Ireland Voted Yes – What next?

In Friday's landmark referendum result the Republic of Ireland chose to decriminalise abortion. What does that mean for the Irish Republic, and what impact will it have on the UK?

The vote has been counted and confirmed and it is clear that the Republic of Ireland voted overwhelmingly in favour of decriminalising abortion.

The vote means that the wording of the eighth amendment to the Irish constitution, which currently asserts the 'equal right to life' for a pregnant woman and an unborn foetus (at any gestation), will be amended to read 'provision may be made by law for the regulation of termination of pregnancies'. For the first time, abortion will become legal in the Republic of Ireland; the first step towards provision of abortion care has been taken.

Abortion in the Irish Republic is illegal unless it occurs as the result of a medical intervention performed to save the life of the woman. This exception (contained in The Protection of Life During Pregnancy Act 2013) is so narrow that it resulted in only 25 abortions in 2016 (figures for 2017 have yet to be released). The penalty for performing or undergoing abortion outside this exception is 14 years in prison. By comparison, the average prison sentence for a rape conviction in the Republic of Ireland is 5 to 7 years.

The Irish Republic has not historically prevented women from seeking abortion elsewhere; it is estimated that 10 women a day travel to England to seek terminations. These women need to pay for the termination procedure and the cost of travel and accommodation.

So what are the practical implications for Ireland? In the immediate future there should be a reduction in the stigma surrounding abortion, given the increased dialogue, and the strength of the result. The referendum allows the Irish Government to enact laws to regulate abortion, so legislation will have to be drafted and implemented. It appears that abortion will be available 'on demand' up to 12 weeks gestation (in line with many other European countries), but there will be thorny issues to decide such as provision for conscientious objection and what (if any) reasons are required for an abortion after 12 weeks.

The Irish health care system will need to take steps to provide adequate abortion services; medical practitioners will need to be trained, and policies, guides and codes of good practice put in place. Medical training in universities will need to be updated to ensure abortion provision is part of the core curriculum for students of Obstetrics and Gynaecology.

In the long term, the result of this vote is hugely significant. It will enable women in the Irish Republic to access abortion services at home, and removes the financial, and emotional, burden of having to travel for abortion procedures abroad. The result is a step towards giving Irish women greater control over their bodies.

The vote is also likely to have an impact on the UK. Given the changes required to Ireland's health care system, UK abortion providers are likely to be asked for input, and as abortion services improve in Ireland, we can expect the numbers of women travelling to the UK for abortions to reduce, which should go some way to reducing the burden on UK abortion providers.

Most importantly, the referendum result throws into stark contrast the position of Northern Ireland, where abortion at any gestation remains a criminal offence. There have already been strident calls for this anomalous situation to be resolved. Will the momentum of the Republic's referendum drive a change in Northern Ireland, or will political considerations demand the status quo?

However you view the outcome, Friday's landmark result will have a vast impact on the provision of health care to women in Ireland, and the UK.