There is no national health service for Northern Irish women. There is not, strictly, an NHS for Northern Ireland – instead, the region is covered by the body Health and Social Care, which provides social services as well as healthcare. But like the NHS in England, Scotland and Wales, the HSC was founded within the scope of the Beveridge report to provide medical treatment free at the point of use. Which it does, unless you are a woman who has use for an abortion, because the 1967 Abortion Act was never extended to Northern Ireland.
For Northern Irish women, terminations are only available in "highly exceptional circumstances". These "highly exceptional circumstances" are undefined, but they do not include: rape, incest, homelessness, poverty, fatal foetal abnormalities, or in fact almost any of the reasons a woman may have for needing to end a pregnancy. In 2013, only 51 abortions were performed in Northern Ireland; meanwhile, over 1,000 women travelled to other parts of the UK in order to have what should be a simple, safe and legal procedure.
And when Northern Irish women travel, they have to pay. They pay for the flights. They pay for the flights of someone to keep them company – or, if they cannot afford that, they come alone, so they pay in loneliness. They pay for accommodation if they need to stay overnight. They pay in secrecy or in social opprobrium. And they pay for the procedure, as reaffirmed yesterday by the High Court's decision that women from Northern Ireland are not entitled to free abortion on the NHS elsewhere in the UK.
In his ruling, Mr Justice King stated that devolutionary powers have to be taken into account. That means devolution to the home nation governing what a woman may or may not choose for her own body, of course: the idea that such a power could be devolved to the level of the pregnant individual is, apparently, quite unthinkable. This does not prevent Northern Irish women from having abortions. But, as Mara Clarke of the charity Abortion Support Network points out, "The fact that abortion is criminalised changes abortion from an issue of personal morality and choice to one of economy and class." Even for those who can afford it, this is a cruel situation. No woman facing the decision to have a termination should be forced to do so alone and in a strange place, hundreds of miles from home.
But if money is not readily available (and often it isn't, since financial restraint is one of the main reasons women choose abortion) the situation goes beyond cruelty and becomes savagely absurd. The less money you have, the longer you have to save, the further your pregnancy progresses, and the more you must ultimately spend. The consequences of this uterine catch-22 are directly observable in the statistics: in England and Wales, only 1.4 per cent of abortions are performed after 20 weeks’ gestation; but for Abortion Support Network's clients, the rate is 7 per cent. Money is time.
And, Clarke says, the girl in yesterday's test case found herself in exactly that pinch of escalating costs when she became pregnant in 2012:
A 15-year-old girl worked up the courage to tell her mother she was pregnant. Her mother fed the family beans on toast for a week to save an extra £50. The abortion cost £350, plus the charge for the mandated consultation, plus travel. By the time they had raised the money, the young girl was 15 weeks pregnant and the price had been pushed up to £600 for just the procedure. She also had to pay to get a photo ID in order to travel.
That is the tax that Northern Ireland's law places on a child who does not want to become a mother. Almost incredibly, it could have been worse: since Abortion Support Network was founded in October 2009, it has helped to arrange travel and treatment for six women who, by the time they reached England, were found to be over the legal limit for abortion. All six had to return, still pregnant, to have a baby they desperately wanted not to have. Anti-abortion zealots may try to celebrate the six lives they regard as saved; I mourn for six women whose lives have been blighted by compulsory maternity.
As far as I'm concerned, a woman's motives for seeking an abortion are of no relevance to her right to the procedure. Sustaining another life inside your body, at non-negligible risk to your own health and freedom, is an enormous thing to do – women should be answerable to no authority but themselves when deciding whether or not to continue a pregnancy. Abortion Support Network does not ask its clients for their reasons. Nevertheless, some have volunteered a little information about themselves, and what is known comprises a catalogue of distress.
Of the 1,175 women from Northern Ireland and the Republic of Ireland helped by Abortion Support Network since 2009, 62 had serious mental health issues; 56 had serious medical issues; a further nine had been warned against conceiving again after health problems in a previous pregnancy; 48 were in or escaping abusive relationships; 49 were pregnant as a result of rape; three were refugees; seven were homeless; 16 had tried to self-harm or self-abort (one woman, Clarke tells me, was desperate enough to plan a car crash that she hoped would induce miscarriage); 25 were suicidal; 83 said that the man involved had disowned responsibility; and 29 were carrying pregnancies with fatal foetal anomalies such as conjoined twins or anencephaly.
Because these figures are based only on what women have chosen to reveal, they are minimums. The depth and breadth of the miseries compounded by Northern Ireland's absurd law are certainly much, much greater. The 1967 Abortion Act cannot be imposed on Northern Ireland by Westminster, but nor should penalising charges be imposed on Northern Irish women by the English NHS. When women are forced from their own home to get medical treatment, the scapegoats of men's colonial wrangling, the least we might do is give them that treatment as we'd give them any other – free at the point of use.
You can donate to Abortion Support Network at its website.