Removing the three-day reflection period from our abortion legislation will cost more lives

The 2018 abortion legislation is up for review by the Dáil this year. There have been calls recently, including from the National Women’s Council of Ireland (NWCI), for the removal from the existing legislation of the requirement for a 3-day reflection period before an abortion can take place.

There is nothing remarkable, it should be said at the outset, about Ireland’s current 3-day reflection period. 

• Eighteen European countries have a mandatory reflection period, and in ten of them (including Ireland) this period is 3 days.
• In Italy the reflection period currently is 7 days, it is 6 days in Belgium and 5 days in the Netherlands.

In fact, and in the face of a system that offers no real state support whatsoever for organisations assisting mothers who choose life, the 3-day reflection period still saved close to 1000 babies’ lives here in 2019. Here's how: 

1. What has the legislation achieved as it stands?

Abortion providers are paid per visit by the HSE, and so the number of women who change their minds about abortion can be gauged from the official figures for payment per visit. If women make a first visit to a GP and then change their mind during the three day reflection period, only one payment is made to the GP. 

At the time of writing, this information is available only for the year 2019. In that year, according to the reply given by the HSE to a parliamentary question from Carol Nolan TD, the 3-day reflection period saved 900-1000 babies’ lives in 2019.

There were 7,536 payments to early abortion providers for initial abortion consultations.

As there were 6,666 abortions here in 2019, according to the official report, this suggests that, at a minimum 870 women (7,536-6,666) changed their minds about having an abortion here in 2019.

But, in fact, if we use the official figure of 6,542 early abortions in 2019 (omitting the 124 abortions that were performed in our hospitals on health grounds for the mother or disability grounds for the baby) then that yields a figure of possibly 994 lives saved in the first year (7,536-6,542), attributable to the 3-day reflection period. 

This figure of 994 may be a slight exaggeration as it is possible that a small number of women, after an initial consultation with the GP, may have been referred on to a hospital for an abortion. 950 lives saved certainly seems a reasonable, indeed cautious, estimate.

That is about 1 in 7 women changing their minds in the course of the 3-day reflection period.

The Irish Family Planning Association report for 2019 has a figure of 1 in 8 of a sample of their clients changing their minds in 2019.

2. How many lives could be saved by tweaking the existing legislation?

The legislation and regime put in place in 2018 had literally no other measures to support a change of mind on the part of the woman. Under the current regulations:

Generous financial assistance is given to abortion providers, averaging €450 per abortion for GPs (and adding up to a total of €20m in the two years 2019-2020, according to the reply to a parliamentary question from Peadar Tóibín TD)

Much less is paid to GPs who care for mother and baby through all 9 months of pregnancy - the average payment here is €250.

A GP who does not provide abortions is required under the current system to refer the woman to an abortion provider, but the reverse is not true – there is no requirement on the abortion provider to provide a mother-to-be with information on alternatives to abortion, nor to refer her to these services.

Finally, there is no financial support whatsoever from the state for organisations like Gianna Care and Every Life Counts who help families in sometimes very difficult circumstances.

If all of these manifest contradictions were removed from the existing regime, could more lives be saved? We collect no information in Ireland about reasons for abortion, but from other countries we know that, very often, the woman feels that she has no choice because of her economic circumstances. Financial assistance and moral support for the women would surely lead to many more lives being saved.

Equitable treatment of GP’s by the state should also help. The current system seems to heavily favour abortion-providing GP’s, and that is quite bizarre.

3. What happens if we get rid of the 3-day reflection period?

If we do as the NWCI suggests, and get rid of the reflection period entirely, what will be the consequences?

Clearly, the immediate consequence might be a jump of close to 1,000 in the abortion numbers per year, which is the same thing as a decline in the number of annual births by a further 1,000. This seems inevitable, because what is proposed here means that the woman will take the abortion pill on, or very soon after, the occasion of first contact with the abortion provider, leaving no time to reflect.

There will also likely be long-term consequences for women’s mental health. A recent American study following up on nearly 4000 women, over a period of 10 years or more [Sullins 2019, Medicina], concluded that women aborting wanted pregnancies (which would include women likely to change their minds, given an opportunity) were significantly more likely to develop subsequent mental disorders (such as depression or suicidality) than other women.

Conclusion

This is a deeply flawed proposal from NWCI, which would likely cause abortions to increase, women’s mental health to be adversely affected, and our declining birth rates to decline further.

It needs to be vehemently opposed by all pro-life organisations and all pro-life politicians. These groups and individuals need to organise resistance to the NWCI proposal, and to embark collectively upon a programme to raise public awareness of its implications.

Deise4Life  Dungarvan