As we approach the publication of the first annual report into the number of abortions in the Republic of Ireland carried out under the 2018 legislation, we are publishing a series of relevant blogs, explaining and unpacking the statistics of abortion in Ireland so we can better understand the changes that come about as a result of repeal.

In the first in this series, we will take a look at the number of abortions that Irish women have obtained in recent decades. We will look at:

1) Abortions obtained in England and Wales from women with Irish addresses;

2) Abortion obtained in the Netherlands from women with Irish addresses; 

3) Abortions that took place illegally in Ireland with the use of abortion pills bought online and;

4) Abortions obtained legally in the Republic of Ireland between 2014–2018 since the operation of the Protection of Life During Pregnancy Act 2013. 

1) Irish women who obtained abortions in the UK under the Abortion Act 1967   

Thanks to the detailed statistics collected in England and Wales annually, the number of Irish women who have obtained abortions in England and Wales has been recorded since 1968. The 13th Amendment to the Irish Constitution in 1993 made this explicitly permissible: ‘This subsection shall not limit freedom to travel between the State and another state’.

It should be noted however that there may have been Irish women who travelled to the UK for an abortion but gave their address as a country other than Ireland. For example they may have listed the address of a friend in England or Wales instead. Obviously we don’t have data on how common this practice is or was, but we do know that the number of women who give no address is very small. 

As can be seen from this graph drawn from the 2019 UK government figures, the number of Irish women who had abortions in England and Wales reached a peak in 2001, and has been in fairly steep decline year-on-year since. 

The Irish Times reported on speculations for the reasons for this decline here. See Table A at the bottom of the post for a year-by-year breakdown (it’s a long table so we’ve shifted it to the bottom for readability).

Sources

1968–86: UK Parliament Hansard – November 30 1987
1987–2001: UK Government Abortion Statistics, England and Wales (No centralised page with all the reports, each individual year searched here.)
2002–2010: UK Government Abortion Statistics, England and Wales
2011 onwards: UK Government Abortion Statistics, England and Wales

2) Irish women who obtained abortions in the Netherlands   

Next we will consider the statistics on Irish women who obtained abortions in the Netherlands between the years 2005 and 2018. Why are we including these figures? Because ‘the Netherlands is the only other jurisdiction [apart from the UK] to which women from Ireland travel for abortions in any significant numbers’ according to the HSE, as reported in The Irish Times in 2016. The HSE again mentioned this fact in a submission to the Citizens’ Assembly in relation to the 8th Amendment.

Those numbers are as follows.

YearIrish women who obtained abortions in the Netherlands
200542
2006461
2007451
2008351
2009134
201031
201133
201224
201312
201416
201534
201622
201734
201818

Sources

2005–16:
The Irish Times – Fact check: Have more than 170,000 Irish women travelled abroad for an abortion?
HSE – Further decrease in the number of women giving Irish addresses at abortion clinics in England and Wales
2016–18:
Government of the Netherlands – Annual Report on Termination of Pregnancy 2018

3) Irish women who obtained abortions via abortion pills online

The use of abortion pills became a significant campaigning issue in the 2018 referendum. Pro-choice advocates used the argument that because some women were taking abortion pills illegally bought on the internet, the law had to change to reflect this. As Carol Nolan TD noted in a recent written question to Minister for Health Simon Harris, the figure of ‘three women per day’ ordering abortion pills online was a key slogan used by Yes campaigners in the run-up to the referendum. 

Data given by Dr Abigail Aiken of the University of Texas from a 2017 study to an Oireachtas Committee show that 5,650 women requested the abortion pill from Women on Web between 2010 and 2015. She doesn’t give a clear breakdown by year in her paper, although she does show a rough chart in her presentation to the Oireachtas. Significantly (and in part undermining the pro-choice narrative of ‘three women a day’) 
– the study also doesn’t give data on actual abortions carried out each year, and 
– the figures are for both the Republic of Ireland and Northern Ireland together. 
She does give specific statistics for the two years of 2010 and 2015 though, and gives the number of abortion pills distributed between the years 2010 and 2012. 

It must be noted that the increase in women ordering abortion pills online corresponded to an increase in abortion pills confiscated by customs officers. In 2018, 740 abortifacient tablets were confiscated in Ireland, according to this media report. From data provided by the Health Products Regulatory Authority, you can see the number of such pills confiscated in this news report here. Given that such a high volume of abortion pills were confiscated in recent years, it could easily be argued that the number of women who actually received illegal abortion pills is much smaller than the number who ordered online. 

In another 2017 study co-authored by Dr Aiken, it showed that of the women who ordered pills online, not all women actually followed through and took them. In fact, of the 1,636 women who ordered abortion pills in Ireland (north and south) from Women on Web between 2010 and 2012, 158 of the women confirmed that they did not actually take the pills. 431 women did not respond to the follow up survey, but even if all who did not respond took the pills, 158 out of 1,636 shows that at least 9.66% of women do not ingest abortion pills they ordered online.

On the basis of the clear increase in abortion pill use from Dr Aiken’s graphs presented to the Oireachtas (despite the fact that no annual figures were presented), it can be presumed that the figure either stayed the same or increased in the years 2016–18. We will generously assume that the figure increased year-on-year at the same rate as the average year-on-year increase over the 2010–15 period. Note that this assumption is almost certainly an overestimate – the total number of pills estimated by this method is significantly in excess of both the ‘three women per day’ figure widely cited by pro-choice campaigners, and the ‘two to five women a day’ claimed by Together for Yes.

While it is impossible to know how many abortions took place from pills bought online, given that the evidence shows that at least 10% of pills do not get ingested, we will reflect this fact in the figures. (Here is one example of a women who ordered abortion pills, yet did not ultimately take them.) 
A final caveat in relation to abortion pills: it appears that the main source of online abortion pills for Irish women was the website Women on Web. It is possible that some women obtained pills from other online sources – but there is no other source mentioned in any of the medical literature we have examined.

Sources 

BJOG – Experiences and Characteristics of Women Seeking and Completing At-Home Medical Termination of Pregnancy Through Online Telemedicine in Ireland and Northern Ireland: A Population-Based Analysis
BMJ – Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland

4) Abortions obtained legally in the Republic of Ireland since the operation of the 2013 Protection of Life During Pregnancy Act

The annual statistics released under the 2013 Act in Ireland contain information about procedures that intentionally end the life of the foetus (abortions) but also procedures which may have resulted in the unintentional death of the foetus during an attempt to save the mother’s life which were always legal in Ireland, even before the 2013 legislation. Thus this blurs the distinction between elective abortions and medically necessary life-saving treatment. For the purposes of simplicity, we will include all terminations listed in the statistics as abortions.

YearTotalS 7: risk from physical illness S 8: emergency risk to lifeS 9: risk of suicide
2014261493
2015261493
2016258161
201715852
20183218131

Sources

2014: Irish Times – 26 terminations under Protection of Life During Pregnancy Bill
2015: Irish Times – Terminations carried out on 26 women last year
2016: Irish Times – 25 legal abortions recorded in Ireland last year
2017: Government of Ireland – Fourth Annual Report on the Protection of Life During Pregnancy Act
2018: Government of Ireland – Fifth Annual Report on the Protection of Life During Pregnancy Act

Conclusion

Before concluding this blog, a final caveat, in addition to those listed throughout this post, must be mentioned: why didn’t we include statistics on Irish women having abortions in all other countries? 

While it is possible that Irish women travelled to other European countries (apart from the UK and the Netherlands) for abortions, the number of women who did so is very small. In 2016 The Irish Times reported the HSE as saying that ‘the Netherlands is the only other jurisdiction [apart from the UK] to which women from Ireland travel for abortions in any significant numbers’.

***

To sum up: here is a table showing the most recent data (discussed above under the four headings) regarding Irish women who had abortions in the last decade

YearUK abortionsDutch abortionsOnline abortion pillsLegal Irish abortionsTotal abortions for Irish women
20104,4023149404,927
20114,1493372004,902
20123,9822476504,771
20133,6791290004,591
20143,73516945264,722
20153,451341,295264,806
20163,265221,575254,887
20173,019341,843154,911
20182,879182,157325,086


Plotted on a graph, it looks like this:

Our generous estimate of the number of Irish abortions show the total holding relatively steady from 2010 to 2018 as abortion pill use increased and UK abortions decreased.

If we extend the time horizon, there’s less data available, but abortion pill usage was relatively uncommon then so that’s less of an issue. Looking at a figures since 1967, we can see that the total number of Irish abortions peaked in 2001 and has substantially declined since, even including abortion pills. In a future post we’ll compare Ireland’s abortion rate during this time period to other countries’ (spoilers: it’s comparatively very low).

Now, if we add the number of abortions Irish women had in 2018

– in England and Wales (2,879),
– in the Netherlands (18),
– from online abortion pills (2,157),
– legally in Ireland (32),

it could be very reasonably claimed, given the significant uncertainties over the number of illegal abortion pills taken, that a generous upper bound of 5,086 ‘Irish’ abortions took place in 2018. Will the 2019 Irish figures be higher or lower? We will find out soon just how many lives the new Irish abortion legislation has cost.

Gavin and Muireann

Table A

YearIrish women who obtained abortions in the UK
Abortion Act 1967 Introduced 
196864
1969123
1970261
1971579
1972975
19731,195
19741,421
19751,575
19761,822
19772,185
19782,550
19792,809
19803,324
19813,605
19823,654
19833,677
8th Amendment introduced
19843,948
19853,888
19863,920
19904,064
19914,154
19924,254
19934,402
19944,590
19954,532
19964,894
19975,340
19985,891
19996,226
20006,391
20016,673
20026,522
20036,320
20046,217
20055,585
20065,042
20074,686
20084,600
20094,422
20104,402
20114,149
20123,982
20133,679
20143,735
20153,451
20163,265 
20173,019
20182,879
8th Amendment repealed
2019375