In June of this year, after the release of the 2021 abortion figures, Gavin and Muireann wrote about the need for more data on abortion in Ireland. When the Irish Human Rights Commission released their submission on abortion in Ireland in November, they agreed with us. As, apparently, would the World Health Organisation. Both of these bodies are pro-choice. And that there could be common ground on the need for data is unsurprising. This seems like a point that everyone should agree on.
The most reported parts of the IHRC submission were ones we strongly disagree with: its recommendations to abolish the three day waiting period and for abortion to be legally available in all situations where there is a ‘fatal foetal anomaly’ diagnosis. For context, abortion is available on request, for any reason, up to 12 weeks. And abortion is already legal up to birth if two medical practitioners agree that the baby has a ‘fatal foetal anomaly’ and think they will not survive for more than 28 days after birth. However, this, the IHRC thinks, is too restrictive. How so? To give one example, it protects babies who have passed the 20 week mark, and who have who have ‘fatal’ conditions but would survive a bit longer than that.
Unsurprisingly, these are the parts of the submission that have received the most attention. Yet, even this submission offers an opportunity for common ground: we all agree that we need to collect more data on abortions in Ireland.
Here’s what we said back in June:
The official Irish statistics provide headline figures of:
1) the number of abortions that took place under each of the four legislative grounds (with the vast majority taking place in “early pregnancy”);
2) the counties where the abortions took place;
3) the month in which they took place.
That’s it. We have no data at all on the person requesting the abortion – nothing on age, employment, education level, obstetric and gynaecological history, urban or rural dwelling, current or historical contraceptive use, nothing. When we compare this to the detailed annual reports available from England and Wales, Scotland, Sweden, or New Zealand, to name a few, the lack of any real information in the Irish data is quite stark. Even the Netherlands, which provides a small amount of detail compared to its peers, still provides context and detail that Ireland doesn’t. For example, the Netherlands reports on trends over time, and calculates and reports the abortion ratio (number of abortions as a proportion of live births).
Here’s what the IHRC thinks.
Publicly available data on Ireland’s abortion services is limited, currently covering only the number of terminations, the grounds under which the termination was provided, the county or place of residence, and the Medical Council registration number of the provider. The WHO Guidelines highlight the need for improved data infrastructure and is currently developing a set of abortion care indicators, in addition to a quality abortion care monitoring and evaluation framework. The Unplanned Pregnancy and Abortion Care study recommended that an appropriate data infrastructure, in the Irish context, would comprise mandated data collection by hospital and primary care providers. At a national level, the Abortion Working Group has also called for a national abortion database.
Our view is that characteristics of a national data framework should include:
– Health system input monitoring, including governance, financing, workforce, and learning and development data;
– Service delivery monitoring, including availability of services, wait times, abortions, conscientious objection, and any related referral information;
– Individual care monitoring, including age of service user, gestation data, previous history, method of abortion, ultrasound referral, complications and contraceptive service uptake post-abortion;
– Population outcome monitoring, including population data on access to services, and population knowledge of knowledge of access to quality, affordable abortion care;
– Impact measurement, including abortion related mortality and morbidity, and the incorporation of abortion service-delivery monitoring data into other administrative data collection mechanisms, including population-based surveys;
– Appropriate disaggregation indicators, including geographic information, age, socioeconomic status, and ethnicity.
The World Health Organisation also thinks that data collection is important and that “[e]fforts should be made to disaggregate data by dimensions of inequality, such as ability, age, caste, education, ethnicity, gender, geography and wealth.” (p. 18)
Our reasons for wanting more data might not be exactly the same. One reason the WHO and the IHRC want more data is to improve access to abortion. This is obviously not a goal they share with pro-life groups. Rather, we want to use it understand how to reduce abortion rates – but mainly by reducing the demand for abortion. For some pro-life advocates, understanding who is most likely to have abortions, and why, has been a way of drawing attention to structural injustices that drive abortion – like poverty, racism, and ableism. It gives us information about where we should invest effort if we want to create a society where women have better alternatives to abortion, and fewer reasons to have one. It can be a source of information for those of us who want to provide women with practical support, or promote policies that would improve the situation of women, parents and families. In the UK, for example, Pregnant then Screwed, an organisation (that is not pro-life) that advocates for women’s right not to be discriminated against for becoming pregnant or having children, recently drew attention to the fact that many women in the UK cite prohibitive childcare costs as a reason why they chose abortion. And there is actually good reason to hope for – indeed, expect – common ground on this. Pro-choice people don’t want women to choose abortion because of burdens imposed by racism or economic injustice – they do not want abortions to happen only because women can’t afford childcare: most would want reproductive freedom for women, they don’t want to replace legal constraints on bodily autonomy with economic ones.
Regardless of the reasons, everyone agrees that we need more data, we do agree that we need more data. If the Irish government doesn’t usually defer to pro-life groups, it might listen to the IHRC and the WHO.