionaftercare.ie.
Regulation of Information Act 1995
215.The freedom to travel to another state for a termination of pregnancy and to obtain information in relation to this service is guaranteed in Article 40.3.3 of the Constitution. The conditions under which information relating to services lawfully available in another State might be made available within Ireland are set out in legislation. No changes to these Regulations are currently proposed.
Family planning, sexual and reproductive health services
216.Establishment of the CPP in 2001 was instrumental in a decrease in the teenage birth rate from 20 per 1000 women aged 15-19 in population in Ireland in 2001 to 9.3 per 1000 women aged 15-19 in population in 2014.
217.While there is good availability of, and access to, contraception methods to people of all ages in Ireland, the National Sexual Health Strategy places a particular focus on the provision of RSE to ensure that children and adolescents attain the knowledge, understanding, attitudes and skills required for healthy sexual expression throughout life, as outlined earlier in this report.
218.The National Maternity Strategy 2016-2016, published in January 2016, recognizes that pregnancy and birth is a time when women have a unique opportunity to focus on their health and wellbeing. It underlines the importance of addressing the sexual health and wellbeing needs of the mother at this time, including information on contraception options. The new National Women & Infants Health Programme will, when established, lead the management, organization and delivery of maternity, gynaecological and neonatal services within the HSE.
10.The Committee recalls its previous observation (A/60/38, part two, para. 382) and regrets that the existing discriminatory provision contained in article 41.2 of the Constitution, which perpetuates traditional stereotypical views of the social roles and responsibilities of women and men in the family and in society at large, has not been amended. The Committee is also concerned that:
(a)The interpretation of article 40.1 of the Constitution is focused on procedural rather than substantive equality; and
(b)Article 40.3.3 of the Constitution (also known as the Eighth Amendment), which protects the right to life of the unborn and therefore unduly restricts access to abortion, has not been amended.
11. The Committee urges the State party to, within a specific time frame:
(a) Amend article 41.2 of the Constitution in order to remove the stereotypical language on the role of women in the home;
(b) Introduce legislative provisions that underline the obligation of the State to pursue actively the achievement of substantive equality between women and men;
(c) Amend article 40.3.3 of the Constitution (also known as the Eighth Amendment), which impedes the introduction of amendments to current legislation governing access to abortion.
42.The Committee welcomes the steps taken by the State party to improve health care for women and girls in the State party. The Committee is concerned that access to abortion in the State party is restricted to cases where there is a real and substantial risk to the life of the pregnant woman under the Protection of Life During Pregnancy Act of 2013, which was enacted following the decision of the European Court of Human Rights in the case of A, B and C v Ireland, and that this exception is interpreted in a very restrictive manner. The Committee is also concerned that under the Regulation of Information (Services Outside the State For Termination of Pregnancies) Act of 1995, the provision of information by health-care providers that advocates and promotes the option of abortion is criminal. The Committee is particularly concerned that owing to this restrictive legal regime:
(a)Abortion in all cases other than where there is a real and substantial risk to the life of the pregnant woman is criminal and carries a maximum penalty of 14 years imprisonment;
(b)Women and girls are compelled to travel outside the State party to obtain an abortion in countries where it is legally available on wider grounds;
(c)Women and girls without means to travel outside the State party to obtain an abortion, such as poor women, asylum seekers and migrant women and girls, may be compelled to carry their pregnancies to full term or to undertake unsafe abortion, which may lead to severe mental pain and suffering;
(d) Health-care providers and pregnancy counsellors cannot freely provide information on abortion for fear of being prosecuted for violating the Regulation of Information Act of 1995.
43. The Committee recommends that the State party:
(a) Repeal the Protection of Life During Pregnancy Act 2013 in order to legalize the termination of pregnancy at least in cases of rape, incest, risk to the physical or mental health or life of the pregnant woman, and severe impairment of the foetus, and decriminalize abortion in all other cases;
(b) Intensify the implementation of health programmes, including awareness-raising programmes, to ensure the availability, accessibility and use of modern contraceptives, in line with general recommendation No. 24 (1999) on women and health;
(c) Repeal the Regulation of Information (Services Outside the State For Termination of Pregnancies) Act of 1995 in order to ensure free access to sexual and reproductive health information and education, and that health-care providers, physicians and pregnancy counsellors do not operate under a constant fear that their services may be subject to criminal investigation and prosecution;
(d) Ensure the provision of post-abortion health-care services for women irrespective of whether they have undergone an illegal or legal abortion.
44.The Committee is concerned at some reports that child delivery is highly medicalized and dependent on the use of artificial methods to accelerate the process such that women are made to deliver babies within 8 hours of hospitalization, owing to a lack of resources in hospitals.
45. The Committee recommends that the State party ensure that women can have access to maternity and delivery services without time pressure or being exposed to artificial methods of accelerating births, and provide information in the next periodic report on the strategic plan aimed at launching a widely supported maternity health-care policy and programme respecting the birth process.