The rollout of services has been hung up by arguments over telemedicine abortions, amid suspicions the health minister is trying to stop the process any way he can.
Credit…Mary Turner for The New York Times
- April 9, 2020
LONDON — A week after abortion was supposed to become freely available in Northern Ireland, women continue to be denied access to services and are instead enduring an eight-hour ferry ride to Liverpool, England, despite the coronavirus lockdown.
The collapse of Northern Ireland’s devolved government in 2017 allowed the British Parliament to step in last year and overturn the region’s highly restrictive, 158-year-old abortion laws, ruling that they were incompatible with the United Kingdom’s human rights commitments.
But even though the new laws went into effect on March 31, the regional power-sharing government, restored in January, is locked in a debate about how to roll out the new services. Many people suspect that the health minister is slow-walking the process, hoping to stymie it altogether.
Northern Ireland’s regional government is led by Sinn Fein, which supports the new abortion legislation, and the Democratic Unionist Party, which ardently opposes abortion in all cases.
The rollout is being delayed by a divisive clash among party leaders regarding telemedicine abortions, recently introduced in the rest of Britain to allow a woman in the early stages of pregnancy to self-administer medication that induces an abortion after a remote consultation with a doctor.
After a closed government meeting on the issue on Monday, Arlene Foster, the first minister of Northern Ireland and leader of the ultraconservative Democratic Unionist Party, said that a “full discussion” about the services was required.
“The health minister will bring papers forward, and we will have discussions in relation to those papers,” Ms. Foster, who previously blocked legalizing abortion in the region, said Monday at a news conference.
“I don’t think it’s any secret that I don’t believe that abortion on demand should be available in Northern Ireland,” she said. “I think it’s a very retrograde step for our society.”
Michelle O’Neil, the deputy first minister and vice president of Sinn Fein, the main nationalist party, said she supported telemedicine abortions, referring to them as “compassionate, modern health care.”
While the issue is hung up in debate, legal experts question why that should be delaying implementation of surgical or pill-induced abortions at clinics, which were supposed to become available up to 12 weeks of pregnancy after the law went into effect.
Abortion is one of the most contentious political issues in Northern Ireland, and many commentators believe that the Department of Health is stalling the process out of ideological objections. The health minister, Robin Swann, has described himself as “pro-life.”
The previous law permitted abortions only if the woman’s life was in danger. Even in the event of rape, incest or fetal abnormalities, women were required to carry their pregnancies to term, and anyone caught procuring an abortion could face life imprisonment.
“We know that health professionals are ready to offer abortion services and that the Trusts have stated they are awaiting approval from the Department of Health,” said Fiona Bloomer, an abortion policy researcher at Ulster University, speaking of the hospital trusts of the National Health Service.
“There is no other blockage to this apart from a decision by the minister of health,” Dr. Bloomer said. “As the D.O.H. has failed to provide any answers, the only conclusion we can draw is that this is a political decision, to stall implementation of the regulations.”
The Department of Health said that an agreement to begin providing abortions had to be reviewed in light of the coronavirus outbreak.
“The minister is currently considering this urgently,” the department said in a statement. “Given the significance and sensitivity of the issue, it will be a decision for the executive,” the statement said, referring to the devolved government of Northern Ireland.
When asked why the coronavirus should delay the rollout of regular abortion services outside of telemedicine, the department did not respond.
Between the political impasse in Northern Ireland and the coronavirus lockdown, women have been left with only one option to secure free abortion services. That is to travel to England on a ferry that takes eight hours each way. Abortions in the Republic of Ireland cost around $500.
Yet, with hotels closed as a result of the coronavirus lockdown, women who travel to England from Northern Ireland for abortions have little choice but to travel immediately back.
“Women are effectively being asked to make an eight-hour journey on a ferry while in the middle of a miscarriage in the middle of a pandemic, without any support,” Emma Campbell, co-chairwoman of the Northern Irish reproductive rights group Alliance for Choice, said in a telephone interview.
Doctors for Choice, an alliance of independent medical professionals advocating for reproductive health services in Ireland, warned that vulnerable women would be hit hard by the restrictions and called their being forced to travel during the pandemic “cruel” and “inhumane.”
“There is no reason these services cannot be established in Northern Ireland quickly, and refusing to do so risks unnecessary spread of the coronavirus, placing women and health care professionals in greater danger,” the group said in a statement.
Between the coronavirus and the delay in rolling out the new law, women in Northern Ireland are finding it harder to access abortion services than they have been in 50 years, women’s rights activists say.
“This whole experience has been terrifying,” said a single mother of three who has been seeking abortion medication in the city of Derry in Northern Ireland. “How am I expected to travel when my three children are home all day, and we are all supposed to be isolating from our extended families and staying at home to protect ourselves?”
The woman, who did not provide her name to protect her privacy, said a social worker had offered to send her the pills and give her instructions and support over the phone. But she said the idea of administering her own abortion scared her.
“I just want to speak to a doctor and be safe,” she said. “I’m still trying to decide what to do, but I think in the end I will have no choice but to do it by myself.”
Updated April 11, 2020
When will this end?
This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.
How can I help?
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
How does coronavirus spread?
It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.
Is there a vaccine yet?
No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.
What makes this outbreak so different?
Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.
What if somebody in my family gets sick?
If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.
Should I stock up on groceries?
Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.
Can I go to the park?
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Should I pull my money from the markets?
That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.
What should I do with my 401(k)?
Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”
All copyrights for this article are reserved to Rss NYT