Earlier this week, a small number of women and men re-staged the ‘Contraceptive Train’ of 1971 as an ‘Abortion Pill Train’. A group organised by ROSA, Re(al)-Productive Health, Action for Choice and the Socialist Party travelled to Belfast, where they collected pills ordered from Women on Web and delivered to friends’ addresses in the North. On return to Connolly Station in Dublin, 10 women took the pills in public, to demonstrate their safety, and explained their actions to the assembled crowd. The video above is by Paula Geraghty, there are some great photographs of the train journey here and video of the protest here. In going to the North, the train mimics a trip frequently undertaken by Irish women. Women on Web do not supply the pills directly to Ireland because the state has become so good at confiscating them. In order to obtain them, you must be able to provide an address in another jurisdiction, typically Northern Ireland, and arrange for them to be collected. No attempt was made to arrest those who travelled on the train, or to seize the pills, and there was no anti-abortion counter-protest.
The Guardian erroneously reported that the train collective had bought their pills from the Marie Stopes clinic, but they are not readily available for purchase in Northern Ireland. As Alliance for Choice remind us, women using them in Northern Ireland do so under the cloud of potential prosecution. Readers may remember that in March 2013 Alliance for Choice highlighted this position by publishing an open letter in which 100 women and men testified that they had used pills to induce an abortion themselves, or had helped someone else to do so.
The pills the train imported are used for early medical abortions. Their use is not a new phenomenon in Ireland. For further details on how they work, see here, here, here and here. Buying them is, of course, much cheaper than travelling abroad for a later abortion (though arranging to collect them from a Northern Irish address is not easy for everyone). This matters deeply when we consider how families are affected by the politics of austerity. But the pills are also more accessible precisely because they can be used in most cases without intensive medical supervision, in private. Regulatory regimes for their use vary significantly from jurisdiction to jurisdiction. However, in the UK, BPAS has been campaigning for some time for amendments to the existing abortion legislation to allow women to take them in their own homes rather than travelling repeatedly to a clinic. The majority of women who use pills procured from Women on Web are able to use them safely (see, for example, this story from The Examiner). The earlier they are used, the safer and more effective they are. However, complications are possible in rare cases even when they are used properly (leaving aside the issue of purchase from unscrupulous providers and use of inappropriate drugs). For example a very small minority of women – about 1% – may experience heavy bleeding requiring medical attention. The Ray D’Arcy show on Today FM recently broadcast a letter from a woman who had experienced two weeks of severe bleeding after inducing a miscarriage using misoprostol purchased in a pharmacy. ((Misoprostol is available from pharmacies in Ireland as a medicine for symptoms of rheumatoid arthritis. It is also used in Irish hospitals in the medical management of miscarriage. It can be used to terminate a pregnancy on its own but it is safer to use it with mifepristone, or RU 486. Mifepristone is a steroid which can be used to induce labour after foetal death in utero. Since 2003, special recording obligations apply to its supply and administration in Ireland, and it is not available in ordinary pharmacies. )) Cases like this one do not demonstrate that the current criminal prohibition on use of the pills is justified. Neither do they show that an intensive regime of scrutiny and surveillance must be established before their use could be legalised in Ireland. Rather they demonstrate the importance of making medical assistance accessible to women in those cases where it becomes necessary. They also show up, yet again, the stress, denial of information, inhibition of access to medical treatment and outright emotional isolation which a regime of criminalisation imposes on women in need of abortions. As Mary Favier of Doctors for Choice has said, stigma means that women often delay visits to the doctor even where an abortion has resulted in complications. To accuse the abortion pill train protestors of ‘dangerous’ behaviour in taking the pills ignores the state-supported structures of stigma and neglect which amplify the very small risks inherent in taking these pills properly.
The abortion pill train is a collection of small illegal or quasi-legal acts which individual Irish women commit on a regular basis. The protest not only breaks several of the abortion laws, but shows up the spaces in which they are already broken: in which they are porous, not enforced, practically or politically unenforceable, or just about surmountable if you have the resources, the courage, the knowledge and the time.
- Taking the pills: A woman who is not pregnant and consumes an abortifacient in Ireland commits no offence under the PLDPA 2013. A pregnant woman successfully using the same pills to successfully terminate her pregnancy might be guilty of the offence of ‘intentional destruction of unborn human life’ under s. 22 of the Act. The heft of this new offence is difficult to gauge. There is no doubt but that women using Women on Web’s services in Ireland may understand themselves to be staring down the barrel of 14 years in prison. In theory, an individual supplying these pills to a woman for the purposes of ending her pregnancy, or being reckless as to whether she might use them for that purpose, might also come within the scope of inchoate offences (attempt etc) under s.22. There are significant evidentiary difficulties inherent in applying these sorts of offences to early medical abortion. A prosecution can only be brought at the instance of the DPP, who will not prosecute unless there is sufficient evidence to justify it, and if a prosecution is in the broader public interest. In the face of suggestions from within his own party that the criminal penalty for this offence be reduced to 5 years, the Minister for Health in debating the Bill suggested that the maximum 14 year prison sentence provided for under the Act was intended for the ‘back street operator who was a recidivist carrying out dangerous procedures on vulnerable persons’ – we might speculate as to whether a woman performing an early medical abortion herself would ever receive such a sentence. That said, cases like those of Ms Y and Ms X demonstrate the risks of a certain kind of zeal in enforcing the letter of the law – we can imagine a woman being prosecuted for using pills for an early medical abortion, or being caught up in another’s prosecution. And that imaginary has its own effects.
- Importing the pills: Both misoprostol and mifepristone are controlled drugs under the Medical Products Regulations 2003. Pills sent in the post are routinely seized on importation by the HPRA and Revenue and Customs – as noted already this programme of seizures has been effective enough to convince Women on Web to effectively cease direct supply to Ireland. The Revenue’s enforcement officers are empowered under the Customs Consolidation Act and the Irish Medicines Board Act 1995 to detain and ultimately seize and destroy them, just as they are empowered to seize medicines found on your person or in baggage at a border. A prosecution is unlikely to result from seizure of a single package. Bulk importation is another problem. In January 2011, Fang Huang was convicted in the District Court of importing mifepristone from China and supplying it to women from a Parnell St Supermarket. Very little information is available about the prosecution. She was fined €5,000 – €500 for each of 10 charges. The Irish Medicines Board initiated the prosecution.
- Advertising Women on Web/informing women on how to use the pills: In theory, speaking about, or advertising, or putting up stickers about Women on Web, or carrying a banner with their web address contravenes the Regulation of Information Act 1995. Offenders are liable to pay a fine of up to IR£1500. Advertisement and public speaking are not the same as one-to-one counselling, which is much more tightly controlled by s. 5 of the Act. A sticker or notice advertising Women on Web in a public place clearly breaches s.4 of the Act: in the terms of the legislation, this is acceptable because the passerby has not voluntarily sought the information out. Where the information is given at a public meeting, or in a television broadcast, the law is less clear. Under s.3 of the Act, it is permissible to provide ‘Act information’ in these contexts if two conditions are satisfied. First, the information must relate ‘only to services which are lawfully available in [a particular] place and to persons who, in providing them, are acting lawfully in that place’. The language of the Act pre-dates transnational online services like Women on Web or Women Help Women, which rely on co-operative networks of agents in several jurisdictions. It is difficult to tell how it applies – in what ‘place’ is the service ‘available’ if the pills are ordered online in Ireland, under the remote guidance of a doctor in Austria via a website hosted somewhere else, supplied from India and finally consumed in Ireland with the guidance of a telephone counsellor in the Netherlands? In 2010, Women on Web, responding to a challenge from the Irish government, obtained a ruling that remote supervision of abortion was not illegal in Austria. The second provision is more problematic in the context of the abortion pill train – the information cannot be accompanied by advocacy or promotion of termination of pregnancy. As always, invoking the Act in any kind of public speech context only serves to highlight the impossibility of enforcing it while maintaining the possibility of informed debate about abortion service provision. Again, we have to wonder whether the DPP could find that the public interest is served by prosecuting activists in this sort of case.
Naturally, there are political risks inherent in choosing law-breaking as a method of protest. In pursuing this kind of disobedience, the protest dares the state to act, or highlights the effects of its inaction. (Ruth Coppinger’s action as a TD -the only woman of three TDs who travelled- in taking the train and publicly taking the pill is particularly interesting in this respect.) There is the danger of drawing official attention to the methods which women and networks of activists such as Women on Web use to cope with the prevailing legal regime, of misleading women into thinking that the law is more easily circumvented than is actually the case, or of provoking conservative disapproval and backlash.
There is also still a sense of the scandalous in law-breaking. Some activists expressed discomfort with the choice of date for the protest – the train returned home a few hours before the vigils held to remember the death of Savita Halappanavar in October 2012. My own view is that there must be a place for both vigils and civil disobedience in abortion protest, particularly when we consider the ways in which the Irish law and politics of abortion have manipulated the deaths and suffering of ‘deserving’ women in order to silence ‘improper’ voices. But then, I write that with the comfort of distance.
It is only a little bit surprising to see sharp distinctions drawn between the contraceptive train and the abortion pill train. The action undertaken by 47 women from the IWLM seems comparatively uncontroversial now because the purchase of contraceptives was not illegal in Northern Ireland in 1971, the IWLM never went as far as to demand abortion access, and in the end (though this was not revealed at the time) those who travelled bought aspirin instead of the contraceptive pill because they did not have prescriptions. Crucially, the train seems so far in the past, and the rightness of the action so obvious in hindsight that it has lost any controversial political bite. Even David Quinn can invoke the condom train now. Perhaps that is why we so readily remember the train, and forget, for example, Women on Waves’ visit to Dublin, or the Sister Ship (just to name transport-themed reproductive rights protests…). The original train was less tame than this public chooses to remember. It was decades before access to contraception was fully liberalised in Ireland. The women in 1971 knew there would be a moment of confrontation with customs officers when they returned to Connolly, they worried about the possibility of arrest, and they had prepared tactics – including outright mockery of the customs officers – to adopt if they were challenged. June Levine in her memoir Sisters documents that each woman had been issued with a leaflet prepared in advance by Nell McCafferty and Mary Anderson – every woman was to be issued with a pill. They were to declare their pill to the customs officers and then swallow it. It is instructive to remember that the contraceptive train in 1971 also sparked divisions with the Irish Women’s Liberation Movement. Nuala Fennell, more interested in institutional reform than in protest, thought it was one in a series of counterproductive stunts ((June Levine, Sisters; Diarmuid Ferriter, Ambiguous Republic)) Mairin de Burca stayed at home to organise the welcome party, because she felt that it would be off-putting for rural women to see single women involved in importing contraceptives. Other single women travelled. ((Ann Stopper, Monday’s at Gaj’s; Mary Kenny, Something of Myself and Others)) On the train on the return journey to Dublin, June Levine writes, a common sentiment was; “Our mothers will kill us!”. ((June Levine, Sisters.)) The women chanted that the law was obsolete, but they also had to negotiate the costs of proving it, and they marched out into Connolly station to the tune of ‘We Shall Overcome’. Perhaps some day, we will see the abortion pill train invoked as the acceptable historical opposite of some new radical act of ‘attention-seeking’.