Across the Irish Sea, abortion rights have rightly been in the spotlight in recent years. It can’t have passed anyone by that Irish women struggle to access basic reproductive healthcare. But on an often overlooked island a few miles closer to the UK mainland women are also being endangered by restrictive legislation on abortion. The Isle of Man seems to be the island that feminism forgot.
But not any more – a group of Manx women are fighting for their right to choose to terminate unwanted pregnancies. The Campaign for Abortion Law Modernisation (Calm) wants to bring Manx law in line with the UK. The Termination of Pregnancy (Medical Defences) Act is up for review in the next parliament, and the feeling on the Rock (as Manx people refer to their home) is that the time is ripe for a long-overdue change.
Beyond offshore tax avoidance, the TT motorbike race and Mark Cavendish’s Olympic successes, the Isle of Man rarely makes the headlines. A Crown dependency, the Isle of Man is part of the British Isles, floating in the Irish Sea between Liverpool and Dublin. Its people are Celtic and have their own language, Manx Gaelic, though the last native speaker died in the 1970s. It is not part of the UK though many of its laws are similar (tax and abortion being two notable exceptions) and the Queen is the constitutional head of state, holding the title Lord of Mann.
Laws on the island are made at Tynwald, which is the oldest continuous parliament in the world, and which celebrated its millennium in 1979. The next election to Tynwald is in two weeks, on 22 September. It's equivalent to MPs are Members of the House of Keys (MHKs), and although the Island does have party politics, most stand as independents. There are 24 MHKs, so about three times the number of elected representatives per capita as the UK (fewer than 90,000 people live on the Isle of Man). Despite having so many elected politicians, the Isle of Man currently only has one woman MHK.
Manx citizens can travel to the UK for healthcare that can’t be provided on the island, such as cancer treatment, neurological surgery and even complicated antenatal care. The NHS on the Isle of Man foots the bill, including travel and accommodation. Abortion is one of the few exceptions.
The campaign was only set up a few months ago and despite the strides that Calm has already made, abortion is still a very taboo subject on the Rock. Most women on the Isle of Man know somebody who has had to “go away” to use the preferred chilling local euphemism. However, many women don’t realise how restrictive the law is until they find themselves facing an unwanted pregnancy.
“We are calling on Tynwald to amend and modernise the Termination of Pregnancy Act, core sections of which are unacceptably restrictive,” Calm spokeswoman Sam Morris says. “Women and families are suffering due to a two-tier system that means if you have money, you have choices.”
If you have money, the current law doesn’t pose a huge problem to you; just book the procedure privately, pay the expensive short-notice air or boat fare and cough up for the hotel. That’s for two people of course, as you will most likely be advised to be accompanied home from the clinic as with any surgery involving anaesthetic. And if you end up having to stay in hospital longer due to unforeseen complications, no matter – you can afford to rebook your flight or stay a few extra nights at a hotel.
Maybe you have a friend or family member who can help you out with the cost. Somebody who you can tell about your pregnancy that is, somebody you trust enough to break the taboo. You won’t be discharged the same day as your procedure without a chaperone, so if you don’t have somebody you trust then expect to pay for at least two nights in a hotel.
Women without access to hundreds, if not thousands, of pounds at short notice have a few options. You could take out a bank loan or use a credit card but this is an option not available to women under the age of 18 or with a poor credit history. You could try to get financial help from a charity. Or you could do what women have been doing for thousands of years – and terminate your pregnancy illegally at home. The only difference is that in 2016, it is a great deal safer than it used to be.
If you are a UK resident and want an abortion, you pay nothing. And unless you live somewhere especially rural, the clinic is likely to be at most a few hours away from home.
Last year, more than 100 women travelled to the UK from the Isle of Man for a termination, although the numbers are thought to be much higher as many women do not give their real address to the clinic. Including travel and accommodation, the procedure typically costs upwards of £1,000 and women have to make the arrangements themselves.
With fairly safe abortion pills available online from Women on Web and Women Help Women, many women bypass their GP altogether. Women on Web told me that they receive about 80 requests a year from Manx women, so it is reasonable to assume that more women self-abort at home than “go away”, despite the fact that they could face up to two years in prison if the pills are intercepted by the Post Office.
BPAS recently launched a free confidential telephone aftercare helpline for women in Ireland, Northern Ireland and the Isle of Man who have bought abortion medication online. The organisation says that the above websites provide the same high quality, safe medications to women who are up to 10 weeks pregnant that are provided from their own clinics. While adverse events are extremely unlikely, BPAS is concerned that because the women are committing an illegal act, they may not always seek help when they need it.
The Termination of Pregnancy Act allows for abortions in specific circumstances – rape, incest, mental health and severe foetal abnormalities – but in reality are almost impossible to access on the island. Currently fewer than 10 abortions are carried out on the island each year. Women are often advised that it would be easier to just access the procedure privately. BPAS and Marie Stopes both offer reduced rates for women from the Isle of Man, Northern Ireland and the Republic of Ireland.
Most Manx women requiring a termination have a surgical abortion (84 per cent vs 50 per cent for UK women), which reflects the fact that Manx women tend to have their procedure later for financial and logistical reasons. However, after inspections of some Marie Stopes clinics by officials from the Care Quality Commission, all surgical abortions involving general anesthetic or conscious sedation have recently been voluntarily suspended. Although BPAS is doing what it can to take on additional patients, Calm has expressed concern.
I spoke to a number of young women among my own circle (I am Manx by marriage) for this piece. Most of these liberal, middle-class women know somebody who has “gone away”. One who herself had to cross to the UK for a procedure while in her teens describes the current law as “vile” and says that she feels like the Isle of Man is “stuck in the 1800s”.
“Lots of my friends have had to go away,” she says. “It is a lot more common than people think. The statistics are definitely wrong. I know personally know a number women who have had abortions and not given their correct details, so wouldn't be registered in the official figures. One of my friends went away when she was 15 and didn’t tell her family because she was so ashamed.”
Alex Allinson, a GP standing as an MHK, characterised the current system as “medieval” and has made abortion law modernisation a manifesto commitment. “The ethos of the original Act was to legalise abortion,” he says, “but it was perverted by amendment after amendment until it became regressive and unwieldy. In most cases, abortion is legal in name only. But many women don’t know this until they arrive at the GP surgery to try to book their procedure. Even in cases where a woman does meet the conditions for an on-island termination, GPs have to jump through hoops and call in favours to make it happen.
“The Isle of Man is trying to present itself to the world as a modern, progressive society – you can’t do that while denying women basic healthcare.”
GPs on the Isle of Man are registered with the General Medical Council (GMC) who confirm that doctors are required to provide advice on accessing a termination or refer the patient to another doctor who will – or face sanctions. Anecdotally, it is apparent that many GPs are not following GMC guidance.
Abortion Support Network (ASN), a UK-based charity, provides advice and financial support to women on the Isle of Man. They provide the closest thing to a counselling service, which was promised when abortion was legalised with the 1995 Act but which has never materialised. They rely entirely on donations. Not a single organisation exists on the island to provide support to women facing a crisis pregnancy or, more worrying still, to provide medical support and advice post-procedure to a woman bleeding out her unwanted pregnancy on the boat home. That is, if the boat isn’t cancelled due to bad weather or the woman doesn’t experience unforeseen complications with the procedure. Such complications are more common for Manx women as they are more likely to have a later-term abortion than women in the UK.
“Women with money will always be able to get a termination,” Mara Clarke of ASN says. “So this law really just punishes poor and vulnerable women. As a charity we can help such women fund the healthcare they need – provided we have money in the bank.”
The treatment of rape victims by the law is especially callous. To meet the criteria, a woman must have reported her rape, and signed an affidavit. This has to be done in time to have the termination within the 12-week limit. Rape Crisis England and Wales, which doesn’t have a Manx equivalent, say that the likelihood of rape survivors being able to fulfil these strict criteria are very slim as it is very common for survivors to experience post-traumatic stress symptoms. This, as well as shame, fear of the perpetrator and fear of not being believed, means the vast majority of rapes are not reported to the police – meaning the victims are not entitled to legal abortion.
The Act is up for review in the next parliament, though as low priority, and not until 2018 – for now. Calm are hopeful that Tynwald will pass more progressive legislation and tell me that they have had a mostly positive response from the MHK candidates that they have spoken to. The Manx Chief Minister, Allan Bell, has made comments in support of a change to the law.
Sadly, however, there is opposition to such progressive sentiment on the island. Another group campaigning for quite a different a change in the law was launched this month. Humanity and Equality in Abortion Reform wants to see abortion even further restricted and – laughably – refers to itself as a feminist campaign.
Abortion is now firmly on the political agenda on the Isle of Man but change isn’t expected any time soon; the island moves at its own pace. In the meantime, hundreds of women will continue to be let down at a time when they are most vulnerable. If you want to help, you can sign and share Calm’s petition .
Rebecca’s* story – ‘The GP said he didn't believe in abortion and just told me to Google it’
When I had my first abortion in early 2013, aged 17, I had just left college and didn’t have a job. I was young and a bit stupid, and wasn’t using contraception. I didn’t think twice about terminating the pregnancy as I knew it was the right decision, but I felt so ashamed of not wanting to stay pregnant.
I was really nervous about going to the GP – he was our family doctor and even looked after my mum when she was pregnant with me. It’s such a small world here.
The GP wasn’t very nice. He said that he didn’t believe in abortion and that it was illegal on the Isle of Man, so told me just to Google what to do or look on the NHS website.
Thankfully my mum was great and organised everything. I was so ill with morning sickness and anaemia that I could barely get out of bed. She booked the procedure at the Marie Stopes clinic in Manchester and came with me when I was nine weeks along. It was OK but it felt a bit like a conveyer belt.
My mum paid for it – it was £1,000 but the guy who made me pregnant would only give me £200. It is so unfair that it is always the women who have to face the financial consequences.
I went to the family planning clinic after I came back and they made me feel so ashamed and stupid, and basically forced me to get a contraceptive implant. Despite this, just months later, I became pregnant again. I didn’t see the point in going back o the GP.
The guy I was dating was then older than me. I tried to be mature about it but he was so awful and didn’t support me at all, just told me I had to have an abortion. I didn’t want to do that again and I didn’t know how I would afford it. My boyfriend made me watch really graphic videos of abortions and I just cried and cried.
My boyfriend became really violent, kicking me in the stomach to try to get rid of the baby but I stayed with him, I guess because I was vulnerable and because I didn’t want to tell anyone about the abuse or the pregnancy.
My mum ended up having to pay for the termination again because my boyfriend wouldn’t give me any money. I had to beg him to come with me because you can’t go alone and he lived in Liverpool where the clinic was.
I couldn’t afford two nights in a hotel so I had to get the boat back the same day. When I got to the clinic I was 17 weeks pregnant, further along than I thought, so I had to pay more. The clinic was great but I had a bad reaction to the anaesthetic. My boyfriend wouldn’t talk to me. I ended up with really bad depression.
Three years later, I am glad that I didn’t have a baby but I do want to be a mum one day. I really hope that speaking out will help change the law because women who want to have abortions will always find a way.
Emma’s story – ‘It was the worst day of my life’
When you are told to go for a walk and come back in for a chat after your 20-week scan, you know that you aren’t about to get good news. Though at that point, I didn’t realise just how bad it was going to be.
“We have some concerns about your baby.”
I was upset, my partner and I both were, but I was adamant everything was going to be fine. We were advised to seek a second opinion in the UK. We were cautiously optimistic, although we knew already that it would be unlikely that our daughter would ever be able to walk. But it quickly became apparent that things were worse than we feared.
We were told that our daughter wouldn’t be able to swallow or breathe without help and would likely have severe learning difficulties. They were quite candid and told us that most parents in our position would choose to terminate the pregnancy.
You might wonder why I wanted to know the sex after getting news like that, but I just needed to hear something lovely rather than something awful and scary.
We were facing the worst of the worst case – upwards of 40 surgeries, just to keep her alive. As a mother, I didn’t feel like putting my child through that was ethical.
We did look seriously at the option of palliative care but we were advised that if we didn’t subject our daughter to surgery as soon as she was born, there was a risk that the hospital would do it anyway and argue it later in court. It was all really woolly though, and we wouldn’t really know where we stood until after the fact. In the end, it turned out that she had more problems than we first thought and probably wouldn’t have lived.
We didn’t want to put her through all those operations and so we felt like we didn’t have much of a choice but to terminate the pregnancy. The NHS on the Isle of Man funded it. I was one of the handful of women who meets the criteria.
It was a black hole in terms of information. We had been passed to the UK and it was for them to deal with us. There was nobody on the island there to help us make the decision, so the law still affects women like me who meet the criteria. The staff in Liverpool were able to be open in a way they couldn’t be at home. They told us that a termination was a valid choice, just like continuing with the pregnancy was.
It was the worst day of my life. I was sent to the UK to have the procedure to terminate the pregnancy and then came back to the Isle of Man to deliver her that day. I could have delivered her in the UK, but I wouldn’t have been able to bring her body back and having a funeral was really important to us.
Most of my friends still don’t know that I had a termination. I was just so scared of a bad reaction at a time when I was already so low and so vulnerable. The stigma that surrounds abortion is amplified on the Isle of Man and it is just something we don't talk about which makes situations like mine even harder to deal with. I didn’t want her to seem like less of a loss. She was wanted and loved and that is why we honoured her with a funeral but I thought people wouldn’t understand that if they knew I had chosen to terminate.
That’s part of the reason why I didn’t want to use my real name for this interview. How do you start untelling that lie to people who came to her funeral? But it’s also because I have other children and one day I would like to discuss this with them. I want them to understand that what we did was both legal and ethical.
I wasn’t sure where I stood on the abortion issue before this happened. I certainly didn’t think I would ever terminate a pregnancy. My eyes have really been opened now and I don’t think it is my place, or anyone’s place, to tell women what they should do in whatever circumstances they find themselves in. I wish we didn’t have such a culture of stigma which makes women like me feel like they just can’t be honest.
I watched the scan while the termination was happening and she died very quickly, in seconds. My baby has only ever been warm and safe listening to my heartbeat. We feel like we kept her safe and made sure that she never, ever had to suffer. Isn’t that what every mother wants for their child?
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