Abortion in the Republic of Ireland

Abortion in Ireland is regulated by the Health (Regulation of Termination of Pregnancy) Act 2018. Abortion is permitted in Ireland during the first twelve weeks of pregnancy, and later in cases where the pregnant woman's life or health is at risk, or in the cases of a fatal fetal abnormality. Abortion services commenced on 1 January 2019, following its legalisation by the aforementioned Act, which became law on 20 December 2018. Previously, the 8th Constitutional Amendment had given the life of the unborn fetus the same value as that of its mother, but the 36th constitutional amendment, approved by referendum in May 2018, replaced this with a clause permitting the Oireachtas (parliament) to legislate for the termination of pregnancies.
Abortion had been prohibited in Ireland by the UK Offences against the Person Act 1861. The Eighth Amendment was added to the Constitution by referendum in 1983, after concerns that laws prohibiting abortion could be found to be unconstitutional based on a right to privacy. In 1992, the Supreme Court held in the X Case that a thirteen-year-old girl who had become pregnant as a result of rape could be permitted to obtain an abortion in the state because there was a risk to her life from suicide. There were unsuccessful constitutional referendums in 1992 and 2002 that aimed to preclude such grounds for abortion in future cases. Between 1 January 2014 and 31 December 2018, abortion in Ireland was regulated by the Protection of Life During Pregnancy Act 2013, under which abortion was illegal unless it occurred as the result of a medical intervention performed to save the life of the woman.
In 2012, Irish abortion law received worldwide attention on the death of Savita Halappanavar, who had been denied an abortion while suffering a septic miscarriage. This increased calls to repeal the Eighth Amendment. The constitutional and legislative provisions were discussed at a Citizens' Assembly in 2016–17, and at an Oireachtas committee in 2017, both of which recommended substantial reform and framed the debate of the referendum in May 2018.
The current provision dates from the Thirty-sixth Amendment of the Constitution of Ireland, passed by referendum on 25 May 2018. For the previous constitutional provisions from 1983 to 2018, see the historical sections below.
The Health (Regulation of Termination of Pregnancy) Act 2018 allows for a termination:
On commencement of the Health (Regulation of Termination of Pregnancy) Act, the Protection of Life During Pregnancy Act 2013 was repealed. Sections 7 and 8 of the 2013 Act provide for legal termination of pregnancies in cases of a risk of loss of life from physical illness, whereas section 9 provides for legal termination of pregnancies in cases of a risk of loss of life from suicide. Sections 58 and 59 of the Offences Against the Person Act 1861 were repealed, and effectively superseded by the offence defined in section 22 of intentionally destroying unborn human life, punishable by fourteen years' imprisonment.
Every year, the government publishes the number of notifications received of terminations performed under legislation. Those between 2014 and 2018 took place under the Protection of Life During Pregnancy Act 2013, with those taking place under the Health (Regulation of Termination of Pregnancy) Act 2018 being published from 2019:
*The government received just 4,577 notifications for abortions performed under the 2018 Act, but acknowledged that "the number of terminations of pregnancy notified to the Minister is substantially lower than the number of terminations carried out in 2021." The Department of Health estimated that 6,700 abortions under the 2018 Act were obtained in 2021, according reimbursements paid by the HSE. The disparity was blamed on Covid-19 and the HSE cyber attack.
Between 2010 and 2012, 1,642 women ordered abortion pills over the Internet from Women on Web, and had an abortion at home, in Ireland. The pills were illegal in Ireland, and Customs occasionally seized shipments.
Estimates as to the number of Irish women seeking abortions in Britain vary. Since the passage of the Thirteenth Amendment (Travel) in 1992, the right to travel for an abortion has had constitutional protection. In 2016, 3,265 Irish women were recorded as having had abortions in Great Britain. In some cases, women travelling do so with the assistance of the Abortion Support Network.
In 1980, Marian Finucane won the Prix Italia for a documentary on abortion; she interviewed a woman who was about to have an abortion, had travelled with her to England, been with her in the hospital and talked to her afterwards. In 2001, an estimated 7,000 women travelled abroad to obtain an abortion. Statistics showed that 4,149 Irish women had abortions in Britain in 2011. A study published in Social & Legal Studies found that in 2014 a total of 5,521 women gave Irish addresses to English and Welsh clinics that provided abortion services. In years leading up to 2018, some Irish women had abortions in the Netherlands.
The issue of travelling to the UK for an abortion was relevant for many Irish abortion cases, such as the X Case in 1992, C Case in 1997 and the case of Miss D in 2007, as well as in the cases of fatal foetal abnormalities. In response to the UNHRC decision in Mellet v Ireland (2016), the government gave Amanda Mellet €30,000 compensation, partially for being forced to travel.
Under sections 58 and 59 of the Offences against the Person Act 1861, as amended by the Statute Law Revision Act 1892 and Statute Law Revision (No. 2) Act 1893, procuring a miscarriage was a criminal offence subject to penal servitude for life.
These provisions enacted by the Parliament of the United Kingdom remained in force in Irish law until they were repealed by the Protection of Life During Pregnancy Act 2013.
Fears were expressed by politicians in 1929 of an increase in criminal abortions and infanticide following the passing of the Criminal Law Amendment Act which prohibited all appliances and substances for contraception; no exceptions whatsoever were made. Over 100 Irish women were dying annually from unsafe backstreet abortions in the 1930s.
The English case of R v. Bourne (1938), which allowed the distress of a pregnant girl as a defence in a prosecution against a doctor for the termination of a pregnancy, led to an increase in abortion in Britain, and thereafter, of Irish women travelling to obtain abortions. There were no prosecutions in Ireland for illegal abortions between 1938 and 1942 but as a result of travel restrictions imposed during the war years, there were 25 cases prosecuted between 1942 and 1946. During the late 1930s and early 1940s, up to 400 terminations (both legal and illegal) were performed daily in England and Wales, and given the high emigration rates it is likely that there was widespread knowledge of the possibility of obtaining backstreet abortions in England by Irish people. The Bell magazine in 1941 said that some young women from well-off backgrounds were "hustled off, normally to London, Paris, Biarritz, comes back without the baby and nobody is any the wiser" After the war the level of prosecutions decreased, though this only relates to abortions that went wrong or were found out. Those found guilty were dealt with severely by the courts, receiving long sentences of penal servitude, with one chemist with an extensive abortion practice in Merrion Square, Dublin in 1944 receiving a 15-year sentence that was reduced to 7 years on appeal. The Garda Commissioner's first annual report on crime published in 1947 made reference to the number of abortions that were performed illegally. In the 1950s novels, autobiographies and works of non-fiction (including medical texts) that promoted or even described abortion were banned. There were extremely few prosecutions for performing illegal abortion between 1952 and 1963, but one of Ireland's best-known abortion providers, Mamie Cadden, was sentenced to death by hanging in 1957 – this was later commuted to life imprisonment – when one of her patients died.
The Abortion Act 1967 in Great Britain made access to the treatment easier for Irish women and the instance of infanticide, which was prevalent, began to decline sharply. In 1974 Noël Browne became the first member of the Oireachtas to propose the provision of therapeutic abortion services during a contribution to a Seanad debate. In 1981 future President of Ireland, Mary McAleese, chaired a meeting at Liberty Hall that advocated a woman's right to choose. She later claimed that she misunderstood the nature of the meeting. McAleese had previously said that "I would see the failure to provide abortion as a human rights issue", but also that she did not feel "that the way to cope with it is through introducing abortion legislation" into Ireland. A number of controversies have arisen following deaths of pregnant women who were prevented from receiving medical care because of their pregnancy, such as Sheila Hodgers in 1983. Sheila Hodgers was a woman from Dundalk, County Louth, who in 1983 died of multiple cancers two days after giving birth to her third child, who died at birth. It is alleged that she was denied treatments for her cancer while pregnant because the hospital did not wish to harm the foetus because of its Catholic ethos.
The Pro-Life Amendment Campaign was founded in 1981 to campaign against the possibility of a judicial ruling in Ireland that would allow abortion. Prior to the 1981 general election, PLAC lobbied the major Irish political parties – Fianna Fáil, Fine Gael and the Labour Party – to urge the introduction of a Bill to allow the amendment to the constitution to prevent the Supreme Court interpreting the constitution as giving a right to abortion. The leaders of the three parties – respectively Charles Haughey, Garret FitzGerald and Frank Cluskey – agreed although there was little consultation with any of their parties' ordinary members. All three parties were in government over the following eighteen months but it was only in late 1982, just before the collapse of a Fianna Fáil minority government, that a proposed wording for the amendment was proposed. After the election, on the advice of Attorney General Peter Sutherland, the new government of Fine Gael and Labour proposed an alternative wording but there was not a majority in the Dáil for it, and the wording proposed by Fianna Fáil was accepted. This inserted the following subsection into the Constitution:
The Eighth Amendment of the Constitution of Ireland was put to a referendum on 7 September 1983 and was approved with 66.9% of the vote.
Protests took place in Ireland in the years leading up to 2018 to remove the eighth amendment. The government set an indicative timescale of early summer 2018 for a referendum on the section of the state's constitution that ensures tight legal restrictions on terminations.
In the 1980s the Society for the Protection of Unborn Children challenged distribution of information relating to abortion services in Britain under the provisions of Article 40.3.3°. In proceedings which they initiated, which were later converted into the name of the Attorney General, AG (SPUC) v Open Door Counselling Ltd. and Dublin Wellwoman Centre Ltd. (1988), the High Court granted an injunction restraining two counselling agencies from assisting women to travel abroad to obtain abortions or informing them of the methods of communications with such clinics. SPUC v Grogan and SPUC v Coogan targeted students' unions, seeking to prohibit them from distributing information on abortion available in the UK.
In response to the success of this litigation, and prompted by the controversy on the X Case, a referendum was held in November 1992 on the Fourteenth Amendment, which passed. The Fourteenth Amendment specified that the prohibition of abortion would not limit the right to distribute information about abortion services in foreign countries. This was governed by the Regulation of Information (Services Outside the State For Termination of Pregnancies) Act 1995. This was referred to the Supreme Court by President Mary Robinson and found to be constitutional. This Act was repealed on the commencement of the 2018 Act.
In 1992, in the X Case, the Attorney General sought an injunction to prevent a thirteen-year-old girl who had been the victim of rape from obtaining an abortion in England, which was granted in the High Court by Justice Declan Costello. On appeal to the Supreme Court, this decision was reversed, on the grounds that the girl was suicidal, and that, therefore, it was permissible to intervene to save her life.
In November 1992, the Twelfth Amendment of the Constitution Bill was proposed, which would have removed a risk of self-destruction as grounds for an abortion, but was defeated in a referendum.
The Thirteenth Amendment was passed in November 1992 in response to the injunction sought by the Attorney General, ensuring that the protection of the unborn in the constitution could not be used to prohibit travel from the state to another state for an abortion.
The Thirteenth and Fourteenth Amendments together added the following paragraphs to Article 40.3.3°:
In August 1997 a 13-year-old girl was raped, and became pregnant. She was suicidal due to the pregnancy, and the High Court ruled in the C Case that the Eastern Health Board could arrange for her to travel to Britain for an abortion against the wishes of her parents.
The woman at the centre of the case has occasionally spoken about her experiences, but has not revealed her identity.
In 1999, as part of constitutional review, the Ahern government produced a 179-page green paper summarising the then-current Irish abortion law and held an All-party Oireactas Committee on the Constitution. It held oral submissions in 2000, producing a Fifth Progress Report: Abortion in November 2000. Following this, a referendum was held on the Twenty-fifth Amendment to the Constitution Bill, which would have introduced legislation into the constitution to permit abortion in cases of a threat to the life of a woman, but not in cases where there was a risk of suicide. This proposal was narrowly defeated (50.4% – 49.6%).
In 2005, two Irish women and a Lithuanian woman who had previously travelled to England for abortion brought suit in the European Court of Human Rights (ECtHR) asserting that restrictive and unclear Irish laws violate several provisions of the European Convention on Human Rights (ECHR). The case, A, B and C v Ireland, was heard before the Grand Chamber of the Court on 9 December 2009 and was decided on 16 December 2010. The court ruled that the first two women's rights were not violated by being forced to travel because Irish law was "legitimately trying to protect public morals". The ECtHR also ruled that Irish law struck a fair balance between the women's rights to respect of their private lives and the rights of the unborn, although it found that Ireland had violated the ECHR by failing to provide an accessible and effective procedure by which a woman can have established whether she qualifies for a legal abortion under current Irish law. This pertained to the case of the woman who identified as C. Since she did not receive accurate information about the risks of pregnancy associated with her prognosis, she believed that she did not qualify for legal abortion in Ireland and was forced to travel to England for the procedure. In this case, the court relied on doctrine that would deny the direct challenge to Ireland's criminal law and this led to the reasoning that abortion is a moral issue. With the complex, lengthy and sensitive debate surrounding the issue, the Court made its ruling that state authorities were better suited than an international judge to balance the competing views and rights in abortion regulation. The Court's decision is binding on Ireland and all of the member states of the Council of Europe.
A government-appointed Expert Group on Abortion released its findings on 13 November 2012, the day before news of the death of Savita Halappanavar broke, saying that Ireland was obliged to implement the court's decision and recommending legislative and statutory reform. This led to the enactment of the Protection of Life During Pregnancy Act the following year.
The death of Savita Halappanavar led to protests in 2012 calling for changes to Ireland's abortion laws and a highly public investigation by the Health Service Executive. After a miscarriage had been diagnosed, she was denied an abortion because the foetus's heart was still beating. She developed sepsis and died. The HSE enquiry found that her death was a result of inadequate assessment and monitoring and a failure to adhere to established clinical guidelines, and made several recommendations, including legislative and constitutional change.
The Protection of Life During Pregnancy Act 2013 was proposed by Minister for Health James Reilly on behalf of the Fine Gael–Labour Party government. It passed the Dáil by 127 votes to 31. Fine Gael, the Labour Party and Sinn Féin had a party whip in favour of the legislation, and among those who opposed it were Fine Gael TDs Lucinda Creighton, Terence Flanagan, Peter Mathews, Billy Timmins, and Brian Walsh, and Sinn Féin TD Peadar Tóibín. Brian Walsh and Peadar Tóibín were both returned to the party whip within the same Dáil term.
Sections 7 and 8 provided for legal termination of pregnancies in cases of a risk of loss of life from physical illness, whereas section 9 provided for legal termination of pregnancies in cases of a risk of loss of life from suicide. Sections 58 and 59 of the Offences Against the Person Act 1861 were repealed, and effectively superseded by the offence defined in section 22:
Prior to this law, there was no standard to what conditions and situations would be considered to qualify for legal abortion in Ireland. This Act included a provision that allowed abortion only if there was a real and substantial risk to life, specifically pertaining to the life and health of the mother. Within this provision, the women seeking to qualify for legal abortion were examined by an obstetrician and a relevant specialist to decide if she qualified. In a case of a mother feeling suicidal or threatening to commit suicide, she was examined by three specialists and the agreement of their decision was required for her to obtain a legal abortion. If certification for a legal abortion was refused, a woman could appeal the decision and have her situation and conditions reviewed again.
President Michael D. Higgins convened the Council of State to consider the constitutionality of the Bill and a possible reference under Article 26 of the Constitution to the Supreme Court. The President decided against such a reference and signed the legislation into law on 30 July 2013.
In 2014, Ms Y, a young, suicidal refugee woman, was denied an abortion under the act. She went on hunger strike. The baby was eventually delivered by Caesarean section.
In 2002, a woman pregnant with a foetus with fatal foetal abnormalities travelled to the UK for a termination. Her letter in The Irish Times was credited with playing a part in the defeat of the Twenty-fifth Amendment referendum. She later took a case against Ireland in the European Court of Human Rights, D v Ireland, which was ruled inadmissible. The State argued that the Constitution of Ireland might allow termination in cases of fatal foetal abnormalities. After the death of Savita Halappanavar, she gave up anonymity and spoke out. In May 2007 a 17-year-old girl, known as "Miss D", who was pregnant with a foetus suffering from anencephaly (the absence of a major portion of the brain, skull, and scalp; blind, deaf, unconscious, and unable to feel pain, a disorder which is invariably fatal), was prevented from travelling to Britain by the Health Service Executive. The High Court ruled on 9 May 2007 that she could not lawfully be prevented from travelling even though she was a ward of the state.
Amanda Mellet became pregnant in 2011; however, the foetus was suffering from Edwards syndrome, a fatal condition. She was unable to have an abortion in Ireland and had to travel to the UK. In 2016, she took a case to the United Nations Human Rights Committee, and in Mellet v Ireland it found that Ireland's abortion law violated the United Nations International Covenant on Civil and Political Rights and called for the law's reform. The Irish government paid her €30,000 in compensation.
In a case in 2010, the government of Ireland denied Siobhán Whelan an abortion despite being diagnosed with fatal foetal syndrome; she had to travel from Ireland to the UK to terminate her pregnancy. In June 2017, the United Nations Human Rights Committee ruled that Ireland's abortion law violated Whelan's human rights along with the International Covenant on Civil and Political Rights, subjecting Whelan to a cruel, inhumane and degrading treatment, and called for legalisation of and access to safe abortions. The ruling was praised by the Center for Reproductive Rights.
Abortion is currently permitted under the Health (Regulation of Termination of Pregnancy) Act 2018 where two medical practitioners are of the opinion formed in good faith that there is present a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth.
On 25 May 2018, the Irish people voted by 66.4% to 33.6% in a referendum to repeal the Eighth Amendment. They approved the Thirty-sixth Amendment of the Constitution Bill 2018 to delete the current provisions of Article 40.3.3° and replace it with the following:
The government also outlined policies which would govern legislation to replace the Protection of Life During Pregnancy Act 2013.
A Citizens' Assembly had been established by the government in 2016 to consider a number of issues. After five meetings on the Eighth Amendment, it voted to amend the constitution to allow the Oireachtas to legislate for abortion. It also voted on the provisions it would support in this legislation. The Report of the Assembly was sent to the Joint Oireachtas Committee on the Eighth Amendment of the Constitution. The Committee delivered its report in December 2017, and the report was debated in both Houses of the Oireachtas in January 2018.
The result of the referendum came after extensive social media campaigning coordinated the civil society organisation, Together For Yes. The influence of using social media as a voice of change reminded voters of how 'local' the abortion issue was in Ireland, allowing women the right to be heard openly on national media. Another strength of the 'feminist campaign' was the positioning of women from the private to the public sphere. By using social media to bring stories into the public, emotions were mobilised as a form of 'political resistance' to shed light on the potential damage a 'No' vote could cause.
Ultimately, 39 of the 40 constituencies voted in favour of repealing the Eight Amendment. The national result was:
A second draft of the Health (Regulation of Termination of Pregnancy) Bill was published by the Department of Health in July 2018.
The Health (Regulation of Termination of Pregnancy) Act 2018 defines the circumstances and processes within which abortion is legally performed in Ireland. It was signed by the President of Ireland on 20 December 2018, after being approved by both Houses of the Oireachtas, legalising abortion in Ireland. Abortion services commenced on 1 January 2019. This Act permits terminations to be carried out up to 12 weeks of pregnancy; or where there is a risk to the life, or of serious harm to the health, of the pregnant woman; or where there is a risk to the life, or of serious harm to the health, of the pregnant woman in an emergency; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth.
In March 2019, a woman in Dublin was told her baby was likely to have Edwards syndrome, considered a fatal foetal condition, following a positive non-invasive prenatal test (NIPT) and a positive chorionic villus sampling (CVS) diagnostic test, the mother opted for an amniocentesis, which did not show Edwards syndrome. She went on to give birth to a healthy baby without the condition.
In 2019, a woman attending the National Maternity Hospital was also given a diagnosis of Edwards syndrome. An abortion was carried out after 15 weeks. Following the abortion, genetic tests proved negative for Edwards syndrome, leaving the parents devastated and demanding an external investigation, which the hospital agreed to.
According to the Irish Air Line Pilots' Association (IALPA), some female pilots of Irish registered airlines are under pressure to have an abortion if they become pregnant. The issue was highlighted as many Irish-registered airlines use pilots hired under self-employed contracts. Such pilots, as they are deemed to be self-employed, can lose out on work and pay if they become pregnant as they are not entitled to maternity leave.
On 6 January 2019, it was reported that 200 GPs had registered to provide abortion services in Ireland. By the end of 2019, less than 15% of the GPs in Ireland had signed up to provide abortion services.
Several polls have been taken on the subject: