Abortion by telemedicine in Northern Ireland: patient and professional rights across borders

This article was first published in NILQ (2017) 68(1): 1–33. The uneasy legal and political settlement regarding abortion in Northern Ireland has long relied on the outsourcing of aspects of reproductive health care. While local health services offer only highly restricted access to termination procedures, women travel to access abortion services elsewhere. However, technological changes, in particular the development of abortifacient medicines, are revolutionising this aspect of reproductive healthcare. Rather than women having to travel to a service, today that service can travel to women through the postal supply of abortion pills, sourced via the internet. While online supply of pharmaceuticals can pose potential public health risks, at least two groups offer safe and effective telemedical services to women in Northern Ireland. Women on Web and Women Help Women each supply abortion pills, under prescription from a doctor based in another country, to women who wish to end a pregnancy of nine weeks or less. Here, we consider the extent to which the telemedical abortion services that they offer are protected by transnational law, in particular, EU provisions on cross-border services. This offers new and hitherto unexplored lines of legal argument (including defences against criminal prosecution and challenges to a state’s attempts to restrict the flow of services). Through claiming the autonomy-based legal relationships implicit in transnational law and the power that flows therefrom, we suggest, women may challenge regulatory arrangements which seek to limit their reproductive rights.