In January 2019, at the very beginning of the new abortion regime here in Ireland, a letter was published in the Irish Independent from a GP, pointing out major inconsistencies in the state’s approach to the matter. A significant part of that letter (Opinion, Independent.ie, 2.1.2019) is concerned with the illogicality of the state providing a free abortion service while continuing to charge the majority of women for contraception.
The implication here is that freely available contraception will somehow remove, or at least substantially reduce, the demand for abortions. But the best way to do that is, and always has been, for parents to raise their children to value chastity and self-control, and for schools, and society generally, to reinforce this message. Free or cheap contraception, in contrast, can only encourage sexual promiscuity, which may increase unwanted pregnancies.
In Switzerland, for example, they have followed such a policy for decades, including provision of morning-after pills (surely much the same thing as abortion?) and extensive sex education in schools. After more than twenty years of these policies, the official abortion rates in Switzerland have indeed steadily reduced year on year, but (a)births prevented by 100,000 morning-after pills a year there (the figure comes from Wikipedia) do not feature in these abortion figures, and (b) in 2018, the Swiss abortion ratio (abortions per 1,000 live births) still stood at 119.1, higher than the Irish ratio of 117.8 for 2019.
I have reservations, therefore, about contraception as a solution to abortion numbers, but I agree with this GP that funding abortion and not contraception is illogical. And I agree wholeheartedly with him on the illogicality of GP payments under the new regime. He writes:
“The fee to be paid to a doctor for a medical termination conducted over three to four visits is €450, whist the fee paid for the management of a pregnancy over eight to ten visits is circa €250. This means that a GP is paid circa €110 per visit to terminate a pregnancy, whilst he/she is paid circa €25 per visit, to manage a pregnancy.”
It is manifestly absurd that a GP is paid more for one abortion-related visit than for four pregnancy-related visits – unless it is the state’s position that an abortion is somehow of more value to the state than a birth. In that case, the current payment system makes perfect sense, as does the legal requirement, on conscientious objectors to abortion, to direct patients to GP’s who will perform abortions, but no legal requirement on abortion providers to direct patients to organisations offering adoption services or other alternatives to abortion.
Leaving aside all arguments based on the immorality of abortion, because the state clearly is in no mood to listen, what the state is doing here, intentionally or inadvertently, is encouraging abortions over births, and this flies in the face of economic reason.
In developed countries like Ireland, with low infant mortality rates, a total fertility rate (TFR) of about 2.1 is sufficient for the population to replace itself. In the 2016 Irish census, according to the CSO, the TFR was below this, at 1.8 – and was also estimated at 1.8 for 2017 and 2018. In 2019, the first year of legalised abortion here, it fell to 1.7. What the state has done with its abortion regime, therefore, is to exacerbate an already declining birth rate.
There is something about abortion that stultifies the minds of otherwise intelligent people. For example, people here voted for abortion as a women’s health issue without asking what maternal medical conditions, exactly, would reduce in prevalence once abortion was legalised. People convinced themselves that abortion numbers would reduce, rather than increase, when abortion was legalised. People ignored the numerous studies from abroad showing that maternal mental health problems increase in prevalence and severity following abortions.
It is not, I hope, elitist to say that people need guidance on this matter. What worries me greatly about Ireland is that the mainstream media here are doing little or nothing to educate people about the realities of abortion. Numerous similar articles, which I have submitted to these outlets in the past, have all been ignored – every last one of them, probably more than a dozen in total.
So, for example, come 2021, when our abortion legislation is due to be reviewed, the likelihood is that the one real safeguard in the current legislation will be removed, the three-day waiting period. There is evidence that this provision saved about 900 lives in 2019, because that number of women went for a first consultation with their GP in 2019, but did not proceed beyond that. (Reply to parliamentary question from Carol Nolan TD). But hardly anyone among the general public is aware of this, because the mainstream media did not report it when the information became available. And they are equally unaware of most post-abortion problems here, as the media have been careful not to pursue these at all.
To sum up: questions of morality aside, we have an illogical abortion regime which is socially and economically damaging, but our media seem intent on preserving it from scrutiny or criticism. In consequence, any changes to it, which occur in 2021, will likely be such as to make it even more illogical, and even more damaging than it is at present.