Safe, Legal and Rare? What Happened to Ireland’s Abortion Promise After the Referendum

Six years of official figures raise a difficult question

On 25 May 2018, Ireland voted to repeal the Eighth Amendment and fundamentally change the country’s abortion laws.

The debate was dominated by appeals to compassion, healthcare and the difficult circumstances faced by women experiencing crisis pregnancies.

One phrase became particularly memorable:

“Safe, legal and rare.”

Six years of official statistics now allow us to ask a simple question:

What happened to the “rare” part?

46,861 abortions in six years

The first full year of abortion provision under the new legal framework was 2019.

According to Department of Health notifications, the number of terminations recorded in Ireland was:

2019 — 6,666

2020 — 6,577

2021 — 4,577*

2022 — 8,156

2023 — 10,033

2024 — 10,852

That is 46,861 reported abortions between 2019 and 2024.

The trend is particularly striking.

In 2019, there were 6,666 notifications.

By 2024, there were 10,852 — an increase of approximately 63%.

The Department of Health describes its annual reports as the official notifications required under the Health (Regulation of Termination of Pregnancy) Act 2018. The 2024 report is the sixth annual report since the expansion of the legal grounds for termination following the 2018 referendum.

*The 2021 figure requires caution. The Department’s notification system recorded 4,577, but other data indicated that the actual number of procedures was higher. COVID-19 and the HSE cyberattack affected reporting that year. Therefore, 46,861 should be regarded as the total of reported notifications, not necessarily the exact number of procedures performed.

Put beside another set of numbers

Now consider another official statistic.

The Central Statistics Office recorded the following victims of murder or manslaughter:

2019 — 38

2020 — 34

2021 — 26

2022 — 47

2023 — 38

2024 — 41

That is 224 people recorded as victims of murder or manslaughter over the same six-year period.

Put the two figures side by side:

46,861 abortions

224 murder/manslaughter victims

Numerically, that is approximately:

209 abortions for every 1 murder/manslaughter victim

That comparison is deliberately stark.

But it is important to understand what it does — and does not — demonstrate.

An abortion and a murder/manslaughter offence are not equivalent legal categories. Irish law does not classify abortion as murder or manslaughter.

The comparison is instead about scale.

It asks us to consider how many pregnancies have been terminated under the abortion regime compared with the number of people recorded by the State as victims of murder or manslaughter during the same period.

What does “rare” mean?

This is where the referendum debate deserves renewed attention.

“Safe” is a question of medical safety.

“Legal” is a question of the law.

But “rare” is a question of frequency.

And the official figures show that abortion has not remained an exceptional phenomenon occurring only a few hundred times a year.

Ireland recorded more than 10,000 notifications in both 2023 and 2024. In 2024 alone, there were 10,852.

That raises a legitimate public question:

When more than 10,000 abortions are being recorded in a single year, can abortion still reasonably be described as “rare”?

There is no single mathematical definition of “rare”, so the statistics cannot by themselves prove that the word was a formal numerical promise.

But they certainly make the question unavoidable.

From exceptional cases to a national system

There is another important part of the story.

The abortion framework introduced after the referendum was not restricted solely to cases involving rape, fatal foetal abnormality or an immediate threat to a woman’s life.

The legislation created a broader legal framework for termination, including abortion during early pregnancy.

Research examining the implementation of Ireland’s abortion system has described early medical abortion delivered through community-based services as the backbone of the system.

That matters because much of the referendum debate understandably focused on heartbreaking and exceptional circumstances.

But the system that followed the referendum is considerably broader than those individual cases.

The question Ireland should now be willing to ask

This isn’t about attacking women who have faced difficult pregnancies.

It isn’t about pretending that every pregnancy occurs in the same circumstances.

And it isn’t about pretending that two completely different legal categories — abortion and murder/manslaughter — are legally identical.

It is about asking whether the reality that developed after the referendum matches the expectations created during the campaign.

In 2018, voters were asked to make a profound constitutional decision.

Six years later, the official figures show:

46,861 reported abortions.

224 murder/manslaughter victims.

Approximately 209 abortions for every recorded murder/manslaughter victim.

And more than 10,800 abortions in 2024 alone.

So perhaps the most important question is not whether abortion is legal.

It is.

The question is:

Was “rare” ever meant to remain rare?

And if it was, what happened?

Sources: Department of Health — Annual Reports on Notifications under the Health (Regulation of Termination of Pregnancy) Act 2018; Central Statistics Office — Recorded Crime Victims, including Murder or Manslaughter statistics; Department of Health — 2024 Annual Report on Notifications.