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AROUND 240 WOMEN still travel from Ireland to the UK each year to access abortion services.
They travel for a variety of reasons: some have passed the 12-week limit, others are dealing with a foetal anomaly and, in some cases, a medical abortion failed.
Many women foot the bill themselves but some people cannot afford to pay for a termination, plus related transport and accommodation costs.
Experts told The Journal Investigates that women continue to encounter bureaucratic hurdles that force them to travel to access a termination.
That is despite a 2023 review recommending the removal of a number of these obstacles, including the three-day waiting period that pushes some women over the 12-week gestation threshold.
Vulnerable populations, including homeless people and those who need visas to travel, are disproportionately impacted by current restrictions.
“No one should be forced to seek abortion care outside the state,” said Clare O’Brien, Director of Counselling at the Irish Family Planning Association (IFPA) who provide early abortion services.
Irish women are not alone. Yesterday, we revealed that over 5,000 women in Europe travel from their home countries across borders to access abortion care each year.
This stark statistic was a key outcome of a months-long project coordinated by Spanish outlet Público, with The Journal Investigates as a core partner. Our Exporting Abortion investigation was conducted by journalists from across the continent and published by 11 media outlets.
An average of 240 women travel every year from Ireland to the UK, data compiled by our investigation team shows. Almost 1,000 women travelled from 2019 to 2022. Statistics from England and Wales for more recent years are not yet available.
Women living in Ireland also travelled to the Netherlands and Spain for abortions in recent years, though in smaller numbers.
When asked about the fact that many women are still unable to access abortion services, a spokesperson for the Department of Health cited the current time restrictions and said: “The Government is committed to ensuring that there is safe and equitable access to termination of pregnancy services.”
They said that there has been a “significant decline in those travelling” since the new legislation was enacted. Over 3,000 women travelled to have an abortion in 2017. This drop “indicates that most women are now accessing safe, woman-centred abortion services”, they added.
Those who need help in Ireland often contact the Abortion Support Network (ASN), a UK-based charity that provides information and financial assistance.
ASN has been helping women from Ireland since 2009 and, despite the fact Ireland expanded its abortion services in 2018, continues to support many women who find themselves forced to travel to access a termination.
ASN has partners across Europe and most commonly helps women from the Republic of Ireland, Poland and France.
Typically, a woman contacts ASN online or via their helpline. Once a person makes initial contact, the charity will respond within 48 hours and begin a conversation with them.
Prior to the Eighth Amendment being repealed, over 600 women in Ireland contacted the ASN for help annually – 684 in 2017 and 624 in 2018.
In recent years, this number has been close to 200. Of the Irish women who contacted them, ASN funds around 90 abortions each year.
Ciara McHugh, ASN’s Helpline Coordinator, explains: “That will mean having a discussion about someone’s income, what savings they have, working out together how much they can afford to contribute and how much we need to contribute.”
McHugh told The Journal Investigates that ASN needs to be “quite diligent about how much we spend per client, so that we can help as many clients as possible”.
In 2024, the average grant given to Irish clients was £904 (about €1,090).
Due to “escalating costs”, the charity launched an urgent funding appeal recently as “a last resort”. If it doesn’t hit its target, ASN warned: “We may have no choice but to reduce our grants.”
In Ireland, a woman can have an abortion for any reason before she is 12 weeks pregnant (this usually means 84 days since the first day of her last period). After this she can only have a termination in exceptional circumstances such as when her life is at risk, or the foetus has an anomaly or life-limiting condition.
Most of the people ASN helps are in their second or third trimester. Some of these cases involve a foetal abnormality, McHugh said, describing this situation as “horrific”.
The charity also supports many women who didn’t even realise they were pregnant until after they passed the 12-week mark.
McHugh said women who find themselves in this scenario may have always had irregular menstrual cycles, “so they just did not know, went to the doctor and found out when they were over 12 weeks”.
In some cases, the woman could be just over 11 weeks pregnant but – because of the three-day mandatory wait period in Ireland – cannot access an abortion before 12 weeks and has to travel.
Removing the three-day wait was one of the recommendations included in a review of Ireland’s abortion services by barrister Marie O’Shea BL, who published her report in April 2023. Nearly two years on, her recommendations are yet to be implemented.
O’Shea told The Journal Investigates the three-day wait means some people are “deprived of care – care that they have a statutory right to receive”.
She said people were presenting to their primary care provider within the required timeframe (even providing for a three-day wait), but were still “timing out” for various reasons.
Often this involved “circumstances beyond their control, such as the non-availability of the primary care provider over the next three days, or delays in the pathway of care from their GP to hospital or dating-scan services”.
Service providers highlighted the fact that “vulnerable populations and marginalised groups” are “most adversely affected by the mandatory nature of the three-day wait”.
O’Shea said vulnerable people, such as those who are homeless, are “more likely to present towards the end of the twelfth week”. There are also “logistical difficulties” in getting some people to attend two appointments.
The barrister said Irish abortion law, as it stands, “allows for no discretion whatsoever”, adding that “it would be difficult to justify” not changing this element of the legislation.
In some cases, women go over the 12-week limit because they had a medical abortion (taking medication called mifepristone and misoprostol) but it didn’t work – this happens in about 1% to 2% of cases.
Every year, ASN deals with a small number of particularly complex cases where they need to help asylum seekers travel from Ireland to elsewhere in Europe to access a termination.
McHugh said these cases are “hugely challenging and hugely traumatic for those clients”.
In such cases, permission to travel abroad must be granted via the Department of Justice – typically the woman in question will receive ‘ministerial travel permission’ which allows her to travel abroad for about three days – as well as a visa from the country she is travelling to (usually the UK or the Netherlands).
McHugh said getting a visa can be “a very lengthy bureaucratic process”, noting “you’re against the clock because of gestational limits for abortion”.
In order to get a visa, proof of return transport needs to be provided. A delay in the visa being granted often results in the woman being unable to travel when planned, meaning transport and accommodation need to be rebooked.
McHugh said the staff at the Department of Justice have been “very helpful” in such scenarios, but “there’s a limit to what they can do, they cannot force another state to issue a visa”.
The IFPA also provides support to women in this situation through their clinics in Dublin and free HSE-funded specialist pregnancy counselling service. O’Brien said:
The impact of being denied abortion care is disproportionately severe on those who require visas to enter other countries.
O’Brien said that “when delays are caused by visa requirements, they are not only stressful but can add to the complexity of the care needed, and therefore also the cost”.
If any “bureaucratic hurdles” are encountered, she said that “everything can come crashing down, leaving a pregnant woman who desperately needs access to time-sensitive healthcare to start over again”.
“This compounds the impact on the psychological well-being of a person who is already in an immensely stressful situation.”
The ASN has been able to help most women who find themselves in this position access an abortion. However, in one recent case the charity was unable to get a visa from either the UK or the Netherlands before the woman passed the gestational limit in both countries.
“That was a continuing pregnancy, and that client gave birth,” McHugh said.
“So you have a very vulnerable client in a country that is not their own, having experienced horrors that we don’t know, forced to continue a pregnancy.”
We asked the Department of Health about the disproportionate impact that the current law has on some women. A spokesperson said: “Termination of pregnancy services are free of charge to anyone who is ordinarily resident in the State.”
A free service, My Options, was also established following the introduction of abortion services and it “provides information about abortion services and medical support for anyone who is having or has had an abortion”. This is available for 240 different languages, the spokesperson said.
“For those women who are unable to access termination of pregnancy services in Ireland,” the DOH said that My Options will put them in touch with ASN.
On visas, the DOH said it “has no role in the issuing of visas to enable people to avail of the service outside of the state”.
While many women can access abortion services in Ireland since we repealed the Eighth Amendment, many others are still forced to travel abroad, said McHugh.
“The idea that ‘we have access now and all as well’, that’s so far from the truth. We’re not out of the shadows of the Magdalene Laundries yet, and it’s the most vulnerable who are still being exported to access care.”
Travelling abroad can carry stigma and lead to anxiety, according to Irish research by the University of Limerick and University of Galway published last year. It examined the impact of travelling by interviewing women who had an abortion abroad before the Irish law change.
It found that women “were largely denied access to comfort and privacy”. The researchers also said that the women interviewed gave “vivid descriptions of long waits in clinics and airports, and complications associated with taking a flight or ferry home post surgery”.
Women who travelled to England in recent years since the new legislation was introduced told The Journal Investigates about similar trauma still faced by many. We tell their stories in an article being published tomorrow morning.
McHugh said the Departments of Health in Ireland and Northern Ireland should examine a Reciprocal Care Agreement “so that people can travel” within the same island, rather than having to go abroad, where possible.
“That will take out that trauma of air travel, the stigma, the shame, the isolation.”
The DOH in Ireland told us that “a Reciprocal Care Agreement with Northern Ireland is not currently under consideration”.
We also asked the Department of Health in Northern Ireland. A spokesperson said that “the introduction of commissioned abortion services” in 2022 has enabled “the majority of demand for these services to be met locally”.
This has “significantly reduced the number of women and girls who historically needed to travel outside the jurisdiction to access services”.
“In light of this, and the differing legal frameworks and service models which have shaped abortion rights and services in both jurisdictions, a reciprocal agreement with the Republic of Ireland has not been considered.”
Aside from removing the three-day wait, O’Shea’s review also recommends removing the risk of decriminalisation of medical professionals who provide abortions in Ireland.
Where a medical issue will almost certainly result in a baby’s death – but it’s difficult to say exactly when i.e. if it will be within 28 days after birth – there is a grey area. Under the Health (Regulation of Termination of Pregnancy) Act 2018, two medical practitioners, including one obstetrician, must agree that the baby will die within 28 days.
“There is not an exhaustive list of conditions where it is known that a foetus may demise before birth or die within 28 days of being born, even though the likelihood would be deemed to be very high,” O’Shea explained.
So there’s a lot of potential for concern of being accused of falling foul of the law inadvertently.
“That, coupled with the potential of the same type of intense adverse media scrutiny that accompanied the very tragic cases that went wrong, is reported as being a factor that comes into play during clinical decision-making.
“Clinicians described feeling tension at multi-disciplinary team meetings, and the practice of defensive medicine.”
The new government has said it will consider making changes to Ireland’s abortion legislation, but no such commitment was included in the recent Programme for Government. O’Shea said there was no “justifiable reason” for not including it.
The Department of Health told us that “significant progress has been made” in regards to the recommendations of O’Shea’s review of abortion services.
This includes all 19 maternity sites providing termination services by March 2025, an increase in community providers to over 450 and the fact it is now “possible for one of the two consultations required for termination in early pregnancy to take place remotely”.
“The cumulative effect of these measures has substantially reduced barriers and has increased access to services for those who need it,” the spokesperson said.
However, O’Brien from the IFPA told us that the “serious flaws” in the legislation identified by the O’Shea report “must be addressed as a matter of urgency”.
“It is simply unacceptable that the burden of organising reproductive healthcare falls on some women, while the majority can access care without cost and within the mainstream healthcare system here.”
McHugh agrees that Ireland needs to urgently implement the recommendations in O’Shea’s report.
“Women’s health is not a political football, and we should know that by now. We should have learned from the Cervical Check scandal. We should have learned from the mother and baby homes.
“The urgency is that women are not accessing healthcare in their own country. It’s not acceptable that we traumatise our most vulnerable.”
Support services:
Reporter: Órla Ryan • Editor: Maria Delaney • Main Image Design: Lorcan O’Reilly • Social Media: Cliodhna Travers
Exporting Abortion is a cross-border investigation coordinated by Público (Spain) in collaboration with journalists from more than ten countries:
Joana Ascensão (Portugal – Expresso), Kristina Bohmer (Slovakia), Magdalena Chrzczonowicz (Poland – OKO.press), Mayya Chernobylskaya (Germany), Nacho Calle (Spain – Público), Maria Delaney (Ireland – The Journal Investigates), Joanna Demarco (Malta), Armelle Desmaison (France), Emilia G. Morales (Spain – Público), Bru Noya (Andorra), Apolena Rychlíková (Czechia), Órla Ryan (Ireland – The Journal Investigates), Sergio Sangiao (Spain – Público), Margot Smolenaars (Netherlands).
This investigation was developed with the support of Journalismfund Europe.
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