In the lead up to the Irish abortion referendum next month, much has rightly been made about the plight of women who are forced to travel to the UK for healthcare as a result of their country’s archaic abortion law.

But an equally pressing issue is the growing number of women who chose a different option – to access the abortion pills online, and take them secretly at home. In a press conference for Together for Yes (the coalition to repeal the eighth amendment) yesterday, campaigner Ailbhe Smyth and others outlined the need to regulate these pills, revealing the country has seen a staggering 190% increase in their usage in the last year alone.

There is nothing inherently dangerous about taking misoprostol, the abortion drug, at home. Indeed, in a move that was welcomed by pro-choice campaigners, Scotland became the first part of the UK to allow women to take the pills in the privacy of their own home last year. But in a country where abortion is illegal, women are often forced to access drugs from unknown online suppliers, meaning they cannot be 100% sure they are even getting the correct drug or dose. Obstetrician and gynaecologist Dr Aoife Mullally said of the current drugs available online, “The medication may not contain what the woman thinks it does,” and “women often take the medication in significantly higher doses than they should because they are so desperate for it to work”.

Even more worryingly, because of the very real threat of criminal ramifications, women are afraid to seek medical attention if something does go wrong. Without the repeal of the Eighth Amendment, there is no way to regulate the sale of online abortion pills. This is just another frustrating example of how the Amendment is not only a barrier to healthcare, but is also literally threatening women’s lives.

And the situation is even more convoluted in Northern Ireland. Despite being technically part of the UK, the province did not see the 1967 Abortion Act extended to its shores. But neither will it see any benefit from the anticipated repeal of the Eighth Amendment, as this will only affect the Republic – leaving women in Northern Ireland in something of an abortion no man’s land. Due to the important work of MP Stella Creasy last year, women from Northern Ireland can now access abortion in England on the NHS. 

But for those unable to travel to the mainland, the only option is to purchase the pills online. And far from turning a sympathetic blind eye, authorities have been gleefully making examples of people while pursuing totally unjust prosecutions. In just one recent harrowing example, a mother who obtained abortion pills for her 15-year-old daughter after her child was raped faces prosecution in a court case in Belfast next month. 

Readers who live in mainland UK should not dismiss these issues as uniquely Irish problems. Figures show that online abortion pill usage is on the rise in England and Wales, too. You may also be surprised to know that you would risk similar criminal convictions if you were to avail yourself of the drug without medical permission and supervision. Abortion is not yet decriminalised in the UK, and the nation has the harshest punishment for self-induced abortion of any country in Europe, bar the Republic of Ireland.

And despite widespread access to abortion services across the mainland UK, more and more women are opting to use the online pills for a variety of reasons. Campaigners cite travel restrictions, abusive relationships and worries of intimidation or judgement when publicly accessing healthcare services which they have every right to use. Just this week, Ealing council voted to enforce the first buffer zone around the town’s Marie Stopes clinic as a shield against increasingly hostile, American-style protests outside it. This serves to demonstrate that, while you may be able to access an abortion in the UK, it is not always with ease and dignity. At present, women have to take the misoprostol pill in a clinic or hospital between 24 and 48 hours after a first pill, mifepristone, is ingested. This means that women need to make two trips to a clinic, which is not only inconvenient but can also be uncomfortable and humiliating, as women can be taken by surprise by how quickly the second pill takes effect, miscarrying in taxis or public transport on their way home.

There is no medical reason for this, as the same drug is licensed for home use in the case of miscarriages, proving the outdated status quo simply fulfils society’s need to make abortion unpleasant and punitive – even when it is legal.

So while I am hopeful the Republic of Ireland will repeal the Eighth Amendment next month, and will happily join in the celebrations when it does, it will not be mission accomplished for women’s reproductive health care in the British Isles. The increase in the use of online abortion pills shows that we have great strides to make in the quest to give women full bodily autonomy. While it’s important to make sure abortion is legal, we also need to make sure it is accessible and practical. We need to continue to push back against the tendency to infantilise or shame women who seek abortions. It’s high time we treated all women like adults, fully capable of making decisions about their own bodies, instead of driving them into desperate and undignified situations. 

Images: Unsplash, Thought Catalog, Toa Heftiba, Kaitlin Baker