Aiken Abigail R A, Padron Elisa, Broussard Kathleen, Johnson Dana
LBJ School of Public Affairs, University of Texas at Austin, Austin, Texas, USA.
Population Research Center, University of Texas at Austin, Austin, Texas, USA.
BMJ Sex Reprod Health. 2018 Oct 19. doi: 10.1136/bmjsrh-2018-200198.
In Northern Ireland, abortion is illegal except in very limited circumstances to preserve a woman's life or to prevent permanent or long-term injury to her physical or mental health. Abortions conducted outside the law are a criminal offence punishable by imprisonment. We assessed the impacts of Northern Ireland's abortion laws on women's decision-making and experiences in accessing abortion.
Between April 2017 and February 2018 we interviewed 30 women living in Northern Ireland who had sought abortion by travelling to a clinic in Great Britain or by using online telemedicine to self-manage a medication abortion at home. We interviewed women both before and after a policy change that allowed women from Northern Ireland access to free abortion services in Great Britain. We used a semi-structured in-depth approach and analysed the interviews using grounded theory methodology to identify key themes.
Four key findings emerged from our analysis: (1) women experience multiple barriers to travelling for abortion services, even when abortion is provided without charge; (2) self-management is often preferred over travel, but its criminalisation engenders fear and isolation; (3) obstruction of import of abortion medications by Northern Ireland Customs contributes to stress, anxiety, a higher risk of complications, and trial of ineffective or unsafe methods; and (4) lack of clarity surrounding the obligations of healthcare professionals in Northern Ireland causes mistrust of the healthcare system.
Northern Ireland's abortion laws negatively affect the quality and safety of women's healthcare and can have serious implications for women's physical and emotional health. Our findings offer new perspectives for the current policy debate over Northern Ireland's abortion laws and suggest a public health rationale for decriminalising abortion.
在北爱尔兰，堕胎是非法的，除非在非常有限的情况下，即为了挽救妇女生命或防止对其身心健康造成永久性或长期伤害。非法进行堕胎属于刑事犯罪，可处以监禁。我们评估了北爱尔兰堕胎法律对妇女堕胎决策及经历的影响。
2017年4月至2018年2月期间，我们采访了30名居住在北爱尔兰的妇女，她们通过前往英国的诊所或使用在线远程医疗在家自行管理药物流产来寻求堕胎。在一项政策变更允许北爱尔兰妇女在英国获得免费堕胎服务前后，我们都对这些妇女进行了采访。我们采用半结构化深入访谈方法，并运用扎根理论方法分析访谈内容以确定关键主题。
我们的分析得出了四个关键发现：（1）即使堕胎免费提供，妇女在前往堕胎服务机构的过程中仍面临多重障碍；（2）比起出行，妇女通常更倾向于自行管理堕胎，但将其定为刑事犯罪会引发恐惧和孤立感；（3）北爱尔兰海关对堕胎药物进口的阻碍导致压力、焦虑、并发症风险增加，以及尝试无效或不安全的方法；（4）北爱尔兰医疗保健专业人员义务的不明确导致对医疗保健系统的不信任。
北爱尔兰的堕胎法律对妇女医疗保健的质量和安全产生负面影响，并可能对妇女的身心健康产生严重影响。我们的研究结果为当前关于北爱尔兰堕胎法律的政策辩论提供了新的视角，并为堕胎非刑事化提出了公共卫生理由。
