Before 2018, most women in the Republic of Ireland were able to get abortions only if they traveled to a clinic in England or Wales or had a self-managed abortion at home, but figuring out how to do either of those options was difficult.
Information on abortion was censored in the first years of the ban, which took effect in 19831. Certain books were prohibited, and even the Irish edition of Cosmopolitan magazine had blank pages instead of adverts for British clinics. Meanwhile, those who sought abortions faced isolation, stigma and limited help from medical professionals. And for the few who were able to overcome those barriers and somehow reach one of the feminist networks that could help with information, logistics and fundraising, they still might pay hundreds of pounds or more for the procedure, transportation, meals and a hotel.
Fiona de Londras, the chair of global legal studies at the University of Birmingham in the U.K., told me that Irish officials would question women on ferries and in airports “if they looked young and kind of pregnant-y.” If you were pregnant in Ireland, you might not have access to medical care that could potentially affect the fetus, even for something like cancer, de Londras said. “The only thing the woman [was] entitled to from the state is that she’s not dead at the end of the pregnancy,” she said. “Apart from that, the state’s obligation was to the fetus.”
Ireland’s laws against abortion were some of the most restrictive in the world.2 From 1983 to 2018, “the right to life of the unborn” was equal to the “right to life of the mother,” and the state was empowered to “defend and vindicate that right.” This was enshrined in the Irish Constitution’s Eighth Amendment, which two-thirds of voters approved in a 1983 referendum. Furthermore, under Irish law, performing or obtaining an abortion was punishable by up to 14 years in prison.
Of course, this didn’t stop abortions in Ireland. Abortions happened anyway, both abroad and underground. But the fact that they still happened — and that they were still in demand — didn’t make the effort to legalize them any easier. It took another 35 years for abortion to become legal in Ireland — and a steady stream of activism and high-profile stories of suffering for abortion rights to expand.
What happened there is an extreme example of the effects of outlawing abortion. The circumstances around abortion rights in the U.S. are different in crucial ways, yet Ireland’s story is instructive because it offers clues as to what could be in store here. And it raises a question that plagued Irish abortion-rights activists for years: What will it take for people to change their minds?
Before Justice Samuel Alito’s majority draft opinion in Dobbs v. Jackson Women’s Health Organization was leaked in May, most Americans didn’t think Roe v. Wade would likely be overturned. The nearly 50-year-old legal precedent that established the constitutional right to abortion had created a kind of complacency in the status quo that meant most Americans, both Democrats and Republicans, didn’t think Roe was at serious risk of not being the law of the land anymore.
Polling on abortion is complicated, but it does show that most Americans don’t want to spend much time thinking about it. Moreover, they don’t actually know a lot about abortion — or, for that matter, pregnancy. Most Americans tend to think both the left and the right are extreme on the issue, and so they avoid the debate altogether. And while it’s true that most Americans don’t think Roe should be overturned, they also don’t know exactly what Roe allows, which means they sometimes support restrictions that conflict with it. Many Americans also don’t know what will happen in their states if Roe is overturned.
This general lack of knowledge existed in Ireland before the referendum establishing fetal personhood was passed, as abortion hadn’t been legal or commonly acknowledged. What’s different in the United States, of course, is that the U.S. Supreme Court is poised to take away a right that has already existed for many women. But the example of Ireland shows that Americans still may not know the full consequences of denying pregnant people access to those rights, including their own rights to a healthy life.
It took almost a decade for the broader Irish public to become aware of the dire consequences faced by those who are denied abortions. In 1991, a 14-year-old girl was raped by the father of one of her friends. The attorney general filed an injunction prohibiting her and her parents from traveling to England to seek an abortion because the law compelled the state to protect the life of the fetus. During that time, the girl was expressing suicidal thoughts, and a clinical psychologist testified in a court hearing that the girl was at risk of killing herself; ultimately, the Irish Supreme Court decided to set aside the initial court ruling, thus allowing the girl to get an abortion because there was a real threat of suicide.
The girl’s case sparked widespread protests both for and against abortion rights, but in the end, de Londras said, “It was maybe the first time society as a whole understood the extent of the restriction the Eighth Amendment actually created in Irish law.” As a result of the case, referendums in 1992 established that Irish citizens couldn’t be prevented from traveling abroad for a legal abortion or from learning about abortion services in other countries.
Another turning point was in 2012, when 31-year-old dentist Savita Halappanavar started to have a miscarriage at a hospital but was denied an abortion because a fetal heartbeat could still be detected. Despite her pleas for treatment over the course of several days, she developed sepsis, experienced multiple organ failure and died of cardiac arrest. The doctors almost certainly misunderstood the law, but Halappanavar’s death gave more women in Ireland space to talk about pregnancy care and abortions, and movements started for women to share their stories anonymously.
Fiona Bloomer, a senior lecturer in social policy at Ulster University in Belfast, who has conducted many surveys, focus groups and lectures on abortion, estimates that around this time, in the final years of the Eighth Amendment, only about 10 percent of the population was strongly against abortion. “The anti-abortion voices dominated, and they were loud and strong and hostile. It created an environment where people didn’t want to talk about abortion,” she said. That began to change, though, in the aftermath of Halappanavar’s death, and it became clear that most people wanted reform.
In addition, it simply got easier for women to have a self-managed abortion at home. In 1988, France and China approved the use of mifepristone3to induce abortions early in pregnancy, in combination with a prostaglandin such as misoprostol; other European countries soon followed suit. With the rise of the Internet and the growing availability of these medications — they could be sent through the mail after an online consultation — the use of this regimen grew over the following years. (It wasn’t illegal to obtain the medications in Ireland, only to use them.)
In 2005, Dr. Rebecca Gomperts founded Women on Web, a nonprofit group that offers consultations to anyone in the world seeking an abortion who cannot get one legally or safely and provides the medications they need to self-manage an abortion at home. Studies showed that women in Ireland began using Women on Web and similar services and were happy and relieved to be able to end their pregnancies without having to travel abroad. They would also recommend these services to friends. The increase in medication abortions highlighted how simple and safe abortions could be. When the referendum to repeal the Eighth Amendment passed in 2018, it got 66.4 percent of the vote.
Is the U.S. now headed down the same path as Ireland once was? The laws poised to go into effect in many states if Roe is overturned are extreme and unpopular. Thirteen states would ban abortions outright either immediately or within weeks, although all 13 states make some sort of exception for the life and health of the mother. Many do not make exceptions in cases of rape or incest, however, according to an analysis from The New York Times. And the Center for Reproductive Rights found that overturning or weakening Roe would effectively ban abortion in 24 states and three U.S. territories, even if local laws don’t ban it explicitly.
What’s more, not only do women already have trouble accessing safe abortions when restrictions are in place, but reproductive health care is affected in other ways. For instance, data shows that in the U.S., being pregnant and giving birth is more dangerous than getting an abortion, which means that if Roe is overturned, maternal mortality rates are likely to get worse — and many of these deaths would be entirely preventable. Being denied an abortion can also have lasting mental-health effects. If Ireland is any example, a lot more women in America will have to die or experience mental-health issues before attitudes toward abortion care dramatically shift.
There are signs that attitudes in the U.S. are already changing, however. Tresa Undem, a public-opinion researcher who co-founded the nonpartisan polling firm PerryUndem, said that since a ban on abortions after six weeks went into effect in Texas, more Texans are aware of anti-abortion laws; in addition, Undem told me, men and independent women voters were talking and thinking about the issue more than they had previously. “For the first time since I’ve been doing research, I heard them really take this issue extremely personally and change their behavior.”
Undem said that sustained news coverage penetrating into local news may be making people more aware of the consequences of Roe being overturned, and this in turn may be making them become more engaged on the issue. For example, a Gallup poll conducted between May 2 and May 22 found that the share of Americans identifying as pro-choice jumped 6 percentage points, to 55 percent, since May 2021. Much of that shift was driven by more Democrats and Democratic-leaning groups like younger adults and women identifying as such; nevertheless, more Americans than not said they wanted abortion to be legal in all or most circumstances.
But the realities of pre-Roe life are in the distant past for most Americans. “People just don’t believe [the worst stories],” said Mary Ziegler, a professor at Florida State University College of Law. “And if they do believe that, they don’t get what it’s going to be like, because they’ve never lived through it.” The stories that really change people’s minds are often extreme, she said.
Consider the stories that ultimately sparked change in Ireland, and how long it took for that change to happen. In reality, many women in the U.S. are already living under similar conditions to those in Ireland before the Eighth Amendment was overturned. But because these stories mostly involve women who are already marginalized — women of color, poor women, undocumented women and women in Southern states — much of the country has not been motivated so far to act to change those conditions. “It’s Black and brown women who are dying now,” said Michele Goodwin, a professor at the University of California, Irvine School of Law. Americans are inured to Black women’s suffering and death, she said. “We shouldn’t have to look any further than the maternal mortality rates in this country to say, ‘Let’s just stay out of women’s reproductive health.’”
But so far, that hasn’t happened. In fact, it seems likely that red and red-leaning states will continue to pass restrictive laws whether or not Roe is overturned, while abortion-rights activists will try to help women overcome them. Activists in blue states haven’t been working to ensure abortion rights in their own states until very recently, and that is in part because the unusual legal system in the U.S. makes federal actions to expand rights much more difficult to implement.
It’s possible, though, that movements for expanding abortion rights worldwide will offer insight into what’s possible for the U.S. After all, abortion rights have expanded in Ireland, Northern Ireland, South Korea, Thailand, Mexico, Colombia and other countries around the globe recently, and the reproductive-justice movement has also been taken up again in many states.
Then again, the movement to restrict abortion rights, now arguably at the height of its success, might be what ultimately prevails in the U.S. Even though these views are held only by a small minority of the public, the anti-abortion movement has worked relentlessly to overcome the structural barriers in the political system for some 50 years, and they’re potentially on the cusp of their biggest victory yet. “The way they’ve chipped away at the meaningful right to access abortion, the way they’ve captured Supreme Court nominee processes … that level of organization and commitment, that’s what works in a fragmented setting like this,” de Londras said. “Even if one says so with grudging admiration, what they’ve done is very extraordinary.”