DUBLIN — The abortion clinic’s website pops up at the top of a Google search for “free ultrasound,” its content and color scheme mimicking the government’s new support service for unplanned pregnancy.
“Looking for abortion advice?” “How far along am I?” The bright orange speech bubbles attached to stock images of smiling medical experts purport to inform women about abortion options that became legally available in Ireland on Jan. 1.
The brick-and-mortar version of the Dublin clinic, however, is less inviting. Hanging out front, like a graphic warning on a cigarette pack, is a giant poster of a 15-year-old girl who died after receiving an abortion in London, and inside sits an ultrasound machine in a small, narrow room that has the air of a back alley medical facility.
In May, Ireland voted decisively to cast aside one of the world’s most restrictive abortion bans, approving a new law that guarantees unrestricted abortion up to the 12th week of pregnancy, and longer in situations in which there is a serious risk to the life or health of a woman, or in which there are fatal fetal abnormalities.
The historic result was hailed as an extraordinary victory for women’s rights, sealing a pronounced shift toward social liberalism — including in recent years the approval of same-sex marriage and the election of a gay prime minister — in a society that had long been dominated by the Roman Catholic Church.
A crowd in Dublin cheered the landslide approval in May of a referendum legalizing abortion.CreditPaulo Nunes dos Santos for The New York Times
But as Irish women are now discovering, the mere passage of a law cannot wipe away deeply held beliefs. Women seeking abortions are finding they must still contend with a deeply ingrained opposition that is hobbling the government’s efforts to make safe and efficient abortion services readily available.
An emboldened anti-abortion movement has started employing United States-style tactics like fake abortion clinics and protests outside legitimate ones. But it is not just the anti-abortion activists who are limiting women’s options.
Worried about the stigma attached to abortion, doctors have been slow to sign up to provide the service, and hospitals have lagged in establishing facilities. Women seeking abortions say that the entire process is still hush-hush, and some say they do not feel comfortable discussing it with their family physician.
“I spent three days on the phone before I found both a doctor willing to do it and a clinic which had the medicine,” said one woman who did manage to have an abortion this month. She gave only her middle name, Arlene, so that her family would not find out. “I felt quite scared and alone. It felt like what I imagine it was like before the referendum, like you’re doing something underground and illegal.”
Last month, she had considered traveling to Britain for the procedure, as generations of Irish women did before her, but opted to wait for the free service at home. As the days passed, though, she grew increasingly concerned that the stigma and deep divisions surrounding the issue would result in a rocky introduction of the service.
The hardest part of the process for her was having to travel to another town to see her doctor and wait for three days as part of a mandatory “cooling off” period that has no medical basis but was written into the law to placate anti-abortion politicians.
“I could have gone back home for those days, it was only a 40-minute drive, but I didn’t want to be around anyone that I knew,” she said. “I was worried that if anyone found out they would try to change my mind, and I suppose that’s what those three days are for.”
One of the biggest complaints about the new legislation is that it requires doctors who agree to perform abortions to opt in to the service, rather than having doctors opt out if they object to it.
So far, in a country with over 4,000 general practitioners of medicine, more than 200 doctors have signed up to provide the procedure — enough to meet current demand, health executives say — but the system has left women having to guess whether their local doctors are for or against the service.
“We’re back in hushed tones,” Erin Darcy, an abortion rights activist, said in an interview at her home near the harbor city of Galway on Ireland’s west coast. In those days, she said, it was taboo even to utter the word abortion.
Sitting across from her at the kitchen table, her friend Gina recalled going to a family planning clinic in Galway 13 years ago and saying, “I’m pregnant and I need to not be.”
In secrecy, Gina ended up traveling alone to the Netherlands to get the procedure. Even when she came back and developed a post-abortive infection that caused her to hemorrhage at work and spend four days in the hospital, she told no one.
“Now, we’re in a position where we have to approach our doctors in a nice, smiley way and try and figure out what side they are on, if we can talk about it,” she said with a sarcastic laugh. “Will they help me knowing I’m pro-choice, or am I going to have to find a new G.P. because now I can’t trust them to care for me?”
Irish women are not entirely on their own. The government has set up an anonymous support line to help them navigate the new system. But even that service got off to an unsteady start after the lines were jammed by anti-abortion activists posing as women seeking abortions so they could identify doctors willing to assist in the procedures and picket their clinics.
“Generally speaking, women’s health services in Ireland have been underfunded for many years,” said Dr. Peter Boylan, an adviser to the Irish Department of Health. “This is a new service that is coming in on top of an already existing service, which is stretched, so that’s causing challenges.”
At the fake abortion clinic in Dublin with the giant poster out front — a place called My Options, the same name as the government’s abortion information service — its director, Eamonn Murphy, recalled the shock of the referendum and how it spurred him into action.
“It was kind of a crucifixion moment,” he said. “But there was a resurrection the same day,” when he decided to establish his operation on an inner-city street, where it is often confused with a women’s health center next door.
“This is new life,” he continued, as he shuffled through pictures of dead fetuses and studies purporting to link abortion to breast cancer that he shows to women seeking abortions. “This meant more women than ever would be saved from cancer and suicide and depression and drug addiction and abandonment than ever before this law came in.”
In recent weeks, anti-abortion activists have staged a series of “silent protests” outside medical centers.
Maria Mahoney, an anti-abortion activist and classics teacher, participates in protests outside the Galvia West Medical Center in Galway several times a week in hopes of persuading some of the women to bring their baby to term.
“We are hoping that the women will engage with us like they do in other countries,” she said. “Sometimes they are just looking for someone to tell them not to do it and show them a better way.”
The stakeouts have spread so widely that abortion rights groups have begun calling for “exclusion zones” around abortion facilities.
Dr. Caitriona Henchion, the medical director of the Irish Family Planning Association, which provides legitimate abortion services, said the main aim of the protests was to intimidate doctors.
“People are really afraid, I think particularly in rural parts,” she said at her clinic, which has been at capacity since the service started at the beginning of the year. “Doctors sending their kids to the local school don’t want them to be abused or shouted at because it becomes known that their mother or father is offering abortion services.”
The clinic has been working around the clock to ensure that women do not miss the 12-week mark that would force them to go abroad for the procedure. Although the services are running far more smoothly now than they were at the beginning of the month, Dr. Henchion said, many women still worry about the limited options in some facilities, especially at hospitals, and the continuing difficulty in getting an abortion.
“I was one of the first women to get an abortion in Ireland,” Arlene, the woman who had to travel to a town 40 minutes away for the procedure, said. “I know this is huge, but my case was pretty straightforward, and even then it was complicated.”
“The fact that women are still traveling shows that there are problems with the legislation,” she said. “I’m sure that once everyone catches their breath from the referendum, there will be protests.”
And abortion rights groups fear they can already see the first stirrings of a sustained effort to overturn the results of the referendum, along the lines of the anti-abortion movement in the United States. Earlier this month, Peadar Toibin, a former member of the Sinn Fein party who left over his stance on abortion, established an anti-abortion party that aims to give political representation to the movement.
“We know that opposition will continue, as it does in other countries,” said Ailbhe Smyth, a co-director of the Together for Yes campaign in support of the referendum. “However, given the overwhelming majority for ‘yes,’ we are not concerned about a serious threat to the legislation in the foreseeable future. The longer future, though, that’s always another matter.”