![Sample our Global Development journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5929/TOC-Subject-Sample-2021-Global-Development.jpg"})
ABSTRACT
The growing availability of abortion pills has transformed the safety and accessibility of abortion worldwide, especially in countries with very restrictive abortion laws. The public health implications of this abortion technology have been widely recognized, but its political and geographical impacts require closer attention. This paper examines the geography of illegal abortion pills in the Republic of Ireland, where abortion pills became widely accessible through transnational activist networks, despite a constitutional abortion ban. It contributes to political geography and international relations conversations about materiality and sovereignty by mapping the flows of abortion pills into Ireland and discussing the varied ways that the institutions of the state conceptualized and responded to these flows. It argues that the state’s response to the influx of illegal abortion pills was predominantly shaped by its understanding of their territorial significance: the state sought to intercept pills at the border and discourage their use at home while advocating abortion travel abroad, eventually legislating for abortion reform that would offer tightly controlled access authorized by doctors. The paper advances the research agendas in reproductive and abortion geographies by bringing them into conversation with broader debates on territory and politics.
ACKNOWLEDGEMENTS
The author is very grateful to those who gave their time to be interviewed for this research. The author also thanks Jennifer Thomson, Lauren Martin, Léonie Newhouse, Tim Brown, Regan Koch, Catherine Nash, Stephen Taylor, Harry Higginson and several anonymous reviewers whose feedback helped to improve the paper.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author.
Notes
1 The drug usually referred to as the ‘abortion pill’ actually comprises two drugs with different histories and geographies: misoprostol and mifepristone. The World Health Organization (WHO) protocol for medication abortion calls for a combination of mifepristone and misoprostol, but misoprostol-only protocols dominate because the drug is often sold in pharmacies for the treatment of ulcers, even in countries where abortion is highly restricted (Drovetta, Citation2015; de Zordo, Citation2016). Unlike misoprostol, mifepristone was developed specifically for the medical termination of pregnancy, so states with very restrictive abortion laws often do not licence it at all (Gynuity, Citation2017). Studies show that misoprostol-only regimens are around 85% effective compared with an effectiveness rate of > 95% for combination mifepristone and misoprostol (Blumenthal et al., Citation2009).
2 The activities and infrastructures of pill networks inside Ireland and Northern Ireland are generally regarded as illegal and have been the subjects of police and prosecutorial action. In order to prevent exposing interviewees or pill networks to legal risk, any specific logistical details about pill networks that appear in this paper have been previously disclosed in the national news media, parliamentary testimony or other academic scholarship.
3 Some studies of abortion pill requests from the island of Ireland do not disaggregate the requests by country, so the available data combine figures from Ireland and Northern Ireland (Aiken et al., Citation2017).
4 Precise data on both abortion access strategies are incomplete: estimates of the total number of Irish abortion travellers are based on self-reporting of home addresses by patients in British abortion clinics, while the estimated numbers of abortion pills entering Ireland can only be collected based on the numbers of impounded pills as reported by the Irish customs agency and numbers of pills requested/shipped as reported by telemedical abortion services abroad.
5 These activists on the Abortion Pill Train designed their protest to echo the 1971 Contraceptive Train, when activists bought legal condoms in Belfast and brought them to Dublin (Connolly, Citation2001, Citation2020). However, in 2014, abortion pills were illegal in both Northern Ireland and the Republic of Ireland. Northern Irish authorities actively investigated and prosecuted users of abortion pills. This Abortion Pill Train action provoked serious disagreement among pro-choice groups north and south, because some groups feared that it endangered women and activists by giving the false impression that abortion pills could be easily purchased over the counter in Northern Ireland (interview, NI-2).
6 Interview ROI-3: Member of the Dáil (lower house of the Irish legislature) and campaigner for repeal, interviewed November 2018.
7 This law was inherited in the Irish criminal code from the period of British colonial rule. The 1861 Offences Against the Person act also governs abortion in parts of the UK today. In October 2019, the sections of this act criminalizing abortion were repealed for Northern Ireland.
8 Interview NI-1: activist in a Northern Irish pro-choice organization, interviewed August 2018.
9 Interview ROI-1: activist in an Irish pro-choice organization, interviewed in July 2018.
10 Interview EU-1: activist leading an Amsterdam-based telemedical abortion service, interviewed June 2018.
11 For reference, the HPRA reports the following (HPRA, Citation2017, p. 23):
12 The ways in which activists navigated legal ambiguities and regulatory infrastructure to smuggle pills strongly resonates with earlier generations of activists who brought condoms into Ireland from Northern Ireland when they were illegal (Cloatre & Enright, Citation2017).
13 Interview ROI-2: activist in an Irish socialist feminist and pro-choice organization, interviewed November 2018.
14 Interview NI-2: Activist in a Northern Irish pro-choice organization, interviewed April 2018.
15 These data cannot be disaggregated by the country in which the end-user lives, because as explained above, the pills may have been shipped to an intermediary in Northern Ireland and then moved south by other means, rather than mailed to the end-user’s home address (Aiken et al., Citation2017).
16 It was later renamed the Crisis Pregnancy Programme, but for clarity it will be referred to throughout as the Crisis Pregnancy Agency.
17 After the abortion law changed in January 2019, these websites were taken down. They can still be accessed as cached versions.
18 The other was the committee’s decision that it would be practically impossible to legislate for abortion only in cases where the pregnancy resulted from a sexual crime (Conlon, Citation2017).