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It’s likely that many of those who voted Yes reluctantly in 2018 have been appalled by the sharp rise in the number of abortions taking place in Ireland at that time. Shock at the spiralling rate is often seen expressed on social media or in private conversation. Even former Taoiseach, Leo Varadkar, who campaigned for a Yes vote said that: “There are over 8,000 abortions happening in Ireland every year. I would like that number to be lower”.
Far from becoming lower, that number soared to 10,000 in 2023, with indications it may be the same in 2024. Yet there are those who quibble with whether this is, in fact, an increase.
One example is Dr Peter Boylan who had a letter published in the Irish Times in July 2024 taking issue with an earlier article from Breda O’Brien claiming that Irish abortions had approximately doubled since repeal of the Eighth Amendment. Dr Boylan’s letter is reproduced below.
Dr Boylan makes a number of points in his letter (reproduced in full at the end of this analysis):
I now respond to each point in turn.
Dr Boylan may be correct that 10,000 abortions a year was a reasonable estimate to make in 2018, but his method of arriving at this estimate was very strange. Norway and Scotland have long-established abortion regimes which are quite different to the regime which was proposed for Ireland. Also, on the figures he himself supplies, Norway and Scotland are quite different from each other, with Scotland having about 50% more abortions than Norway. It is also unclear how he combined and adjusted the Scotland and Norway figures to arrive at 10,000 for Ireland.
But 10,000 was itself a reasonable estimate, in line with actuarial and statistical estimates from the pro-life side in the abortion referendum – estimates which, along with Dr Boylan’s estimate, were carefully kept from the public at the time. Politicians kept their mouths shut, and news media ignored these estimates. The mantra “Safe, Legal and Rare” went largely unchallenged at the time.
One final point under this heading: Dr Boylan fails to mention that, while our population increased between 2018 and 2024, the number of annual births actually fell by about 5000. The rise to 10,000 abortions here took place at a time when the total number of pregnancies was substantially declining. And when, incidentally, the government introduced free contraception alongside the availability of free abortions.
This claim by Dr Boylan is very hard to sustain.
Since the official figure for 2018 Irish abortions was less than 3000, he is actually suggesting that women importing and self-administering abortion pills, and women giving false addresses, amounted to about 7000 in 2018.
He says that the numbers self-administering are unknown, but these numbers can be estimated by counting the number of Irish-based women accessing websites that sell these abortion pills. In fact, then Minister for Health, Simon Harris, told the Oireachtas Select Committee on Health debate on 6 Nov 2018 that around 1000 Irish women per year self-administering abortion pills was a reasonable estimate.
But here’s the thing. If there were about 3000 official abortions in 2018, and 1000 self-administered abortions, then Dr Boylan is actually claiming that about 6000 Irish women gave false addresses in 2018. That is, for every Irish woman who gave an Irish address when accessing abortion services, he claims that two other Irish women gave a non-Irish address.
I think not. Neither Dr Boylan nor I have any idea what the correct number is for these women. No one ever carried out a proper statistical investigation. I think most people would agree, however, that the figure is likely to have been a lot closer to 0 than to 6000.
In that case, it follows logically that Breda O’Brien was correct that Repeal led to a substantial increase in Irish abortions. In the unlikely event that there were more than 1000 women giving false addresses each year prior to 2019, then claiming that Irish abortions actually doubled may warrant examination, but Dr Boylan is surely very wrong in asserting that there was no change after Repeal.
No one looking at the abortion and birth data for 2020 and 2021 would argue with Dr Boylan’s statement that Covid restrictions etc led to lower abortion numbers in those years. – though the decrease from 2019 to 2020 was almost insignificant. I am not sure, however, that his other stated reasons have much merit.
County Sligo had no GPs at all in 2019 and 2020 providing abortion services, yet had higher abortion ratios (abortions per 1000 births) in those years than its neighbouring counties Mayo, Leitrim, Roscommon and Donegal.
Ireland is not the size of the United States, it is only a fraction of the size of Texas. Talk about geographical access to abortion in Ireland is a bit silly. No one really believes that there was a real problem with access, the drive to increase the numbers providing abortions likely had more to do with ideology than with actual evidence of widespread problems of access.
He also implies that women continued to go abroad in large numbers in the early years of the new regime. In fact, there were less than 500 of these women in 2019, and the annual number has fallen substantially since then. Unless you accept, like Dr Boylan, that we should double these official figures and then add them in too, to allow for women giving non-Irish addresses, it seems obvious that abortions obtained abroad have had little effect on the size of our recent official abortion numbers.
Summary
Dr Boylan’s letter, on a first reading, creates an impression of being based on sound statistical research. It is nothing of the sort, as should be obvious from the above. The sensible conclusion remains what it always was – that making abortion available countrywide, and not charging for it, caused a substantial rise in the number of Irish abortions after we repealed the Eighth Amendment.
Letter to Irish Times from Peter Boylan 15th July 2024
Sir, – Breda O’Brien’s claim that there has been an “astonishing rise” in abortion services accessed by women in the Republic of Ireland since the repeal of the Eighth Amendment is misplaced (“In Ireland, you can tell people abortion figures won’t rise and still be unaccountable when they double”, Opinion & Analysis, July 13th).
The statistic of 3,019 women from the Republic accessing abortion in England and Wales in 2017 refers only to the number of women who gave addresses in the Republic. Many others provided the UK addresses of family, friends or supporters. This practice was well-identified over many years when abortion was illegal here. Similarly, the number of women who used abortion pills prior to repeal cannot be accurately determined.
When I was appointed in October 2018 by then-minister for health Simon Harris to coordinate the implementation of abortion services after the vote to repeal the Eighth Amendment, I estimated that we should plan for 10,000 terminations annually before 12 weeks, with 80 per cent of those before nine weeks once the service was embedded. This was based on the figures in Scotland and Norway, two neighbouring countries with populations similar to Ireland in size and distribution, with numbers adjusted for the Irish population. The Department of Health and the HSE agreed with these figures and planned accordingly.
In 2019, 6,666 women accessed abortion services in the State. UK Government statistics show that 375 women giving Republic of Ireland addresses sought abortion services in England and Wales in the same year, and a further unknown number gave a UK address. At the time, patchy provision of services across the country and lingering stigma were identified as factors in women continuing to travel outside the State. The 2019 figures, therefore, also understate the true position.
As was the case globally, fewer women sought abortion services in 2020 and 2021 during the Covid-19 pandemic for a variety of reasons including a decline in the pregnancy rate, travel and financial barriers, fear of infection, and privacy concerns. The effects of the pandemic lingered into 2022, reducing the numbers accessing services in that year also.
As abortion services in the Republic of Ireland have become established over the past five years, we see that the figure for 10,033 abortions in 2023 is exactly in line with what was predicted in 2018, or rather less considering the 8 per cent growth in population from 4,885,000 to 5,281,000 during those years. The 2023 figures represent a rate of 18.3 per 10,000 population.
Meanwhile, there were 18,207 abortions in Scotland in 2023 in a population of 5,463,000, a rate of 33 per 10,000.
Norway recorded 12,814 abortions in 2023 in a population of 5,474,000, a rate of 23 per 10,000.
Far from abortion numbers in Ireland being in any way astonishing, they are in line with, or slightly below, the numbers that were expected after repeal of the Eighth Amendment, and less than the numbers in comparator countries. This is exactly what was predicted and planned for in 2018. – Yours, etc,
Dr PETER BOYLAN
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