Last week, the HSE produced a report covering the first six years of abortion provision in Ireland. The report is called “Termination of Pregnancy services in Ireland” and was produced by the National Women and Infants Health Programme.

Generally, I like to assume and act as though health providers, whether on the clinical, administrative, or policy side, are all just doing their job in good faith. While I vehemently disagree with pro-choice people on the specifics of the issue of abortion, I always like to ask myself “If I believed abortion was a valid moral choice, would I have any issue with what these people are doing? Would I believe they were doing anything bad, or wrong, or incompetent, or would I just believe they were and are doing their job to the best of their ability?” This approach often puts me at odds with other pro-life people, and I understand their frustration.

On this occasion, however, even I am kind of sick reading this report, particularly its framing. The report itself and the associated press release state:

One in four pregnancies worldwide ends in a termination, making it one of the most common medical procedures experienced by women of reproductive age. Safe, high-quality termination of pregnancy care is therefore a key element of the healthcare services the HSE provides.

It is so frustrating to read this. After being constantly accused of “scaremongering” about how common abortion is in so many countries worldwide, and after being repeatedly assured that “the floodgates would not open”, to see the Clinical Leads for this “service” in Ireland finally, openly and brazenly admit that abortion is as common as it is is maddening. I have no recollection of any pro-choice campaigner citing this statistic before, during or after the unending debates about abortion in Ireland, and yet here it is, not just buried somewhere in the report but posted right in their press release.

I don’t want to dwell on this because, frankly, doing so is totally unhelpful. I think this report deserves time and attention, and I will write future blogs on the details and statistics included in the report, but pro-life people are right to be angry and fed up at how much we were dismissed and demeaned for attempting to draw attention to basic facts when those facts were inconvenient to the pro-choice side, but are now front and centre of a report into termination of pregnancy now that abortion is legal.

There are two other high-level things worth noting in this report. The first is that the report itself is a really welcome document. Here at the Minimise Project, we have been calling, as have pro-choice groups, for proper, comprehensive data on abortion provision in Ireland. We cannot reduce the number of abortions if we don’t know why people get abortions in the first place. This report is a really welcome first step in filling that knowledge gap.

Furthermore, the report itself notes the lack of data, and the issues and challenges associated with it, along with steps taken by the HSE to collect better data. So far, this seems to be limited to hospital settings only, where only a minority of abortions take place:

Until recently, there was no formalised or systematic national mechanism for the monitoring and evaluation of termination of pregnancy services. Data collection was primarily undertaken through the aforementioned statutory notification process as required under the Act. While this process fulfilled legal reporting obligations, it did not provide a comprehensive framework for service evaluation, quality assurance, or workforce planning.

Following the findings and recommendations of two national reviews of termination of pregnancy services, the O’Shea Review and the Regan Review (Link to the section in this report – page 30), NWIHP, in partnership with the National Perinatal Epidemiology Centre (NPEC), developed a national electronic data collection system for termination of pregnancy services.

The system is initially focused on hospital-based termination of pregnancy services and is designed to support clinical governance, service planning, and continuous quality improvement.

Pro-life advocates should lobby to have all abortions covered by this new centralised data collection effort, in order to gain a comprehensive picture of the reasons for abortion going forward.

The final overarching point is truly depressing. The report paints a picture of abortion essentially becoming normalised and destigmatised:

The legalisation of termination of pregnancy within the parameters set out in the Act, required a huge mindset shift within the healthcare environment. Six years on, the termination of pregnancy service has evolved and is largely acknowledged as a routine and normal part of healthcare provision.

This is something that pro-life people really, really need to understand and grapple with. So often, I hear pro-life people talking about friends, relatives or colleagues of theirs who “didn’t know” what they were voting for, who “didn’t understand” how “wide-ranging” abortion is, who are “horrified to think that abortion is happening in their own town”, etc. Pro-life people all know and think of people who fall into this camp of not liking or approving of abortion themselves, but who did reluctantly think abortion needed to be available in certain limited circumstances.

I agree that many such people exist. However I don’t think those people are much help to us in the pro-life movement. Such people were helpful and important when the pro-life movement really needed lots of people to vote a certain way. However, those days are behind us. We desperately need more people to move far beyond personal disapproval of abortion and to become fully convinced of the entirety of the pro-life position. Why? Because someone who merely personally disapproves of abortion can very easily lose that personal disapproval if abortion becomes normalised.

There are surely doctors, midwives, pharmacists and others in our health services who staunchly opposed abortion, who maybe even voted or campaigned for a No vote in 2018, and who have since seen their colleagues providing abortions to women in Ireland. They’ve seen these “services” bed in as part of normal daily life in our hospitals and communities. They’ve seen women who had a pregnancy last year come back for a termination this year, and they’ve seen life go on as normal. And they’ve started to rethink their personal opposition to abortion.

Someone who is genuinely convicted of the injustice of abortion is far less likely to go through such an evolution. That is why we at the Minimise Project are so focused not just on showing people that they have good reasons to be personally put off by abortion, and far more focused on making the Basic Case: abortion is wrong because there is no consistent way to grant equal rights to all humans that doesn’t include the unborn, and because the foetus’s right to life does override the right to bodily autonomy in the particular case of pregnancy. We cannot rely on an underlying “ick” reaction to abortion, because that reaction crumbles as soon as abortion is destigmatised. The HSE’s report makes that soberingly clear.

Muireann