Women in Northern Ireland worry that their abortion rights have been “forgotten” and could be at further risk in light of last week’s Roe v Wade ruling, which saw an end to the constitutional right to abortion in the US.

Abortion was decriminalised in Northern Ireland in October 2019, but three years on, the government has failed to commission abortion services.

Naomi Connor, co-convener of Northern Ireland’s leading abortion rights group Alliance for Choice, told openDemocracy anti-abortion groups had been on the rise since abortion was decriminalised in the country – and added that last week’s Roe v Wade ruling gave them the additional impetus they needed.

When Roe v Wade was overturned, Bernie Smyth, director of Precious Life, one of Northern Ireland’s biggest anti-abortion groups, said: "It’s a bit of a wake-up for us here… There’s a lot to be learnt from what is happening in the US.

“My personal hope for the future is that we too will one day reverse the legislation. This brings a lot of hope, and the battle goes on.”

Connor told openDemocracy this was deeply worrying: “Five years ago, two years ago, would anyone have said that Roe v Wade was going to be overturned? But now states have the legislation ready to go.

“The US has a lot of sway in terms of geopolitics so it will give rise to these politics in other contexts.”

Ashleigh Topley, 35, started campaigning for abortion rights in Northern Ireland after she was denied one eight years ago. Her 20-week scan had revealed a fatal foetal abnormality.

“It was awful and devastating to be forced to continue a doomed pregnancy – there’s no other way to describe it,” she told openDemocracy. To this day, she says she’s too traumatised to leave her house on a Tuesday evening when she knows anti-abortion protesters gather outside a local hospital.

Now she’s worried that anti-abortion groups in Northern Ireland will be “emboldened” by what they’ve seen in the US.

“We fought hard for these rights for years but you can never take these things for granted,” she said. “It’s one thing to achieve your aim but you have to be ready to protect it.”

Topley says that, while technically she would be allowed an abortion today if she was to find herself in the same situation again, there are still huge barriers to access.

The concern is magnified because women and pregnant people in Northern Ireland are already struggling to access the services they should be entitled to.

A month after abortion was decriminalised in 2019, 24-year-old mother Hannah Deannie had to travel to England for the procedure because a legal framework for providing the services across NI had yet to be published.

She said she immediately approached her GP for information but felt she got “a very hostile response”.

Deannie used the British Pregnancy Advice Service (BPAS), a charity that provides support to women in Northern Ireland who can’t access abortion locally.

“Even when it was available, it just didn’t feel like an accessible option,” she said. “It probably depends on who you get on the day because everyone is so divided.”

‘Postcode lottery’

The number of people travelling to England and Wales from Northern Ireland to access services has declined since decriminalisation, but there were still at least 161 abortions carried out in the two nations for Northern Irish people in 2021.

In terms of abortions taking place within Northern Ireland, Assembly documents reveal that there were 2,794 terminations recorded between 31 March 2020 and 31 January 2022.

But access varies across the five health and social care trusts, with a number of early medical abortion services having collapsed in recent years including both the Northern Trust and South Eastern Trust for periods of time. The Western Trust has been suspended since April 2021.

During this time, women who want abortions have to travel to other trusts or to England – or pay privately in the Republic of Ireland.

Grainne Teggart, deputy programme director of Northern Ireland for Amnesty International UK, says fully commissioned services are “long overdue”.

“We need to see a swift end to our postcode lottery for provision,” she said. “The refusal of the Northern Ireland health minister to deliver commissioned services is a damning indictment of his failure to prioritise the health of women and girls.”

As Connor puts it: “Abortion rights in and of themselves are not enough when they don’t mean much in practice.”

Polarised politics

Goretti Horgan from Alliance for Choice explains that the political landscape of Northern Ireland is vital to understanding abortion there.

Like the US, which largely sees Republicans and Democrats on opposite sides of the abortion question, in Northern Ireland the difference in position between unionists and nationalists is stark. The Democratic Unionist Party (DUP) and Ulster Unionist Party are both anti-abortion in all instances.

Importantly, says Horgan, Northern Ireland health minister Robin Swann, of the Ulster Unionist Party, is openly anti-abortion – even though he is in charge of commissioning full abortion services in Northern Ireland.

In February 2016, Swann voted against an amendment to introduce abortion for life-limiting disabilities and in June 2020, he voted in favour of a motion to reject the imposition of abortion legislation in Northern Ireland.

In March 2021, he voted in favour of another motion to remove the provision in regulations for abortion up to birth for disabilities.

Swann has consistently delayed the full commissioning of abortion services in Northern Ireland, claiming it is a “cross-cutting matter” that requires approval from all parties in the Assembly.

But last month, the UK Northern Ireland secretary Brandon Lewis announced he would be removing the need for executive approval and moving forward with the provision of abortion services.

In response, Swann said he was seeking legal advice on the minister of health’s legal responsibilities detailed in the ministerial code.

Christian Right influence

Connor says that one of the most concerning things she has seen is an increase in women approaching their clinics who have already been in touch with so-called crisis pregnancy centres.

These pose as neutral-looking health facilities to conceal their anti-abortion stances while working to persuade people to continue with unwanted pregnancies.

One of the most well-known in the country is Stanton Healthcare Clinic, which has clinics in the US and is funded by US evangelical forces.

An openDemocracy investigation in 2020 found a global network of ‘crisis pregnancy centres’ linked to two US Christian Right groups – Heartbeat International and Human Life International. Both are active in Northern Ireland.

“We had a woman this week who was in a violent relationship,” said Connor. “Stanton kept phoning her to the point she had to block their number. She was panicked that her partner would find out.”

Connor believes the lack of a central access point for abortion information means women may inadvertently end up contacting groups like Stanton believing they provide abortion services.

‘It's never over’

Horgan from Alliance for Choice says above all she believes they have the public on their side – and things are changing.

The Northern Irish Life and Times survey found in 2016 that about 71% thought abortion should be a matter for medical regulation and not criminal law. This went up to 82% in 2018.

Horgan points out that DUP supporters were among those who agreed with abortion.

Topley echoes these thoughts. “I think it’s hard for people in the rest of the UK to really understand the level of abortion stigma here,” she said. “I needed my abortion when I was 28 years old – up until that point I’d never ever heard anyone speak about it.”

She’s optimistic that the younger generation will think differently, with decriminalised abortion, access to the internet and the knowledge of what’s happened in the US.

“You have to continuously fight for your rights,” she said. “It’s never over.”